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10 CapitalPress.com Friday, May 7, 2021 Q&A: WSU infectious disease expert discusses COVID-19 By MATTHEW WEAVER Capital Press PULLMAN, Wash. — As a college student, Guy Palmer was fascinated by how infectious diseases work — how they emerge and spread. His primary interest is in public health, but he wanted to understand diseases in different species and how they can spread to humans. “Knowledge is power and understanding how dis- ease is transmitted provides confidence that it can be pre- vented,” Palmer said. “Since I started working with rabies virus, which is 100% fatal, I learned early the importance of vaccination and proper procedures when handling infected tissues.” As regents professor of pathology and infectious diseases in Washington State University’s Allen School for Global Animal Health, most of Palmer’s cur- rent work is on the human side, especially during the COVID-19 pandemic. He’s most interested in the interface between ani- mals, humans and the envi- ronment. He points to the Rabies Free Africa pro- gram, a campaign to elim- inate human deaths due to rabies by 2030. Currently, about 30,000 people die of rabies each year on the con- tinent. Consistent vaccina- tion of the dog population is key, he said. Palmer spoke with the Capital Press by phone April 15, with follow-up ques- tions. The interview has been edited for length and clarity. Capital Press: As an expert, what are your thoughts on COVID-19 and how does it compare to other infectious diseases? Palmer: Well, certainly, every infectious disease is a little bit different. ... This one, we’ve had to be learn- ing on the fly from, ‘Yes, it looks like something iso- lated to China, looks like it’s spreading,’ and now obvi- ously it’s a very entrenched pandemic. We really have to go back to 1918, what was called the Spanish Flu, to find a pan- demic that really, truly hit all the world. The other difference that makes this unique is the global economic impacts have been probably more pronounced than any prior pandemic, and that’s because we’re much more globally connected than we were 100 years ago. I think a year, 18 months ago, peo- ple would have said a pan- demic, ‘Oh, it’s something that has to do with infec- tious diseases,’ and wouldn’t really relate it to their per- sonal lives. Today, we real- ize it’s mental health, K-12 education, our small busi- nesses, global supply chains. CP: What are the big- gest questions we have about COVID-19 now? Palmer: Can we vacci- nate enough individuals and get this under control with- out variants that can get around or escape the immu- nity produced by the current vaccines? The evidence is the vac- cines are still working against all the variants. They may not work as well as they initially did, but they still certainly meet any reason- able threshold for ability to protect individuals. CP: A recent “60 Min- utes” report called for a more in-depth investiga- tion of the origins of the disease in China. Your thoughts? Palmer: The most likely scenario is emergence from a bat, possibly transiting through some kind of cap- tive animal. That could be a wild animal market, or a domestic animal mar- ket, and then spread into humans. That is the most likely scenario. We know that because that’s how the original SARS developed ... that’s how the first coro- navirus initially detected in WSU Guy Palmer is regents professor of pathology and in- fectious diseases at Washington State University, and senior director of global health at WSU’s Paul G. Allen School for Global Animal Health. Saudi Arabia, bat to camel to human, occurred. That is the most likely. The really hard question to ask is was that virus per- haps already in a laboratory, did it escape from a labora- tory? There’s two parts to that. One is, could the Chi- nese in this case or anyone else create a virus intention- ally as a bioweapon? Just the ability to do that and know that it would spread is extraordinarily unlikely, maybe to the point of being impossible. The other question is, could they have iso- lated the virus from a bat or another animal, had it in the laboratory and had it escape from the labora- tory? That’s a very hard question to answer. The (World Health Organiza- tion) essentially ... ruled that out. That’s what’s actually been kind of the flashpoint, people saying, “How can you be sure?” They don’t have the evi- dence to be sure that could not have happened. That remains in some places more of a political ques- tion than an epidemiologi- cal question at the moment. It’s possible they could dissect that, it depends on a lot of questions, which that task force didn’t ask, proba- bly weren’t allowed to ask. CP: We’re hearing about COVID concerns in rabbits and mink. What are the next steps? Palmer: Yeah, there’s no question that the virus can spread to mink, rabbits and can infect cats. The con- cern is in certain parts of the world where mink are raised commercially, they’re kept in very confined quar- ters. A virus loves con- fined quarters, doesn’t mat- ter if it’s people or animals. It certainly can spread from humans to mink. I think the concern was there was some evidence in the Netherlands that it also can spread back from mink to humans. There was concern that, could a mink farm or rabbit farm serve as a long-term reser- voir for the virus? Probably not impossible, there’s not a lot of evidence. What’s occurring now is human-to-human spread. While there are some con- cerns about that, and cer- tainly it would make sense to do surveillance, which can easily be done, and obviously increasing the personal protection of peo- ple working with those ani- mals is critical to avoid any spread. But right now there’s no strong evidence. CP: Thoughts on how the agriculture and ani- mal agriculture industries responded to COVID-19? Palmer: Because it’s really not involved animals as a primary reservoir or vector for transmission, the direct impacts on spread to humans have been pretty minor. I think one of the con- cerns is some of the animal processing, meat processing plants had some high degree of infection. That wasn’t really related to the animals themselves, it’s related to the people working in close proximity to one another. I think it’s probably increased the attention needed to have better per- sonal protective gear in meat processing. It’s not unique to anything in ani- mal agriculture or agri- culture in general. It’s a little bit some of the con- sequences of our produc- tion systems and, here in Washington, like the tree fruit harvests, where you have significant numbers of people, about half of which come from outside of the region, and they’re mov- ing as the harvest occurs. It obviously creates an avenue for possible transmission. That’s been a challenge. It’s getting the atten- tion to personal protection. At the point we are now, the emphasis is on getting those individuals vacci- nated, which can be tricky because you have a migra- tory population. The Wash- ington Department of Agri- culture and Washington Department of Health have been working very closely on that issue. CP: What might we expect now? Palmer: We’re at an inflection point between three things: Increased trans- mission, which is in part due to the variants of the virus. Behavior, we’re now 14 months into this pandemic. People are tired, the weather is getting warmer, they’re dropping their guard. Those two things are contributing to increased spread. At the same time, we have the vac- cine rollout. We have three things coming together all at once. I think there’s a lot of concern whether the vaccine rollout is going to be quick enough to really dampen that wave, versus not. It’s probably going to be a mat- ter of weeks. CP: Do you recommend people get the vaccine? What would you tell some- one who’s reluctant? Palmer: I absolutely rec- ommend getting the vaccine. It’s the only way we are going to end the pandemic and return to life as normal, K-12 schools open, going on vaca- tions, visiting grandparents, doing all the things that make life enjoyable. Basically, there is an exceedingly low risk of com- plications from the J&J vac- cine, roughly 1 per million. The guidance by the FDA and CDC will be to inform physi- cians regarding these compli- cations, how to identify indi- viduals most at risk, and the treatment approach. However, it is important to put this risk in context of actual COVID- 19 infection: 1 in roughly 1,600 unvaccinated individu- als will die and a much higher percentage of those who are hospitalized will die. 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