Learning to live with Covid-19

By Dr Upul Wijayawardhana

Experts, quite a few of them self-declared or pseudo-experts, and agitators alike must be thrilled and claiming the credit for the current lockdown and curfew. Now, ingenious minds of Sri Lankans would be in overdrive to work out how to overcome curfew regulations and the police would be out in strength to catch curfew-violators. Media would be itching, waiting for the ubiquitous mobile phone footages of the inevitable fracases between misbehaving public and the police! Is this the way to overcome an epidemic?

Lockdown is a much hyped and much misused term during this pandemic. Even during the most-strict phase of the lockdown in the UK, supermarkets and corner shops were open; so were pharmacies and we were allowed to go out for exercise, once a day, though family visits were not allowed. Much praised ‘lockdown queen’, Prime Minister of New Zealand, too allowed such liberties. Interestingly, New Zealand, with a population of just under five million is lagging behind in vaccinations, under 20% being fully vaccinated; this failure of the great lady seems to be conveniently forgotten! Some experts claim, low vaccination rates coupled with lockdowns, may be a recipe for disaster but that is another story.

Limitations in force in Sri Lanka, before the imposition of the curfew, were similar to the strictest lockdown measures in countries like the UK. Why is that Sri Lanka needs to go a step further and introduce a curfew? The simple answer is discipline; whereas in the UK the majority show disciplined behaviour, unfortunately, the opposite is true in Sri Lanka. Flouting regulations and promoting the spread of the virus, the Opposition held protests, followed by teachers mislead by a trade union leader with a name the Russians have opted to forget! Another union leader, parading as the president of a college, threatened to lockdown the country using trade union muscle, unless the government obliged!

Instead, what should all these well-meaning patriots have done? In one voice, they should have appealed to the public, repeatedly, to strictly follow health guidelines. Even leading medical associations failed in this duty, sad to say. Afterall, the long-term outcome of the pandemic depends more on our changing behaviour than government regulations. Without discipline, can we learn to live with the epidemic?

Who suffers by curfews? It is the poor town-dwellers and villagers who would not be able to go to nearby shops to get their daily needs. The rich and the privileged can order on-line and get their needs delivered to their doorsteps. Whilst the underprivileged suffer, some in influential positions seem to be attempting to make a name for themselves, perhaps for their entry to Diyawannawa at the next election! Worryingly, there are reports that foreign funds are flowing to fund some agitators with a more sinister motive; a regime change?

In my article “English experiment: Bold or Barmy” (The Island, 24 July), where the printer’s devil changed English to Enblish in the title unfortunately, I stated: “It is entirely possible that with the continuing energetic campaign of vaccination, which is reducing morbidity and the mortality rates considerably, and the rapid spread of the virus which too would lead to the production of antibodies, a wall of immunity would develop soon, ‘taming’ the virus.”

Though it is too early to be certain, emerging data points to movement in the right direction. After lifting of restrictions on 19 July, it was widely predicted that cases would rocket but, instead, they fell and levelled off but rates seem rising again slightly. Compared to August last year, many more cases are diagnosed now, around 31,000 a day but most are asymptomatic or have mild symptoms. Hospitals are able to cope without difficulty and death rate remains around 100 per day, having dropped from around 2000 a day, at the peak! But there is concern about an autumn spike and emergence of new virulent strains.

Some try to portray Sri Lanka doing badly with very high mortality rates but this is artificial because our testing is limited. It is very likely, for every diagnosed case there would be at least ten more and the government has done itself harm by not admitting that there is community spread. Some are clamouring for wider testing forgetting that all this costs in foreign exchange which we are short of. In my humble opinion, the President has adopted the correct strategy by concentrating on vaccination and new data supports this strategy.

The analysis of data, from two and a half million tests results from 743,526 participants in the UK’s Covid-19 household-infection survey, done by Oxford University and the Office for National Statistics shows that:

1.

The Pfizer-BioNTech vaccine had 93% effectiveness against symptomatic infection two weeks after the second dose, compared with Oxford-AstraZeneca’s 71%

2.

The Oxford-AstraZeneca jab, though initially less effective, offers the same high protection as the Pfizer-BioNTech after four to five months. This is because over time, the Pfizer-BioNTech’s effectiveness dropped while the Oxford-AstraZeneca’s remained largely the same.

3.

Neither is as effective as it is against the Alpha variant, responsible for most, the UK infections last winter.

4.

There is insufficient data for Moderna but researchers believe it “almost certainly at least as good as the others”.

5.

Those who have had Covid-19 gain even more antibodies when fully vaccinated.

6.

The time between first and second doses does not affect the vaccines’ effectiveness.

7.

Younger people gain more protection from vaccination than elders

The ‘English experiment’ seems to be working and experts feel the UK is nearing the “endemic equilibrium” – the point where cases are neither increasing nor falling because a large proportion of the UK population has developed a degree of protection against the virus. Office of National Statistics figures show more than nine in 10 adults in the UK now have antibodies to coronavirus, either through vaccination or infection.

There is emerging data that immunity gained by getting Covid is better than what you get by vaccination and that vaccination, even if it does not give complete protection, significantly reduces the severity even if one gets infected. Therefore, instead of spreading fear and panic, it is the duty of all to support the vaccination drive and stress the importance of continuing with public health measures like social distancing, wearing masks and washing hands. If more virulent strains do not emerge, there will be hope for improvement soon. Let us remain positive, reminding ourselves that it is important to learn to live with Covid.