Covid-19 Vaccines: A plea for lesser mortals

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

March 2021 marked just one year since the World Health Organization (WHO) declared COVID-19 as a global pandemic. It was a year of enormous strife, lockdowns, deprivations of all kinds, restrictions, conflicts, imposition of new behaviour patterns and also the advent of a variety of different vaccines. There is no question about it; all of us want to knock this little virus for a six, emerge victorious and get back to some kind of a normal life. Make no mistake, even we doctors have had a very tough year in many respects, not to mention the enormous risks that were taken by them.

Getting COVID-19 vaccines to every part of Mother Earth is just one piece of the global recovery endeavour. Yet, for all that, it is perhaps the most promising of the measures that could be undertaken in a committed venture to recover from the absolutely massive and intolerable impact of the virus. However, there is a whole host of confounding circumstances that have had a telling effect on all efforts being made to vaccinate people the world over. Inadequate supplies to meet the demand, all kinds of inappropriate purchasing, vaccine hoarding, anti-vaxxers, vaccine-hesitancy, misinformation, tall tales and many other factors have had a telling effect on all efforts being taken by governments and health authorities of the entire planet to vaccinate the populace. You name it, a whole lot of undesirable circumstances are all there. Many of these objectionable situations affect the developing countries, the poor and the down-trodden in them, a whole lot more than the rich Western nations. The human rights principles of equal and equitable supplies of the vaccines to under-developed and developing nations are being violated brazenly and nonchalantly by the powerful and rich Western nations. They think they are ‘it’ and only the people in those privileged nations matter. They have the audacity to whine about human rights violations in many poorer countries while they shamelessly desecrate the very principles of human rights as far as provision of adequate supplies of the COVID vaccines to the impoverished nations are concerned.

Here in the Paradise Isle, we now have a limited supply of the Oxford-AstraZeneca vaccine. The COVAX initiative has so far supplied it in instalments and tranches of hundreds of thousands of doses. The supplies are by no means adequate to vaccinate at least 70 per cent of the population. In point of fact, we have so far been able to vaccinate just about four per cent, yes, a measly single digit percentage, of our population with the first dose of the vaccine. At the present time, the vulnerable over 60-year-old people are being vaccinated. The susceptible healthcare personnel, frontline tri-forces and police personnel have already been given the first dose of the vaccine. Just for the record, this write, who is a retired consultant from the Government Health Service but still in active patient-care practice in the private sector, was called up, treated like royalty, and given the first dose of the vaccine from the Lady Ridgeway Hospital, from which he retired eons ago.

However, there seems to be a somewhat unfortunate glitch in the processes employed in that ever so laudable venture to vaccinate ALL healthcare personnel. True enough the healthcare workers in the public sector have been vaccinated; most rightly so, as they are in the frontline of the battle against this coronavirus. Retired medical personnel who are in active medical practice have also been provided the vaccine. The staff at risk in the larger private hospitals in the major towns have been vaccinated. But yet for all that, WHAT ABOUT THE STAFF IN THE SMALLER MEDICAL FACILITIES ALL OVER THE COUNTRY? To the very best of my knowledge they have really been left out, perhaps quite inadvertently, of this laudable venture of vaccinating the high-risk personnel.

One important and over-riding occurrence has not been taken into consideration by the local powers-that-be, who decide on who should get the vaccine. Because of a variety of different reasons, including the reluctance on the part of patients to present themselves to government hospitals, the fear of quarantine, the stigma attached to the disease and a variegated plethora of misinformation regarding the illness, even many SYMPTOMATIC COVID-19 PATIENTS may prefer to get treatment from smaller medical facilities, medium-sized or small private hospitals as well as little General Practitioner Surgeries and Clinics. This could happen without the patients or the healthcare personnel being aware of it. After all, the initial symptoms of COVID-19 may resemble a common cold. These patients, in the very early phases of the illness, are the most infective as has been proven beyond any doubt by scientific research. They are capable of transmitting the disease to all the healthcare personnel consisting of nurses, attendants and even minor staff in these little smaller facilities. These workers are probably at even a greater risk than the workers in the public healthcare institutions. In fact, when severely ill patients are admitted to public medical institutions, the patients may be quite unwell but they are not all that infective.

It is most likely that the doctors in all these smaller institutions have been given the vaccine. However, it is noteworthy that a highly experienced Consultant Physician, who runs a medium sized nursing home down South in the country, lamented miserably about not being able to get the vaccine for his staff. Verbatim, his personal communication to this author reads as “I am ashamed to be in this country as a health worker when my own staff is denied this privilege”. Having known this man for a number of years, if this vaccine was available for purchase in the private sector, he would have bought them, even from his personal finances, for his staff. There must surely be loads of other doctors with similar problems and dilemmas.

I must admit that this article of mine was triggered and catalysed by that heart-rendering sentiments so eloquently expressed by that Consultant Physician. The healthcare workers in these private institutions are Sri Lankans, our very own people, who risk their own lives in their day-to-day work. They are the fathers, mothers, spouses, aunts, uncles and relations of my fellow countrymen and countrywomen. The very least we can do is to try and protect them from this dastardly menace of a coronavirus.

This effort on my part is most definitely NOT designed to try and find fault with the authorities, nor is it a witch-hunt. In fact, it is as far away as we can get from it. It is a fervent plea to the powers-that-be; the health authorities, Mr Lalith Weeratunga who is in charge of COVID Control, the politicians, Honourable Ministers and State Ministers, the Honourable Prime Minister and even His Excellency the Executive President of our Motherland, all of whom are intimately involved in this fight against COVID-19, to consider favourably the ways in which they can correct this unfortunate incongruity. For my part, it is just another human and humane endeavour, for our own people, who were responsible for funding my own career. It is just a kind of an enthusiastic supplication on behalf of the powerless and the voiceless.