Still many miles to go

We have to proceed on the road towards normality step by step in the light of the state of vaccination, infection and economic recovery in each of our principal trading partners and sources of tourists

By Mrinal Roy

The new trail of Covid-19 infection detected locally as from 5 March has jolted the country out of the self congratulatory rhetoric and complacency of being Covid-safe. The local chain of infection mapped out through contact tracing from four identified clusters of infection is a potent reminder to all those infected and everyone in the country that we need at all times to rigorously abide by sanitary rules of protection against the risk of coronavirus infection such as social distancing, the wearing of masks and strict compliance with hygiene norms.

We should remember that these basic preventive measures were put in place by health authorities across the world and the World Health Organization last year after the outbreak of the Covid-19 pandemic to contain the spread of the virus, protect people against the risk of infection and break the person to person chain of transmission of coronavirus in the community. Surges of infection witnessed since last year in the US, the EU, Brazil, UK and countries across the world invariably show a causal correlation between the failure of people to strictly abide by these essential protective measures and spikes of infection.

 “On the local front, we urgently need to review and rev up our vaccination drive to attain the required herd immunity as quickly as possible. We have to proceed on the road towards normality step by step in the light of the state of vaccination, infection and economic recovery in each of our principal trading partners and sources of tourists. We therefore still have many miles to go and many hurdles to cross…”

The world must realize that people cannot afford to be complacent against an extremely resilient virus which constantly adapts to changing circumstances and mutates into extremely more contagious strains which are causing alarming surges of infection in the UK, South Africa, Brazil, Europe and other countries. Aware of the potent risks of such mutations, vaccine research scientists have already started work on tweaking coronavirus vaccines to beef up protection against variants. Covid-19 vaccines teach our immune systems how to recognize and fight the virus that causes the disease. The world therefore needs to monitor and be alert to the adaptations and mutations of the virus faced with the defense mechanism and antibodies built by anti-Covid-19 vaccines.

Vaccination drive

After a year of innovative and fast-tracked research, seven Covid-19 vaccines have been approved for emergency or full use by at least one WHO-recognized regulatory authority. We must certainly count our blessings as vaccines help robustly protect the world against a deadly virus. Israel is leading the vaccination roll out campaign as more than half of its population has already been administered at least one dose of vaccine and more than a third has received the required two doses.

Since the start of the vaccination programme on 14 December, more than 109 million doses have been administered in the US, representing some 21.4% of the total US population. In the UK which was the first country to kick start its Covid-19 vaccination programme as from 8 December 2020, more than 24 million people have received at least one dose of a coronavirus vaccine. In India which has launched the world’s biggest inoculation drive as from 16 January 2021, more than 30 million people have already received at least one dose of a covid-19 vaccine. Thus, more than 381 million doses of vaccines have to date been administered worldwide in some 132 countries and territories.

Significantly more people than the 121 million people infected by the virus since the outbreak of the pandemic have therefore already received the first dose of a Covid-19 vaccine. In Israel, there is also encouraging evidence that as more people above 60 years old are vaccinated, hospital admissions among this age group is falling significantly. There is also evidence that vaccines protect people against severe forms of coronavirus infection and death.

Unequal access to vaccines

We must however realize that the battle against Covid-19 still faces a series of daunting challenges and will necessarily be a long drawn affair.

The biggest challenge relates to the timely production and equitable distribution of enough doses of approved vaccines to protect the 7.8 billion people in the world. By December 2020 more than 10 billion vaccine doses had been preordered by countries. Half of this quantity is earmarked for high-income countries which represent only 14% of the world’s population. Indications are that in 2021 Astra Zeneca-Oxford plans to produce 3 billion doses, Pfizer-BioNTech 1.3 billion doses and Sputnik V, Sinopharm, Sinovac, and Johnson & Johnson 1 billion doses each. Moderna aims at producing 600 million doses and Convidicea 500 million doses in 2021.

A new form of inequality is therefore dividing the world as there is already a stark gap between vaccination programmes in different countries, with many yet to receive a single dose. There is therefore an urgent need to ensure that everyone in the world has access to Covid-19 vaccines. This is a key condition of success of the world’s battle against the pandemic.

Still many hurdles to cross

According to UNICEF there are some 130 countries that ‘are yet to administer a single dose’ of a coronavirus vaccine. This represents 2.5 billion people who have so far been completely shut out of the global vaccine campaign.

The WHO COVAX initiative aims at ensuring that people in these countries and all corners of the world get access to Covid-19 vaccines regardless of their wealth, once these are available. How soon this happens is a determinant factor towards achieving a modicum of normality in respect of economic recovery, trade flows and the movement of people.

From the above it transpires that it is not until 2022 that the world will be able to ascertain if the whole world has access to approved vaccines.

It should also be flagged that vaccines are not administered to those below 18 years old as the trials to test the vaccines did not include the young. But these as evidenced in cases of infection detected in the country can still be carriers of the virus. In addition, swathes of people across the world still refuse to be vaccinated for diverse reasons. They could also be potential carriers of the virus.

However research on vaccines never stops. The drug company Moderna has already started testing its vaccines on babies as young as 6 months and young children. According to a study carried in February in Israel, pregnant women vaccinated against Covid-19 could pass along protection to their babies. The study showed that antibodies were detected in all 20 women administered both doses of the Pfizer/BioNTech vaccine during their third trimester of pregnancy and in their newborns, through placental transfer.

There is also no indication regarding the timeline of protection of the Covid-19 vaccines. Scientists and medical experts are still learning on how long the vaccines protect people. Will it for example be necessary to administer a booster dose of the vaccine in future in the light of the findings of scientific research and advice?

The upshot of this situation is that Covid-19 will remain an endemic disease. In the light of the above it is therefore imperative that despite being vaccinated against Covid-19, people should continue taking precautions in public places and strictly abide by prescribed sanitary measures to protect themselves. The wearing of masks, social distancing and strict compliance with hygiene norms will remain part of our lives for the foreseeable future. We need to reconcile ourselves with this new reality.

More than meets the eye?

A controversy is now threatening to rock the boat of affordable vaccine supplies. Despite firm assurances given by the head of the European Medicines Agency (EMA) which is the EU Regulator approving the use of vaccines in the continent, the WTO as well as other experts, that Astra Zeneca-Oxford the most utilized Covid-19 vaccine in the world is safe to use, several countries in Europe and South Africa have suspended its use because of a few instances of blood clotting. The EMA and the UK

Medicines and Healthcare products Regulatory Agency (MHRA) stated that evidence “does not suggest” the jab causes clots.

Affordable, safe, easily available and stored Covid-19 vaccines are also profitable ventures subject to fierce commercial competition. Is there more to it than meets the eye?

The AstraZeneca vaccine, produced by the U.K.-based pharmaceutical company and Oxford University, is currently the leading candidate to vaccinate people in low-resource countries. It is relatively cheap, does not need to be kept at very low temperatures and assures swift logistics as it is currently being manufactured in production units around the globe. Countries have signed delivery contracts for more than 2 billion doses which is nearly twice the volume being promised this year by the next leading manufacturer, Pfizer BioNtech. Some countries, including Bangladesh and El Salvador, have only been able to secure contracts with AstraZeneca to supplement doses they hope to get from the COVAX programme to carry out their Covid-19 vaccination programme.

Vasudhaiva kutumbakam

The world is one family. The world’s priority should therefore be to unite our efforts to ensure that the whole world has access to affordable vaccines and is vaccinated as quickly as possible. This is the most important step towards achieving a modicum of normality.

On the local front, we urgently need to review and rev up our vaccination drive to attain the required herd immunity as quickly as possible. We have to proceed on the road towards normality step by step in the light of the state of vaccination, infection and economic recovery in each of our principal trading partners and sources of tourists. We therefore still have many miles to go and many hurdles to cross.

* Published in print edition on 19 March 2021

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