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Significant rise in Covid deaths and cases: Urgent collective action by Govt. and community necessary

03 Aug 2021

By Prof. Tissa Vitarana Red alert The Covid-19 pandemic is gathering momentum at an alarming rate. There has been a steep rise in the number of deaths and cases, especially after the B.1.617.2 Indian Delta strain became widespread, not only due to the more rapid spread, but also the increased severity of this Delta variant. However, efforts are being made to downplay this danger. The Government report of 29 July states that up to then, the total confirmed cases were 304,202, and that 26,448 active cases were in hospitals. On that day, there were 2,329 new cases and 66 deaths. The total deaths recorded up to then were 4,324. Even the daily figures up to then showed an increasing trend in both the number of deaths and new cases. But, as everyone knows, many more people are falling ill and dying at home, without going to hospital. One can speculate that the real number is two or three times more than the official figures. It is also estimated that about 80% of those who are infected are asymptomatic (that is they do not show any illness), but they too are infectious. Thus, the situation is explosive, but our society is functioning near normal, and people are gathering in large groups for parties, weddings, meetings, and public transport services like buses are overloaded. This is mainly in towns, especially in the Colombo District. In the last 10 days, the tendency for people to gather in groups of 10 or more has also increased. If this is allowed to continue, there will be an explosive pandemic with thousands of deaths. A suitable plan for Sri Lanka The situation will get out of hand unless the whole Sri Lankan community and the Government act with vigour, strictly according to a precise plan. Everyone will have to fall in line with this plan. Given below are some highlights of a suitable plan:
  • Make everyone aware that the virus is in the whole community and that each person can be infected by any other person. Therefore, each person is in danger and must protect themselves. To get this across, an intensive programme of health education must be carried out by every available communication channel
  • To achieve this objective, every person must avoid crowds (10 people or more)
  • Social distancing – ensure that the distance between any two people exceeds one metre (preferably two metres)
  • Ensure that everyone wears a proper mask whenever they leave their home. Even at home, if there is a visitor, the mask should be worn
  • Any article touched by another person may have the live virus. Anyone else who touches that article should promptly wash their hands, applying soap for at least 20 seconds
  • To ensure that the above objectives are observed, Covid-19 committees should be set up in all villages, groups of impoverished dwellings, offices, and all work places
  • The above Covid-19 committees should also spot any sick persons who might be having Covid-19 like symptoms, and promptly dispatch them to a doctor or a hospital. They must obtain the PCR report as soon as it is ready, and if it is positive, ensure that all contacts are quarantined in the house
  • The Covid-19 committee must carry out intensive health education among all the people. This should be supported by colourful, easily understood messages about the virus and its behaviour, and how to safeguard oneself should be illustrated by cartoons
Vaccines If an effective safe vaccine becomes available, that should be used widely and selectively. Unfortunately, this has not yet been achieved, because on an average, it takes five to seven years of research to produce an effective and safe vaccine. As there is a big demand for vaccines, many have been put into the market within a short period of less than one year, without adequate safety and efficacy testing. Vaccines like Oxford AstraZeneca Covishield (manufactured by the Serum Institute of India) and Sputnik-V (developed by the Gamaleya Research Institute of Epidemiology and Microbiology of Russia), use a proven vaccine technology based on the adenovirus as a vector, and should be safe and have reasonably high efficacy.  The Chinese vaccines are based on the use of the killed virus or attenuated virus, like Sinopharm, which use the whole virus but without them being alive, or able to cause infection. These are safe but the efficacy may be lower. This is also a well tried technique in vaccine production. The German-US Pfizer-BioNTech and the US’s Moderna vaccines are messenger ribonucleic acid (mRNA) vaccines. This is a new technology which has not been used before in vaccine production and also transfers viable genetic material. These have been shown to give good protection, but their safety is questionable. The introduction of genetic material through the vaccine may lead to and have an effect on our genes, even several generations later, that can be harmful. I am not in favour of their use. Vaccination schedule for Sri Lanka If Sri Lanka was a rich country, it could have given two doses of any of the above recommended vaccines. However, we have limited resources. The World Health Organisation (WHO) gave us sufficient recommended vaccines as a gift to immunise 20% of our population. It would be best to give these vaccines to the vulnerable groups (that is the groups that are liable to develop severe disease and even die). The vulnerable groups are; frontline workers such as doctors, nurses, attendants, and ambulance drivers, etc., those over 60 years of age, those with co-morbidities (severe chronic lung and heart diseases, diabetes, etc.). These may be those over 60 years, over 30 years, under 30 years, or children, in that order, according to the availability of vaccines (the above vulnerable group of three categories must be given the vaccine even if it is necessary for it to be bought from the manufacturers). As for the non-vulnerable groups, all the others need not be vaccinated at State expense. Those who can afford it could get vaccinated. But for children under 12 years, vaccination is not indicated. (The writer is a Virologist, Government Parliamentarian, the Committee on Public Accounts Chairman, and the Lanka Sama Samaja Party Leader)


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