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Defying Delta with vaccines and discipline

10 Aug 2021

  • Authorities and experts urge continued and stricter adherence to health guidelines
By Sumudu Chamara  Although the vaccination drive was expected to mark the beginning of the end of the Covid-19 pandemic in Sri Lanka, the country is seeing more Covid-19 cases and deaths at present, despite the drive being successfully underway. While the number of deaths reported per day has increased up to around 100, the number of daily Covid-19 cases has increased to almost 3,000. To make matters worse, Sri Lanka is now reporting more and more Covid-19 cases caused by the virulent B.1.617.2 Delta Indian variant, which is becoming a cause for concern, as it was the same strain that exacerbated India’s Covid-19 situation. Delta in Sri Lanka  In a context where fresh discussion about the Delta variant has started in society, the Sri Jayewardenepura University Allergy, Immunology, and Cell Biology Unit Director Dr. Chandima Jeewandara had recently tweeted that the Delta variant is spreading fast in Colombo, and that the PCR test samples analysed in the university’s labs had shown that the number of Delta variant infections recorded in July had surpassed the number of B.1.1.7 Alpha UK variant infections.  According to the data Dr. Jeewandara presented, the number of Delta variant infections, which was around 19.3% in the first week of July, had climbed up to more than 75% by the end of the month. He called this spread an “ultra fast” spread. Speaking to the media earlier, Dr. Jeewandara had said that the first few Delta variant infections had been reported in June, where five out of nine random samples had confirmed the existence of the Delta variant in the country. Stressing the importance of getting vaccinated, he added that the human immune system can only fight the virus if both vaccine doses are received, and that while the first dose gives 33% protection, the second dose increases that protection up to 60-88%. Meanwhile, the Health Ministry Communications Director, Public Health Services Deputy Director General, and Disaster Preparedness and Response Division Head Dr. Hemantha Herath told the media that all districts may contain people infected with the Delta variant. He added that according to studies carried out by the health authorities, it can be suspected that 20-30% of Delta variant infections could be from the Colombo District. He further said that the total number of Delta variant infections cannot be confirmed, and that the number of such infections, however, might be higher than the reported numbers. When queried as to whether the increasing number of Covid-19 related deaths is a result of the Delta variant, the Sri Lanka Medical Association (SLMA) Vice President Consultant Endocrinologist Manilka Sumanatilleke said that there is no adequate data to identify a significant relationship between the deadly nature of the variants, even though the aggressiveness and contagiousness can be assessed. “We do not have enough evidence to say how deadly the Alpha and Delta variants are. However, we certainly know that the Delta variant is more transmissible. While a person infected with the Alpha variant can transmit it to two to three persons on average, a person infected with the Delta variant can transmit it to about seven to eight people more rapidly. When it comes to the death count, as a percentage, when more and more numbers of people are infected, then naturally, the death rate also goes up.  “In that sense, we can say that the Delta variant is deadlier. It is difficult to compare the number of deaths caused by the two variants separately. The death rate goes up because more and more people are getting infected, and naturally a certain percentage succumbs to the virus, which is around 1.5% at present. If the numbers are wrong and it saturates the health services, the death rate will jump even higher because we cannot get optimal treatment for all the infected persons. The death rate can be due to many reasons, not purely due to the virus,” he told The Morning. He added: “When we look at the number of patients, the reason seems to be the Delta variant, because it is spreading faster than the other variants. We have seen similar situations in other countries, and the Delta variant causes more severe complications than the previously identified variants of the virus.  “We can say that the overall situation, however, is critical, because hospitals are filled with patients and hospitals are reaching their capacity. When we cannot treat them properly, the death rate goes up rapidly. The number of deaths may not necessarily be a result of the virus; it can also be due to the lack of health resources.”  He added that even though travel restrictions are important, it is more important to ensure that the people adhere to the Covid-19 safety guidelines, because it is mainly due to the people’s failure to adhere to these guidelines that the Covid-19 situation got out of hand. When contacted by The Morning, the Association of Medical Specialists (AMS) President Dr. Lakkumar Fernando said that even though the Delta variant is not the only variant that causes deaths, a considerable number can be attributed to the Delta variant, since this variant is currently the most prevalent (around 75%) in the country, especially in the Western Province. He further noted that a high increase in Covid-19 cases and deaths have been observed in all the countries where the Delta variant is prevalent, and that therefore, it is possible to assume that the prevailing Covid-19 situation in the country too could be a result of the Delta variant. Delta variant and vaccination According to health experts, the Delta variant is more aggressive and contagious than the other variants identified earlier. It was initially reported in India in December 2020, which caused it to be dubbed the “Indian variant”, and then reached Britain and the US. The US national public health agency, the Centres for Disease Control and Prevention (CDC), identified Delta as more transmissible than the common cold, influenza, and the viruses that cause smallpox, the Middle East respiratory syndrome, the severe acute respiratory syndrome, and ebola. The CDC added that a higher spread and severe outcomes are reported in places with low vaccination rates, and that virtually all hospitalisations and deaths have been among the unvaccinated.  According to the researchers, the Delta variant is 40-60% more transmissible than the Alpha variant, and even the original Wuhan, China strain of the virus. The World Health Organisation (WHO) considers the Delta variant as “the fastest and fittest” variant so far.   According to Dr. Jeewandara, while the original virus that causes Covid-19 caused symptoms such as cough, fever, and the loss of taste and smell, a person infected with the Delta variant may experience sore throat and a runny nose, in addition to the other symptoms. He explained that the Delta variant carries a specific mutation that forms a strong attachment to human cells, and there is therefore an increased transmissibility compared to the other variants. Meanwhile, the WHO’s Chief Scientist Dr. Soumya Swaminathan said that the Delta variant was named as the fourth variant of concern by the WHO, taking into consideration the fact that this variant is more transmissible than the previously identified variants, and has been able to resist the antibodies that humans have in their blood. “What that means is that we need a higher level of antibodies to overcome the Delta variant, compared to the Alpha variant,” she said, adding that the good news, however, is that all of the WHO emergency use-listed vaccines protect against developing severe disease, hospitalisation, and even death due to the Delta variant. She explained that according to studies conducted in countries where there is a predominance of the Delta variant, people who have been vaccinated are much less likely to end up in a hospital. However, the full course of vaccination is needed to give a person the full immunity to protect against the Delta variant. In addition, she emphasised that if a person has access to a vaccine approved by the WHO, they should take the full course of that vaccination to ensure protection against both the Delta and other variants of the virus. Further, she explained the importance of vaccines against the Delta variant: “The main goal of these vaccines is really to prevent severe disease, because what we want is for people, even if they get the infection, to recover from it and not become seriously ill. So that is something that all of these vaccines do really well.  “Of course, there are different levels. When it comes to the efficacy trials, they may range from 70% to 90%. But, in terms of just looking at the prevention of severe disease and hospitalisation, they are all very good, and are over 90% effective. None of the vaccines that we have currently are 100% protective.  “So this is why even if you are vaccinated, you can get the infection, but the chances are that you will get very mild symptoms or no symptoms at all, and that the chances of getting seriously ill are really low. There are two very good reasons to get vaccinated. The first is to protect yourself from getting severely ill if you catch the infection, and the second reason is, if you get vaccinated, you may still get the infection because we know that these vaccines are not going to protect you 100% from the infection.” According to WHO Lead Epidemiologist and Covid-19 Technical Lead Dr. Maria Van Kerkhove, the Delta variant has certain mutations that allow the virus to attach to human cells more easily and experts are seeing a higher viral load in individuals infected with this variant. She called the Delta variant, the “dangerous and the most transmissible SARS-CoV-2 Virus (the Virus that causes Covid-19) to date”.  She added that according to the results of certain laboratory studies, there is an increased replication in some of the modelled human airway systems. She added that even though there has been an increase in hospitalisations in certain countries due to this variant, experts have not seen an increase in mortality so far.  Moreover, she clarified that the Delta variant does not specifically target children as some reports have suggested, and cautioned that as long as the variants are circulating, they will infect any person that is not taking proper precautions. She explained the nature of this variant: “It is in the virus’s interests to evolve. Viruses are not alive and they do not have a brain to think through this; however, the more they circulate, the more they become fit, and therefore, the virus will likely become even more transmissible because they evolve and change over time.” The WHO Health Emergencies Executive Director Dr. Michael Ryan added that the Delta variant is a warning that this virus is evolving, but it is also a call to action before more dangerous variants emerge. Even though the emergence of new and more aggressive variants has the ability to considerably worsen the prevailing situation, according to the experts, the vaccine, regardless of its type, can still protect a person against the new variants. Therefore, despite new variants, vaccination is still the best solution we have at present. Also, we must not forget that prevention too plays a big role in preventing more infections.  


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