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Race between vaccination and mutation of virus

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The Covid-19 pandemic, globally, has developed into a race between vaccination of the world population and mutations of the virus into more dangerous strains. This, in a way, is a struggle for survival and a case of survival of the fittest. In the history of this planet Earth, such struggles have resulted in the total disappearance of species. In such struggles, human species have been successful in eliminating infectious microorganisms, like Small Pox, Polio, Measles, etc. But new bugs emerge, like HIV, Ebola, SARS, MRSA infections, etc. Mutations are part of the process of evolution of species and natural selection.

If there were no genetic mutations, there would be no life on earth. It is genetic mutations that survive that could produce variants and eventually new species. Out of thousands of mutations, it is a few that survive to produce new strains with new characteristics. And only a few of these characteristics would be capable of being useful for the survival of the organism. Some of these characteristics in microorganisms would be important for us from the health point of view. In the Covid-19 virus, it is mainly the changes in the spike protein of the virus that is of concern, for it is the structure that gives the ability to the virus to gain entry into cells of certain systems in the human body such as the respiratory system. Changes in the spike protein could make it more infectious and cause faster spread of the infection.

Viruses mutate at different frequencies. Some are fast and others are slow. Covid virus mutates slowly and accumulates about two changes per month. These are the stable changes that may assist the virus in its struggle for survival and help it to gain entry into host cells. When billions and billions of viruses in a global pandemic undergo mutations, and they have the potential of accumulating two stable changes per month, the chances of such changes being harmful to the host are high. This is a factor in the race between virus mutations and vaccination. Wider the spread and longer the virus lingers, greater is the chance of a virus victory. Faster the rate of vaccination of human beings worldwide, greater is the chance of a human victory.

Going by the recent picture emerging in countries like the UK, Singapore, Australia, etc., where new variants are gaining ground even though sufficient numbers are said to have been vaccinated, the virus seems to have the edge. This is because in other parts of the world sufficient numbers have not been vaccinated, and there is ample opportunity for the virus to replicate, increase its numbers and numbers of stable mutations and development of variants against which the presently available vaccines are less effective. This has happened in countries where the virus has had a free run, such as Brazil, South Africa, India and Peru.

The virus variants that emerged from these countries have been increasingly more infectious if not more lethal. As the numbers they could infect are greater, the number of deaths is also increased. The variants that have been tagged by WHO as Alpha, Beta, Delta and Lambda in that order are believed to have increased their ability to invade human beings. Whether they are more deadly has not been proved. Yet, their ability to spread much faster than their predecessors, pose a big threat to the vaccination process and creates a greater need for faster vaccination. Further, the successful vaccination in one part of the world does not make it safe for them as the picture unfolding at present shows. Even in Israel, where 80% vaccination was achieved very early, new variants are appearing. This is because, as the WHO Chief said, “no one is safe until everyone is safe”.

However, the good news is that some of the vaccines are proving to be more successful than expected. Particularly the mRNA vaccines like Pfizer are found to be more effective. They are proving to be as effective, if not more, in the real world as they were in clinical trials. For instance, Pfizer and also Moderna, which were expected to be 70-75% effective have been found to be 90-95% effective. It does not always go this way with vaccines. The construction of the mRNA vaccines involves a new technique, where part of the genome responsible for the development of the spike protein of the virus is carried in a harmless virus and used for the inoculation. This has been made possible due to diligent investment in molecular biology research for the last 40 years. These vaccines aim at the spike protein, while traditional vaccines like Sinopharm aim at the whole virus. The former appears to be more effective.

Effectiveness of the available vaccines against variants differs according to the type; but all of them are found to be effective in preventing serious illness and death. Pfizer and AstraZeneca vaccines are found to be 75% and 60% effective respectively, against the Brazil and South African variants in preventing the infection. They may be less effective against the Indian Delta and Peruvian Lambda. This shows that the Covid virus could gain the upper hand over vaccines when given the chance to undergo mutations.

The fact that several countries are lagging behind in the vaccination effort has to be viewed in this background. Though the US, the UK, Europe and other developed countries have succeeded in vaccinating more than 60% of their population, it is still only 8% of the global population that has received the jab. In 60 countries, less than 5% have been given the vaccine. If the emergence of variants totally resistant to vaccines is to be avoided, the global population has to be vaccinated in double quick time. Countries which have the capability of producing vaccines, but do not have the know-how to produce vaccines effective against Covid, should be given access to the technology. Now is not the time to hold on to patency rights. But it appears that the developed countries are driven by commercial considerations and not concerned with the safety of the world. They must realize that they too are in danger. The winner of the race between vaccination and mutation may be decided by what action the developed countries would take, to make available the vaccines to everybody in the world and how quickly that would happen.

 

N. A. de S. AMARATUNGA



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Opinion

Support move to generate electricity from garbage

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There had been several letters in the press where the Minister for Power, Dallas Alahapperuma, has enthusiastically declared to achieve 70% of power from Renewable Sources by the year 2030, without knowing the capability and the resources available with the CEB, and the time taken to provide transmission lines to connect the national grid, if international tender procedure is adopted or even otherwise.

I recall a letter sent to the press earlier, wherein I have stated, the garbage problem in Colombo is talked of as an urgent matter, but no action taken for over four decades, and the situation is getting worse day-by-day. The Colombo Municipal Council had once initiated action to set up an incinerator and there had been proposals from interested parties willing to undertake it, but for some unknown reason, these have been shelved by CMC or any other authority concerned.

A report submitted by an internationally famous foreign firm of consultants, Lahmeyer International of Germany, which produced a Master Plan for the Ministry for Power and Energy, touched on the possibility of setting up of an incinerator plant to serve a dual purpose – to eradicate the garbage problem and generate electricity.

What action the Ministry for Power or the CEB has taken is not known. It may be that the CEB has taken action to implement other recommendations and but did not pursue this matter with the CMC. The plant could also produce compost manure and reduce the foreign exchange spent on importing fertilisers. In this well compiled, meaningful and workable report, it is stated: “The incinerator plants use garbage to produce electricity. They are similar to conventional coal fired steam plants, but require elaborate refuse feeder, grate, firing and air quality control system. Also, the required land area is greater.

“Some two million people live in the Greater Colombo area, and the amount of garbage collected annually could be about 600 tons. About 65% is made up of organic substances. The garbage is at present dumped on marshy lands in the vicinity of Colombo for the purpose of land reclamation, that practice caused environmental problems [i.e., smells and ground and surface water pollution.]

“The average heat content of the garbage is not exactly known, but based on the few tests done, it may be in the region of 8 Joule per ton, compared with 40 to 45 Joule per ton of oil. Hence, the fuel saving potentially achievable with an incinerator plant could be 100,000 tons of oil per year [under 1988 conditions] . This would be sufficient for generation of some 400Mw of power, and at the same time would contribute to the solution of Greater Colombo’s waste disposal problem. “

The aforesaid estimates were prepared in 1988 almost 33 years back, and the present amounts will be very much more, perhaps thrice, due to increase of population. The report also states that without exact analysis of the moisture content and composition of the collected garbage, it is difficult to make an exact estimate but the investment may be around USD160 to 240 million at 1988 estimates.

If at today’s estimation at thrice the increase, then the production every day may be around 1200 Mw, which is far more than the 300×3 = 900 Mw. produced by the Norochcholai coal-fired project.

It is therefore suggested that either the Minister for Energy or the Minister for Agriculture, as Fertiliser Corporation comes under him, take up this matter with the Urban Development Authority or the Colombo Municipal Council to expedite it.

It should also be said that undertaking this project will also satisfy those who object to filling marshy land.

The government should give top priority to this project of producing electricity and fertilizer from garbage.

G.A.D. SIRIMAL [SLAS]
Retd. Former Asst. Secretary
Ministry for Power & Energy

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Opinion

A ‘painless shot’ from Army

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When I was told that the Army was administering Sinopharm Covid vaccinations at Viharamaha Devi Park with special provisions for individuals with disabilities, I decided to take my wife, herself a Rehabilitation Medicine Physician, but now afflicted with Alzheimers disease, for her Covid shot, not knowing quite what to expect.

At the driveway into the park an Officer in smart uniform stopped me and inquired politely if there was anyone with a disability. When I answered in the affirmative, indicating my wife, I was asked to drive in and given instructions where to park my vehicle. In the parking area, another army officer kindly directed me to park under the shade of a “Nuga” tree for my wife’s comfort and asked me to proceed to the Registration desk and obtain my vaccination card.

Walking the short distance to the registration desk I observed those awaiting the vaccination seated comfortably in shaded and green surroundings. There was even a vending machine which was, I presume to provide refreshments for those waiting.

The several registration desks were manned by smart young male and female army personnel. The gentleman who attended to me took down my details and when my contact number was given information that the owner of this phone number had already had the vaccination appeared on the computer correctly, as I had been already vaccinated. Now, I expected a typical “public servant’ response that the “rule” is that a contact number could be registered only once. However, the officer used his brain, and after listening to my wife’s situation proceeded to complete the form. Then came the consent form that had to be signed. When I explained that my wife was unable to do so again I expected him to say, “Then get a letter from a doctor saying she cannot sign.” But this officer who did not behave like a robot used his judgement and allowed me to sign the form.

The paper work having been duly completed, I was asked to bring my wife to get her shot. When I explained that it would be very difficult, but not impossible, I was directed to the doctor at the site. I walked up to the young yet professional looking doctor attired in scrubs. When I explained my position, he promptly directed a staff member to go along with me to the vehicle and administer the injection while my wife was still seated there.

I then inquired if the young man who was helping my wife could also get his vaccination, and “no problem” was the answer. And before I could say “Sinopharm” the whole procedure was done and dusted!

What first class service!

To be at the receiving end of empathy and kindness was indeed a satisfying experience.

My thanks and appreciation to the organisers of the vaccination programme at Viharmahdevi Park on Wednesday (21 July)

Those who are critical of the army playing a lead role in Covid pandemic control, please take note.

Dr. N.Jayasinghe

Physician.

Colombo 7

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Opinion

On ‘misinformation’ against Minister of Health

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Dr. Upul Wijayawardhana (UW) is a regular contributor to this newspaper. His articles are almost always interesting and sometimes they provide valuable perspectives.

I find his criticism/castigation of the Minister of Health (MOH) in an ‘epidemic of misinformation’ (Island 19.07.2021) unfair and baseless. UW singles the MOH out as ‘the leader of the pack, undoubtedly is the Minister of Health who conveys wrong health messages’. This is erroneous and unwarranted

The main issues that UW quotes in support of his argument is that ‘she recently went to a shrine to thank a goddess for protecting her’ and ‘that she dropped pots in rivers to prevent the spread of the pandemic’.

From the onset of this pandemic a multitude of rituals have been conducted and they are still in force; all night Pirith, Bodhi Pooja, continuous chanting of the Ratana Suthraya, etc. The MOH releasing pots to the rivers that would wash down the ‘pandemic’ to the sea was one such ritual. A salient point to be appreciated is that while there is the possibility that the MOH herself believed in the effects of releasing these pots; this ritual was done primarily for the country/public rather than herself- hence the coverage on TV and news.

In contrast to this, her fulfilling a vow that she and/or her family made on her behalf when she was at death’s door, is based on a personal belief, and unlike the previous public action was done as an extremely private affair. If not for the fact that she is the MOH and her actions got reported in the press, none of us would have been even aware of this act. One would be hard pressed to find anyone in this country who has not fulfilled a vow; be it for himself or herself / siblings/ parents /children with regard to examinations, illnesses, promotions, etc…

None of these actions has any bearing on how the MOH has advised the public based on the counsel that she has received from her health officials and as such she is certainly not guilty of conveying any ‘wrong health messages’.

The MOH contracted Covid -19 because she was at the forefront of this epidemic and was constantly in touch with frontline workers. Not because she abandoned good health practices in favour of a cultural ritual! She had to be admitted to the IDH, was in the intensive care unit and according to medical sources was quite sick. We now see her on TV, the effects of the Covid-19 are apparent, a person who has had a near brush with death, fully cognizant of the danger of her current position. Certainly this would not have been something she signed up for when she took on the job as the MOH! This being the case, for UW, a doctor of medicine, to refer to ‘There are other idiotic politicians around the world who paid with their lives for the folly of not accepting the reality of a viral pandemic’ is not worthy of a healer.

Having recovered from her illness the MOH at a press conference publicly thanked her medical team for the effort they put into saving her life. I am sure that she would have thanked them personally as well. UW concludes his diatribe against her saying ‘Her life was saved not by goddesses, but by the excellent doctors, nurses and other health professionals Sri Lanka is blessed with. A person who is unable to even grasp that reality surely does not deserve to be the Minister of Health’. Is UW seriously suggesting to this readership that the MOH is unaware of the difference between science and culture? Is it his contention that anyone who engages in a religious /cultural ritual has no grasp of reality?

As a side note I am amused by the use of the term ‘Sri Lanka is blessed with ’. Based on UW’s logic ‘who are highly trained in Sri Lanka’ ought to have been a more appropriate term as blessings have nothing to do with a scientific reality!

 

Dr. Sumedha S. Amarasekara

 

 

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