As New Zealand is hit with an outbreak that has put dozens of children in ICU fighting for breath, a prominent medical researcher says it's time we made headway with an RSV vaccine.
The void of influenza and Covid-19 this winter has exposed the dangers of RSV (respiratory syncytial virus), an infectious disease much older than Covid - which has gone half a century without a vaccine.
In Wellington Regional Hospital on Thursday there were 31 children in hospital, and five in ICU with RSV or respiratory-type illness. Earlier this week the Herald reported a 63-year-old north Auckland woman died after contracting the virus.
Research director at Wellington's Malaghan Institute of Medical Research Professor Graham Le Gros said the outbreak highlighted how vulnerable New Zealand was to infectious disease.
"In the absence of influenza and the absence of Covid-19 we're now seeing just what impact RSV can have on our community, especially with the new normal which is more social distancing and protecting us from infection," said Le Gros, who believes he himself caught the virus just last week.
In spite of how long RSV has been around, unlike Covid-19 and influenza, there is still no vaccine available.
"If you look at significant infectious diseases of human beings that we can't get rid of and we're trying to make a vaccine, RSV is one of the longest-standing ones that we identified a long time ago."
"We have tried to mount several research campaigns here at the Malaghan Institute over the past 20 years, trying to understand it better."
Coincidentally, a phase three clinical trial is currently taking place in New Zealand, through which pregnant women could be vaccinated in the hope of protecting their unborn child.
"The vaccine is in mothers so you vaccinate the mother so they can transfer the protective antibodies to the foetus and the newborn," he said.
"It's amazing science, because you can't vaccinate the babies, they don't have immune systems yet."
"They're trying to recruit ladies who are pregnant to be vaccinated [for the trial] ... it's something in which New Zealand could play a critical role in stopping this awful virus."
In contrast to other winter illnesses that affect the head and sinuses, Le Gros said RSV gets into the chest and lungs, causing pneumonia-like symptoms in children and the elderly.
"It's an illness that affects your lungs and reduces your breathing capacity and you could be coughing for five weeks afterwards," he said.
"It will get into an old person's home and go through everyone. People used to think it was influenza but it was probably RSV."
He said the severity of this year's outbreak was likely due to weakened immunity due to lockdowns, prior to an opening up of the transtasman bubble with Australia.
"We don't understand the full significance of why RSV is coming across as worse – is it a worse variant, or is it just because we missed a year due to extreme lockdown of boosting up our immunity by being exposed to the RSV going around?"
He said the weakened immunity to RSV during the pandemic was a further reason to invest in a vaccine.
"Immunity generated by natural infection is very short-lived in the RSV … and that's why we need a vaccine," he said.
"Say we lock our borders down for five years and didn't have any RSV year after year, it may well be that when RSV does come back in the teenagers and the 30-year-olds and the 40-year-olds, it could actually be quite a serious disease."
Just as concerning was the speed at which the RSV outbreak overwhelmed intensive care facilities, said Le Gros, highlighting New Zealand's exposure to serious Covid-19 outbreak.
"The maintaining of our population immunity with regular infections may be compromised, so with the closing of borders we may be more susceptible to severe, catastrophic outbreaks of infectious disease."
"And immunity doesn't last very long - that's why we need a vaccine."
A phase three clinical trial for RSV is taking place in Auckland, with Middlemore Clinical Trials still recruiting participants.