New Delhi: According to Martin Schalling, Professor of Medical Genetics, Department of Molecular Medicine and Surgery, at the Karolinska Institute in Sweden, COVID-19 is clearly not the last pandemic that the world has seen, and India has the potential and mechanism to fight in the advent of a new pandemic

Speaking to IANS, Schalling said that Covid is the first big pandemic in 100 years, but clearly not the last.

"We're going to have more pandemics and how do we prepare ourselves to not be as sort of troubled and helpless as we were in the early phases of Covid-19 is the key," Schalling said.

"And there, I think there's a lot that India can contribute -- both in the information technology sphere and the digital health sphere -- to mitigate the problems of a new pandemic," he said.

Schalling, who was in India to attend a conference by Religare Enterprises on the occasion of World Health Day, also detailed the mechanisms of post-Covid syndromes, also known as long Covid. He also shared his views on the much-debated origins of COVID-19.

Excerpts from the interview:

Can you explain what is long Covid? Is it just 'brain fog' as ambiguously described by the WHO?

There's a lot that is not known about post-Covid right now. Besides the brain, it affects immunity, the heart system, and other organs of the body. This is a virus that can infect almost all human organs. And as a consequence, you can have lasting symptoms from many different organs.

More specifically in the brain, we recently discovered that when the virus infects brain cells it activates a sort of cleaning cell in the brain called microglia. As a result, it starts a process known as pruning, which reduces the amount of connectivity between nerve cells, the so-called synapses.

We believe that the case where you see a cognitive decline and a brain haze as a result of post-Covid probably relates to this process where you sort of lose connectivity.

Are there any medical tests to gauge long Covid conditions?

Similar to how drugs help control the activity of the immune system to cut down the ill effects of Covid, you can imagine that reducing the pruning activity or these microglia might be a way forward to decrease the effect of brain dysfunction.

Having said that, I don't think that today we have an arsenal of drugs that are really effective towards the post-Covid problems.

It's more about mapping the individual's problems and then trying to support them as much as possible with rehabilitation and recovery at this stage, so there's a lot more research that needs to be done.

Do you think the next pandemic will be something related to a zoonotic spillover or is it going to be something else?

We have absolutely no idea. There were, as you know, a few outbreaks of viruses similar to the SARS Covid virus, say in the decade or so before we had Covid-19.

The new pandemic doesn't have to be a relative of these viruses, it could be you know, there are many zoonotic risk factors as humans interact more and more and go deeper and deeper into habitats that may have been more isolated before.

There's always this risk of spillover. But the virus or other infections can also occur through genetic changes that can be spontaneous.

While a viral source is likely, it is not necessarily the only one that can cause a new pandemic.

How can we tackle a new pandemic? What role can India play?

We need to accumulate as much knowledge as we can about what to do, sort of in a medical context, and how we handle pandemics or catastrophic events more generally, such that we have the readiness to be able to act.

At the same time, I think that digital medical solutions such as telemedicine and digital monitoring devices will become very important in the future.

India can be a major contributor to developing tomorrow's digital tools. I am convinced that this is the major market of tomorrow in medicine.

I think that the strength of India resides, among many other things in information technology, and there is a strong global trend towards, you know, creating what could be called the 'digital hospital'.

What's your opinion on the origins of Covid?

I think it's quite clear that the origin of Covid was more specifically from China. However, the big speculation is whether something got released from a laboratory or it was a naturally occurring recombination or such, and I honestly, I don't know.

Personally, it appears to me, at least what we can say, it's not an intentional release. So I think you can forget about conspiracy theories and ideas that someone was out to hurt the human population - that was clearly not the case.

There could have been an accident of some sort, but most likely, this was a natural phenomenon that occurred somewhere in the vicinity of Wuhan in 2019.

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