By George Gilson
For the broader public in Greece Emmanouil (Manolis) Dermitzakis became known late last year when Prime Minister Kyriakos Mitsotakis tapped him to co-chair his new National Council on Research, Technology, and Innovation.
What most certainly drew the PM to the professor aside from Dermitzakis’ international distinction in his field was their shared focus and excitement about the prospects that scientific research and technology could allow Greece to compete internationally in crucial fields of the future due the extremely high level of human capital.
Dermitzakis as a full professor has his own research group at the University of Geneva School of Medicine and serves as director of the Health 2030.
He sits on the Board of The mission of the Institute of Genetics and Genomics of Geneva (iGE3), the aim of which is «to promote internationally competitive biomedical research and high quality teaching by using primarily genetic and genomic scientific analysis».
«The iGE3 is interdisciplinary since its members cover a wide spectrum of expertise from medical sciences to modal organisms and biodiversity and the ethical, social, legal and financial aspects of the genomics research,» website states.
Its research areas include human genetics and genomics, genomics and health, genetics and development of model organisms and the biodiversity, genomics research on evolution and human history, and last but not least ethical, social, legal, financial and educational issues around the genome.
In dozens upon dozens of papers Dermitzakis has garnered slightly over 75,000 citations (Google Scholar), 39,000 of them in just the last five years, since 2015.
In this interview he also speaks about the lasting influence and impact of one of his key mentors, the late Harvard Professor of Biology Fotis Kafatos, who after decades in the US taught at the University of Crete. He sees Kafatos’ philosophy of science, his view of how one approaches science, as an enduring legacy that is useful today.
Political and scientific power: A marriage of necessity
Mitsotakis swept to power on a platform of deep reforms and a restructuring of the country’s economic base that allow it to compete in the new dominant fields in the global economic terrain.
In an interview with To Vima English Dermitzakis reveals that he met eye-to-eye with the PM from their first discussions nearly a year ago and that, crucially, he has an open line to Mr. Mitsotakis with whom he has had regular contact in the past months.
The two part ways perhaps in terms of the weighting of the two pillars of future growth – the purely entrepreneurial angle of supporting start-ups and new innovative companies and luring investment on which Mitsotakis has focused like a laser beam and on the other hand the super-big funding (with both state and EU money) needed to create the infrastructure and framework for international league research in the fields whose growth the National Council is supposed to pursue.
Major state research funding key to tapping top-flight Greek scientists globally
Though the Council is a consultative organ, Mitsotakis has granted Dermitzakis and his colleagues plenty of leeway so as not to act as merely as an executive organic advancing political decisions but rather to operate as a vehicle for the creation of a medium and long-term strategy and roadmap which will be taken under advisement by the government and will presumably be submitted to a broader public dialogue.
Such a clear and effective and well-funded framework, Dermitzakis says, would allow brilliant global scientific talents of Greek descent to return and take a leading role in allowing Greece to exploit its full potential in the various fields of science.
Dermitzakis notes that for himself and other Greek scientific researchers of his caliber globally such a framework – and not matching their current income – is the paramount factor in deciding whether they will make a full-fledged investment in Greece.
All that was months before the University of Geneva professor of genetics would be led by his own scientific discipline to dive into the study of the new coronavirus and its links to human
He is now conducting a genomic study in Greece on 3,500 patients that have fallen ill with SARS-CoV-2 at 10 different laboratories throughout the country.
The full transcript of the telephone interview is as follows:
How did your career path bring you to Geneva?
I left Greece twenty-three years ago. I took my degree and Masters in Biology at the University of Crete. I did not study medicine. Then I went to the US for my Ph.D. in 1997. Then I came to Geneva for a post-doc for two years and then I went to Cambridge for five years where I was at a genomics research lab. Eleven years ago I returned to Geneva with a Chair as professor.
Now Prime Minister Mitsotakis has appointed you to chair a committee on research and technology. Does Greece have the capability to compete with other countries in research in this area of developing medicines or perhaps contributing to the development of a vaccine for coronavirus let’s say?
We cannot compete in developing a vaccine as that is not developed from research but rather from pharmaceutical companies. We certainly cannot do that. If we’re talking more generally about research there is infrastructure in Greece and the human capital exists to compete internationally as regards the mechanisms of the virus and so forth.
Before the large pharmaceutical companies get the vaccine it is necessary to have clinical trials which are now going on around the world. Some are concerned that the understandable rush will lead to the production of a vaccine about which we do not have all the necessary information and that could lead to unexpected and negative results.
Vaccines more generally regard viruses. We have technologies that have been tested. This is not the first time we have such technology. Simply one uses a different virus as the basis of which we will develop immunity. Consequently, for the majority of technologies there is no worry. The problem is simply that it takes time to pass these testing stages.
I underline that you are part of an effort to develop a method of tracing if that’s the right word in 3,500 individuals through the genetic imprint. What are the elements or data that tell us that a specific type of DNA will react to a specific therapy?
That is premature right now. There is data that tells us that it is useful to conduct this study. Firstly there is the fact that in very many significant diseases, viruses and others there are very strong genetic factors that determine both the probability of infection and the progress of the patient such as in HIV, the various forms of Hepatitis, Ebola, and others.
There is a huge diversity in the development of antibodies among patients from entirely asymptomatic ones to very seriously ill patients who die even within a group of the same category, such as young people. All this diversity tells us that there is a factor that we cannot see from someone’s clinical health characteristics and these factors could be genetic. That is why we study the genetic background of patients in order to detect these genetic factors so as to first cover the prognosis factor but genetics also offers us mechanisms. If we find the genes that are involved we can see which mechanisms we can target if we have a certain medicine that aims at these mechanisms.
Did you work with the great biologist Fotis Kafatos who taught at Harvard for many years?
Indeed. Fotis Kafatos was the reason I became a biologist. He was a classmate of my father’s [in Crete] from kindergarten through the end of high school. He was an inspiration as I read about him when he first came to the University of Crete where he later taught and naturally I later became acquainted with him at various events, conferences, and so forth.
Tell us a bit about Kafatos’ contributions to science and which issues you believe he would be focusing on if he were alive today.
Fotis Kafatos made a very great contribution, so much so that it would be difficult to explain here. Beyond the infrastructure, universities, and the very obvious things that he did I think his most important legacy is a philosophy on how we should approach science. I think that influenced a lot of people to aim as high as they possibly could. I was one of them. He was a person who was brilliant with a very strong mind.
If Fotis were alive I think he would have been one of the first people who would coordinate teams of researchers both within and outside Greece in an effort to solve current problems. Due to his stellar reputation internationally he could have brought funding to Greece in order to accomplish certain things. He could have played a very important role in scientific developments internationally through Greece. The rest of us are trying to do the same but he was in a different league.
Who would be a Greek in your field today with a strong international impact?
I would cite George Pavlakis who is a virologist at the NIH in Washington and works at the National Cancer Institute where he studies viruses connected to cancer. There is not a Greek virologist of huge international import that I can think of. That area has not developed so much perhaps because it has not attracted so much interest among Greek scientists.
As we speak there are over 1,500 strains of coronavirus. Can one study each of those individually or are they so related genetically that the same therapy can be applied to all of them?
At this point in all the mutations that have been identified there does not appear to have any difference between them either in terms of the evolution of the virus or in how we handle them and in any event we do not have any medication at the moment. Remdesivir is new so we cannot detect differences in the response to it, nor are the levels of mutations such that we should be concerned that a vaccine would be effective in one type rather than another. They are very close and this virus does not appear to evolve rapidly so as to easily escape immunity.
What is the desired result of your study of 3,500 patients?
The best result that we could expect is to find a very strong genetic factor that would make a huge difference between those that have a genetic mutation and those that do not. For example, one sees certain people who have a mutation ailing heavily and others ailing very mildly and you look for a medicine that exists already that is able to target that gene.
For example there is a gene in the HIV virus which is called CCR5. When it mutates in a very specific manner patients that have that mutation will not fall ill – comparable mutation that could block the disease itself or its development as regards that virus and we had the good fortune to already have a medicine that targets that gene. There have developed very many medicines that target genes in various illnesses. In other instances some company might already have a medicine that can be used and make the difference. Genetics can offer us that very swiftly.
Let’s say someone has for example chronic lymphocytic leukaemia, if one were to analyse a lymph node can one determine if one the person is vulnerable to infection by the coronavirus and how the person should be treated? Would the DNA analysis allow us to fashion a more targeted therapy?
We cannot tell because we do not yet know how the virus interacts with cancer. We must study this because for better or for worse there are not a lot of patients who have that type of cancer and fell ill with Covid-19 so as to have a large enough sample to conduct a proper study. That can be done in the laboratory but it takes time.
This type of study would not concern that specific type of cancer but it would cover the broader category in which it falls [leukaemia]. It is not necessary to go to that cancer and the specific type but it is a secondary type of cancer. Most likely in combination with certain strains of the virus one might see a different result. We do not know yet and we have to study that. This is true of cancer, diabetes, heart disease, and other ailments.
Every ailment is not just one illness. Every cancer patient is not a cancer patient in the same way. If we had studies with large numbers of people and we will next year because there are genetic studies being conducted internationally, we could combine which characteristics of the human gene are involved. It will take one or two years to have the data at that level of complexity.
What is your opinion as a citizen of Prime Minister Kyriakos Mitsotakis?
I was not very familiar with him. I was aware of his course as an MP. He was always a logical person with balanced rhetoric as an MP. I might say that what impressed me initially and slightly before he became New Democracy leader is that what he appeared to be at that moment – someone who could bring a new reasoning and outlook into politics.
It was on the one hand technocratic which I believe is very important in order to solve problems without an excessively partisan approach, and secondly he struck me as a person who had the ability to say certain things more openly. In the course of things and seeing everything I believe that he is doing what said he would do. He is a person who brought a different spirit to Greece’s political stage. That drew more people with a similar mindset and I hope that this will gradually bring more generally a different philosophy in governance. I respect him.
How many times have you met with the PM?
It has been four or five times on a personal level. We have spoken by phone and Skype repeatedly.
What is the main thing that Mr. Mitsotakis asked you to do or resolve scientifically?
What I can say impressed me was that in all our conversations he was more informed even about technical details on certain issues than I might have expected. He has a broad field of activities and issues that he confronts daily. He had as a non-expert very deep knowledge of certain technical issues that allowed us to have a very productive conversation.
Who is the PM’s main advisor on Covid-19 and such scientific issues?
Dr. Tsiodras is his main advisor on the coronavirus. This is a public health issue firstly and then a research issue. It involves management of a health system and managing patients before research begins. Mr Tsiodras was already at EODY [The National Public Health Organisation]. He was a person who had the requisite specialisation. He had represented Greece at various international organizations. He was clearly a person who could play that role.
Now Mr. Mosialos represents Greece at international organization as regards Covid-19.
Yes, however Mr. Mosialos is in London. One needs a person such as Mr. Tsiodras who can visit for example Kranidi when necessary. You may need a person to help out and be at the frontline. You need a person who can run around and get things done.
When the PM asked you to chair the research council did you set any terms on how you wanted this to work, such as direct access to the PM?
The discussions were not quite like that. They were such that I did not need to set terms. For a person like me to accept this kind of project is related to what I receive from the other side so that I too can agree to join the group.
How did the PM describe to you the task that he wanted you to carry out.
He didn’t describe something. We discussed the issue and found common ground on which he could accept my offer to participate and make it productive and for me to find a framework in which I might prove useful.
What are the main objectives of the committee?
It is a consultative committee designed to propose a shorter and long-term framework to strengthen research in Greece, so as to create a source of knowledge that is rooted in Greece.
On a second level, we want to translate a percentage of this knowledge so that it can have a positive impact on the economy. The idea is to make an ecosystem which combines knowledge and innovation and will have a positive impact on the economy. The essence of the economy is not just money. It is to provide solutions to real problems, problems affecting society such as healthcare or the environment or whatever. That is its main role -to find that framework.
If a foundation were to call and tell you they will give you a university chair with your current salary in Geneva and make you a ultra-modern lab [with a 500,000 euro grant let’s say] would you accept?
Well, just to give you an idea my lab costs two million a year. The funds derive from various sources – the university budget, Swiss research funding, European programmes and so forth.
I can tell you the type of proposal that would attract someone like myself. It is not just an issue of what I will receive. For a high-level researcher to come to Greece (and there are many Greek researchers abroad) it will not suffice for them to have certain personal qualifications. The entire framework has to change because we scientific researchers do no seek only our own welfare. We also want to have colleagues with whom we can conduct competitive research globally.
So one condition I would place in dealing with the government, a foundation, or whomever is that they build a very strong funding framework for RESEARCH in Greece – not just the entrepreneurial start-ups angle, but for research and the production of knowledge which will guarantee continuity, stability, and regularity so that I could compete with my colleagues internationally. I would prefer to be in an environment that can ensure me that this framework exists, rather than to receive money to come here and all the rest stay abroad. That would attract many researchers like me and younger ones and create a competitive environment. It is a matter of the structures and organisation that has to be created.
Before the crisis started, I spent half my time in Greece. I was working on the Council and undertaking various other initiatives to develop the ideas we discuss. I cannot return to Greece because I have my family and I do not have a permanent position in Greece. Chairman of the committee is not a paid position so I cannot do it for a very long time without making sure to keep my livelihood. I would do this and I am willing to. But these things will happen slowly. We will submit as the central council on research and innovation various proposals that we have drafted.
We have really done a lot of work over the last months. The Council started in December, 2019, and we have prepared a series of proposals which we would have already submitted were it not for the pandemic crisis.
With what frequency will the committee be meeting?
The Council has a total of eleven members and convenes twice monthly. We have already had ten sessions. We are extremely active and each meeting as at least two or three hours and I can tell you that at each meeting all members participate. This is a very strong committee that is very dynamic and very energetic. We work very, very well together.
The ministry submits questions for us to answer, but a main characteristic of this Council, as compared to prior efforts, is that we have been given a free hand to construct a strategy ourselves. It is very important because this way we can exploit both the Council’s firepower and discuss with all related groups to determine the best kind of interventions and that is what we have done.
‘Without research Greece would be in the backwaters’
Without research and the health sector, there would be nothing for Greece to do. We would have been a poor Third World country. The research sector and our strong university medical faculties are the reason that Greece was able to escape from what it left behind.
I want people to understand that without research infrastructure (even when not in the best condition) and without universities that produce knowledge, and without scientists who can support it, this whole structure would have collapsed. So the recovery must begin there, because in the next pandemic no one else can save us.
People must understand that the economy is based on certain basic human characteristics.
Doesn’t social cohesion not come first as without it you’ve lost the game from the start?
Social cohesion without science is useless.
I had proposed some time ago an inter-disciplinary pandemic recovery committee with economists, sociologists, a representative of labour, a constitutional scholar to study how developments affect fundamental rights, and of course scientists, who could be you and Professor [Gkikas] Magiorkinis for example as you both have an international reputation [in fields linked to the pandemic]. Are you receptive to that?
In principle I think it is a good idea. Mr. Magiorkinis is very good at what he does. Although he was young and joined a system that is rather complex – the health system in Greece with the professors who traditionally have strong positions – he is a person who can make an enormous difference with his scientific talent. That is my personal evaluation. Certain people may not be that sensational but are excellent scientists. He set up scientific research communication on television. I agree with your judgment.
To establish a committee of people who will push a variety of areas is positive. The pandemic created an economic and social crisis, but it also opens new doors. There has to be a re-evaluation of priorities in society, and not just in Greece, so as to make the proper investment.
The prospect of Greece having a productive part in manufacturing and industry is very important because that is what gave us the rapid solutions, such as wearing masks for example.
Are summer arrangements for tourism strict enough to preserve Greece’s excellent record so far in managing the pandemic and keeping cases very low?
I would want travelers to be tested two or three days prior to departure and to require that they sign a statement that afterwards they were in self-isolation. Obviously we cannot guarantee this but I think that if we request it most people would comply because they do not want to get sick while on vacation. A German tourist does not want to fall ill in Greece. They want to be at home if it is to happen. Hence, everyone is protected.
Testing tourists, calculated risk
That gives us a calculated risk. If we combine the probability of someone being infected in a country such as Germany which has a very low number of cases with the probability of them testing negative, along with the probability of contracting the virus between the test and the travel date, all that vastly reduces the prospect of a case entering Greece. If you have one case in 1,000 or 10,000 that is manageable.
Should a ceiling be set on the number of tourists visiting Greece during the summer vacation season?
I think that we should accept – I have not calculated the precise number – that there should be a certain number of tourists in Greece at any given moment so as not to allow a peak and fall. If a lot of people visit in a short time span, let’s say half the tourists come in a 15-day period out of the two months that Greece will be open for business there is a danger that there may be a high absolute number of cases despite the low overall percentage among travelers.
Otherwise ICUs will be overburdened. So you must set the number of tourists for each specific time-period and check who is entering and from where. We can have stricter criteria for a traveler from France or Spain than from Germany.
For someone from France for example aside from the negative test they can be asked to observe a five-day quarantine.
We don’t have a precise prescription.
Switzerland for example went through one of the worst experiences in Europe.
China now says that if it is pushed for an on-site WHO investigation of how the virus emerged and was handled at first it will not cooperate with Western countries in the next pandemic. How do you view that?
The Chinese have faced very intense pressure from the US far before there was any effort for us to understand where the virus came from and whether it was naturally formed or not. In Trump’s America first Trump decides what he wants done and then he looks for the evidence to prove it. One recalls how he handled the pandemic at first and his approach is still not serious. He began by saying it’s a simple flu. Then he said the cases will be entirely wiped out. When asked why that didn’t occur he said it would happen “at the appropriate time”, whatever that means. Then he said there were guidelines on how to re-open states and encouraged them to open and be “liberated”.
He encouraged people to use detergent against the virus and we saw a big jump in poisonings in the US in the ensuing weeks. Some people tried Lysol injections. People suffered burns. The man is off-base. In the weeks after the statement while the average number of poisonings in New York is 13, that week there were 30.