Features
UPDATE ON COVID 19 VACCINES:
Vaccination drive commendable, but don’t lower guard
BY Dr. H. T, Wickremasinghe
Senior Consultant Paediatrician
President, Vaccine and Infectious Diseases Forum of Sri Lanka
It is commendable that the government of Sri Lanka has planned to get down 9 million doses of Covishield Vaccine from Serum Institute of India, the world’s largest vaccine manufacturing company. This vaccine is actually none other than AstraZeneca –Oxford Vaccine manufactured by The Serum Institute of India, by the name of Covishield. To date, Sri Lanka has already administered about 200,000 doses to healthcare workers. The next consignment would be given to persons over 65 years and persons with comorbid conditions such as diabetes, hypertension, heart disease and kidney disease.
With the rolling out of the vaccine globally, new observations have surfaced. The original schedule of the vaccine was to give two doses 28 days apart. This provided almost 70% immunity. However, new evidence has come out last month, suggesting that it would be better to increase the gap between two doses to 12 weeks (three months) instead of four weeks. This would offer a more robust 84% immunity. The United Kingdom is already using the 3 months interval between two doses. This will provide greater flexibility for vaccine rollout, and help the health authorities to deal with any possible supply disruptions, while consistently sustaining the maximum immunity to the public.
A study done by the independent COVID-19 Vaccine Research Group in the UK had shown that until the time of conclusion of the study at three months, a single standard dose would provide 76% protection with no declining of immunity. How long this protection would last is not known yet. But time would tell us. As with any other vaccine, an introduction of a second dose at three months would certainly boost the immunity.
The second observation made during the roll out of this vaccine is that it appears to provide some form of protection to community spread of the disease. This study revealed that there was 67% reduction in community spread of the disease. This is in fact very good news, as when we go on vaccinating more and more people, there would be less and less community spread of the disease, reducing the burden on hospital medical services.
Another issue which surfaced while rolling out of the vaccine is the safety and efficacy of the vaccine in persons over 65 years of age. Unfortunately, all phase 3 trials done by AstraZeneca have not included many persons over 65 years of age. They primarily targeted the 18-55 year age group. According to the data from AstraZeneca’s phase 3 trials, only two out of 660 persons in the trial aged over 65 were infected with COVID-19. Such a small number of participants is grossly insufficient to make a global decision. It is obvious that AstraZeneca has failed to provide reasonable data of safety and efficacy of their vaccine in the elderly population. They are already paying the penalty as countries such as Germany, France, Austria, and South Africa have declined to use the vaccine for persons over 65 years, despite the recommendation made by the European Medicines Agency (The governing body of drug evaluation in EU countries) to use the vaccine for all ages. However, the United Kingdom decided to continue vaccination for all ages, including persons of over 80. Their interim analysis during the early part of the vaccination programme shows that the vaccine is not only effective and provide the same immunity as for others but also has slightly less side effects.
Considering the seriousness of COVID 19 in the elderly and it’s very high mortality, it is my considered opinion that even if the vaccine is less effective or has more side effects, it is still worth giving it to old persons as it would save their lives.
With more and more new genetic variations of SARS CoV 2 virus emerging, a reasonable concern has transpired among scientists whether the vaccines would be able to provide immunity to the new emerging strains. Up to now globally there are more than 8000 variants. Out of those, three variants, the South African variant, the Kent (UK) variant and the Brazilian variant are few rapidly gaining global spread. The UK variant has been identified in Colombo, Avissawella, Biyagama and Vuvuniya.
Studies done in UK has shown that AstraZeneca vaccine would provide immunity to the UK variant. However, a similar study done on over 2000 participants in South Africa has unfortunately revealed that this vaccine is not effective against the new South African strain.
There are more than 150 vaccines against COVID 19 in the production pipeline. Out of those, a dozen are nearing completion and awaiting submission of their dossiers to the World Health Organization for approval. With such a vast array of vaccines, it would be easy for WHO to distribute vaccines early to provide vaccination to all needy people in the world. But it would not be easy to have the same vaccine supply without disruptions with the expanding global demand. At the same time, some vaccines would show immunity to some new emerging variants, while another vaccine would show immunity to other variants. This brings us to another new strategy. What if we combine vaccines? Combined vaccines theoretically will provide greater flexibility for vaccine rollout and help to deal with any possible intermittent supply shortages of a particular brand.
However, the official guidance given by vaccine authorities in the world state that anyone who has already taken a vaccine should get the same brand of vaccine for both doses. The US Food and Drug Administration and the UK’s Joint Committee on Vaccination and Immunization (JCVI) recommend as much. It’s only in ‘very rare circumstances’ that vaccines of different brands may be used and only if one vaccine is available at a certain time, or it is not known which one was administered for the first dose. Nevertheless, the usefulness of a combined vaccine, in case of a short supply or with combating a new emergent variant, cannot be underestimated. New research is underway to find out the efficacy and safety of such combinations. The initial report with AstraZeneca-Pfizer vaccine combination will be available by mid-2021. Similar trials will be undertaken soon, so that the health authorities of countries would have a better and competitive option of choosing vaccines for their public.
Despite all this good news, we still have a question for which we have to wait for an answer. How long the immunity will last is the question for with no answers are available yet. Many countries have already commenced their vaccination programme, even before the introduction of the free vaccine programme by WHO sponsored COVAX. In the race of COVID-19 mass vaccination, Israel is well ahead of all the countries in the world already covering 43% of the total population. The number of new cases and deaths due to COVID-19 has come down. Even in the US, the initial wave of vaccination is slowly showing results of reduction of mortality from COVID-19 related complications.
The majority of the vaccines used so far may not provide the expected picture-perfect immunity and the world may continue to have COVID 19 infections, but based on evidence, speculations have already been made to claim that vaccination could provide almost 100% protection from death. This is what we all want.
With that positive note, let me conclude while emphasizing the need to continue our general public health measures such as wearing masks, social distancing and avoiding crowded gatherings to reduce the risk of contact with an infected person.
There is no science to beat common sense.
Features
The challenge of keeping value-based politics alive
The current outbreak of anti-immigrant protests in Durban, South Africa is bound to have taken many a subscriber to value-based politics or political idealism quite by surprise. After all, this is evidence that despite the historic accomplishments of nation-builders of the stature of the late President Nelson Mandela it cannot be taken for granted that identity politics, including racism in its worst forms, is no more in South Africa.
At the time of this writing details are scarce on the substantive root causes of the protests but it could very well be that economic grievances, particularly on the part of the majority community in South Africa, are contributing considerably to the disaffection. Shrinking employment and material prospects are likely to figure majorly among the factors igniting the unrest.
Fortunately, the local authorities in Durban are losing no time in calling for peaceful co-existence among the relevant communities and are pointing to the vital importance of stepping-up national integration processes. Apparently, immigrants in sizable numbers from neighbouring countries are present in Durban. However, international TV footage of the protests quoted some local authorities as saying that the majority of the immigrants in some centres that housed them were not illegal migrants and had the documents that entitle them to be in Durban.
In the Durban protests the world has fresh proof of the socially divisive consequences of the gathering globe-wide economic disaffection, touched off particularly by the continuing crisis in West Asia. Going ahead, the world would need to brace for increasing identity-based unrest of the kind it is just witnessing in South Africa.
Considering that the material lot of ordinary people everywhere could only aggravate progressively, with the US and Iran showing no signs of negotiating an end to their confrontation any time soon, it will be left to the more democratic and progressive sections of the world community to initiate positive measures collectively to bring a measure of relief to the discontented.
The swiftness with which such relief will be provided would depend crucially on the importance those sections taking up these undertakings attach to value-based politics as opposed to Realpolitik of power politics.
Going by these yardsticks, Italy could be considered to be moving in the right direction. Recently Italy came to the fore in initiating the collective named, ‘Rome Coalition for Food Security and Access to Fertilizer’, which has as one of its aims the swift provision of fertilizer to economically weak African countries.
In a recent statement Italian Minister of Foreign Affairs and International Cooperation, Antonio Tajani, said that a principal aim of the project was to ensure that the farmers of Africa gained easy access to fertilizer, considering that food security is a growing concern among some of Africa’s economically vulnerable countries.
The statement went on to mention that some 30 countries hailing from the Mediterranean region, the Middle East, the Balkans as well as the FAO had been invited to join the coalition. The venture is far-seeing in that food security is main among the reasons for social discontent which in turn could degenerate into endemic political turmoil and bloodshed. Separatist violence and geographical fragmentation of countries wouldn’t be too far behind these developments, as Africa itself has often proved.
It is hoped that more G7 countries would take the cue from Italy and do what they could to ease the hardships of economically distressed countries, particularly of the global South. In these efforts they would need to break rank with the US, which is today brutally indifferent to the consequences of its policy of making ‘America First’, come what may.
Going by current developments, the Trump administration seems to be blithely oblivious to the wider, deleterious effects of its policy course in West Asia. Besides rendering Iran militarily and otherwise impotent nothing else seems to matter to Washington, as regards West Asia. This is policy short-sightedness of an extreme kind. After all, right now West Asia could be said to be sitting on the proverbial powder keg.
On the other hand, Iran is not giving the world the impression that it is doing anything constructive to get out of the policy straitjacket that it wove for itself decades ago. Rather than enter into a policy of ‘live and let live’ in relation to Israel in particular and initiate a process of reconciliation with the latter, it has chosen to operate within policy parameters that continue to damn Israel. This has put Israel always on the ‘defensive’ so to speak and prevented the opening up of space for meaningful dialogue.
That said, Israel is obliged to explore the possibilities of entering into a negotiatory process with the Arab-Islamic world that could lead to a de-escalation of tensions and bloodshed. It cannot continue to look at its neighbours through lenses that distort them as archetypal enemies who should be ‘wiped off completely from the face of the earth.’
In other words, the need is urgent for Realpolitik to give way to value-based politicks. Italy is beginning to prove that the latter approach could be pursued with some success. May be the EU and the UK could throw their weight behind these initiatives as well and establish that international politics could be refashioned on the basis of humane, civilized norms. The UN would need to be fully supportive of these moves and prove an organizational nucleus of the operations that follow.
In fact the time is ripe for people of conscience to collectively stand up on the side of peace and say ‘No’ to war and violence. Organizations such as the ICRC, the WHO and Medicines Sans Frontiers have already taken up this call. Referring to the widespread destruction of health facilities and their dehumanizing results these organizations have said, among other things, that ‘This is not a failure of the law. It is a failure of political will.’
True, ‘failure of political will’ among those powers that matter accounts for the runaway, uncontrollable nature of war and destruction in contemporary times, but more fundamentally it is a failure of the human conscience. It could very well be that the phenomenal levels to which violence and war have been unleashed today have had the effect of deadening consciences. This is a matter for urgent study and wide discussion.
Features
Vesak celebrations … with Cuteefly
I would describe Indunil Kaushalya Dissanayaka as innovative and creative, and she operates under the name of Cuteefly.
Indunil always comes up with something novel to celebrate special occasions, and she does it with candles … and that’s her profession.
She was in the spotlight when she created a happening scene, with candles, for Christmas, Sinhala and Tamil New Year, and Valentine’s Day.
As lanterns light up Sri Lanka for Vesak, the Colombo-based candle maker is quietly turning wax and wick into little pieces of the festival.

Candles reflecting Vesak themes
Her candles reflect Vesak themes – light, peace, remembrance, giving, etc., to enable you to fill your Vesak celebration with devotion and beauty.
Among her Vesak creations is a lotus-shaped soy candle, scented with sandalwood, lavender, etc., meant to burn during this Vesak Poya Day.

Indunil Kaushalya Dissanayaka: Customers
praise her for her creativity
These handcrafted Vesak candles are perfect for offering at the temple, she says.
What makes her creations so novel is that they come in different shapes, scents, themes, and all are handmade.
What’s more, her customers have heaped praise on her for her creativity.
According to Indunil, her creations are perfect as a thoughtful gift … to bring beauty, unity, and light into every moment.
Says Indunil: “Our beautifully handcrafted Unity candles are designed with premium detail and love, making them perfect for celebrations, gifts, and meaningful occasions.”
Cuteefly, says Indunil, is available online.
Readers could contact Indunil on 0778506066 for more details.
He Facebook Page is: Cuteefly.

Handmade with love
Features
Dark Spots …
Yes, dark spots do crop up on the skin, especially with sun exposure and, of course, as the skin ages.
However, these tips should be of immense benefit to those who are faced with dark spots.
* Lemon and Honey Glow Mask:
You will need 01 teaspoon lemon juice and 01 teaspoon honey.
Mix the lemon juice and honey well and then apply this mixture, only on the dark spots.
Leave for 10–15 minutes and then rinse with cool water.
Benefits:
Lemon helps brighten pigmentation.
Honey moisturises and heals skin.
Gives a natural glow.
* Aloe Vera Gel Treatment:
All you need is fresh aloe vera gel.
Apply the gel apply on dark spots, before going to bed.
Leave overnight and wash in the morning.
Benefits:
Reduces acne marks and pigmentation.
Soothes irritated skin.
Helps skin repair naturally.
* Turmeric and Yoghurt Paste:
You will need 01 teaspoon yoghurt and a pinch of turmeric
Mix the yoghurt and turmeric into a smooth paste and apply on affected areas.
Leave for 15 minutes and then wash gently with lukewarm water.
Benefits:
Turmeric brightens skin naturally.
Yoghurt removes dead skin cells.
Helps fade dark spots gradually.
Use these packs 02-03 times a week as results are generally seen over time.
You can also try this out: Mix a ripe papaya into a smooth paste and apply to the face, or directly on to the dark spots. Leave for 15-20 minutes and then wash with lukewarm water.
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