“Vaccinating as many people as quickly as possible, preventive measures like masking and better medicines will eventually control the pandemic”

Dr Pierrot Chitson, Specialist in Internal Medicine and Gastroenterologist

* ‘Let’s hope that like most epidemics the virus eventually becomes less deadly!’

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Dr Pierrot Chitson, Specialist in Internal Medicine and Gastroenterologist, has been following the Covid-19 pandemic situation at global and local levels very closely from the very beginning of its spread. In view of the detection of what appears to be a locally transmitted cluster, we sought his views on its possible evolution in the context of the global developments taking place. This interview was held before the PM’s press conference on Tuesday night March 9.

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* The overriding issue of concern at the moment in the country is the detection of a local case of Covid-19 that has built up into a cluster, the source being still uncertain. And yet we have been Covid-safe for so long compared to so many other countries. Have we failed somewhere or was this to happen whatever we do?

It was bound to happen sooner or later as the public had this false sense of security of the country being “Covid free”.
Most people had their masks on because of the law but did not use them properly and effectively (as these were worn under the chin or nose). There was no social distancing in public places/restaurants/places of worship. We even had health personnel complaining why we were screening patients for Covid before surgery or endoscopy!
It is a very tricky virus and bound to escape sooner or later despite quarantine, etc.

* How do you view the national response in the face of this new emergency?

I think we already have experience in testing and isolation strategies, but we need the capacity to do more rapid tests and as a small country we don’t have the means to identify the various variants. Knowing which variant is circulating in the country will help to track the spread of the virus. Many countries are now monitoring sewage for assessing virus spread.

* At this stage, do you apprehend a surge?

The fact that our frontiers are still almost closed and that the public, private and religious institutions are keenly aware of the serious situation, we might get away from a second surge but rapid contact tracing, testing and isolation will be the key to quash the outbreak. And the public will have to collaborate in following the preventive measures.

* Is it premature to speculate about a possible lockdown to stop the transmission of the virus?

We probably need to learn from other countries like Singapore which managed to control the surges without locking down the country. Tracking technologies have been used but these have to be balanced with individual rights.

But we have to remember that we are not as disciplined like the East Asians who in general trust the authorities.

* People had been initially hesitant about being vaccinated, and there are so many rumours going around about the Oxford Astra Zeneca vaccine produced by India that has been gifted to Mauritius. Tell us something about vaccines in general, and about this particular one, Covishield.

Unfortunately vaccine politics have confused many people. Scientific data are being discussed by the press, politicians and other lay people.

It is the first time in medical history that so many vaccines have received “emergency use” authorization. The bottom line is that all the current vaccines work very well in preventing severe disease, hospitalization and death. Issues like efficacy and herd immunity are controversial and may be already out of date with all the new variants.

Also all the current vaccines appear relatively safe, but only time will tell if all these new technologies are safer than the inactivated vaccines currently used for influenza for example.

* How much of our population needs to be vaccinated for the country to be considered Covid-safe again?

For a stable virus it is accepted that 60% of the population with immunity can provide herd immunity meaning that it will be difficult for the virus to spread. However with Covid-19, it is not known. Recently in Manaus (Brazil) there has been another surge with a new variant despite being said that 70% of the population already had Covid antibodies according to surveys in blood donors.

* What about developments in the treatment of the different aspects of the disease? For it seems to affect not only the lungs but other organs as well?

More is known about the disease. Apart from the virus destroying lung tissues, it also disturbs the host immune response creating auto-immune, inflammatory and coagulation syndromes.

While oxygen treatment is very important, cheap therapies like steroids and anticoagulants are being used with good effect. Future and more expensive treatment will be monoclonal antibodies and other biological agents.

* How do you compare the mortality rate of Covid-19 with that of equally lethal viruses?

It could be comparable to the “Spanish Flu” of nearly a century ago, or even the H1N1 virus of a decade ago, but these viruses were lethal to the younger healthy population and lost their virulence after a few years.

This Covid virus is unfortunately more complicated and much more virulent in the elderly by a factor of probably more than a hundred. Also, the obese/overweight/diabetic/immune compromised are also more at risk.

* One year after its appearance on the global stage, how do you view the pandemic situation? Is it getting under control fast enough?

Unfortunately things won’t improve much in the foreseeable future due to two big factors: it will take a few years to vaccinate the whole world; further, just like the flu, because of mutations, booster doses might be needed meaning we will be playing catch up!

Let’s hope that like most epidemics the virus eventually becomes less deadly!

* Do you think we will succeed in eliminating it? If not, what then should people and countries do for their long term protection?

Many countries are now suffering from “Covid fatigue” and the health personnel especially nurses and doctors of many countries are now on the verge of exhaustion. Fortunately most personnel in health care facilities are dedicated to their jobs.

Unfortunately politics instead of science has prevented more effective policies and timely interventions. Vaccinating as many people as quickly as possible, preventive measures like masking and better medicines will eventually control the pandemic. And this pandemic has shown that freedom without responsibility can be a toxic mix.

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* Published in print edition on 12 March 2021

Tags:COVID-19, Dr Pierrot Chitson, H1N1 virus, Interview, Mauritius Times, Oxford Astra Zeneca