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Currently available Covid-19 vaccines: Some important considerations

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By Dr. B. J. C. Perera

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

 

Just about a year or so into the coronavirus pandemic, the thing that is in everyone’s mind, as well as in their hearts and souls, is the COVID-19 vaccine that is thought to be one of the answers to the problem. The disease has taken a frightful toll. Many have died and scores of others have suffered immeasurably, directly as well as indirectly. Many countries are in shambles and most of us are wondering as to what would come next.

As at present, there are several vaccines that have been rolled out and some are being administered in committed immunisation programmes in quite a few countries. This is no mean feat as these vaccines have been manufactured, tested and licensed in double-quick time. We, too, in this resplendent isle, have now got some stocks of the vaccine, through the generosity of several countries and institutions. The future plans are to deploy the vaccines globally in a dedicated effort towards controlling this blight that has caused all this mayhem. It speaks so much for the brilliance, dedication and commitment of many scientists that a process that normally takes several years has been shortened to just under a year.

Yet, for all that, this spectacle of the shortening of the time-frame has led to many questions being asked in several quarters and some inclinations of suspicion, and even mistrust, being expressed by some. This has been further amplified by the novel technology employed in producing the vaccines. However, there is hardly any doubt that vaccines are the principal tool by which we can challenge this pandemic which is now going onto its second year. If we are to have any worthwhile hope of getting back to some sort of “normalcy” and saving countless millions of lives, extensive immunity, through vaccine inoculation, is of the essence. There is incontrovertible evidence that the currently available vaccines do produce a reasonable degree of protection, especially against the severity of the disease, by mobilising the resources of the human immune system. They are likely to reduce the morbidity and the mortality of the disease. However, we do not know for sure whether it would prevent the spread from person to person. In addition, we also do not know for sure as to how long the immunity would last in the vaccinated people. These would need to be sorted out once more scientific information is available post-vaccination.

There is quite a bit of apprehension as to whether the vaccines were ‘rushed’. The scientists assure us that no safety steps were either cut down or even short-circuited. These vaccines have gone through the mill of testing in several Standard Phase Clinical Trials, just like any others that have been in use for many other contagious infective diseases. True enough, the timelines have been considerably shortened but the due processes have been followed. All three phases of research trials have been undertaken, albeit at a fast-tracked pace. The efficacy, safety and tolerability have been adequately looked into. None of these steps have been omitted or side-tracked for the Pfizer, Moderna or AstraZeneca vaccine development processes. In fact, mainly due to the extensive occurrence of the disease and the committed focus on developing a vaccine, there was no shortage of patients with the disease and there were more than enough subjects ready to be enrolled into trials as well as sufficient funds were available to conduct the research work that was needed. It may be a surprise but it is a fact of life in these circumstances and it is indeed most encouraging to see the way science has progressed in leaps and bounds to move that much faster through sheer necessity, to do all the work necessary in producing effective vaccines.

As for the safety of these vaccines, the detailed studies that were conducted over a period of about 9-10 months have shown them to be safe. The Phase 3 studies for all the major vaccine candidates are still ongoing. Furthermore, many side-effects from vaccines occur within a short period vaccination and as trials have been going on since April 2020, these reactions would have already been seen. There has been mild undesirable effect but so far, no major side-effects have been reported in a scale that would invalidate the vaccines. However, we have to await further results of the research endeavours to know about any possible long-term side effects. These would usually come through post-marketing surveillance.

In fact, BioNtech and Moderna have been working on their proprietary messenger ribonucleic acid (mRNA) technology long before COVID-19 came into the arena. They knew a lot even about the vagaries of the process. Scientists view this expertise as a ground-breaker when it comes to vaccine advancement; cutting down development time and thereby making mRNA candidates cheaper and more amiable to be custom-made than the traditional vaccine candidates.

There are some concerns expressed by many as to whether the mRNA vaccines could alter the deoxy ribonucleic acid (DNA) of humans. So far there is no tangible evidence that this is the case. Apparently, mRNA does not alter or interfere with DNA as it does not hang around in humans for long periods of time. It crumbles and disappears after a certain short time and thereby are thought to be even safer than old-style vaccines. Traditional live vaccines inject small amounts of the live virus and attenuated vaccines inject the inactivated virus into the body. With mRNA, it is only a kind of a blue-print of a recognisable component of the organism that is injected.

The well-known target of a vaccine is to teach the body defences to detect and recognise the causative organism of a disease. When a virus infects a host cell, the virus releases its RNA which gets into the host cell nucleus and reproduces itself using host cell machinery. Viral mRNA then copies viral RNA into proteins which then reassemble as more viruses. These newly synthesised viruses enter into the host cell blood stream and then all hell breaks loose.

The current mRNA vaccines generally recreate the blue-print of the outer shell or the spike protein of the virus. The spikes are the components that enable the virus to attach itself and get into the host cells. Therefore, anything that can interfere with these spikes will knock off the virus before it can get into the human cells. All that the vaccines do is to induce the human immune systems to recognise and interfere with the spike proteins. Our immune system recognises Sars-Cov-2 via the spike protein and by sending some “placebo-like” spike proteins into the system via the vaccine, it gives them an early start in being prepared for potential infection. Members of our immune system are usually moving around in the bloodstream looking for possible ‘none-self’ intruders. When these sentinels come across the spike proteins, they launch an immune response. That would be the end of the story for the virus.

Having said all this, there is a current dilemma that needs to be addressed urgently. Very recently, both AstraZeneca and Pfizer have reported considerable delays in production and supply of their vaccines. As if we do not have enough problems on our hands due to this blight of a virus, this adds another dimension to the equation of the equity of provision of the vaccines to those desperately needy people of our planet. This graphically highlights the massive constraint the world is facing in getting everyone, everywhere, vaccinated because of the exclusive rights pharmaceutical companies hold over who is allowed to produce and manufacture their vaccines. Given the current crisis, this is very definitely quite unacceptable. While every week higher and higher new infection records are hit, hospitals are overwhelmed, and people struggle to feed their families, pharmaceutical companies ‘cherry-pick’ as to who gets access to vaccines. Commercial interests and filthy lucre seem to rule the entire scenario. The market will not solve this challenge. What we need are exceptional measures and incomparable leadership from the statesmen and stateswomen of the world to solve this problem. It is time to call a spade, just that – a spade.



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Investigative Journalism?

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I usually end up totally exhausted when I finish reading the local newspapers from the Pearl. There are so many burning questions and so much is written about them but there are no conclusions and definitely no answers. For example, we seem to have three burning issues right now and this is not in order of importance.

We have a lengthy report that has been published on the Easter Sunday carnage. Everybody knows what I am talking about. However, no one, be it an editor, a paid journalist or a single one of the many amateurs who write to the papers, has reached a conclusion or even expressed an opinion as to who was responsible. At least not a believable one! Surely there are energetic and committed young people in the field of journalism today who, if asked, or directed properly will go out and find a source that would give them at least a credible hypothesis? Or do conclusions exist and has no one the courage to publish them?

At least interview the authors or should I use the word perpetrators of that report. If they refuse to be interviewed ask them why and publish an item every day asking them why! Once you get a hold of them, cross-examine them, trap them into admissions and have no mercy. It is usually geriatrics who write these reports in the Pearl and surely a bright young journalist can catch them out with a smart question or two, or at least show us that they tried? The future of the country depends on it!

We have allegations of contaminated coconut oil been imported. These are very serious allegations and could lead to much harm to the general populace. Do you really believe that no one can find out who the importers are and what brands they sell their products under? In this the Pearl, where everyone has a price, you mean to say that if a keen young journalist was given the correct ammunition (and I don’t mean 45 calibres) and sent out on a specific message, he or she couldn’t get the information required?

We are told that a massive amount of money has been printed over the last few months. There is only speculation as to the sums involved and even more speculation as to what this means to the people of the Pearl. Surely, there are records, probably guarded by extremely lowly paid government servants. I am not condoning bribery but there is nothing left to condone, is there? There are peons in government ministries who will gladly slip you the details if you are committed enough and if you are sent there to get it by a boss who will stand by you and refuse to disclose his sources.

I put it to you, dear readers, that we do not have enough professional, committed and adequately funded news organisations in the country. We can straightaway discount the government-owned joints. We can also largely discount those being run by magnates for personal gain and on personal agendas. As far as the Internet goes, we can forget about those that specialise in speculative and sensationalist untruths, what are we left with O denizens of the Pearl? Are there enough sources of news that you would consider willing to investigate a matter and risk of life and limb and expose the culprits for the greater good of society? Can they be counted even on the fingers of one hand?

In this era when we have useless political leaders, when law and order are non-existent when the police force is a joke, it is time the fourth estate stepped up to the mark! I am sure we have the personnel; it is the commitment from the top and by this, I mean funding and the willingness to risk life and limb, that we lack. Governments over the last few decades have done their best to intimidate the press and systematically destroy any news outlet that tried to buck the usual sycophantic behaviour that is expected from them by those holding absolute power.

Do you think Richard Nixon would ever have been impeached if not for the Watergate reporting? Donald Trump partially owes his defeat to the unrelenting campaign carried out against him by the “fake news” outlets that he tried to denigrate. Trump took on too much. The fourth estate of America is too strong and too powerful to destroy in a head-to-head battle and even the most powerful man in the world, lost. Let’s not go into the merits and demerits of the victor as this is open to debate.

Now, do we have anything like that in the Pearl? Surely, with 20 million-plus “literate” people, we should? We should have over 70 years of independence built up the Fourth Estate to be proud of. One that would, if it stood strong and didn’t waver and collapse under pressure from the rulers, have ensured a better situation for our land. Here is Aotearoa with just five million people, we have journalists who keep holding the government to account. They are well-funded by newspapers and TV networks with audiences that are only a fraction of what is available in the Pearl. Some of the matters they highlight often bring a smirk of derision to my face for such matters wouldn’t even warrant one single line of newsprint, should they happen in the Pearl.

Talking of intimidation from the rulers, most of us are familiar with the nationalisation of the press, the murder and torture of journalists, the burning of presses to insidious laws been passed to curtail the activities of Journalism. These things have happened in other countries, too, but the people and press have been stronger, and they have prevailed. We are at a watershed, an absolutely crucial time. It is now that our last few credible news sources should lift their game. Give us carefully researched and accurate reports with specific conclusions, not generalisations. Refuse to disclose your sources as is your right, especially now that the myopic eye of the UNHCR is turned in our direction.

All other ways and means of saving our beloved motherland, be it government, religion, sources of law and order and even civil society leadership seems to have lapsed into the realm of theory and rhetoric. Our last chance lies with the Fourth Esate and all it stands for. I call for, nay BEG for, a favourable reaction from those decision-makers in that field, who have enough credibility left in society, DON’T LET US DOWN NOW!

 

 

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The world sees ugly side of our beauty pageants

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Yes, it’s still the talk-of-the-town…not only here, but the world over – the fracas that took place at a recently held beauty pageant, in Colombo.

It’s not surprising that the local beauty scene has hit a new low because, in the past, there have been many unpleasant happenings taking place at these so-called beauty pageants.

On several occasions I have, in my articles, mentioned that the state, or some responsible authority, should step in and monitor these events – lay down rules and guidelines, and make sure that everything is above board.

My suggestions, obviously, have fallen on deaf ears, and this is the end result – our beauty pageants have become the laughing stock the world over; talk show hosts are creating scenes, connected with the recent incidents, to amuse their audience.

Australians had the opportunity of enjoying this scenario, so did folks in Canada – via talk show hosts, discussing our issue, and bringing a lot of fun, and laughter, into their discussions!

Many believe that some of these pageants are put together, by individuals…solely to project their image, or to make money, or to have fun with the participants.

And, there are also pageants, I’m told, where the winner is picked in advance…for various reasons, and the finals are just a camouflage. Yes, and rigging, too, takes place.

I was witnessed to one such incident where I was invited to be a judge for the Talent section of a beauty contest.

There were three judges, including me, and while we were engrossed in what we were assigned to do, I suddenly realised that one of the contestants was known to me…as a good dancer.

But, here’s the catch! Her number didn’t tally with the name on the scoresheet, given to the judges.

When I brought this to the notice of the organiser, her sheepish reply was that these contestants would have switched numbers in the dressing room.

Come on, they are no babes!

On another occasion, an organiser collected money from the mother of a contestant, promising to send her daughter for the finals, in the Philippines.

It never happened and she had lots of excuses not to return the money, until a police entry was made.

Still another episode occurred, at one of these so-called pageants, where the organiser promised to make a certain contestant the winner…for obvious reasons.

The judges smelt something fishy and made certain that their scoresheets were not tampered with, and their choice was crowned the winner.

The contestant, who was promised the crown, went onto a frenzy, with the organiser being manhandled.

I’m also told there are organisers who promise contestants the crown if they could part with a very high fee (Rs.500,000 and above!), and also pay for their air ticket.

Some even ask would-be contestants to check out sponsors, on behalf of the organisers. One wonders what that would entail!

Right now, in spite of the pandemic, that is crippling the whole world, we are going ahead with beauty pageants…for whose benefit!

Are the organisers adhering to the Covid-19 health guidelines? No way. Every rule is disregarded.

The recently-held contest saw the contestants, on the move, for workshops, etc., with no face masks, and no social distancing.

They were even seen in an open double-decker bus, checking out the city of Colombo…with NO FACE MASKS.

Perhaps, the instructions given by Police Spokesman DIG Ajith Rohana, and Army Commander, General Shavendra Silva, mean nothing to the organisers of these beauty pageants…in this pandemic setting.

My sincere advice to those who are keen to participate in such events is to check, and double check. Or else, you will end up being deceived…wasting your money, time, and energy.

For the record, when it comes to international beauty pageants for women, Miss World, Miss Universe, Miss Earth and Miss International are the four titles which reign supreme.

In pageantry, these competitions are referred to as the ‘Big Four.’

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Better use of vanity projects; Cass apologises, and New Year graciousness

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A wise one, with the interests of the country at heart, calling himself ‘A Member of the Silent Majority’, wrote in The Island of Friday, April 9, offering an excellent solution for the better and genuine use of the Mattala Mahinda Rajapaksa International Airport which was built at a stupendous cost to both the Treasury, and wildlife abundant in the area, to satisfy an ego and sycophants’ cries of Hail to the King. Even sans Covid and lockdowns and shut downs of airports, the Mattala Airport was a white elephant, endangering and displacing the black elephants, roaming along their familiar corridors; receiving such few airplanes. Thus, as the writer Cass mentions says, convert the airport to a super hotel with excellent and sure-fire access to wildlife watching, like referred to hotels in Kenya and elsewhere. Yes, it will definitely be a bigger money earner than an airport waiting for a plane to land. Expensive equipment going rusty could be transferred to smaller airports being developed all over the island. There was such a hue and cry when storerooms, within the deserted airport, were used for paddy storage, but not even a whimper of concerted protest when the vanity projects were being built. We also heard that on the rare occasions a plane was to land/take off, peacocks in the area were shot at to prevent them flying into the planes. Aney, what a sin, just to have a name on a nameboard! Use the Suriyawewa Cricket Stadium too for a better purpose and less costly to water and maintain green in near desert climate conditions. What about a residential training institute for youth, perhaps in small industries? If the king-sized ego demands the name be present, OK, leave it. What’s in a name?

Any matter, financial or economic, with benefit to country buttressing it – refer to Dr Harsha de Silva and Eran Wickremaratne. Likewise, anything pertaining to fauna, flora and preservation of natural habitats ask Devani Jayathilake. Cassandra would give two years of her life (she does not have 10 left, she suspects) to know what the answers of the three wise and sincere ones mentioned would be to the proposal to convert the Mattala Airport, oops sorry – Mattala Mahinda Rajapaksa International Airport – to a 7 star hotel for wildlife watching and then tourists proceeding to Yala and other places that were touted to be reached easier if planes brimful of tourists, landed in Mattala. Pipe dream even sans Covid-19.

The thought of the millions, nay billions, our country was indebted to China to construct these vanity projects aka white elephants of the Rajapaksa fiefdom sends Cass’s blood racing in her contracting veins. And now another hair-brained scheme is being exposed, not new but re-exposed: that of the stupendous amount sent direct from the Central Bank with no nod, as reported, from the then Cabinet or Parliament, to an American-resident con-man to improve our appearance on the world stage or at least American stage. My word!! Cosmetics of creams and colours and such like can improve the face of an already beautiful woman. But a country that was once beautiful, glorified, accepted internationally and then politician-spoilt, cannot be redeemed by PR work, however expensively. Nivard Cabraal was the then Govenor of the CB. Of course, as every Banda, Singho and their women say, nothing will come of this. Powerful political sweeping under the carpet in the presence of cardboard administrators and sycophantic hosanna singers, makes the matter disappear and not merely hides it. Unless of course there are enough intrepid outers-of-truths and persistent protestors, brave and national minded enough to continuously tease the matter like a cat its caught rat. Ranjan is locked away in hard labour for four solid years, losing his Parliamentary seat for misusing the gift of his gab, while convicted murderers of the right colour attend Parliament, escorted and all.

Cass apologises

To the reigning Mrs World, Mrs Caroline Jurie, for crowning, uncrowning and recrowning of the winner of the recent Mrs Sri Lanka contest. Caroline Jurie took this stride because the winning contestant was four years on the way to being a divorcee, which status forbids a woman from attempting to wear the crown of Mrs…. (country) with a view to becoming Mrs World. This title and honour is bestowed on a woman who promotes, holds sacred the institution of marriage and is a married woman. Cass castigated Caroline Jurie without knowing then the fact that Jurie had protested about this candidate being considered due to her impending divorce; and allowed to contest. She said she withdrew from the panel of judges since her point was not taken by the others. WHY is the Q. Easy to answer. The new beauty queen of shaky married status was a loud speaker in favour of Presidential Candidate Gotabaya R in Polonnaruwa (captured on social media) and probably spoke on stages for SLPP Parliamentary candidates. So of course she was slated to win; vision impaired over rules and future probabilities, She has her height – one advantage. Beauty can always be dexterously rubbed and painted in. But honesty is important and cannot be cloned or grafted in.

Cass now definitely faults the new Mrs Sri Lanka. She should not have contested, having her papers sent in for divorce and not retracted. What happens when she wins the divorce (or her husband wins it, however the divorce was first mooted). Another local contest? And if the divorce was still pending and she went overseas at great expense and won THE crown or a lesser one. To be returned forthwith when she has to remove the present gold band from her third finger, which probably she has already removed but hastily wore for the contest and when preparing for it? This is why Cass avows that many young women particularly, are so very selfish and forward and uppity and even dishonest now. In Cass’ time and even a decade or two later, a girl would never do what this new beauty has done, flipped aside a core rule and necessity of the contest, just to win by honest means or foul. Way the country’s going, my friend.

Post – Aluth Avurudhu

Cassandra is stuffed gill-high with kavun, aluwa and crunchy kokis, preceded by kiributh and lunumiris. She is fending for herself because a dip in Covid numbers and having had the jab, her domestic wished to enjoy a family new year having missed the last one, locked down as we were. Cass made her own kiributh – tasting somewhat like it should, but the sweets were all gifted her. So, also the offers of help, sleep-ins at others’ homes and solicitous frequent inquiries of ‘how are you?’ Kind and gracious relatives and friends, acquaintances too are thanked; and the most appreciated being neighbouring kitchen helps and care givers. Three-wheeler drivers who spin Cass around on errands too make enquiries. And thus her thoughts when resuming work at the nekath time and word processing this article. Sri Lankans are such good people: kind, caring, willing to share and genuine. And then specters themselves on this very sunny landscape: the dishonest, selfish, revengeful and disgraceful. Shrug them off, clear the mental picture and pronounce thank goodness for goodness around.

May all of us (decent people) have a very good year to follow today –Subha Aluth Avuruddhak!

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