As Omicron is continuing to sweep the world, 18 million Covid-19 cases have been reported across the globe during the last week. The number of cases apparently has reached its peak in some countries and the pandemic itself is far from over. Although the number of deaths are not increasing significantly, the impact on already overburdened health systems of countries and the impact on exhausted healthcare workers cannot be overlooked.
Sri Lanka has reported more than 200 Omicron-infected patients and the numbers are rapidly increasing. As we are stepping into the third year with Covid-19, the Department of Government Information conducted a media briefing to give an update on the current situation. University of Sri Jayewardenepura Faculty of Medical Sciences Department of Immunology and Molecular Medicine Head Prof. Neelika Malavige, Infectious Diseases Hospital, Colombo Consultant Physician Dr. Ananda Wijewickrama, and National Hospital Sri Lanka Consultant Physician Dr. Harsha Sathischandra joined the meeting. This article contains excerpts of their discussion.
Covid-19 vaccination
Since the Covid-19 vaccination programme was highly successful in Sri Lanka, the number of cases were controlled to a manageable level without compromising the health system to a disruptive level. As the number of severe cases and number of deaths were controlled, the country could come back to a near-normal status with the reopening of schools and reinstating the economically important institutions. In Sri Lanka, over 16 million individuals have obtained at least one dose of the Covid-19 vaccine, while nearly 14 million have been vaccinated with two doses. This accounts for approximately 70% of the total population. This remarkable achievement has immensely supported this level of control we experience.
Rising cases of Covid-19
A rapid rise in the numbers of Covid-19 cases is being observed at present in Sri Lanka and this is mostly due to the rapid spread of the Omicron variant, which the entire world is facing at the moment. In the US, approximately one million patients are being detected daily. In comparison to the Delta variant, the percentage of patients severely infected and the percentage of deaths are less in terms of the Omicron variant. However, as the Omicron variant is spreading more rapidly than the Delta variant, the number of persons getting infected is still high and the number of deaths remains high. In the US, 1,500-2,000 deaths are reported each day due to Covid-19, even during the current situation.
Is vaccination effective against Omicron?
Deaths due to Covid-19 are mostly reported among the patients who are elderly or have comorbidities. When we consider the Covid-19 vaccination situation in the US, among the people older than 65 years, about 12.5% have not obtained even a single dose of vaccine. This is approximately 85 million of their population. A similar situation is seen in the UK. This is mainly due to the spread of misinformation about vaccines by teams of anti-vaxxers. This is the main contributory reason for the overflow of healthcare facilities and intensive care units (ICUs) in these countries. According to global data, the patients who are being hospitalised are the people who have not obtained even a single dose of vaccine. Latest evidence shows that Covid-19 vaccination would still protect against severe disease even with the most mutated Omicron variant.
Why get a booster dose?
Generally, the immunity developed by any vaccine wanes off with time and a booster dose is required to enhance the immunity. This is seen in many vaccines in the Expanded Programme on Immunisation (EPI) schedule. For example, it is required to give five doses of the polio vaccine to achieve the required immunity. Even for measles, it is necessary to take two doses. This scenario is applicable for Covid-19 as well. With current evidence of Covid-19, it may require obtaining about three to four doses of vaccines to attain sufficient immunity. However, this may vary as the virus is still evolving.
There is strong scientific evidence to show that the hospitalisation of elderly patients due to Omicron is reduced by 50% after Covid-19 vaccination and this protection is increased up to 90% if they take a booster dose. Hence, it is very important to get the booster dose to minimise the chances of developing severe disease and to spend a near-normal life amidst the pandemic.
According to a study conducted in the UK, two weeks after receiving the second dose of the Covid-19 vaccine, approximately 90% of protection is achieved. However, after three months from the second dose, the protection drops to about 70% and this further drops to 50% after six months. Furthermore, they have observed that the protection rises to 90% after the booster vaccine and the protection remains at least for another three months.
Who is eligible to get the booster dose?
In Sri Lanka, the Pfizer vaccine is given as the booster dose for all eligible individuals and there are adequate stocks in the country. The following categories of individuals are eligible to get the booster dose:
- All individuals older than 19 years can get the booster dose three months after the second dose of Covid-19 vaccine
- If a person has got infected with Covid-19 after obtaining the first two doses he/she can get the booster dose in six months following recovery
- Pregnant mothers also should take the booster vaccine as they are in the high-risk category
- All individuals between 16 and 19 years can get two doses 12 weeks apart
- Children between 12 and 16 years are given one dose
- Children between 12 and 16 years with comorbidities are given two doses
- Keep a physical distance of at least one metre from others, even if they don’t appear to be sick
- Avoid crowded and poorly ventilated settings
- Wear a properly fitted mask
- Clean your hands frequently with alcohol-based hand rub or soap and water
- Cover your mouth and nose with a bent elbow or tissue when you cough or sneeze. Dispose of used tissues immediately and clean hands regularly
- If you develop symptoms or test positive for Covid-19, self-isolate until you recover
- Get vaccinated and obtain the booster dose