Dr. H. T, Wickremasinghe
It is commendable that the government of Sri Lanka has planned to get down nine million doses of Covishield Vaccine from Serum Institute of India, the world’s largest vaccine manufacturing company. This vaccine is actually none other than AstraZeneca –Oxford Vaccine manufactured by The Serum Institute of India, by the name of Covishield. To date, Sri Lanka has already administered about 200,000 doses to healthcare workers. The next consignment would be given to persons over 65 years and persons with co-morbid conditions such as diabetes, hypertension, heart disease and kidney disease.
With the rolling out of the vaccine globally, new observations have surfaced. The original schedule of the vaccine was to give two doses 28 days apart. This provided almost 70% immunity. However, new evidence has come out last month, suggesting that it would be better to increase the gap between two doses to 12 weeks (3 months) instead of four weeks. This would offer a more robust 84% immunity. The United Kingdom is already using the three months interval between two doses. This will provide greater flexibility for vaccine roll-out, and help the health authorities to deal with any possible supply disruptions, while consistently sustaining the maximum immunity to the public.
A study done by the independent COVID 19 Vaccine Research Group in UK had shown that until the time of conclusion of the study at three months, a single standard dose would provide 76% protection with no declining of immunity. How long this protection would last is not known yet. But time would tell us. As with any other vaccine, an introduction of a second dose at three months would certainly boost the immunity.
The second observation made during the roll out of this vaccine is that it appears to provide some form of protection to community spread of the disease. This study revealed that there was 67% reduction in community spread of the disease. This is in fact very good news, as when we go on vaccinating more and more people, there would be less and less community spread of the disease, reducing the burden on hospital medical services.
Another issue which surfaced while rolling out of the vaccine is the safety and efficacy of the vaccine in persons over 65-years of age. Unfortunately, all phase three trials done by AstraZeneca have not included many persons over 65 years of age. They primarily targeted the 18-55 year age group. According to the data from AstraZeneca’s phase three trials, only two out of 660 persons in the trial aged over 65 were infected with COVID 19. Such a small number of participants is grossly insufficient to make a global decision. It is obvious that AstraZeneca has failed to provide reasonable data of safety and efficacy of their vaccine in the elderly population. They are already paying the penalty as countries such as Germany, France, Austria, and South Africa have declined to use the vaccine for persons over 65 years, despite the recommendation made by the European Medicines Agency (The governing body of drug evaluation in EU countries) to use the vaccine for all ages. However, the United Kingdom decided to continue vaccination for all ages including persons of over 80. Their interim analysis during the early part of the vaccination programme shows that the vaccine is not only effective and provide the same immunity as for others but also has slightly less side effects.
Considering the seriousness of COVID 19 in the elderly and it’s very high mortality, it is my considered opinion that even if the vaccine is less effective or has more side effects, it is still worth giving it to old persons as it would save their lives.
With more and more new genetic variations of SARS CoV 2 virus emerging, a reasonable concern has transpired among scientists whether the vaccines would be able to provide immunity to the new emerging strains. Up to now globally there are more than 8,000 variants. Out of those, three variants, the South African variant, the Kent (UK) variant and the Brazilian variant are few rapidly gaining global spread. The UK variant has been identified in Colombo, Avissawella, Biyagama and Vavuniya.
Studies done in UK has shown that AstraZeneca vaccine would provide immunity to the UK variant. However, a similar study done on over 2,000 participants in South Africa has unfortunately revealed that this vaccine is not effective against the new South African strain.
There are more than 150 vaccines against COVID 19 in the production pipeline. Out of those a dozen are nearing completion and awaiting submission of their dossiers to World Health Organization for approval. With such a vast array of vaccines, it would be easy for WHO to distribute vaccines early to provide vaccination to all needy people in the world. But it would not be easy to have the same vaccine supply without disruptions with the expanding global demand. At the same time, some vaccines would show immunity to some new emerging variants, while another vaccine would show immunity to other variants. This brings us to another new strategy. What if we combine vaccines? Combined vaccines theoretically will provide greater flexibility for vaccine rollout and help to deal with any possible intermittent supply shortages of a particular brand.
However, the official guidance given by vaccine authorities in the world state that anyone who has already taken a vaccine should get the same brand of vaccine for both doses. The US Food and Drug Administration and the UK’s Joint Committee on Vaccination and Immunization (JCVI) recommend as much. It’s only in ‘very rare circumstances’ that vaccines of different brands may be used and only if one vaccine is available at a certain time, or it is not known which one was administered for the first dose. Nevertheless, the usefulness of a combined vaccine, in case of a short supply or with combating a new emergent variant, cannot be underestimated. New research is underway to find out the efficacy and safety of such combinations. The initial report with AstraZeneca-Pfizer vaccine combination will be available by mid-2021. Similar trials will be undertaken soon, so that the health authorities of countries would have a better and competitive option of choosing vaccines for their public.
Despite all this good news, we still have question for which we have to wait for an answer. How long the immunity will last is the question for with no answers are available yet. Many countries have already commenced their vaccination programme, even before the introduction of free vaccine programme by WHO sponsored COVAX. In the race of COVID 19 mass vaccination, Israel is well ahead of all the countries in the world already covering 43% of the total population. The number of new cases and deaths due to COVID 19 has come down. Even in the US, the initial wave of vaccination is slowly showing results of reduction of mortality from COVID 19 related complications.
The majority of the vaccines used so far may not provide the expected picture-perfect immunity and the world may continue to have COVID 19 infections, but based on evidence, speculations have already been made to claim that vaccination could provide almost 100% protection from death, This is what we all want.
With that positive note, let me conclude while emphasizing the need to continue our general public health measures such as wearing masks, social distancing and avoiding crowded gatherings to reduce the risk of contact with an infected person. There is no science to beat common sense.
(The writer, a Senior Consultant Paediatrician, is President of the Vaccine and Infectious Diseases Forum of Sri Lanka)
Science vs religion-I
Like oil and water, science and religion are immiscible and belong to mutually exclusive domains without any interface. Whenever they have been attempted to be brought together, the result invariably has been confusion, conflict, and bloodshed, of which there are too many gory examples in history. Allow religion to explain the origin of the Universe, according to its own ideas, and you end up with corpses of men and women burnt at stakes.
By GOVIND BHATTACHARJEE
In Tao of Physics, Fritzof Capra wrote that science does not need religion and religion does not need science, while a man needs both. I am not so sure. Again, in The Demon-Haunted World: Science as a Candle in the Dark, Carl Sagan wrote, “Science is not only compatible with spirituality; it is a profound source of spirituality.
“When we recognize our place in an immensity of light-years and in the passage of ages, when we grasp the intricacy, beauty, and subtlety of life, then that soaring feeling, that sense of elation and humility combined, is surely spiritual.” If spirituality implies appreciating our own insignificance in the Universe and the resulting feeling of humbleness, then this has nothing to do with religion.
But, leaving aside spirituality, religion and science have never been compatible. While science teaches us a systematic, rational way of exploring this universe to understand the laws of nature that guide life and non-life, religion has brought untold misery and suffering upon humanity. throughout the course of history. by claiming certainty in “information” and “facts” amenable neither to reason nor to observation.
Like oil and water, science and religion are immiscible and belong to mutually exclusive domains without any interface. Whenever they have been attempted to be brought together, the result invariably has been confusion, conflict, and bloodshed, of which there are too many gory examples in history.
Allow religion to explain the origin of the Universe, according to its own ideas, and you end up with corpses of men and women burnt at stakes. Same with politics. Allow religion to rule a nation, according to its own theories, and you end up with Afghanistan, Pakistan, or Iran where the laws of Sharia are more important than human life or human happiness.
Given the chance, religion would turn this world into a demon-haunted place in no time – in fact it has attained a remarkable degree of success in doing so. But, what exactly is science, and what is religion? According to The Stanford Encyclopaedia of Philosophy, “One way to distinguish between science and religion is the claim that science concerns the natural world, whereas religion concerns the supernatural world and its relationship to the natural. Scientific explanations do not appeal to supernatural entities such as gods or angels (fallen or not), or to non-natural forces (such as miracles, karma, or qi).
“For example, neuroscientists typically explain our thoughts in terms of brain states, not by reference to an immaterial soul or spirit, and legal scholars do not invoke karmic load when discussing why people commit crimes.” Science concerns itself with what is or can be observed and seeks an immediate answer. Religion claims the answer is either unknowable or explained only with the help of faith, that is acceptance of something whose existence is indeterminate.
Science claims to explain phenomena or mysteries only through the tested method of empirical inquiry which is a series of steps involving observation-hypothesis-experiment-inference-theory-prediction-testing. This process is indispensable, even where it may not succeed in explaining all observed phenomena, whereas religion takes recourse to God and finds it absurd that by studying STEM subjects (Science-Technology, Engineering and Mathematics) alone, the concept of God can be reduced to irrelevance. Given the chance, it will subsume science, too.
In fact, a great deal of effort has already been invested towards this end, to start a dialogue between science and religion that is actually an exercise in futility.In 1998, the Harvard biologist Edward O. Wilson in his book, Consilience: The Unity of Knowledge, argued that knowledge is a unified system that embraces science, morality, and ethics as well. The aim was perhaps not to make science spiritual but to make religion scientific.
In the 1990s, with its multi-million-dollar grants, the John Templeton Foundation launched a magazine called Science & Spirit, “to explain what science cannot, and asking science to validate religious teachings”. The magazine died a natural death in 2009.The Foundation also financed several documentaries like “Faith and Reason”, “Cybergrace: The Search for God in the Digital World” or “God & the Big Bang: Discovering Harmony Between Science & Spirituality”.
Scores of bestselling books, written by eminent scientists, followed, like Belief in God in an Age of Science (1998) by John Polkinghorne, a Cambridge physicist turned Anglican priest, The Language of God: A Scientist Presents Evidence for Belief (2006) by Francis Collins, Director of the Human Genome Project, or Return of the God Hypothesis: Three Scientific Discoveries That Reveal the Mind Behind the Universe (2021) by Stephen Meyer, Director of the Center for Science and Culture of the Discovery Institute which is the main organization behind the so-called Intelligent Design Movement, according to which the universe was created by an intelligent designer, the God almighty.
But physics explains the origin of the universe convincingly from quantum electrodynamics as arising from a vacuum fluctuation and biology explains the evolution of all life, starting with a chance molecule that learned to replicate itself. But both intelligent design and evolution cannot be true at the same time, hence the attempt to find a middle path – an absurd one at that – that God created the universe and left it to the laws of nature, also designed by him, to run it, without any further interference in its future course.
As the New York Times science journalist George Johnson wrote, thus “God becomes a metaphor for the laws that science tries to uncover.” On the question of faith, there are deep divisions among the scientists themselves. While Einstein’s God was one “who reveals himself in the lawful harmony of all that exists”, and not one “who concerns himself with the fate and the doings of mankind”, many scientists hold radically different views. Some, like the cosmologist Allan Sandage, wonder: “‘How is it that inanimate matter can organize itself to contemplate itself? That’s outside of any science I know”, while others, like the Oxford biologist Richard Dawkins, believe that pursuing God is a “waste” of time that never has “added anything to the storehouse of human wisdom”.
Believers in God hold that a grand unified theory to explain the universe in terms of a single theory that is the holy grain of science would be incomplete without the integration of faith and ancient wisdom in it, while others, like Christians, were outraged when the radiocarbon dating of the shroud of Turin suggested it as a medieval forgery and not the burial cloth of Jesus, feel that as science develops more sophisticated techniques, their religious beliefs will be vindicated.
Fortunately, the endeavour of all these new-age scientists to blur and finally erase the boundary between science and pseudoscience has not yet succeeded. Similar efforts are on even in our own country. Religion is essentially about worship, and worship means surrender.
Faith is necessarily blind and has to disregard evidence in order to reinforce and validate its belief system. Human life is full of misery and suffering ~ indeed it is a “flash of occasional enjoyments lighting up a mass of pain and misery” from which faith alone can provide a temporary deliverance. “Happiness is but only an occasional episode in the general drama of pain” that surrounds us, as Thomas Hardy said, and if surrender could mitigate even a little of that pain, it should be welcome.
Surrender can also be made more convincing when imbued with love and fear that a God is capable of inspiring in human minds. Finally, if the surrender can hold out the promise of something eternal, like an eternal deliverance from pain or from the endless cycles of birth and death, such an eternal vision becomes too tantalising to resist by most.
All that remains is to remind and reinforce these ideas continually through repetitive rituals, meaningless though they are, and the whole package becomes so overwhelming that few could emerge out of its enchanting aura to be able to see the world and reality with objectivity.
After all, we still do not know how the objective reality conveyed to our brain through the senses acquires a subjective meaning in our mind, how the scent of a rose gets transformed into the memory of our first love, or a fading photograph brings back long-forgotten emotions.
Subjectivity rules the roost, everything else, even hard evidence, becomes mere speculation. Blind faith has no rival, and when blind faith masquerades as science, the conquest of the mind by religion becomes total, and all logic has been clinically erased. The evolution of life and that too on a tiny planet called earth that has just about the right conditions with the right values of fundamental constants among billions of such planets is an awesome mystery that the believers cite to establish intelligent design as the only explanation.
They ignore the fact that there are planets with all possibilities and ours happen to be the one with only just one of these permutations that made life – and God – possible. Logic and faith, like science and religion – are incompatible; if bring them together, there will be combustion and conflict.
But bring complexity to replace conflict, and the science-religion debate immediately acquires a political dimension ~ struggle between secular liberalism and traditional conservatism, authority versus individual liberty, herd mentality versus reason, and state versus individual. In each one of these struggles, rationality is the obvious victim that is left bleeding to die.
Vijayabahu, Gajabahu, and meanings of names
By Uditha Devapriya
The Sri Lanka Navy recently commissioned Vijayabahu, a former US Coastguard Cutter. The ship joins two other US origin vessels in the Navy. For some reason, the name seems to have caused consternation among certain circles. Alan Keenan of the International Crisis Group, for instance, has noted on Twitter that it is “loaded with social and political meaning” and that “it’s hardly an advertisement for the multi-ethnic, multicultural #SriLanka western govts say they want to promote.” He cites two other names, Gajabahu and Samudura.
The Pali and Sinhalese Chronicles depict both Gajabahu and Vijayabahu as national heroes: Gajabahu (113-136 AD) for having led a campaign to rescue 12,000 Sinhala captives in the Chola (or Soli) kingdom, and Vijayabahu (1055-1110 AD) for having driven Chola invaders from Polonnaruwa and laid the foundation for the unification of the polity by one of his successors, Parakramabahu (1123–1186 AD). Alan Keenan’s reference to the “social” and “political” meanings of these names is doubtless based on how Sinhalese Buddhists imagine these kings today, and how military regiments have appropriated them.
There is no denying that nationalist historiography has reduced these personages into mythical heroes today. It’s not just the military. Even popular writers prefer to see history through a particular prism. Their interpretation of the past places these kings as saviours of the race (jatiya) and unifiers of the polity (rata). This presents an interesting problem. In praising these monarchs for having brought the country together, nationalist writers tend to impute contemporary terms, like sovereignty, on what was essentially a non-unitary State. This is historical anachronism at its best (or worst?), and it is from there that these writers extract the contemporary meanings of these kings and their names.
I have implied in many of my essays that by viewing history through these prisms, Sinhala nationalists have done a disservice to their own history. In other words, they have not been fair to their past. We must be careful not to commit the same mistake when criticising these writers. While pointing out the errors of their methodology, it would be prudent not to use the same categories and binaries they deploy. To that end, it would be more constructive, instead of pointing out the “contemporary” meanings of Sinhala kings and their names, to highlight their historical and non-mythical meanings. Once we do that, we will be able to reconstruct a past more in keeping with the multi-ethnic, multi-caste character of Sri Lankan history, particularly in the Anuradhapura and Polonnaruwa periods.
Vijayabahu, for instance, was the product of a period that saw deep and close interaction between Sri Lankan (Sinhala) monarchs and their South Indian contemporaries. In his book Rewriting Buddhism: Pali Literature and Monastic Reform in Sri Lanka, 1157-1270, Alastair Gornall notes three “interrelated” changes in the 10th and 11th centuries that profoundly shaped Sri Lankan history: the invasions of two Cola kings (Raja Raja and Rajendra I), the “fragmentation” of the ruling family, and “changing attitudes” to Sanskrit literature, which influenced Sinhala and Pali literary works. The early Chola invasions laid the foundation for Kalinga Magha’s conquests in the 13th century AD and the later shift from Anuradhapura to Polonnaruwa. In other words, there were linkages between an ostensibly “Sinhala Buddhist” polity and a “Hindu” South Indian dynasty that makes the use of binaries like Sinhala/Tamil, Buddhist/Hindu, and Sri Lanka/Soli redundant, if not anachronistic.
Indeed, the kings of these times actively involved themselves in the politics of South India. During the first millennium AD, Gornall writes, conflicts within the State were “contained.” What this means is that they never threatened the social and political patterns of the country. Once we pass this period, though, the Anuradhapura State becomes embroiled in the politics of its neighbouring states. As Professor Raj Somadeva has argued, between the reigns of Sena I (833-853 AD), Dappula IV (924-935 AD), and Mahinda V (982-1029 AD), Sinhala kings sided with one or the other contending dynasties in South India, thus exposing themselves to “the threat of outside invasion.” These interventions eventually lead to the humiliating deposal of Mahinda V, the last ruler of Anuradhapura.
Vijayabahu is celebrated in nationalist reconstructions of history as a just and able ruler who put an end to these humiliations, recaptured the State from the Chola invaders, and fortified the State. However, his hold was considerably tenuous. In seeking to unify the State, he had to account for and accommodate certain realities: he therefore entrusted the tooth relic of the Buddha to Velaikkara mercenaries. Gornall suggests that the Chola invaders harboured very little cultural ambitions in Sri Lanka: it was the South Indian social and mercantile elites who patronised and built Hindu temples in Polonnaruwa. Yet they did exert an influence on the political, social, and literary landscape of the post-Anuradhapura State.
In his book Foreign relations of Sri Lanka, from earliest times to 1965, Vernon Mendis argues that history has not been fair to this ruler: he is castigated for having capitulated to South Indian overlords and mercenaries. Nevertheless, to borrow an oft-quoted phrase, there was little that he could do. Vijayabahu’s response to these geopolitical realities was pragmatic, if not inevitable: in the interests of the State, he put up with a South Indian presence, to the extent that an inscription eulogising him was carved in literary Tamil, and married a Kalinga princess, Tiloka Sundari, to ensure “the longevity of his own lineage.” Not surprisingly, it is in this ruler’s reign that ties with South India become complex.
What nationalist interpretations of Vijayabahu’s achievements and failures thus omit is that the times he lived in were simply too complex to accommodate the binaries that popular writers impute to their reading of history. Long before Vijayabahu, before even the collapse of Anuradhapura, Sinhala kings had begun a tradition of claiming descent from the Kalinga line. This was, at one level, to add respectability to their office. It was also a creative way of accommodating the rise of South Indian power and the decline of Sinhalese power, both of which can be dated between the fourth and 14th centuries AD.
Following these cycles of decline and revival, we come across literary works, predominantly Sinhalese, that legitimise certain colonisation and nationalist myths. While the authors of the early Chronicles, especially the Mahavamsa, sought to validate specific religious sects, the authors of the later Chronicles, especially the Rajavaliya, sought to romanticise if not mythologise these cycles of decline and revival and to valorise the supposedly “enduring” character of Sinhala society. Hence the Rajavaliya eulogises Gajabahu for having rescued 12,000 captives from the clutches of a Chola king, though as Obeyesekere has pointed out there is little historical evidence for this. It also depicts him as settling Tamil communities in and around Kandy, though the rather anachronistic inclusion of Kandy indicates that this episode would have been the basis for a colonisation myth.
The polity and State presented in these stories are, to be sure, Sinhalese and Buddhist, and they admittedly legitimise the hero/villain distinctions that popular writers deploy in their re-imaginings of the past. Yet embedded with these same stories are important clues and signs of a vibrant, diverse, even multi-ethnic society. Gajabahu is presented as a Sinhalese hero, but there are narratives that depict him as the patron of the Pattini cult in Sri Lanka. Obeyesekere questions these myths and posits that they are “worthless.” Yet the inclusion of this king in a major Tamil literary work, the Silppadikaram, and the invocation of him in a ritual associated with the Pattini cult, the gammaduwa, tells us that the society of his time was more multifaceted that what the Chronicles would have us believe.
The Pattini cult itself shows clear linkages between Sinhalese and Tamil communities that have survived the many fratricidal conflicts we have seen since independence. Gananath Obeyesekere’s advice, in that sense, is probably the most important: when reading these myths, it is essential that we do not literalise them, since a literalist reading can pave the way for conflict and tension. That is why Alan Keenan’s point about the social and political meanings of names is highly relevant. However, it is important to not only highlight those meanings, but also look at possible alternative meanings. This admittedly requires historical and anthropological research of a sort we simply do not have here. It is only through such research and scholarship that we can prevent the country from sliding down into the murky waters of ethno-supremacism. For that, we need to return to our past.
The writer is an international relations analyst, researcher, and columnist who can be reached at firstname.lastname@example.org
Relationship between sleep and blood glucose levels
Therapeutic sleep might furthermore reduce lethal blood sugar levels by facilitating healthy systems. Curtailed sleep is a risk aspect for improved blood sugar levels.
SNS: Sleep and blood glucose levels: Contended Sleep and good health is inseparable with immense health benefits. Sleep deprivation leads to many health complications including blood sugar levels which has a major link with sleep cycle. There are proven facts that decrease in sleep impacts the blood sugar level leading to diabetes which, if stretched longer may result in heart diseases.
However, the connection between sleep and blood sugar is complicated. There is not a reasonable formula that demonstrates a relationship between the amount of sleep and an interconnected increase or decrease in blood sugar.
How does sleep impact Glucose Levels in Blood?
It sounds antithetical that sleep can both raise and lower glucose levels. According to a Rutgers University study report our bodies encounter a cycle of changes every day which is called a “circadian rhythm” which naturally boosts blood sugar levels at night and when an individual sleeps. However these natural blood sugar mounds are not a reason for worry.
Therapeutic sleep might furthermore reduce lethal blood sugar levels by facilitating healthy systems. Curtailed sleep is a risk aspect for improved blood sugar levels. Even discriminatory sleep deprivation over one night improves insulin resistance, which can in turn upswing blood sugar levels. As a result, a lack of sleep has been linked with diabetes, a blood sugar disorder.
Additional analysis is needed to better understand the relationship between sleep and blood sugar.
Factors managing the relationship between sleep and blood sugar levels:
-The abundance of time a person sleeps.
-The phases of sleep a person experiences.
-The time of day a person sleeps.
-A person’s age.
-A person’s eating habits (which coincide with nourishment and sleep).
How does inadequate sleep and Blood Sugar levels?
According to Dr Stuti Sharma, PG Resident MAMC Delhi, inadequacy of sleep and blood sugar levels are connected. Inadequate sleeping significantly increases blood sugar levels. Researchers have conveyed the following relationships between sugar and lack of sleep or sleep problems:
Sleep-disordered breathing is related to higher glucose levels
Obstructive sleep apnea is attributed to defective glucose tolerance
More intense sleep breathing issues are linked with higher blood sugar
Obstructive sleep apnea stringency is associated with increased fasting glucose
Poor sleep is associated with a decreased capacity to control glucose levels in diabetic patients
Sleep loss is correlated with risen glucose levels in hospitalized patients with and without diabetes
Relationship between blood sugar levels and heart disease
People with diabetes have a higher chances of developing various health problems including heart disease. High blood sugar levels over time can damage the blood vessels of our heart and other organs leading to different health problems. It means the longer you have diabetes the greater your risk for heart disease. Because of higher blood glucose level the heart may suffer from stroke and even death. But if blood sugar levels are maintained then there will be less chances of heart diseases. And it can be done by sound sleep as discussed earlier.
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