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Unjustified hype on coming COVID-19 vaccines

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by Dr B. J. C. Perera

Specialist Consultant Paediatrician

Many portals of information of various types of media are agog, enthusiastic and terribly excited with the so-called ‘fantastic news’ of the possibility of the arrival of a vaccine against SARS-CoV-2, the coronavirus that causes the disease COVID-19. This little blight of a virus has been responsible for causing a pandemic that has spread through the entire world like an uncontrollable wildfire, practically causing chaos, disorder and bringing untold misery to virtually every nation on our planet. The Homo sapiens have been eagerly waiting and even praying, for something, be it a medicine or a vaccine, which can be used to tame this microorganism. They, the public, are practically wailing for a respite. There is intense expectation that a vaccine, against this bug would be the panacea for all ills of this nasty disease. There are reports of vaccines in the pipeline that are thought to produce intense protection against the disease. If that is the case, it would indeed be like ‘Manna from Heaven’ for suffering humanity.

There is intense expectation among the general public of the entire world and most definitely in the people of this emerald isle as well, that an effective vaccine against COVID-19 is just round the corner and would be available even within one or two months from now. Yet for all that, it is time, and time well spent at that, to somewhat critically examine the realities of the publicity and hype that has been catalysed by these reports. The general populace is of course totally justified in their expectations following these promulgations from a variety of sources. However, is it really the truth and nothing but the truth? Or is it somewhat far from the real and genuine truth?

Many claims have been made, at least by two of the purported manufacturers of vaccines that their trial vaccines are kind of around 95 per cent effective. These claims seem to be based on provisional and interim results of all phases of animal and human 

clinical trials, announced grandiosely in the public domain, even before proper completion of Phase 3 Clinical Trials. It is pertinent to remind people that Phase 3 Clinical Trials by sheer definition, should involve tens of thousands of human volunteers. By virtue of the lack of completeness of Phase 3 Clinical Trials, none of these claims have been substantiated through publication in reputed Scientific Journals. That really means that there has not been any intense and rigorous scientific scrutiny and peer-review of the results that have been claimed. What we have today are outwardly impressive and dazzlingly attractive statements made by the manufacturers of these vaccines, whose claims have not been

 validated and accepted by a discerning scientific community.

So far, no vaccin e against COVID-19 has been registered under any internationally recognized regulatory authority, or for that matter, even the World Health Organisation (WHO). True enough, the WHO has been examining the feasibility of securing an effective vaccine, its provision to the entire world and the tremendously complicated logistics of its distribution. However, that is really in anticipation of the arrival of a scientifically effective and safe vaccine. It is of course a very wise course of action to follow. If and when such a vaccine arrives, we should not be caught napping.

At least one manufacturer of a vaccine, that has claimed around 95 per cent effectiveness, has suggested that their vaccine would be available for the general public by the first half of 2021, which is just next year and perhaps just a few months from now on. Even then, are we likely to get it in Sri Lanka? Even if we manage to get it, is it for everybody in the country?

It is on record that millions and even billions of doses of the vaccine have already been contracted for and even paid for by some of the countries of the developed Western world. It will probably become a despicable tragedy of vaccine nationalism. ‘I’ and ‘We’ before all others seem to be the buzz phrase. The administration of one notorious leader from a very affluent Western country has compared the global allocation of vaccines against COVID-19 to oxygen masks dropping inside a depressurizing aircraft. They have so pontificated; “You put on your own first, and then we want to help others as quickly as possible”. Incidentally, Sri Lanka has no such contracts with the manufacturers of these vaccines. As these vaccines have not completed safety studies and as no recognized regulatory body has registered them, Sri Lanka is not in a position to make upfront payment and reservations for them either, even if we can garner the money in the face of an economic downfall caused by the virus itself.

At the time of writing of this article in the evening of 23rd November 2020, it was reported in the media that the G-20 Summit declared that their members would take all necessary steps to ensure equal and equitable distribution of a COVID vaccine to all countries of Mother Earth. To some in the know-how, this may definitely appear to be wishful thinking. Some of these very same countries that made this pledge are the same worthies who, not all that long ago and in the face of global shortages, hoarded supplies of respirators, surgical masks, and gloves for their own hospital workers’ use. Overall, more than 70 countries plus the European Union imposed export controls on local supplies of personal protective equipment, ventilators, or medicines during the first four months of the pandemic. That group also includes most of the countries where potential Covid-19 vaccines are likely to be manufactured. In fact it is well recorded that such hoarding of vital equipment, medicines and vaccines is not new. A case in point is that of a vaccine that was developed in just seven months for the 2009 pandemic of the influenza A virus H1N1, also known as swine flu. That contagion killed as many as 284,000 people globally. But wealthy countries bought up virtually all the supplies of the vaccine. After the World Health Organization appealed and intervened, several of these very same countries agreed to share just 10 per cent of their vaccines with poorer countries. However, the caveat of that ‘magnanimous’ gesture was the stipulation that they would do so only after determining that their remaining supplies would be sufficient to meet their domestic needs. As for the future behaviour patterns of these very same countries regarding a COVID vaccine, your guess is as good as mine. If history is anything worthwhile to go by, they would get up to their tricks, once again.

We have an organisation, The Vaccine and Infectious Diseases Forum of Sri Lanka, which was established over a decade ago. Its objectives are to educate healthcare workers and the public regarding vaccines and vaccination and to have a dialogue with the Ministry of Health on vaccine related matters. It consists of, among others, immunologists, microbiologists, paediatricians, community physicians and family physicians, who practice vaccination and/or have an interest in vaccines. In a recent communiqué, published in The Island Newspaper on 24th November 2020, they have decreed that the only way that Sri Lanka would get the COVID vaccine would be through COVAX, the initiative of the Global Alliance on Vaccines and Immunization (GAVI), WHO and others. COVAX pledges to give all low and middle income countries equitable access to vaccines. The vaccines will be made available to priority groups. These include healthcare and social care workers, elderly, and persons with chronic non-communicable diseases. However, the most likely chances are that WHO/COVAX would be able to provide some vaccine doses to Sri Lanka only towards the end of 2021. WHO/COVAX has pledged that they would reserve a supply of vaccines necessary for only about 20% of our total population, and Sri Lanka will have to pay for them. They have also indicated that they do not wish to buy vaccines that exceed a cost of 20 US dollars per dose for any country. Apart from anything else, what the reaction of the general public would be to a scenario where only 20 per cent of the population is provided with a vaccine that is claimed to protect against a potentially fatal infection, is indeed mind-boggling. It would not be a surprise at all if the populace decides to get on to the roads in protest. There might even be combative riots.

In a truly scientific sense, the COVID vaccine research studies that have been carried out so far, apart from the claims of around 95 per cent efficacy, have not given us reliable information as to how long the immunity would last, how it might wane over time, the degree of protection in different age groups, whether yearly vaccination like the influenza vaccine would be necessary, whether the effectiveness would be just to prevent symptomatic disease rather than preventing infection by the virus, the absolutely essential logistics of transport of the vaccines, possibilities of major adverse effects that may come on after a protracted period of time, the manufacturing capabilities of the providers and the actual cost of bulk purchases of these vaccines. These are just a few among several other hitherto unanswered questions. In particular, we have no information about the use of the vaccine together with or without physical distancing, hand washing and mask wearing. Would the usage of even an effective vaccine contribute to our getting on with life as it was in the Pre-COVID era? Would it allow us to abandon all the measures advocated by health professionals as proven preventive strategies? These seem to be queries that need to be addressed most urgently and ever so decisively, well before a vaccine is released for general usage.

We need to face the spectre of stark reality in the face of many unknowns in this novel virus infection. There are many significant questions and very few answers. Real and rigorous scholarly science dictates that these have to be firmly and truthfully dealt with before we can claim that we would be able to defeat this marauding virus by using a vaccine. Scientifically unsubstantiated sensational proclamations that trigger public hysteria and the vision of a bright light at the end of the tunnel, are certainly not of the essence, and are very definitely not in the dominion of the desperate need of the hour.

In such a scenario, the general public should consider these contemplations ever so carefully and, of course, sanity should prevail. For at least the time being, it is vitally essential to implement mechanisms to educate the public on getting vulnerable persons to hospital early for management of complications of COVID-19 and to prevent unnecessary deaths. As so eloquently expounded by The Vaccine and Infectious Diseases Forum of Sri Lanka, it cannot be stressed too strongly that it is absolutely essential and undoubtedly crucial to continue vigorously with the public health recommendations on wearing face masks, physical distancing, hand washing and related mechanisms, which have stood the acid test of time, even from the era of the Spanish Flu of 1918.

There is a recent movement known as ‘BLACK LIVES MATTER’ in the Western world. It has taken those countries by storm to protest against injustices to people whose skin colour is black. The Westerners sometimes label South Asians as ‘Brown Sahibs’ because our skin colour is more akin to brown than to real black. In case there comes a time when this world has a safe and effective vaccine against COVID-19, all we can tell the foreign powers who control such a vaccine is that ‘BROWN LIVES MATTER TOO’.

Features

31st night…Down Under

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The NYE scene at the Grand Reception Centre, in Melbourne

Despite the COVID-19 restrictions, the Voluntary Outreach Club (VOC) in Victoria, Australia, was able to hold a successful New Year’s Eve celebration, at The Grand Reception Centre, in Cathies Lane, Wantirna South.

In a venue that comfortably holds 800, the 200 guests (Covid restrictions), spanning three generations, had plenty of room to move around and dance to the array of fabulous music provided by the four bands – Replay 6, Ebony, Cloud 9 with Sonali, Redemption and All About That Brass. 

The drinks provided, they say, oiled the rusty feet of the guests, who were able to finally dress up and attend such an event after nine months of lockdown and restrictions. With plenty of room for dancing, the guests had a thoroughly enjoyable time. 

According to an insider, the sustenance of an antipasto platter, eastern and western smorgasbord, and the midnight milk rice and katta sambol, were simply delicious, not forgetting the fantastic service provided by Jude de Silva, AJ Senewiratne and The Grand staff.

The icing on the cake, I’m told, was the hugely generous sponsorship of the bands by Bert Ekenaike. This gesture boosted the coffers of the VOC, which helps 80 beneficiaries, in Sri Lanka, comprising singles and couples, by sending Rs. 3,000 to Rs. 3,500, per month, to each of these beneficiaries, and augmenting this sum, twice a year, in July and December, with a bonus of the same amounts.

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Fall armyworm:

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Strategies for effective management

by Prof. Rohan Rajapakse

Emeritus Professor of Entomology University of Ruhuna and former Executive Director Sri Lanka Council of Agriculture Research Policy

Fall armyworm Spodoptera frugiperda (Lepidoptera; Noctuidae), a quarantine pest, has been identified as a very destructive insect pest of Maize/Corn. This insect originated in Americas and invaded the African region in 2016 and was detected in India the following year and perhaps would have naturally migrated to Sri Lanka last year from India. Now, it is reported that FAW is present in all districts of Sri Lanka except Nuwara-Eliya and Jaffna. In winter in the USA the pest is found in Texas and Florida and subsequent summer when it gets warmed up, the pest migrates up to the Canadian border. The corn belt of China is also at a risk due to its migratory habit and the cost to Africa, due to this invasion, will exceed $ 6 billion. Maize is a staple food crop in Africa and millions depends on it for food. Hence in Africa and now in Asia it is a global food security issue for millions of people that could be at a risk if FAW is not controlled. The adult moth migrates very fast almost 100 km every night and nearly 500 km, before laying 1,500 eggs on average. The entire life cycle lasts 30 days in tropical climate. There are six larval instars and mostly the destruction is caused by the last three instars and the growing moth pupates in the soil for 10-12 days and the nocturnal adults lay eggs on leaves for about 10 days The pest thrives on about 80 host plants but the most preferable host is Corn/Maize. In Sri Lanka the preferred hosts includes Kurakkan and Sugarcane in addition to Maize. The symptoms of damage- scrapping of leaves, pin holes, small to medium elongated holes. Loss of top portion of leaves fecal pellets in leaf whorl which are easily recognizable. The Comb is also attacked in later stages with a heavy infestation, but after removing the FAW affected portion of the comb the remaining portion is still suitable for consumption and there is no fear of any toxicity. There are two morphologically identical strains––maize strain that feeds on maize and sorghum, and rice strain that feeds on rice and pasture grasses. However, in Sri Lanka only the maize strain has been detected so far. FAW thrives in a climate where drought is followed by heavy rains on a similar way we have experienced last year.

Although new agricultural insect pests are found in Sri Lanka, from time to time a number of factors make FAW unique (FAO Publication 2018)

1

FAW consumes many different crops 2 FAW spreads quickly across large geographical areas 3.FAW can persists throughout the year. Therefore Sri Lanka needs to develop a coordinated evidence based effort to scout FAW for farming communities and effective monitoring by the research staff

 

Management

Since the pest has already arrived in Sri Lanka, the Government/ Ministry of Agriculture should formulate short, mid and long term strategies for its effective management with all stakeholders. Also it has to be clear that a single strategy ex pesticides will not help in effective control but a proper combination of tactics, such as integrated pest management should be employed in the long term. In the short term, the recommended pesticides by the Department of Agriculture should be employed along with cultural and sanitary control strategies. These strategies have now been formulated and what is required to enlighten the farmers and people by utilizing the trained staff. The country should be placed on a war footing and an emergency should be declared in the affected areas to coordinate the control strategies. The integrated control tactics, such as cultural control, should be integrated with pesticides based on the recommendation of the research staff. The residues should be destroyed after harvest and avoid late planting and staggered planting. The Ministry of Agriculture should create awareness among the farmers and train the farmers on early detection of egg masses found on leaves and destroy them by hand. The pesticides for FAW control is recommended by the Department of Agriculture (Please contact Registrar of Pesticides of the Department of Agriculture for the recommended list of Pesticides) and they have to make it available at subsidized rates or given free with technical information considering the emergency. When the larvae are small early detection and proper timing of pesticides are critical for elimination of the pest. With this outbreak some farmers and the private sector is engaged using highly hazardous pesticides which should be avoided to make way for sustainable alternatives. The Department Entomologists should train the farmers for early detection of egg masses when present on 5% of the plants and when 25% of the plants show damage symptoms and live larvae are present on war footing. The economic threshold has been calculated as 2-3 live larvae per plant and the control strategies should commence as soon as this threshold is detected by visual observation. The majority of development officers, agriculture and science graduates working in Divisional Secretariats, are already trained on pest control and their participation on training the farmers for early detection and pesticide selection and application warrants the strategy. Some of the recommended pesticides are follows: Chlorantraniliprole 200g/1SC: Trade name Corogen, Emamectin benzoate 5%SG: Trade name Proclaim,, Flubendiamide 24% WG : Trade name Belt. The Principle Entomologist of the Dry Zone Research Station of the Department of Agriculture ( Mrs KNC Gunawardena) has prepared an effective online presentation on FAW control and this has to be shared by all. The African country Ghana has declared a state of emergency in response to this invasion as Maize is a staple crop which should be followed by us in Sri Lanka.

The long term strategies include early detection. Stopping its spread and initiation of a long term research programme to identify tolerant varieties and granting permission to import such varieties as seeds. The country should ear mark on a Biological control strategy by breeding and releasing FAW parasitoids regularly. In USA larval parasitoids such as Apanteles marginiventris, Chelonus insularis and Microplitis manilae have contributed to keep the pest population down along with egg parasitoids Trichrogramma spp and a similar program should be initiated in the affected districts. Finally the best option is to establish a task force with the involvement of entomologists, extension personnel along with the administrators and scientists working in the universities to ensure the country are safe with regards to food security

 

 

The author has read for a PhD at University of Florida Gainesville in the USA in 1985 and his PhD thesis exclusively deals on Fall armyworm parasitoids and its ecology

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President’s decision on Colombo Port in national interest

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by Jehan Perera

President Gotabaya Rajapaksa has announced that the government will be entering into an agreement with the Adani Group, based in India, to offer them 49 percent of the shares in a joint venture company. This joint venture will include Japanese government financing and will manage one of the terminals in the Colombo port. The entry of Adani Group, into the Colombo port, has been opposed by a wide coalition of organisations, ranging from port workers, and left political parties, to nationalists and civil society groups. These groups have little in common with each other but on this particular issue they have made common cause and even held joint protests together. The main thrust of their objections is that control over the East Terminal of the Colombo port will pass into foreign hands and result in an erosion of Sri Lankan sovereignty.

The cause for alarm, among the protesting groups, may be fueled by the observation that one by one, the ports of Sri Lanka are being utilized by foreign powers. In particular, China has entered into Sri Lanka in a big way, obtaining a 99-year lease in the Hambantota port that it constructed. The Hambantota port, in its early period, showed it was economically unviable in the absence of Chinese cooperation. The burden of debt repayment induced the previous government to enter into this agreement which may become unfavorable in terms of national sovereignty. There were protests at the time of the signing of that lease agreement, too, though not as effective as the present protests regarding the change of management in the Colombo port, which is led by the very forces that helped to bring the present government into power.

In addition to the Hambantota port, control over the South Terminal in the Colombo port, and a section of the harbour, has been given to China through one of its companies on a 35-year lease. In both cases, large Chinese investments have helped to upgrade Sri Lanka’s capacity to attract international shipping lines to make use of the port facilities. The Hambantota port, in particular, could benefit enormously from Chinese ships that traverse the Indian Ocean, the Middle East and Africa. Instead of making refuelling stops elsewhere along the way, such as Singapore, they could now come to Hambantota. However, with these investments would also come a Chinese presence that could cause concerns among international actors that have geopolitics in mind. It may be that these concerns are finding expression in the opposition to the Indian entry into the Colombo port.

 

RATIONAL ANALYSIS

It will not only be Sri Lankans who are concerned about the Chinese presence in the country’s ports. As Sri Lanka’s nearest neighbour, India, too, would have concerns, which are mirrored by other international powers, such as Japan. It might be remembered that when Japan’s prime minister visited Sri Lanka, in 2014, there was a diplomatic furor that a Chinese submarine entered the Colombo port, unannounced, even to the Sri Lankan government, and docked there. With its excellent relations with China, that go back to the 1950s, when the two countries signed a barter agreement, exchanging rice for rubber, most Sri Lankans would tend to see such Chinese actions in a benign light. In recent years, China has emerged as Sri Lanka’s largest donor and its assistance is much appreciated. However, India’s relations with China are more complex.

The two countries have massive trade links, but they have also gone to war with each other due to territorial disputes. Even at the present time Indian and Chinese troops are in a stand-off on their disputed Himalayan border. In this context, India would be concerned that the Chinese presence in Sri Lankan ports could eventually take the form of an overall strategy to encircle it and use this leverage to India’s disadvantage. Sri Lanka’s location at the bottom of the Asian continent gives it a strategic importance in the Indian Ocean that goes beyond any possible India-China rivalry. The recent visit of US Secretary of State to Sri Lanka included an acerbic exchange of words between the US and Chinese representatives on that occasion and an open call to Sri Lanka to take sides, or not to take sides. As a small actor in itself, Sri Lanka would have no interest in getting involved in international geopolitics and has a longstanding policy of non-alignment and friendship with all.

More than anyone else, President Gotabaya Rajapaksa would be aware of these geopolitical issues. As Defence Secretary, during the years of war with the LTTE, he was a key member of the government team that obtained wide ranging international support for prosecuting the war. Today, the President’s key advisers include those with military backgrounds who have special expertise in geopolitical analysis and who have spent time in leading military academies in different parts of the world, including the US, China and India. This contrasts with the more parochial thinking of political, nationalist and even civil society groups who have come out in opposition to the agreement that the government has entered into with the Indian company to manage the Eastern Terminal of the Colombo port.

 

GEOPOLITICAL IMPERATIVE

President Rajapaksa was elected to the presidency in the context of the security debacle of the Easter Sunday suicide bomb attacks and with the expectation that he would provide clear-cut leadership in protecting the country’s national security without permitting partisan interests from becoming obstacles. In his meeting with the representatives of the trade unions, opposing the handing of management of the Eastern Terminal to foreign hands, the President is reported to have said that geopolitics had also to be taken into account. As many as 23 trade unions, representing the Ports Authority, the National Organisations collective, and a number of civil organizations, have joined the formation of a new national movement named the ‘Movement to protect the East Container Terminal’.

One of those political representatives at the meeting, leader of the Frontline Socialist Party (FSP), Pubudu Jayagoda, is reported to have said, “When trade unions met President Gotabaya Rajapaksa on Wednesday (13), he told them about the broad geopolitical factors in play. This is reminiscent when the unions met former Prime Minister Ranil Wickremesinghe a few years back. The unions told Wickremesinghe what they told Rajapaksa––the ECT could be operated by Sri Lanka in a profitable manner. Wickremesinghe told the union representatives, ‘You are talking about the port, I am talking about geopolitics’.” However, former Prime Minister Wickremesinghe may not have had the necessary political power to ensure that his vision prevailed and failed to ensure the implementation of the agreement.

Entering into the agreement with the Indian company will serve Sri Lanka’s national interests in several ways. By ensuring that India is given a presence in Sri Lanka’s most important port, it will reassure our closest neighbour, as well as Japan, which has been Sri Lanka’s most consistent international donor, that our national security interests and theirs are not in opposition to each other. Second, it takes cognizance of the reality that about two-thirds of the Colombo port’s shipping is due to transshipment with India, and thereby ensures that this profitable business continues. Third, it will give Sri Lanka more leverage to negotiate with India regarding key concerns, which includes Indian support to Sri Lanka at international forums and in providing guarantees for the unity of the country in the face of possible future threats and the need to ensure devolution of power to satisfy ethnic minority aspirations.

 

 

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