Covid Resurgence

Covid is here to stay – and so too the politics of vaccines!

By Dr R Neerunjun Gopee

If there is one constant that has plagued the Covid virus and the pandemic that it caused, it is uncertainties, and some controversies. The first uncertainty was about the origin of the virus – whether it came from a wet market in Wuhan or was a lab leak from the Wuhan Institute of Virology – and it is still not resolved, despite several scientific studies, and investigations commissioned by WHO and the US government. Then there were uncertainties about diagnosis, about treatment, about preventive measures, about vaccines, about the capacity of health systems to cope with the overwhelming load (even in developed countries), about the capacity to manufacture all the medical paraphernalia (equipment, etc) required in real time to deal with the disease, about access to all these by different countries especially the poorer ones, about the health sequelae in those who had suffered from it.

Covid-19 will come back every year, similar to the flu: Dr Amesh Adalja, Johns Hopkins Center for Health Security. Pic – CNBC

However, within months of its onset and spread across the world, it became clear that this was not a simple ‘influenza’ virus by the way it was affecting multiple organs instead of only the respiratory system but – like the influenza virus – it was likely to become endemic as has indeed happened, and that variants would continue to emerge at unpredictable intervals.

It is no surprise therefore that a new variant of the Omicron variant, XBB.1.16, has emerged in several countries and has also caused some deaths, although it is not as severe though more contagious. To date locally there have been two deaths and a little over 100 cases, and people have been advised to take the precautionary measures such as masking up and frequent hand washing that are already well-known to everybody. It goes without saying that because of another phenomenon that emerged – mask fatigue, lockdown fatigue – as soon as restrictions were lifted people in all countries started to discard masks and to start moving about more freely. However, here I have observed that quite a number of individuals still wear their masks in places like supermarkets.

Locally, while there is general agreement that the public health measures and the vaccination roll-out were implemented efficiently enough, there were problems as regards treatment. In part this reflects what was also happening elsewhere especially in the initial stages of the disease when there was uncertainty about issues such as antibiotics and the use of cortisone. The matter was settled several months later when a study published by The Lancet established the benefit of the drug dexamethasone.

While the controversies about the emergency procurement procedures are still awaiting resolution or official clarification, there definitely was a problem with the 50 ventilators that were ordered. I learnt from a senior anaesthetist who was involved in the management of Covid that all these ventilators were defective (specifically the knobs were not functioning, amongst other things). The staff had therefore to fall back on existing ventilators, which were few in number.

Another issue is of course the refusal of the authorities to make public the report of the commission of inquiry set up to look into the deaths of patients under dialysis at Souillac Hospital. Undoubtedly this saps the trust of the public vis-à-vis the authorities, and sending the bereaved relatives to seek legal redress is to my mind not the best way to deal with this issue, which could have been done in a more humane way.

On the other hand, one could learn from countries such as India and New Zealand. In the latter, the government has officially acknowledged that there may have been gaps in its handling of the pandemic at different levels and has set up a Royal Commission to look at all the aspects of its management from the very beginning, identify the good points and the bad points, and make recommendations for dealing with any future such event.

In the case of India, a detailed analysis has been made of how the country rapidly geared itself up under the robust political leadership of Prime Minister Narendra Modi whose personal involvement in fighting the pandemic spanned all the critical aspects that were surfacing as the disease spread.

Directing, inspiring, releasing ample funds, setting up the technical and logistical coordination committees, creating the CoWin digital platform for the vaccination process, actively and effectively promoting the Atmanirbhar concept of self-sufficiency and self-reliance in the production of vaccines and other materials needed – this is the ‘whole-of-government’ approach that has been comprehensively and meticulously detailed in the excellent book, ‘Braving A Viral Storm’ by two authors Aashish Chandorkar and Suraj Sudhir.

The former works as counsellor at the Permanent Mission of India to the World Trade Organisation in Geneva, and the latter is in the field of computer systems and machine learning in California. They also explain how in light of lessons learnt from the pandemic India has now fully prepared itself to face others of similar magnitude in future.

As Sanjeev Sanyal, a member of the Economic Advisory Council to the Prime Minister of India, and writer underlines on the book’s back cover: ‘The true story of how India dealt with the biggest medical and socioeconomic shock since the Second World War. Importantly India did it in its own way, often shunning the advice of “experts”. This book is a riveting account of the pandemic years – the fear and uncertainty, the difficult policy decisions, and the extraordinary display of social and administrative capacity.’

One of the major problems was the sourcing of vaccines from the companies manufacturing or supplying them, which have made huge profits beyond their expectations. India went its own way and developed and produced its own vaccines over and above partnering with AstraZeneca to put the world’s largest vaccine manufacturer, the Serum Institute of India, at the latter’s disposal to produce the billions of vaccines that were required in a relatively short time. It may be noted that India supplied vaccines to the world as well, in part as gifts in the Vaccine Maitri scheme (about 260 million doses for free, including to Mauritius).

But there is also a darker side to the vaccine story, and this is playing out as reported by Remix News between Poland and Pfizer. In an article headlined ‘Polish health minister slams Pfizer for refusing to let Europe off the hook for millions of unwanted Covid-19 doses,’ it is noted that that Polish Health Minister ‘Adam Niedzielski penned an open letter to the pharmaceutical giant’s shareholders on Tuesday, calling on them to put social responsibility ahead of short-term profit.’

The author of the article Thomas Brooke goes on to point out that ‘Pharmaceutical giant Pfizer has gone from being part of the solution to part of the problem after insisting that the European Union must adhere to its contractual commitment to purchase a further 70 million Covid-19 vaccines, despite there no longer being a demand for the product, Poland’s Health Minister Adam Niedzielski warned on Tuesday…

‘The Polish minister explained that Europe is living in a “completely different reality than two years ago,” and the war in Ukraine has used up substantial financial resources of EU member states. He suggested that Pfizer has made enough money from the European Union’s procurement of its Covid-19 vaccinations and called on executives at the pharmaceutical giant to practice more corporate social responsibility by essentially letting the European Union off the hook for the remaining doses.’

Covid is here to stay – and so too the politics of vaccines!

Mauritius Times ePaper Friday 5 May 2023