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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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Features

Mindset changes and the dangerous ‘Religious War’ rhetoric

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Israeli border police on patrol at the Damascus Gate in occupied East Jerusalem (Pic courtesy Al Jazeera)

Nothing could be more vital at present in the conflict and war zones of the world than positive mindset changes and the wish of the humanist is likely to be that such momentous developments would quickly come to pass in particularly the Middle East. Because in the latter theatre almost every passing hour surfaces problems that call for more than average peace-making capabilities for their resolution.

For instance, the Islamic Supreme Fatwa Council in Palestine has reportedly warned of a ‘Religious War’ in the wake of recent allegations that Israel is planning to prevent the Muslim community from having access to the Al-Aqsa Mosque in East Jerusalem in the month of Ramadan. If true, this development is likely to further compound the Gaza violence and take it along an even more treacherous track. This is on account of the fact that religious passions, if not managed effectively, could prove most volatile and destructive.

As pointed out in this column previously, peace movements on both sides of the main divide in the region would need to quickly activate themselves, link-up and work as one towards the de-escalation of the conflict. What the Middle East and the world’s other war zones urgently need are persons and groups who are endowed with a pro-peace mind set who could work towards an elimination of the destructive attitudes that are instrumental in keeping the conflicts concerned raging.

This could prove an uphill task in the Middle East in particular. For, every passing minute in the region is seeing a hardening of attitudes on both sides in the wake of issues growing out of the violence. Accordingly, if peace-making is to be contemplated by the more moderate sections in the conflict, first, we need to see a lull in the violence. Achieving such a de-escalation in the violence has emerged as a foremost need for the region.

Right now, the Israeli state is showing no signs of climbing down from its position of seeing a decisive end to the Hamas militants and their support bases and going forward this policy stance could get in the way of de-escalating the violence even to a degree.

On the other hand, it would not be realistic on the part of the world community to expect a mindset change among Israeli government quarters and their supporters unless and until the security of the Israeli state is ensured on a permanent basis. Ideally, the world should be united on the position that Israel’s security is non-negotiable; this could be considered a veritable cornerstone of Middle East peace.

Interestingly, the Sri Lankan state seems to have come round to the above view on a Middle East peace settlement. Prior to the Ranil Wickremesinghe regime taking this stance, this columnist called repeatedly over the past few months in this commentary, in fact since October 7th last year, for the adoption of such a policy. That is, a peace settlement that accords priority to also the security needs of the Israelis. It was indicated that ensuring the security and stability of the Palestinians only would fall short of a comprehensive settlement of the Middle East imbroglio.

However, in the case of the Ranil Wickremesinghe regime, the above change in policy seems to be dictated almost wholly by economic survival considerations rather than by any well thought out principle or a sense of fairness to all relevant stakeholders.

For example, close on the heels of the regime playing host to the Israeli Transport Minister recently, it accorded a reverential welcome to the Iranian Foreign Minister as well. From the viewpoint of a small country struggling to survive, this is the way to go, since it needs every morsel of economic assistance and succour.

However, if permanent peace is to have a chance in the Middle East it would need to be based on the principle of justice to all the main parties to the conflict. Seen from this point of view, justice and fairness should be accorded to the Palestinians as well as the Israelis. Both parties, that is, should live within stable states.

The immediate need, though, is to at least bring a lull to the fighting. This will enable the Palestinian population in the Gaza to access humanitarian assistance and other essential needs. Besides, it could have the all-important effect of tempering hostile attitudes on both sides of the divide.

The US is currently calling for a ‘temporary ceasefire’ to the conflict, but the challenge before Washington is to get the Israeli side to agree to it. If the Israeli Prime Minister’s recent pronouncements are anything to go by, the US proposal is unlikely to make any impression on Tel Aviv. In other words, the Israeli Right is remaining an obstacle to a ceasefire or even some form of temporary relief for the affected populations, leave alone a political solution. However, changing their government is entirely a matter for the Israeli people.

Accordingly, if a stable peace is to be arrived at, hostile, dogmatic attitudes on both sides may need to be eased out permanently. Ideally, both sides should see themselves as having a common future in a peacefully shared territory.

Peace groups and moderate opinion should be at centre stage on both sides of the divide in the region for the facilitation of such envisaged positive changes. The UN and democratic opinion worldwide should take it upon themselves to raise awareness among both communities on the need for a political solution. They should consider it incumbent upon themselves to work proactively with peace groups in the region.

The world is a vast distance from the stage when both parties to the conflict could even toy with the idea of reconciliation. Because reconciliation anywhere requires the relevant antagonists to begin by saying, ‘I am sorry for harming you.’ This is unthinkable currently, considering the enmity and acrimony that have built up over the years among the volatile sections of both communities.

However, relevant UN agencies and global democratic opinion could begin by convincing the warring sections that unless they cooperate and coexist, mutual annihilation could be their lot. Mindset changes of this kind are the only guarantors of lasting peace and mindset changes need to be worked on untiringly.

As this is being written, the ICJ is hearing representations from numerous countries on the Middle East situation. The opinions aired thus far are lopsided in that they do not present the Israeli viewpoint on the conflict. If a fair solution is to be arrived at to the conflict Israel’s concerns too would need to be taken into account expeditiously.

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Dubai scene brightening up for SL fashion designers

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Sri Lankans are lighting up the scene in Dubai, not only as musicians, but in other fields, as well.

At the recently held Ceylon Food Festival, in Dubai, a fashion show was held, with Sri Lankan designers doing the needful.

The fashion show highlighted the creations of Pubudu Jayasinghe, Tehani Rukshika and Peshala Rasanganee Wickramasuriya, in three different segments, with each designer assigned 10 models.

The fashion show was choreographed by Shashi Kaluarachchi, who won the Miss Supermodel Globe International 2020, held in India, and was 1st runner-up at the Mr., Miss and Mrs. Sri Lanka, in Dubai.

Shashi says she was trained by Brian Karkoven and his know-how gave her a good start to her modelling career.

She has done many fashions shows in Sri Lanka, as well as in Dubai, and has worked with many pioneers in the fashion designing field.

The designers involved in the fashion show, in Dubai, were:

Pubudu Jayasinghe,

a 22-year-old creative and skilled makeup artist and nail technician. With a wealth of experience gained from working in various salons and participating in makeup and fashion projects in both Dubai and Sri Lanka, he has honed his talents in the beauty industry. Passionate about fashion, Pubudu has also acquired knowledge and experience in fashion designing, modelling, and choreography, showcasing his multifaceted expertise in the dynamic world of fashion.

Tehani Rukshika,

who studied at St Joseph’s Girls School, Nugegoda, says she went to Dubai, where her mom works, and joined the Westford University in fashion designing faculty for her Masters. Her very first fashion show was a Sri Lankan cultural event, called ‘Batik’. “This was my first event, and a special one, too, as my mom was modelling an Arabic Batik dress.”

Shashi Kaluarachchi

Peshala Rasanganee Wickramasuriya

has been living in Dubai for the past 21 years and has a batik shop in Dubai, called 20Step.

According to Shashi, who is on vacation in Sri Lanka, at the moment, there will be more Sri Lankan fashion shows in Dubai, highlighting the creations of Sri Lankan designers.

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Features

A mask of DATES…

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Yes, another one of my favourites…dates, and they are freely available here, so you don’t need to go searching for this item. And they are reasonably priced, too.

Okay, readers, let’s do it…with dates, of course – making a mask that will leave your skin feeling refreshed, and glowing

To make this mask, you will need 03-04 dates, and 02 tablespoons of milk.

Remove the seeds and soak the dates, in warm milk, for about 20 minutes. This method will soften the dates and make them easier to blend.

After the 20 minutes is up, put the dates in a blender and blend until you have a smooth paste. Check to make sure there are no lumps, or chunks, left.

Add the 02 tablespoons of milk to the blended date paste and mix well.

Okay, now gently apply this mixture to your face, avoiding the eye area. Use your fingertips, or a clean brush, to evenly distribute the mask all over your face.

Once the mask is applied, find a comfortable place to sit, or lie down. Relax for about 15-20 minutes, allowing the mask to work its magic on your skin.

After the mentioned time has passed, rinse off the mask with lukewarm water. Gently massage your face while rinsing to exfoliate any dead skin cells.

After rinsing off the mask, pat dry your face with a soft towel, and then follow up with your favourite moisturizer to lock in the hydration and keep your skin moisturized.

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