Celebrating ESWI 30 years!

Aida Bakri: 0:16

Welcome to this special edition of the ESWI Airborne podcast series. My name is Aida Bakri and I'm the director of the ESWI Secretariat, and today it is my pleasure to mark the occasion of ESWI's 30th anniversary by inviting our ESWI founder, current chair and future chair for an inspiring intergenerational fireside chat. I hope you enjoy this unique episode as much as I did.

Ab Osterhaus: 0:42

Well, my name is Ab Osterhaus, I'm the chairman of ESWI and I would like to welcome you to this podcast of ESWI, which is one of a whole series that we have that's quite popular. And, especially since it's now 30 years that, since ESWI was founded by a group of founding fathers 30 years we thought it was a good idea to ask one of the founding fathers, who was the first chairman of ESWI, to ask him to explain to us why this was done, with whom it was done and what were the circumstances, et cetera, at that time 30 years ago. And then subsequently, I will talk a little about ESWI to date, and then the chairman- elect, Colin Russell, the next chairman, is going to finalise the call. We agreed that it is not impolite to interrupt or to ask questions in between. Is that agreed amongst all of us? Agreed, yes, okay. Well, as I said, we have three participants here Claude Hannoun, the founding father, Colin Russell, the chairman-elect, and myself. So the first one I would like to give the floor is Claude. Can you briefly introduce yourself? What's your background? And why did you start this whole organisation of ESWI?

Claude Hannoun: 2:15

Yes, well, I am a virologist, an old virologist, starting virology when that discipline was still very young and I assisted to the evolution of the knowledge about viruses in a very, I would say, dramatic situation because of many outbreaks, many incidents and terrible catastrophes like the Spanish flu of 1918. Now I was impressed in the 80s, in the 1980s, I was impressed by a book that I received, a red book like this one, which was called “Options for the control of influenza”. It had been edited by CDC in America and by Alan Kendall and others and in 1980 it contained all information, all new information about influenza virus which was now at the turn after the different outbreaks of '58 and '68. And that book contained everything about influenza and I was admiring and I was giving it to my students for study and that was very interesting. I met in a meeting, I happened to meet Alan Kendall, one of the authors of that book, and I told him that I was admiring this type of work and he told me that he was sorry not to be anymore at the CDC and it was not possible for him to make another meeting of the same kind. And during our conversation the idea came out that it would eventually be possible to do again a meeting like that and with Alan Kendall and a few others we started the project to establish options for the control of influenza 2.

And that's what happened in 1992 in Courchevel when we organised a meeting with 300 European scientists working in the field of influenza. And we did a meeting for which we edited that green book. And during that meeting came the idea of organising a group of scientists in Europe working on influenza to put together our efforts and try to coordinate these efforts. At that time diagnostic of influenza was difficult, like it is now also. The clinical diagnostic is almost impossible. We have to, you have to make isolation of the virus or identification of the virus to be sure that it's influenza. And that is not an easy process. In fact, in the labs where we were working we received only a few samples every winter and we could not isolate, we could not identify influenza. And one of the objectives of this new group of a number of European scientists was to try to coordinate the efforts to improve the collection of data, the collection of strains.

So that is the time that you also coined the name ESWI. Is that correct?

European Scientific Working Group on Influenza.

During the meeting in 1992 in Courchevel, Options 2, we decided to create this group called ESWI, and ESWI started a new life and organising a number of different meetings. The next meetings we organised was in Crete and two years later, in 1994, putting together the efforts of European scientists was an interesting situation.

So perhaps, if I may ask so, at the beginning you were just in inverted commas, a group of virologists.

Yes, about 12 virologists from different countries in Europe, from Germany, Czechoslovakia, Italy, Spain and Netherlands in different countries in Europe.

If I remember well, already at that time you started to organise communication as well. Because initially you were just in inverted commas, a scientific group, but you were also starting to disseminate information to stakeholders.

So, of course, the promotion of vaccine was one of the important goals of that situation. And promotion of vaccine was better obtained by informing the public of what is the disease, what is the situation, what is the possibility for this particular virus to move, to change. And because it's not a vaccine like others, it's a vaccine which is always changing year after year, and that is a difficult situation to explain to the public. You have to explain to people that the virus changes, then the vaccine changes and the vaccination has to be done every year.

At that time it was not an easy thing to convince the public.

It was not known at all, it was a completely new concept. It was going against the habitual, the usual concepts for vaccines and vaccination once for forever, like for measles or others. In influenza it's completely different and this needs information and information to the great public.

What you didn't say, you have a medical background. Is that correct? You are a medic?

No, no, I'm a virologist.

You worked at the Institute Pasteur.

Yes, I worked at the Pasteur .

And you were a virologist by training.

I was a virologist. I was working on the bench. You know I was inoculating eggs, I was doing a maglutination inhibition test. I was working at the bench, so I was not taking care of patients, I was taking care of virus.

And so in principle, you mentioned this meeting. So basically what you did, you organised meetings, scientific meetings, where you got together, exchanged information amongst the virologists, and then you talked about the meeting in Crete where already, to a certain extent, the communication with the public at large and with the stakeholder was being started. And I remember at that time, it was in Crete when I came on board, and that's interesting because then gradually, we discussed what to do, how to collaborate with stakeholders. Yeah, and stakeholders we considered stakeholders to be professional organisations, on the one hand, the medical specialists and authorities like WHO, but also national authorities. And you already started that. And I think it's quite interesting because what we started to do after that is moving a little bit from, or not a little bit moving from, a group of scientists, and you didn't mention all the names, but all the names of the people who were on board at that time. They were really icons at that time. A really high class virologist. And it's interesting because gradually we shifted to a slightly different approach.

And that's when I became the chairman as well. We shifted gradually to a situation where we had scientists of different backgrounds, so initially it was only virologists and we brought on board immunologists, but a lot of medical scientists as well, especially clinical people as well. Because we realised that if we want to translate the message to the public at large, we should do that through basically the professional organisation, because, as the European Scientific Working Group on Influenza. And in the meantime we have extended that to other acute respiratory virus infections, because for influenza obviously there was a vaccine, there were vaccines, but for the other important ones, like RSV and we know today that RSV is at least well, not at least is at the same range as influenza we have just come through the COVID pandemic. But we were also focusing and you also at that time at epidemic influenza, the annual influenza epidemics, but also on the pandemic. And it's interesting because it was not until the Mexican swine flu that we actually had the possibility to start vaccinating, which was not possible for pandemic flu and which was possible for COVID. So you were on board at that time and and also you were in favour for the change of direction that we said well, with the possibilities that we have as a group of scientists it is better to spend our efforts on really informing the public at large through our stakeholders, to what the importance is of vaccination. In the meantime, in addition to vaccination, we have antivirals as well. We have good diagnostics in the meantime, so the scientific field has changed. But also, how to educate the public?

Yes, in a few words, we have moved from virology to public health.

So basically, if you look at ESWI today, that's slightly different. We are now a group of scientists with different relevant disciplines in fighting flu, so we have people with a medical background. Pure virologists are still on board, but they are in the minority today.

Colin Russell: 13:23

I think it's interesting, if I can just interject briefly. I mean when Claude was talking a moment ago about the origins, one of the key issues at the time when ESWI was formed was virus isolation, which is something that we essentially take for granted now. It's just something that obviously happens, and yet at the time it was a key issue that we needed the best minds to get together and think about, because it was one of the key issues for influenza control.

That's important that you say that, because just before we started we were just talking a little bit about the old days here in Paris, where we are doing this podcast, and Claude was telling me about the network he set up initially in Paris, of some 20 doctors. Can you tell that again, because I was quite impressed because basically the ECDC things and the CDC thing that was avant la lettre, he was doing that here in France, initially in Paris, extending it to France and then bringing it into the whole group.

Yes, the initial gesture is isolating the virus. That's the basic of everything which happens later and that at the time I was starting '92, there was no possibility of doing that because the laboratory, my laboratory, has no access to patients. I was in the lab of virology, I was isolating the virus in eggs and inoculating particles in trays and so on, but I had no patients. I had to organise, that's what I started to do. I had to organise a network of physicians and provide them with samples, with bottles with fluid and with small things to take the samples. And I had about 40 doctors in Paris and the region to whom I was providing the material and they were sending me by mail or by someone who would bring the sample in the lab. It was very primitive organisation. But starting from there I started to isolate 400, 500 strains per year instead of 20. And that changes completely because I had samples. I had samples to study the virus, I needed virus to make the study and I had to find myself the virus running after the samples in the patients.

But that's interesting that you're telling that, because what you did at that time. You had your own setup in France and then actually extended that into different European countries, CDC getting involved. So you were really at that time already setting up the organisation and that was really eventually, of course, taken over by the CDC and the ECDC, still with the input of all those physicians that were sending in samples. So that was happening in many countries in Europe, but you managed to get them together, first in Courchevel and later also in Crete, and then we realised at that ESWI as it was at that time, that there was so much information that had to be disseminated and that all this information should be shared with those people who can use it the best, that we decided to really, rather than just, not just, but being a scientific organisation, being a communication organisation for the communication with stakeholders, not forgetting, of course, the cross-disciplinary work, the scientific work that needed to be done.

And it is similar to what happens today with the sequencing of the other viruses, and you have to collect information about the nature of these viruses, to establish their circulation, to understand how they emerge, how they disappear. And it's exactly the same with different techniques and with different possibilities of action.

So what basically happened to date is that we changed the mission a little bit. So we changed the mission into a broad statement of reducing the burden of acute respiratory virus infections, and you initiated that whole thing. And if you're looking at the organisation as it stands today, we have 12 members. This is, in principle, it's a not-for-profit organisation. We have 12 members, yeah, of these are all scientists of different plumage and different backgrounds. We have five or six associated members at the moment. Yeah, you are one of the associated members in the meantime and so basically what we do is is really we organise big meetings, like you initiated them. We are currently actually at the 9th. So the meeting that's going to happen this year in September in Valencia was actually already a meeting that was planned two years ago during the COVID. So then we had to change to a virtual meeting and now the result of that is going to become a hybrid meeting, which is nice because in this way we reach many more people. But perhaps, to say something about the meeting, if you go to the Courchevel, the Crete meetings, the early ones, it's quite interesting to see that this was science, science, science, really very much so, although the clinicians got involved more and more, which is quite important, of course.

But then, gradually one of the ideas came up at that time, yeah, and it was actually Chris van Langendonk and some of the members we were looking into the possibilities to really change the scene. And that's why, when we realised that we have to communicate also not only to the professional organisations, which we are doing quite extensively, so we have a whole group o f 25 and plus coalition partners. There's all these different organisations that are treating risk groups, but also, you know, the policy makers. So those are policymakers at the level of WHO, but also policymakers, let's say, directors general of ministries of health of the respective European countries, and there's a whole network now. And so, at the meeting in Valencia and we started that early at earlier meetings and that has expanded was an enormous success, I think, is that we have a separate track now where we have all the scientists together on the one hand but besides the scientists we have a track of policymakers and they can ask whatever question they they want to ask to the key scientists that we have together and that has become an enormous success really, that interface.

So I think it's quite important to realise that through the work that you started gradually from a scientific organisation, we have not abandoned the science, because all the people who are members to date they are scientists in their own field and we realise that there is more than just virology, just immunology. There's a lot of other scientists and that might be a nice bridge to talk to Colin as well, because Colin is at a meeting in Valencia. He's going to take over as a chairman, so he will be my successor there and I'm a veterinarian by origin, by training, and people have asked a lot why are you in such a flu meeting? Well, I think to date everyone understands that these flu viruses they come from the animal world, so it's very important to do. We did a lot of work on that. It's a very different group, so a veterinary background is quite a nice background there. But then now we get Colin as our next chairman and we just wanted to ask him, Colin, you briefly introduce yourself and what are you going to do? So you are a modeler. So, basically, well, I think many people understand today that modeling is important since COVID, but why are we going to have a modeler as a chairman? So, Colin, can you tell me a little bit more about yourself? Tell us a little bit more about yourself and what you're going to do.

You're absolutely correct by background, I am a mathematical modeler. But I think that really, if we go back to the beginning of this conversation and the beginnings of ESWI, which is to talk about the problems that we confronted as a respiratory virus disease community at that time, as Claude said, at the genesis moment of ESWI, we were mainly concerned about virus isolation. That was one of the key scientific challenges that we faced at that time. And now virus isolation is something that we almost take for granted. Then Claude also suggested, now we have sequencing data to think about and the lessons that we can learn from that. But also, if we go back just 30 years, sequencing was something that was almost never performed. It was an exceptional thing to sequence a virus and now again, it's just something that we take for granted. And I think that why a modeler now? Well, it could be anyone. I mean, fundamentally, virology and hardcore lab science is still one of the core businesses of ESWI. But the challenges that we confront for controlling respiratory virus diseases in general has changed and the skill sets that we expect for scientists to possess has changed. You know we hear these stories of ah, 50 years ago, if you were doing a PhD, all you had to do was learn one technique and then repeat it a few times, and then you could get your PhD, and then after that, you could go on to do a postdoc, where you learn another technique, and then you can get a faculty job. And of course, now we expect a huge diversity of techniques from our PhD students and postdocs and all of the people that are working with us. But it's true basically for the community as well. Whereas now we have a situation that we confront where we are almost saturated with data. We have so many virus isolations and so much sequence data and so many other kinds of data that we need new and different ways to analyse it and think about it, and so modeling is one of the tools that we use for that. But of course, we still need to have virologists around the table, and we need immunologists and we need those clinicians, because making sense of all of that data requires a huge diversity of skills.

Because one of the things we did not talk about too much is the advent of the new possibilities for new viruses. So we have to be in the middle of a problem of RSV, which is not only a big thing in children, filling up our PQs, so our pediatric intensive care units, but also in the elderly. Now and now there are possibilities. So within one or two years we will see the first vaccines there and we have seen for the COVID, so with all the techniques that you were talking about. So the landscape has changed completely and since it's, on the one hand, epidemic things that we are interested in, we're talking RSV, Covid, that is there to stay, probably SARS-CoV-2, and we have flu, so these three things together and is there more to follow? So we still have maximum virus and so there's a lot to be done there. So what do you see as the future for ESWI?

So I mean, I think the key thing is that you know, when you're talking earlier about sort of the advocacy that ESWI needed to participate in, it was broadly around increasing the awareness of vaccines. Because the public themselves were not aware that vaccination was a good opportunity to help combat the burden of flu. Now, especially with the ever-changing landscape of options for diagnostics, both PCR in the hospital for rapid diagnosis of influenza, or RSV, or human metanuma or Covid, but also the increasing decentralisation of diagnostics, where in the near future we're going to have home tests that allow us to determine which respiratory virus we have. Along those same lines, we then have increasing options for clinical management of these disease. Antivirals against flu and Covid, and soon RSV as well.

And then in the public health sphere, we have this ever-changing vaccine landscape now, where we have the trivalent inactivated vaccines that we've been using for a long time, but we also now have quadrivalent vaccines, live attenuated vaccines, recombinant vaccines, mRNA vaccines. And there we enter interesting new public health challenges where we have to confront managing the best available options for at-risk groups but at the same time making sure that everyone who wants access to vaccines has access to them. And so the issues now are not just around whether or not people should get vaccinated, it's around which vaccine they should get, and this issue becomes even more complicated as we move into the sphere of RSV and Covid and human metapneumovirus eventually. And I think ESWI is extremely well positioned to basically be a key leader in this space because of our expertise in flu, but also now our expertise in RSV and Covid and the expertise in human metanivirus that we're going to expand into in the coming

Well, that's great. So I asked you, what has a modeler to do with all this ESWI thing? And now I think you quite, very passionately explained where we can fill a gap there between the science on the one hand and really the patient on the other hand. And in that whole field, I think Claude, you can agree that it is the way that it was expressed by Colin how we are going to go with ESWI. That's the way to go. And could you ever have imagined, you know, when you started these meetings in Courchevel and after that in Crete, when we took over and expanded that and took some of the new direction, that when you started we would grow out? I remember Courchevel, but also Crete.

No, that was completely unpredictable. You know, we could not imagine all the complications that we are just facing now. We have, in fact, a new problem with these new viruses like Covid. The problem is that immunity doesn't seem to be as solid as usually considered. You know, I happen to have been vaccinated four times, like all the high-risk people of my age have been vaccinated four times. Now, after these four vaccines, I got positive by PCR three times in June, in July and in August without any symptom. So you see, that for me is a puzzling problem because being positive for the virus without any symptom is a problem. The fact of being immunised and having a high level of antibody because my antibodies are titrated regularly I have more than 2000 or I don't know how much, and however, I have been found positive by PCR three times. So there is something, there's something wrong. It is a complicated problem and we have to rethink our theories about vaccination and immunity for this type of virus.

I think we as virologists, I think we are a little bit strange people because whenever anything happens to us, when we start coughing or whatever, we immediately start to check, and it would be good if everyone was doing that. But we as virologists I had the same thing also being PCR very positive and not having anything. Anyway, I think we got back to the virologist here. I think we have discussed 30 years of ESWI and definitely we haven't covered the whole thing, obviously. So we have talked about how the mission has changed, what we have achieved. We went from a small group of virologists into now a much bigger organisation with a lot of additional ambitions. That was actually initiated by you as well. And I think it's fantastic, and I think especially the next international meeting that we're going to have in Valencia, Spain, the ninth meeting just imagine the ninth meeting in Spain, which will be a hybrid meeting, I think that you will have the opportunity when you listen to this podcast, you will have the opportunity to see us there and to discuss with us. One of the things we did not mention, I think this is a nice thing to close with, is that we really have also as a very important issue, young scientists, stimulating young scientists in science. So we have some prizes for young scientists. The most important one is the Claude Hannoun Prize, and you have been able in the past to hand out this prize a number of times, and the good thing is that those young scientists that got the prize they have established virtually all of them now have established them as key scientists in the field. So our legacy well, basically your legacy is fantastic. You have left behind a number of scientists who are really working in the flu field, working in the respiratory virus field, working with COVID SARS-CoV-2, that those people that were still young postdocs or late PhD students getting the Claude Hannoun Prize, and they form a little community at the moment and I think we can be very proud of that. So I would like to thank you, Claude, for having me here in Paris. It's fantastic to be here. Colin, I would like to thank you as well and we wish you - i t's a little bit early still, but wish you a lot of success as the new chairman after the Valencia meeting and I think we have had a nice overview of what ESWI was, what it is today, but also and I'm looking at Colin now also what it's going to be in the future. Thank you very much.

I completely agree. Thank you Ab.

Well, I also am very, very grateful to you, Ab, for what you have done for ESWI. You have completely changed the initial orientation to make it richer and to make it more useful for public health, and I am sure that what Colin will do now, with another turn in orientation, will bring very interesting results and will help to solve some of our problems, these problems which seem to be so difficult today.

Well, I certainly hope so. Well, thank you, and thank you both honestly. It is something where I feel tremendously privileged to try to stand in your shoes. And I do feel in one of these moments that it is one of these situations that, if anything that we managed to do now is because we are standing on the shoulders of giants and it is genuinely a privilege to take the helm of this organisation when that time comes. But for now, Ab, you've got nine months left.

I'll do my best, Colin. Thank you very much for all the nice words and hope to see you all in Valencia.

Aida Bakri: 34:02

ESWI Airborne is brought to you by ESWI, the European Scientific Working Group on Influenza and other acute respiratory viruses. These episodes would not be possible without the team's efforts and we would like to extend special thanks to our ESWI secretariat, our technical and IT teams, our arts team and our host, Clare Taylor. The podcasts are recorded virtually and we thank our guests for their participation in this inspiring series. Talks are adapted to a global audience and are intended to be educational. For any specific medical questions you may have, these should be addressed to your local general practitioner. Many thanks to our sponsoring partners and thank you for listening.

Celebrating ESWI 30 years!

ESWI Airborne: Meet the Members

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ESWI Airborne: Meet the Members