MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
I have written several articles in The Island about the COVID vaccine in the very recent past, where I discussed some important bits of information. This present effort is undertaken to provide some additional details regarding the current state-of-play in this vitally important endeavour, geared towards winning the war against this tiny, but unbelievably powerful blight of a coronavirus.
The vaccine is here now, in our land, albeit in rather limited quantities and, up to the present time, it has arrived in about three tranches or batches. What we have got down, is the Oxford-AstraZeneca viral vector type of vaccine. It uses an inactivated chimpanzee adenovirus as just a vehicle to get a component of the SARS-CoV-2 virus that causes the COVID-19 disease, into the human body. This component then induces an immunological reaction in the recipient that induces the immune system of the body to recognise the spike protein of the virus, and mount an immunological reaction against it by producing antibodies. The spikes of the coronavirus are the all-important components that enable the virus to attach itself to human cells, particularly of the respiratory tract. The vaccine also induces the immunological system to develop antigenic memory where in any subsequent infection by the virus, the cells of the immune system react and produce antibodies to neutralise the coronavirus that causes COVID-19 disease. A second dose of the vaccine enhances the immunological capabilities of the body so that an immediate and sustained attack could be initiated quite rapidly, if and when the body is exposed to the pandemic virus.
The currently available vaccine in Sri Lanka was rolled out in the country from about mid-January, or so, this year. It was initially given to all frontline healthcare workers, the tri-forces and the police personnel who were involved in patient care, tracing of contacts and running the quarantine facilities. All these people belonged to a high-risk group who needed to be protected at all cost. Following the first dose, the recipients were requested to come back in four weeks for the second dose to complete the initial vaccination process. This procedure of administering the second dose was scheduled for the four-week period because the original clinical trials of all vaccines, except the single dose Johnson and Johnson vaccine, however were carried out with this time schedule. The studies showed a reasonable degree of protection from about 12 to 14 days after the initial dose. Following the initial vaccination efforts, some other age groups were also vaccinated, the efforts at this being dictated to by the resources available and the logistics that could be mustered. There was a huge demand for the vaccine but, unfortunately, the supplies were limited and certainly not quite sufficient to meet all the needs. To complicate matters further, ad hoc decisions were also made and some of the science-dictated priority lists were disregarded to a certain extent, perhaps for just a few days.
Then it was vaguely intimated that the second dose was going to be delayed to around three months after the first dose. Unfortunately, no proper communication as to the scientific reasons for this abrupt change in the timing schedule was conveyed to the general public and they were left wondering as to why this was done. Some thought that there was something wrong with the vaccine while others thought that the authorities were not able to get sufficient stocks of the vaccine to administer the second dose after four weeks. Many others smelled a rat in that entire endeavour.
In point of fact, there are some valid scientific reasons for changing the schedule. Once the vaccine was rolled out in other countries, especially in Europe and particularly so in the United Kingdom, continuing scientific assessments made it clear that the initial protection to a degree of around 60% was quite robust and was even extended to a period of more than three months. There was also some suggestion that by delaying the second dose, one might even get a stronger immune response and a more prolonged period of protection. Although opinions were divided, the United Kingdom went ahead and changed the schedule to have the second dose administered after three months. A secondary reason for extending the time interval was that as the supplies were sparse even in the UK. The positive benefit was that it was possible to give the first dose to a larger number of people, thereby increasing the total number of people who would have some immunity. There were protests even from some doctors in the UK that the authorities were going against science as the clinical trials of the vaccines had used the four-week time interval originally. Yet for all that it must be remembered that science could and does change with the unravelling of new data and that the decision that was taken by the authorities in the UK was based on sound public health principles. The advantages of protecting a larger group of people of a populace with the first dose of the vaccine is also scientifically tenable in a potentially lethal disease.
All these principles are also quite tenable and should be acceptable in the Sri Lankan scenario. But the down side of it all is that nobody came over the mass media to explain the reasons for the decision that was made to change the time schedule. It is absolutely imperative that we keep the public properly informed, mainly to prevent all kinds of unsubstantiated “devil’s playground” type of canards spreading around like wildfire and initiating as well as propagating public panic.
All clinical trials have shown up the vaccine to be quite effective and safe apart from mild side effects during the first 48 hours or so after the administration of the vaccine. These were very well documented as chills (feeling cold), fever and body aches. All these respond quite well to simple pain-killers such as paracetamol. Generally, both here and abroad, these side-effects have not led to any cause for alarm.
However, over the last week or so, there are disturbing reports of more serious problems that have occurred in certain countries in Europe. These have been reported and generally even sensationalised by all types of media. The general public of our country must be getting really worried about these latest developments as regards the vaccine. These worrying effects seem to have occurred predominantly, although not exclusively, after the second dose of the vaccine and have been reported with the Oxford-AstraZenica vaccine. These undesirable effects consist primarily of documented cases of unexplained clotting of blood in deep veins with, in some cases, the clots being detached and getting deposited in the blood vessels of the lungs. There has been a couple of deaths as a result of the clots getting deposited in the lung arteries, a condition known as pulmonary embolism. As a result of these initial reports, many European countries have temporarily suspended the administration of the Oxford-AstraZenica vaccine till more intensive investigations are carried out to ascertain a definitive cause-and-effect relationship.
At the present time, there is no direct evidence as to whether the problem was definitely caused by the vaccine. We do not know whether the affected individuals had a coexistent abnormality in clotting of blood. These clotting problems in deep veins are more common in the European countries anyway. Though seen from time to time, these deep vein thrombosis problems are quite rare in tropical countries, especially in Sri Lanka. It is generally seen here after major surgery where mobility of the patient had been severely curtailed and clotting occurs in the deep veins of the legs. The increased tendency for clotting of blood in deep veins may also be related to the use of certain other medications such as oral contraceptive drugs, which are used a lot more in the European countries and in the Western hemisphere of the world. The message that we should convey to the public is that THERE IS NO CAUSE FOR UNDUE ALARM AND PANIC in our country regarding this problem at the present time. The position would be clearer within the next few weeks when these cases are thoroughly investigated. For the time being at least, there are no grounds for suspending the administration of the Oxford-AstraZenica vaccine in our country.
Initially, all the clinical trials indicated that the vaccine was capable of reducing the severity of the disease and would thereby reduce deaths. That was the primary reason for the use of the vaccine. However, there seems to be some accumulating evidence now that it would reduce the ability of the virus to infect humans as well, at least to a certain extent. There is some evidence that even if the vaccinated subject gets infected, the number of virus particles in the body may be reduced by a considerable extent. Although all these findings imply that this is not a complete or one hundred percent protection against being infected, the implication of this is that it could perhaps reduce transmission of the virus from infected people to those uninfected. In a new scientific paper published in a pre-print journal on the 01st of
February 2021, the researchers found that the vaccine cut the number of cases with detectable virus by 67% after a single standard dose, and wrote that this shows the potential for a substantial reduction in transmission.
From a public health perspective that is an added bonus. If sufficient herd immunity could be instituted by widespread use of this vaccine, then the rate of spread could also be reduced and then the pandemic could be controlled. It would also serve the main purpose of reducing the severity of symptoms and thereby reduce the all-important deaths while reducing the need for high-powered intensive care for those who become symptomatic.
As so graphically pointed out by Dr Tedros Ghebreyesus, the Director General of the World Health Organisation (WHO) and reproduced verbatim here, “This is a time for facts, not fear. This is a time for rationality, not rumours. This is a time for solidarity, not stigma“. These are indeed a set of golden words for our populace as well as for the powers-that-be in our paradise isle. We are learning a lot about this coronavirus and the pandemic virtually daily. We need to explore windows of opportunities and change our strategies according to the scientific details that would be unravelled.
Yet for all that, all of us…, every single one of us, need to still comply very strictly with the all-important health recommendations of the 3Ws…, Wearing a mask; Washing of hands and Watching out for the maintenance of the physical distance of at least one to one and a half metres. The vaccines do not give us unabridged permission to abandon these public health measures towards controlling the pandemic. There is no way in which the observance of these measures could be put aside at the present time. By all means, get the vaccine when it is made available to you but even after that, do abide by the health guidelines. That will be your humble but priceless contribution towards saving lives.
All communities should be treated equally without distinction
by Jehan Perera
The government was elected on a platform that stressed national security and unity. The elections took place in the aftermath of the Easter suicide bomb attacks of 2019 that caused the highest numbers of casualties in Christian churches. As the bombers were all Muslim, the Muslim population in the country came under public suspicion which was spontaneous and widespread. There was also equally widespread fear and anxiety about follow on attacks that could target Christians in particular and also the population in general. The cause of the attacks and the master minds behind them were a mystery then as they are now.
Due to the timely intervention of Malcolm Cardinal Ranjith, Archbishop of Colombo, in whose diocese the two most serious attacks took place, there was no retaliation against the Muslim population by those who had lost their kith and kin. However, in the weeks that followed, there were mob attacks against the Muslim community in parts of the country that were distant from the bomb attacks. These attacks were not spontaneous but organised and intended to loot Muslim property and cause fear in them. The government, which was under political siege for having failed to prevent the suicide bomb attacks, failed once again to adequately protect the Muslim community.
It is in this context that Malcolm Cardinal Ranjith’s statement on the occasion of the second anniversary of the Easter bombings takes on significance. About two months ago he gave a deadline by which he asked the government to identify who was behind the Easter attacks and the cause for them. The Cardinal has consistently spoken up on the issue of the Easter bombing, first to ask for restraint on the part of the victims, then to ask the government to identify the perpetrators and prior to the elections to take the position that the people needed a government that could protect them. Now he has said that “Our brethren were attacked not by religious extremism, but by a group that exploited it to use the attackers as pawns in order to strengthen their political power.”
Two years after the Easter bombings in which they were branded as supporters of religious extremism, the Muslim community seeks in many different ways to overcome the suspicion that once engulfed them and which they fear can do so again. The use of the black Islamic dress that was an increasing trend among Muslim women has been much reduced. Muslim organisations are making energetic efforts to network with other religious organisations, join inter-religious groups and to liaise with civil society. They make available to them the Islamic teachings on peace and coexistence. This weekend I was invited to the opening of a community centre in the Kurunegala District by a Muslim organization.
On the walls of the community centre there were panels put up with sayings from the different religions on a number of important matters, such as how to treat others, and the role of spiritual values in everyday life. The foremost place at the opening ceremony was given to Buddhist monks who had come to attend the ceremony along with government officials and police officers. The monks who spoke said that the Muslim community living in the village had good relations with the Sinhalese living in the neighbouring villages, and this had continued for generations. Another monk said that after the Easter bombings they had heard there were violent gangs heading in the direction of the Muslim village, they had come there to ensure no harm would befall those people.
In this context, the announcement that the government will ban 11 Muslim organisations sends a negative message to the country at large about the Muslim community. It creates an impression that Muslims organisations are under suspicion and possibly even close to performing acts of violence which necessitates them being banned. Of the 11 banned organisations, two are foreign ones, the Islamic State and Al Qaeda which have been reported internationally as engaging in violence. However, the other nine are Sri Lankan organisations which do not have a track record of violence or illegality. Four of them have the name “Thowheed” in them, which in the Arabic language means “faith.”
The ban on these Thowheed organisations may be due to the fact that the leader of the suicide squad, Zahran, was part of an organisation that had the name “Thowheed” in it. The ban on them may also be due to the fact that the Commission of Inquiry into the Easter bombings recommended such action against them. However, the Commission also recommended that other non-Muslim organisations be banned which has not happened. This suggests that the Muslim organisations are being treated differently. The danger is that when it treats organisations differently, the government may be generating resentment in the Muslim community, especially the youth. If the words of Malcolm Cardinal Ranjith are correct, the problem lies not in Muslim extremism but in partisan power politics.
Sri Lanka has experienced Sinhalese youth insurrections twice and even the Tamil militant movement was started by youth, who were once called “the boys.” Perhaps in anticipation of such a radicalisation phenomenon, the government has recently passed an add-on called the “De-radicalisation from holding violent extremist religious ideology” to the Prevention of Terrorism Act. This will permit people who fall into its ambit to be send to rehabilitation centres for up to two years without trial. This may provide the government with an opportunity to release up to 250 Muslim citizens currently under detention on suspicion of being involved in the Easter bombings and send them for rehabilitation. On the other hand, this regulation may be used in the future in regard to other persons and other groups. The better way to prevent radicalization is to make people feel that the law is even-handed to all, and also to encourage engagement between communities.
During the discussion that took place at the opening of the community centre in Kurunegala, it was noted that the younger generation had fewer inter-community linkages than those of older generations. This may be due to the changing nature of society and the economy where people spend less time with other people and more time with machines or doing narrow and specialised jobs. In multi-ethnic and multi-religious societies in which there is conflictual relations, the tendency on the part of those from different communities will be to live in their own silos rather than interact with those of other communities. Living in peace in plural societies requires purposeful and energetic interaction which is organised. Where there has been ethnic and religious strife the world over, the better answer has been to provide people with encouragement and incentives to mix together, which is what the Muslim organization in Kurunegala was trying to do.
TNGlive…a boon to artistes affected by the pandemic
No doubt, Covid-19 has ruined the entertainment industry, throughout the world.
Entertainment venues have been shut down, concerts cancelled…and musicians are finding the going pretty tough.
However, it’s heartening to know that there are performers who find solace in keeping the public entertained, via online performances.
In this instance, those responsible for TNGlive must be congratulated for creating this platform, on social media, in order to give lots of folks, from around the globe, the opportunity to showcase their talent, on a regular basis.
Quite a few Sri Lankans have been featured on TNGlive, including Melantha Perera, Suzi Croner (Fluckiger), Sureshni Wanigasuriya, Yasmin de Silva, and Kay Jay Gunesekere,
Suzi did this scene twice, and on both occasions her performance was highly rated, with bouquets galore coming her way…on social media.
On Saturday, April 10th, she was featured (8.00 pm Sri Lankan time) doing songs from the country and western catalogue.
It was a very entertaining programme, which also contained some dance scenes (line dancing) from the audience present, in her living room – her friends.
Her repertoire included ‘Joline, ‘Me And Bobby McGee, “Johnny B. Goode,’ ‘Blue By You,’ ‘Okie From Muskogee,’ ‘Tennessee Waltz,’ ‘Rose Garden,’ ‘Mississippi’ and ‘Cotton Eyed Joe.’
Suzi is to make her third appearance, on TNGlive, shortly, but this time it won’t be a solo effort, she says.
“For variety, I would be having a guy from the Philippines, and he sings the hit songs of Tom Jones and Engelbert.”
So get ready for another special from Suzi, who now resides in Switzerland.
Suzi was the frontline vocalist for the group Friends who were, at that point in time, top of the pops!
Another artiste who impressed viewers, performing on TNGlive, with his daughter, was Nigel Gerrard John Galway.
Nigel is from India, and has been a Chef for the last 23 years, with 12 years spent at the Oberoi hotels. He was also an executive Sous Chef at Taj, in Coimbatore.
In fact, Allwyn Stephen, TNGlive chief, referred to Nigel as…probably the first Singing/Dancing Chef in the world!
He, and his 18-year-old daughter, Lean Pamela Mary, did get the attention of many, with their unique style of presentation; while Nigel handled the vocals, Lean, using only gestures, expression, and movements, brought out the meaning of the lyrics in most of the songs her dad did. And, she did it beautifully.
Yes, she also did exercise her vocal cords, on this particular programme
Says Nigel: “We come from a family of musicians, but we attempted singing, only during the pandemic, on various social media groups, and we did so only because we were all stuck at home.
“We joined TNGlive, through a friend, and have been performing ever since. The love and support we received from people around only encouraged us to keep growing and now we have a page of our own called THE SINGING CHEF.”
Heard at the club
A member reminisced an incident that happened long years ago, during those peaceful times when terrorism was unheard of. He had been driving his car, on the Deniyaya Road, when about six miles from Galle, he saw a village in a state of panic. So he stopped his car near the village boutique and asked the mudalali what was happening? The mudalali had said that the self-opinionated ‘mudliyar’ of the village (a court interpreter) had organised a ‘dane’ (an alms giving) and was awaiting the procession of monks, complete with drummers, from the temple. And, seeing it coming over the paddy fields which was a short cut, instead of the village road as show off, put him in a paddy, and he had chased the monks away. So the monks had gone back to the temple. As the meal time deadline for monks was fast approaching, the villagers brought the meals they had cooked in their homes, to serve the monks! That was the panic.
He was an unpopular villager who rose to a high position in the public service with political influence. Cussed by nature, he used his official position to harass villagers. When he met with an untimely death and, right at the moment the coffin was taken to the hearse, the whole village reverberated with the sound of fire crackers, organised by the irate villagers.
Once a terrible post office blunder very nearly wrecked a marriage. A certain sales rep sometimes sold his wares on credit. One such creditor was the owner of a shop named ‘Chandra Cafe’ who was slack in his payments. So the sales rep sent him a telegram that he would be coming to collect his dues, next Monday. On receipt, the owner of Chandra Cafe telegraphed the rep asking him not to come on Monday and the telegram received by him read, ‘Do not come on Monday – Chandra K.P.’ And when the rep’s wife read the telegram there was some misunderstanding at home which nearly rocked his marriage.
This reminded us of another telegram. An army officer was to go back to camp by the night mail. When he arrived at the railway station, he found a lady in an advanced state of pregnancy, almost in tears, because no berths were available. Gallantly the officer offered her his berth and, at the nearest post office, sent a telegram to his commanding officer saying ‘Unable to return tomorrow as ordered. Gave berth to lady. Arriving tomorrow evening.’
Obviously, the vital word ‘berth’ had been misspelt as ‘birth’, for the gallant officer received this reply from his commanding officer, ‘Your next confinement will be to barracks’.
A philanthropist donated a building to his old school. An opening ceremony was held with a VVIP as the chief guest. A group photograph was also taken. As the donor was keen to get this photograph published in the newspapers without delay, he sent the local correspondent in his limousine to Colombo. He met the editor who happened to be an old boy of the same school. After a look at the photograph, he folded it in such away to eliminate the principal and sent it for publication. The editor seemed to have an axe to grind with the principal!
It was in the early 60s and I was on my way to the club in the evening, when I met a friend near the club. With him was another, I invited them both to the club and after a few drinks we were headed out of the club, when near the gate, my friend pulled me aside and said that his friend was going for some trade union work to Hambantota and was short of funds. I told him that he should have told me that before I paid the club bill and also told him I had only Rs.18.00 which I gave. This trade union leader was non other than Rohana Wijeweera, who was to become JVP leader.
It was towards the end of the 1980s and a club member, a tea factory owner was on his way home all alone in his car, at the break of down, after finishing his factory work. He had to travel 12 miles. After about five miles, he saw a youth profusely bleeding with injuries, coming down a hill. The good Samaritan that he was, he took him in his car to the hospital. On the way, the police took him and the injured youth into custody for terrorist activities. Fortunately for him, Major-General Lucky Wijeratna, who was a classmate of his at school, was there to save him.
This happened several decades ago. There was a certain popular elderly club member, who was a wealthy businessman and drank nothing but whisky. That day when he came to the club, he seemed to have lost his bearings. He told his friends that he was going to donate all his wealth to the Home for Disabled Children which was close to his house, because his only child, a daughter, had eloped. His friends prevailed on him to defer his decision for a few months. About a year or so later, he came to the club one evening carrying a big flask in his hand. He said that it was for his errant daughter who has now reconciled, adding that he was a grandfather now!
A busy garage was located in a residential area and it was open day and night. To highlight their services, they put up an impressive signboard, ‘We never sleep’. The following day a prankster had written below it ‘and neither do the neighbours’.
During the day of insanity – 29th July 1987, the Open University at Matara was burnt down and the Ruhunu University remained closed. A wall poster came up. It read: ‘Close the Open University’ and ‘Open the closed University’.
A young teacher, met a young man at the Dehiwala Zoological Gardens. Although their native villages were far apart, they
became close friends and planned to get married in the near future. He posed as a private bus owner. One day on a visit to his fiancée, he stayed the night over and muttered in his sleep, “Borella – Battaramulla! Borella – Battaramulla!” This aroused serious suspicions about his identity. So a few days later, her parents came to the Borella junction, to see him in a sarong loading passengers to private buses as a ‘bus crier’. And the love story ended right there.
A long time ago a wealthy industrialist, a popular member of the club, was having his drink in a secluded corner of the club, most unlike him. He appeared to be quite agitated. Some concerned friends asked him what happened. He said that his only daughter (he also had a son) had married a man of her choice adding that his wife was in favour of the marriage. The daughter he said, was 22 years old. His friends told him that at that age, she was entitled to choose her partner in life and appealed to him to take things easy as his wife too approved of the marriage. After about a year or so, a friend visited him. Proudly pointing out a large multiple storey house in his sprawling garden, he had said that it was built by his son-in-law.
A certain member served abroad for many years. One morning he come back to his native Galle in a hired helicopter. That evening he came to the club and ordered a case of beer for his friends!
Several years ago, a member had gone to the Galle Post Office to send a telegram to a close relative. He was informed by the postal authorities that there was a breakdown in the telegraphic services and that it was unlikely that his message, about a bereavement in the friend’s family, would reach his relative in time. They advised our friend to telephone someone in the area where his relative lived and to get the message delivered orally. Those were the days when only a few had telephones. As the member did not know anyone in that area with a telephone, he thought of S. Jayasinghe, known as Mr. S, who was not know to him personally and who was a Junior Minister residing in the area where our friend’s relative lived.
When our friend telephoned him from the post office, he had just got into his car to go somewhere. Soon after he was speaking to our friend over the phone as if he was talking to an old friend. He also told our friend that he was about to go to the site where he was building a new house. Our friend then gave him the message and appealed to him to get it delivered. The rest of the story was told to our friend by his relative who had said that during a heavy shower of rain, he found a car near his gate and that when he went up to the car he recognized him to be the Junior Minister. Like my friend, he did not personally know the Junior Minister. Instead of giving the message then and there, he had got off the car and had gone to our friend’s house and not only given the message but also consoled him by talking to him for a few minutes.
It was in the late 1980s, at the height of the insurrection, that this member was travelling all alone to Galle in his jeep. He was going through the Kottawa Forest which was famous at the time for tyre pyres. The Navy had stopped his vehicle and asked him to take a young man who was injured in a motorcycle accident, to the Galle Hospital, about eight miles away. The young man was bleeding profusely. He got him admitted to the hospital but our friend was forced to stay there for a long length of time, culminating in his having to give his consent for a surgical operation on the injured, whom he had never seen before. Alas! The purpose of his visit to Galle was lost.
A member had two sons, twins aged three years. As they fell ill, he channelled a specialist doctor who examined one twin and refused to examine the other, as an appointment was not made for him. So our friend had the other twin channelled as well. Certainly, it was no personification of Hippocrates!
A popular elderly member used to come to the club only on his pay day to keep himself warm. He worked at ‘Sathosa’ (C.W.E). The younger members would then tell him that he is very fortunate to work in a historic establishment like ‘Sathosa’ which is also referred to in Guttila Kavya (an epic) thus:
‘Sara Salelu Jana Sathose.’
Highly elated he would order a round of drinks, adding ‘Surapana karathi mese’.
This happened many decades ago. A member who was an inveterate gambler once lost heavily at the card table and mortgaged his expensive wrist watch. A member who was not well disposed towards him had sent a post card to his wife informing her that her husband sold his watch to gamble. He also had a 15-acre well-maintained tea estate which he had to sell when his gambles failed.
This story was related by a member and is about the ‘kings’ in the planting circles. A planter in the coconut belt of the North Western Province who owned acres of coconut, once named himself ‘King Coconut’. He argued that if a planter in the Kalutara District who owned vast acres of rubber could be referred to as a ‘Rubber King’ why shouldn’t he be called ‘King Coconut’.
One day a member related a story, which is hard to believe. A teacher who served in an uncongenial station, in his quest for higher knowledge, had studied for an external degree at a university. And he passed the examination with flying colours, obtaining first class honours and was highly commended by the university authorities for his brilliance, while serving in a different area. He had confided to his friends that his success at the exam was due to the gift of seeing all the question papers in a dream, before the examination!
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