What’s happening on the Covid-19 front?

By Dr R Neerunjun Gopee

Plenty, as the total number of cases worldwide continue to rise. According to the John Hopkins University website, as at 10 am yesterday, there were 27,766,325 cases worldwide, and 902,468 deaths. The US still leads, with (in rounded figures) nearly 6.4 million cases, followed by India 4.4 million and Brazil 4.2 million which works out at 1944/323/2004 cases per 100,000 people for each country respectively. As regards deaths, again in rounded figures it’s respectively 191,000/74,000/129,000 which puts the number of deaths per 100,000 at 58/6/61.

“For the first time, Reunion is experiencing real viral circulation”, lamented, Friday August 21, the prefect Jacques Billant. Photo – archyworldys.com

Locally we are at 346 cases and 10 deaths, whereas our next-door neighbour Reunion island has registered a recent increase to a tally of 2346 cases and 13 deaths, i.e. Reunion has nearly seven times as many cases as we have. Again, according to the John Hopkins website, their doubling time – an important parameter in Covid stats – is 3 weeks, whereas for Mauritius it is 10 months.

At the beginning of the pandemic there was a headlined comment in the local media by a doctor from Reunion that there were lacunae in the Mauritian Health System which accounted for a higher number of cases here than in Reunion. Now that the situation is reversed there has been no observation forthcoming from that source.

Suffice it to say that we have a very robust Public Health System, which explains why we have been able to keep the island Covid-free, that is, there is no local transmission since around early May. The latest report is about the family of four who came in from Dubai a couple of days ago, who were tested negative before boarding, but have been found to be positive on testing at arrival, and have therefore been admitted to ENT Hospital for observation despite the fact that they are asymptomatic.

The repatriation of Mauritian citizens seems to be proceeding smoothly enough after the initial lull, a relief to those who have been impatiently waiting to get back, as well as to their families. The returnees are being quarantined in hotels around the coast, and barring some complaints about food in some hotels, they are putting up a brave face as they count down to the 14th day of their isolation before being reunited with family. No need to say that they are enthusiastically looking forward to resume their routine here, where comparatively there are less restrictions on movement and meetings in every respect compared to the more severe constraints that they have had to endure elsewhere, and that have been particularly hard for children.

On the whole I must say that we have behaved rather well as responsible citizens, largely complying with the precautionary measures advised. We have been a little more lax about social distancing in some public places such as supermarkets, but let us not let up on hand washing/sanitizing and wearing of mask which are key to prevention and keeping us Covid-free.

The issue of lifting lockdowns to allow resumption of activities in several sectors – shopping, bars and pubs, gyms, salons, etc., – is giving much headache to all governments the world over, with some countries already having announced recession, something that goes above my head. I therefore stick to the more direct kind of news report regarding what is happening on the pandemic front, except for the medical and health aspects which are of course of great interest to me.

But I do share the larger concerns that affect all of us. One of them for example is the announcement by no less that UK Prime Minister Boris Johnson himself a few days ago about the ‘Rule of 6’ – only groups of no more than 6 people will be allowed in public places, and that also they have to comply with the sanitary measures. There will be rigorous legal enforcement. This announcement followed recent surges that have been experienced there after partial lockdowns, which is also the case in France. These two countries, along with Reunion, are the source of a majority of our tourists – and as we contemplate reopening, we are therefore warned. It is a paradox that in some of the most advanced countries with high literacy and educational levels, people have a tendency to be less compliant as they flock to beaches and other public places, with resulting surges.

On the other hand, whereas school opening here has been managed more or less smoothly, elsewhere this is a real conundrum. I read about school opening in Florida, USA which has been followed by a surge of cases among teenagers – reminding us that all age groups are potentially vulnerable. As closures have had to be imposed again, there is a lot of hard thinking that has to be done about how to reengineer the educational system(s) so as to make up for the loss that students have suffered and plan for their future educational cycles upon which their careers critically depend.  

But fortunately it’s not all bad news. For example, as regards treatment of severe cases of lung infection by Covid-19, a review of studies conducted around the world has confirmed the benefit of treatment by dexamethasone, which reduces mortality by up to 30% in these cases. The great advantage of this cortisone drug is that it has been in wide use for a long time and in a variety of conditions by doctors, who are therefore quite familiar with both its effects and side-effects and how to deal with the latter should they arise. Besides, it is used in such large quantities that availability is not a problem – and for the same reason so is the cost, which is quite affordable. It goes without saying that it must be used strictly within a strict protocol guiding treatment of Covid-19 because it is not a panacea that applies indiscriminately to all cases of Covid-19.

On the other hand, as regards vaccine, the Oxford vaccine under trial by the AstraZeneca group has been put on hold after one of the persons in the trial developed an illness, which may or may not be related to the vaccine. He is being investigated in depth, and the arrest of the trial meanwhile is an indication of the concern about efficacy that scientists have when they are developing new vaccines.

The most cautious estimate coming from WHO is that not before well into 2021 will a vaccine be available for covid-19, and we would be wise not to try and rush the process. Any mishap will sap the confidence of the public, and be grist to the mill of what are known as the ‘anti-vaxxers’, those who for religious or other obscure reasons are opposed to any form of vaccination.

There has been criticism to the effect that the Ministry of Health has not yet made provision for the procurement of an anti-Covid vaccine. When there are over 100 vaccine candidates under development and no one can give any assurance as to when a safe and effective vaccine will be ready, such criticism is unjustified and premature.

Our situation has been under control for nearly four months now. If we continue to behave as responsible citizens, and any reopening is carefully calibrated, we can afford to wait as long as is required until a proper vaccine is ready.

RN Gopee

* Published in print edition on 11 September 2020

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