While there is palpable excitement in the world about finally being able to stop the march of that monster, this does not mean that Covid-19 will go away so soon
By Dr R Neerunjun Gopee
With the announcement that some vaccine candidates have achieved over 90% efficacy, there is palpable excitement in the world about finally being able to stop the march of that monster called Covid-19 which has caused so much of disruption in all countries, without exception. While that wish and hope is understandable, what must be realized is that this does not mean that Covid-19 will go away so soon: we will still have a long way to go because there is such a lot that is not known about the behaviour of the virus in the long term, such as whether it can or will mutate to such a degree that we may have to start all over again.
The announcement by the UK government that it has given emergency authorization to Pfizer’s coronavirus vaccine is a sign for optimism. Photo – i.ytimg.com
Most likely therefore, we will have to continue with sanitary measures for a good while to come. Which is not a bad thing anyway – after all keeping ourselves clean for the sake of our health is surely worth the effort and the little sacrifice required, isn’t it. At least, Covid-19 ought to remind us that health is our most precious gift which we must do everything to preserve.
Nevertheless, the announcement by the UK government that it has given emergency authorization to Pfizer’s coronavirus vaccine, with hospitals in the country already scheduling doses to be given starting in London at 7 a.m. on Monday next, is a sign for optimism. Pfizer will be shipping 800,000 doses to the UK, a total of 40 million doses having been ordered. Patients will need two doses each, given a month apart.
It may be recalled that the UK has registered the highest number of deaths in Europe at about 60,000. Numbers have been surging and restrictions imposed afresh, despite public resentment – as of course has happened in several other countries such as Germany, France, Italy, the US among others.
So this is a welcome development as far as the UK is concerned. Though described as a first, this is not quite so because China had already produced a vaccine and started a vaccination programme, and so too Russia with its Sputnik vaccine. There have been criticisms levelled to the effect that not much information has filtered out about these two vaccines regarding their efficacy and safety.
In particular, concern has been expressed about the fact that not enough people have been enrolled in the crucial Phase 3 trials, which have involved up to 30,000 volunteers in trials of the other vaccine candidates. However, it may be noted that the Sputnik vaccine is being trialled in India and depending on the outcome of trials it may then be rolled out there.
Besides efficacy (how good is the vaccine at producing adequate amounts of antibodies in clinical trials) and safety (does it produce any side effects?), there are other issues that need to be addressed and are as important. These include price, access, rollout logistics, post-vaccination surveillance, who will receive the vaccines first in any country.
It goes without saying that wealthy countries will have better financing means, which will allow them to make bilateral arrangements with manufacturers, from those that belong to the middle income and lower income, and poor, categories. The latter have to depend on the World Health Organisation.
In fact WHO has set up COVAX, a vaccines platform which, according to its website, ‘will ensure that all participating countries, regardless of income levels, will have equal access to these vaccines once they are developed and available. The aim is to have 2 billion doses of vaccine available by the end of 2021’. This is considered enough to protect high risk and vulnerable people, as well as frontline healthcare workers.
Further, ‘by joining COVAX, both self-financing countries and funded countries will gain access to this portfolio of vaccines, as and when they prove to be both safe and effective. Self-financing countries will be guaranteed sufficient doses to protect a certain proportion of their population, depending upon how much they buy into it.
‘Subject to funding availability, funded countries will receive enough doses to vaccinate up to 20 per cent of their population in the longer term. Since demand is initially likely to exceed supply once vaccines do become available, allocation will be spread across countries based on the number of doses that are available and increase as that availability increases’.
We learn that Mauritius is one of the 92 countries that have joined COVAX, which means that in due course we will also be able to start an anti-Covid vaccination programme, probably by the end of the first quarter of 2021 at the earliest.
This is conditional upon ‘any of the COVAX portfolio vaccines have successfully undergone clinical trials and proved themselves to be both safe and effective, and have received regulatory approval’. Following this, ‘available doses will be allocated to all participating countries at the same rate, proportional to their total population size’.
It is important to note that ‘no country will receive enough doses to vaccinate more than 20% of its population until all countries in the financing group have been offered this amount. The only exception is those countries that have opted to receive fewer than 20%’.
The Primary Healthcare Directorate in Mauritius has a robust and well-honed immunization system and there should be no problem to roll out the vaccine once it is available, that is, managing its deployment, implementation and monitoring. Perhaps the only constraint that has to be addressed is the storage, which is likely to require additional cold chain facilities. But given that we will initially be receiving only up to 20% of total requirements – and that too probably in batches – this may not be a major issue.
With these developments, the world may look forward to a better 2021 – at least let us hope so!
* Published in print edition on 4 December 2020
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