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The deadly Delta wave must be overcome for the vaccine programme to succeed 

29 Aug 2021

BY Prof. Tissa Vitarana It is with great sorrow that I write this article due to the sudden death of my friend The Sunday Island newspaper News Editor Suresh Perera. He was a victim of the present wave of the deadly Covid-19 Delta (B.1.617.2) variant of Indian origin which is sweeping all parts of Sri Lanka, and the world. He was 59 years of age and at the height of his career. I extend my deepest sympathies to his wife, two children, and the rest of his family and staff who are in a state of shock after his sudden death. Like many Sri Lankans, he took little care about his safety, and had he exercised more care, he would still have been with us. But the same can be said of all the other thousands who have died and are yet to die from the Delta variant.  Those who died and the many seriously ill patients who have taken up every available intensive care unit (ICU) bed in the hospitals, and have filled the other beds, and are even forced to sleep under them, were all careless. Why? Because the fact that the health rules were for their own safety had not been instilled into their minds. They treated them as government regulations that had to be observed. On television, we have seen jostling crowds, all wearing the masks below the chin, and immediately when a policeman is sighted, they cover their nose as well. A new mindset has to be developed nationwide, with a new behaviour pattern, if we are to survive.   An important solution is getting immunised through vaccination. The Government, with President Gotabaya Rajapaksa and Prime Minister Mahinda Rajapaksa giving the lead, have done well to procure a maximum amount of vaccines from abroad, in the face of a heavy demand worldwide. The health and military personnel have expended their energy and done a great number of vaccinations. Unfortunately, there does not appear to be a good plan and the population groups selected do not conform to any thought out risk-based priority list. There are still a significant number of over 60s to be vaccinated. The same for those with relevant comorbidities, e.g. diabetes, heart and lung disease, etc. Outside this vulnerable group, there should be a “drop according to the age” selection process giving preference to those working in crowded locations, e.g. garment factories, etc. But a problem is that both immunity after infection and after vaccination appears to be low, six months to one year, so that repeated boosters at least once a year may be required, which is a costly exercise. If I may suggest, why not start our own Covid-19 vaccine production factory? It can save foreign exchange and also earn it. The use of messenger ribonucleic acid (mRNA) vaccines (like Pfizer-BioNTech and Moderna) is better avoided, as they are gene material which have not been used in the preparation of vaccines ever before. The European Union has banned the import of genetically modified foods as they contain added or modified genetic material. That is food which gets processed in the bowel, but in the case of a vaccine, there is direct injection into our tissues. Finally, recipients of vaccines must be made aware of the delay in developing protection till about two weeks after the second dose. They must not lower their guard even after that because of the large number of infected people in society and the relatively short period of immunity. The danger of more virulent and infectious variants can arise at any time and cause problems when immunity is dropping. Everyone must take the vaccine as it helps to build up herd immunity, so that with time, resistance in the community to new variants will keep on increasing. But the vaccine defence of the community takes time.   But a short-term solution is required for the present Delta pandemic tragedy which is going to lead to more and more severe cases with no ICU facilities available, more deaths, and suffering for the people of Sri Lanka. If we have a spark of humanity left in us, we must act positively to end the transmission of the virus, as much as possible. At this moment, the most effective action would be a lockdown for two weeks. Depending on how well this is done, it will be at least a partial success in reducing the number of cases and deaths. Every day that we delay, more the number of deaths that will result. The only time I met former Health Minister Pavithra Devi Wanniarachchi about seven months ago at the Health Advisory Committee, I said that the virus is no longer in containable clusters. It is spreading in the community to several people, mainly in the Western Province, from one unknown person to another. No traceable connections have been found. It is now a case of community spread. The two main points I made were one, to set up a Covid-19 Committee of Party Leaders in the Parliament that could interact with the Minister. They too can get to know the Minister’s plans and progress. With their input, it becomes a national campaign. This can be extended down to the village and slum level. Covid-19 committees at the village level will ensure that everyone observes the four health regulations. The whole village will have to be educated on why the observance of those rules will protect each one. There are many asymptomatic cases. They will not be able to infect the others. Transmission should stop if effective. The virus will have no access to the live cells of the human respiratory tract where it takes over each cell and gets it to produce thousands of viral replicas. When that stops, the virus which is unable to multiply on its own; it will just die out. Two, the village Covid-19 Committees, besides health education and the enforcement of the health rules, will spot likely cases as soon as they arise and get them seen by a doctor and polymerase chain reaction (PCR) tested. (The writer is a virologist, Government Parliamentarian, the Committee on Public Accounts Chairman, and the Lanka Sama Samaja Party General Secretary)  


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