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Editorial

Covid vaccination reflections

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We are running several stories in today’s issue of this newspaper on a matter that is of great moment not only to this country but the whole wide world. Yes, you guessed right. These reports are about the vaccination roll-out against the Covid virus which which is now ongoing and is a matter of highest national priority. What clearly emerges is that there is no unity among particularly the various medical experts, both in the health bureaucracy and health professionals outside it, on whether we are setting about this war against the virus in the correct way. That is clearly evident in the differing statements issued one after another by various concerned parties.

Take the statement issued by Infectious Diseases Forum of Sri Lanka, comprising many eminent doctors, who have warned that if the elderly are not vaccinated, the entire purpose of the of the vaccination program would have been in vain. The Forum has accused those responsible of “maldistribution” of vaccine and described an alleged decision of the Health Ministry – whether correctly or not we do not know – not to vaccinate people between the ages of 30 and 59 years as “meaningless.” Nobody, as far as we know, has made an authoritative statement on the age cohort who will be or will not be vaccinated. What we do know that older people and those with non-infectious diseases like diabetes are considered more vulnerable and deserve priority.

On the other hand, there is what Dr. Sudarshini Fernandopulle, the State Minister of of Primary Health Care, Epidemics and Covid Disease Control, had told reporters last week. She alleged that top officials of the Health Ministry had taken snap decisions on the vaccination roll-out in complete disregard of Ministry-sanctioned recommendations made by a technical committee. Such rash decisions were the reason for what she calls the “sudden appearance of vaccination centers.” She has added that these officials even override directives of the President given via the task force appointed to oversee the vaccination drive. A report we publish today quotes the state minister saying “When decisions have already been made (regarding the roll-out timetable) these officials suddenly call at night and say start the program right away. We can’t do it this way.”

Are all these accusations and allegations correct? It is high time that somebody in authority cleared the air. This business of who rates priority age-wise is not clear although we believe that the vaccine will be administered to all age groups in high risk areas identified and mapped as ‘red spots.’ Most of these are in the densely populated areas of the Western Province and commonsense would tell us that as many of those possible, regardless of age, living in riskyh areas should be vaccinated. We all know that the already procured doses of vaccine falls far short of what is needed to cover our total population of 22 million plus. Thus the thrust of the current effort is to first cover the Western Province and this is what seems to be attempted at present.

Fortunately there have been no reports of vaccine stocks running out on a large scale. True, vaccine ran out in some centers with long lines of people awaiting their turns but this has not been widespread. Colombo’s Mayor Rosy Senanayake has denied a widely distributed social media post that she had submitted a list of names for preferential vaccination at a center at the Colombo Public Library. Her media secretary had said that the mayor had visited that center following these reports and instructed that those using her name be denied vaccination. We cannot comment on the rights and wrongs of these allegations for the simple reason that we do not know. But the professionally tabulated list doing the rounds had several well known names, many of them affluent.

We all know that influence peddling is a fine art that is widely indulged in this country. Nobody did or could complain about front-line health workers, armed forces and police personnel etc. being accorded priority. But senior health official have confirmed that there had been attempts to pressure officials. There have been people armed with numbers who had gone to various vaccination points expecting favours. But those of them we spoke to said that they had to wait hours on line though they were not forthcoming about the origin on the numbers they carried. All that suggests that not everything has been happening above board; but that’s something that we are well used to in this so-called independent, sovereign, democratic, socialist republic of ours.

However that be, there is one area that urgently requires clarification and that relates to age-priority. Different things have been said at different times. The College of Community Physicians had noted that the vaccine prioritization of of the Ministry of Health had deviated from the original plan. Targeting the 30 – 60 age group “had been implemented in a few selected communities and this is a clear deviation from the scientifically agreed prioritization statement in the National Vaccine Deployment Plan.” There has been an explanation that the decision to vaccinate those between 30 and 59 was due to high transmission rate within this age group.

What is necessary is to clear the air on this matter. Obviously communications on this drive is far from satisfactory. People must know what’s what and that part of the act must be urgently put right. General Shavendra Silva who heads the National Operations Center on Covid has said that over 175,000 frontline workers and over 100,000 in high risk areas in the Western Province have been already inoculated. There’s a lot more distance to cover in this province alone, but doing that would mean significantly reducing the national risk. A regular contributor has in an article in this newspaper made a very complimentary reference to his personal experience at Dehiwela. That’s a clear demonstration of the fact that regardless of our penchant of criticizing most things Lankan, there is much that we can do and we have the people to do it.



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Editorial

Stop playing blame game, heed expert advice

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Wednesday 12th May, 2021

There is a lot of brouhaha over the government’s claim that it influenced the World Health Organization (WHO) decision to approve the emergency use of China’s Sinopharm vaccine; the WHO is reported to have denied this claim. Government propagandists cannot resist the temptation to perform foot-in-the-mouth stunts that embarrass their masters beyond measure. However, the real issue is not how the WHO approval was granted for Sinopharm, or any other vaccine for that matter. The issues that warrant public attention are whether enough vaccine stocks will be available; how effective the jabs will be against the new variants of coronavirus, and how to face the socio-economic issues caused by the pandemic.

Thankfully, some vaccine stocks are arriving here while the pandemic transmission and death toll are increasing steadily although there is a shortage of AstraZeneca vaccine for booster doses. Inoculation is a prerequisite for beating the virus, and given the ever-worsening health crisis, one does not have the luxury of picking and choosing vaccines, especially in respect of the first dose. If the people (as well as the government) had behaved responsibly during the recent festive season, they would have been able to wait until the arrival of the vaccines of their choice. On the other hand, all Covid-19 vaccines currently in use have been found to be highly effective in preventing severe disease and hospitalisation although their efficacy rates are said to vary.

The WHO says everyone has to get the Covid-19 jab fast, and the world must strive to attain global herd immunity through vaccination as soon as possible if the transmission of the virus is to be curbed. WHO lead scientist Dr. Maria Van Kerkhove has, in the weekly epidemiological update, said, “We do not have anything to suggest that our diagnostics or therapeutics and our vaccines don’t work.” This may be some good news in these troubled times, but the situation is far from rosy. One should not lose sight of the fact that Dr. Kerkhove, on Monday, announced that the WHO had changed its classification of the B.1.617 coronavirus variant first found in India last October from a ‘variant of interest’ to a ‘variant of concern’; it has already spread to several countries including Sri Lanka and is wreaking havoc.

Some scientists are of the view that certain coronavirus variants may have the potential to evade antibodies induced by natural infection or vaccination. This, however, does not mean that one should not get inoculated. Instead, one ought to realise that one should not lower one’s guard simply because of the ongoing vaccine rollouts. Nothing should be left to chance in fighting the virus. One should bear in mind WHO chief scientist Dr. Soumya Swaminathan’s wise counsel as regards India.

Dr. Swaminathan is reported to have said that the Indian variant is not vaccine resistant, but India has to depend on its tried and tested public health and social measures to curtail the transmission of the pandemic in addition to boosting its national vaccination drive. This, we believe, is applicable to Sri Lanka as well. Hence, measures such as the ban on interprovincial travel are welcome albeit long overdue. The government has apparently begun to take expert opinion seriously. If such travel restrictions had been imposed during the recent April holidays, the transmission of the virus could have been reduced to a manageable level.

Head of the National Operations Centre for Prevention of COVID-19 Outbreak and Army Commander, Gen. Shavendra Silva, has warned that unless the pandemic situation improves, district borders too will have to be closed. Chances are that far more stringent measures will have to be adopted unless the public fully cooperates with the health authorities to bring the pandemic under control and prevent the projected death rates from becoming a reality. The Association of Medical Specialists (AMS) has already urged President Gotabaya Rajapaksa to impose ‘lockdowns’ at the district level with immediate effect.

The country is in the current predicament because both the government and the public acted irresponsibly. They have to stop blaming each other for the explosive spread of the pandemic they have jointly brought about, share the blame and act responsibly. There is no other way out.

 

 

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Editorial

From shaman’s syrup to docs’ pills

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Tuesday 11th May, 2021

The Covid-19 morbidity and mortality rates have been on the rise steadily since the conclusion of the recent avurudu celebrations. What we are experiencing at present looks the early warnings of a viral tsunami, whose landfall is only a matter of time. The national healthcare system has reached breaking point, as a collective of professional outfits––the Sri Lanka Medical Association, the Government Medical Officers Association, the Association of Medical Specialists, and the SLMA Intercollegiate Committee––have pointed out in a letter to President Gotabaya Rajapaksa.

Unless urgent action is taken to reduce the worsening caseloads, people will start dying here in their numbers on roads without treatment, as in India. The first thing that needs to be done to prevent the rapid transmission of the pandemic is to impose movement restrictions, which the good doctors have recommended in their letter. If travel among districts had been banned, or at least restricted, during the recent festive season, the country would not have been in the current predicament. The government allowed the public to do as they pleased, for political reasons, and we are where we are today.

The doctors’ associations have, in their letter, made some science-based recommendations such as the imposition of movement restrictions, the isolation of areas depending on density of caseloads, the strengthening of the curative sector by supplying adequate facilities, especially oxygen, ICU facilities and laboratory services countrywide for diagnosis of COVID-19 with PCR testing, and the acceleration of the national vaccination drive.

Some of these recommendations may not find favour with the government, which tends to lay everything on the Procrustean bed of political expediency. But they are the proverbial stitch in time, which, if implemented urgently, will spare the government and the country a lot of trouble in the future. The pills that docs have prescribed are bitter but have to be swallowed.

It is popularly said in this country that when politicians have power, they have no brains, and vice versa—mole thiyanakota bale ne, bale thiyanakota mole ne. So, the problem with most government politicians is that they consider themselves far more knowledgeable than experts such as doctors, engineers, scientists and environmentalists. One may recall that a minister of the current administration once asked what the use of having oxygen was, during a heated argument with an intrepid female Forest Officer who opposed a move to destroy a mangrove forest, pointing out that environmental degradation would reduce the oxygen level in the air. He demanded to know whether oxygen could be eaten—oxygen kannada. A ministerial colleague of his did something cretinous, the other day, exposing the public to Covid-19.

Piliyandala, a populous section of the conurbation of Colombo, accounted for nearly one half of 755 Covid-19 cases reported from the Colombo District, yesterday. The health authorities’ decision to impose movement restrictions in the Piliyandala police area, last week, has been vindicated by the rapid increase in infections there during the past few days. If the restrictions had not been lifted at the behest of Minister Gamini Lokuge, the situation could have been brought under control. Lokuge has sought to justify his intervention to have the decision of the Director General of Health Services (DGHS), who alone can decide on lockdowns, movement restrictions, etc., countermanded, by claiming that such action would have affected daily wage earners in Piliyandala, which is his electorate. True, the vulnerable sections of society have to be protected, but an explosive transmission of the pandemic will have a far more devastating impact on them as well as others than a lockdown. Of economic hardships and an increase in the pandemic death toll, which is the worse? It is not only the residents of Piliyandala who undergo economic hardships owing to lockdowns and other such Covid-19 preventive measures. What if the ruling party politicians in other parts of the country emulate Lokuge? The DGHS will not be able to have any area locked down, in such an eventuality.

Meanwhile, other countries battling the new variants of the virus have adopted double masking, which has proved quite effective in curbing the spread of the pandemic. Why it has not been made mandatory here is the question.

One can only hope that the doctors’ letter at issue will knock some sense into the ruling party politicians and their officials in charge of the anti-Covid-19 campaign. There is no reason why a government that chose to do as a crafty shaman said, and even promoted his peniya or syrup, touted as a cure for Covid-19, should not take the views of respected medical professionals on board and act accordingly.

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Editorial

All hat and no cattle

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Monday 10th May, 2021

The global pandemic situation is far worse than it looks. The University of Washington estimates reveal that Covid-19 has snuffed out 6.9 million deaths across the globe, and this is more than double the officially reported number. Many countries are struggling to save lives, and shocking scenes of mass cremations in India and other such heartrending instances reported from Brazil, etc., must be weighing on the conscience of the global community heavily, but the response of the developed world to the pandemic has been appallingly slow and woefully inadequate. It is now engaged in a vaccine patent row to the neglect of what needs to be done urgently to save lives the world over. Pope Francis got it right, on Saturday, when he declared that the world was infected with the ‘virus of individualism’, and the ‘laws of intellectual property, etc., had taken precedence ‘over the laws of love and the health of humanity’. The world is facing a ‘catastrophic moral failure’ as Head of the World Health Organization (WHO) Dr. Tedros A. Ghebreyesus has said.

‘Vaccine nationalism’, which characterises the developed world’s pandemic response, is a major impediment to efforts being made to achieve global herd immunity against Covid-19 through vaccination, according to the WHO, which has called for the co-operation of the rich nations to carry out an equitable vaccine rollout across the globe. This fervent appeal has not yielded the desired results if the slow progress of COVAX (COVID-19 Vaccines Global Access) initiative is any indication. As vaccine donations have not reached a satisfactory level, the pandemic-hit countries have had to think of alternative ways of meeting their urgent vaccine needs. Hence their desperate call for lifting vaccine patents in the hope that such action will help boost the global jab production.

India and Brazil are among the nations that have urged the World Trade Organisation (WTO) to lift patents on the Covid-19 vaccines to boost the world’s fight against the virus. This proposal has struck a responsive chord with most countries, but some European nations are not favourably disposed towards it. They are reportedly in favour of a voluntary licensing system similar to the one between Oxford-AstraZeneca and the Serum Institute of India. The proponents of this method of boosting global vaccine production in the short-term point out that the rich countries could make the licensing system mandatory for their pharmaceutical companies, which, however, will have to be compensated; the WTO regulations permit this kind of arrangement.

Opinion is however divided on the effectiveness of the proposed patent waiver. The opponents thereof argue that patents are necessary as they provide incentives and encourages innovation; this is the reason why Covid-19 vaccines have been produced in record time, they maintain. It is also being argued in some quarters that even if the patents are lifted, it will take a long time to commence vaccine production elsewhere. This argument cannot be dismissed as baseless in that there is much more to vaccine production than recipes. Supply chains have to be established, personnel trained, facilities made available and necessary processes set up. All these could be time-consuming. The world cannot wait as the virus keeps mutating and destroying more and more lives, and the only way to neutralise it is to inoculate as many people as possible across the world so as to achieve global herd immunity.

French President Emmanuel Macron has exuded pragmatism in addressing the issue of vaccine nationalism. He has urged the US to abolish its bans on the export of vaccines and ingredients so that other nations can supercharge their production.

The US has, despite initial reluctance, agreed to the proposal for lifting vaccine patents temporarily, but there are better options, as President Macron has pointed out. Being a nation that never misses an opportunity to take moral high ground, the US should put an end to its vaccine nationalism and part with some of its huge vaccine stockpiles, especially the AstraZeneca jab, which it does not use. It does not have to do so as charity; it can make available those vaccine stocks to other nations at reasonable prices. Sadly, it has so far been all mouth and no action; assistance in other forms in dribs and drabs is of little use in a pandemic situation.

The world is not short of crusaders for human rights, and they, led by the US, even ignore the concept of national sovereignty (of other countries) when they want to make interventions purportedly in keeping with the much-vaunted global political commitments such as R2P (Responsibility to Protect). But they stand accused of abusing these universal commitments to advance their geo-political and economic agendas. Nothing is more valuable to humans or any other species for that matter, than the right to life, and the current pandemic has provided the self-proclaimed defenders of human rights with an opportunity to save hundreds of thousands of lives by making Covid-19 vaccines available, and, thereby establish their liberal bona fides, if any.

The developed world is labouring under the delusion that the safety of its people can be ensured through efficient vaccine rollouts at the expense of others, but there is no guarantee that immunity so gained will last for more than one year, according to international medical experts; nobody will be safe unless the virus is beaten, once and for all, through a truly global vaccination drive. The only way out is to follow the motto—unus pro omnibus, omnes pro uno (‘one for all, all for one’).

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