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Vaccine roll-out: Clear and strict plan need of the hour
The vaccine rollout against COVID-19 has been mired in controversy since its very inception.
While ugly scenes were witnessed this week with powerful people demanding priority for their ‘personal lists’, nearly 600,000 men and women who received the first dose of AstraZeneca’s vaccine are sick with worry that they will not be able to get their second dose.
“Sri Lanka needs to come up with a quick but well-thought out plan to overcome this issue while allaying the concerns of the public,” said the President of the Association of Medical Specialists (AMS), Dr. LakKumar Fernando said yesterday.
He said that there is a shortage of vaccines and unwittingly Sri Lanka got “stranded” by placing its trust in assurances given by the World Health Organization (WHO) that the country would get adequate vaccines for 20-27% of its population. The country was to receive 1.7 million doses by June through the global vaccine initiative, COVAX, but has got only 264,000 doses up to now. To aggravate the crisis, India’s Serum Institute reneged on its promises to provide 1.5 million doses of COVISHIELD, even after Sri Lanka made the full payment.
Without crying over what we should have done, the government needs to face the challenge and act promptly, said Dr. Fernando, calling for the setting up of a small group of experts to come up with an “alternative plan” in case the people who have got the first dose of AstraZeneca since mid-February, are unable to get the second from the same vaccine.
“A clear and strict vaccine roll-out plan even at this late stage is essential,” he said.
Having studied research and data from across the world, Dr. Fernando tells those who got the first dose of AstraZeneca that they can await their second dose in 16 weeks (four months). So those who got the jab in mid-February can hold on until mid-June, as they have developed a certain level of immunity against the virus.
He stressed that the government needs to continue all efforts to secure the 600,000 doses needed for the second jab of AstraZeneca’s vaccine from a credible source with manufacturer guarantee. If, however, all such efforts fail, the government would have to decide on experts’ recommendations whether these people should start all over again and get a different vaccine or there would be ‘mixing and matching’ of two vaccines but of the same base.
A scientific option may also be to mix and match AstraZeneca’s vaccine and Gamaleya’s Sputnik V vaccine as they are both developed on an adenovirus vector base. Sri Lanka could launch a clinical trial with people who are willing to participate, he added.
“Vaccination is the final rescue mission to put our programme on track to win the confidence of the public, while successfully beating the pandemic,” the AMS said in a scathing statement issued on Thursday.
In a statement titled ‘COVID-19 vaccine roll-out – What are we doing and who is responsible for the current mess?’, the AMS said that they had witnessed the programme taking another dramatic turn with the display of thuggery by the Mayor of the Moratuwa Urban Council.
It said: “We have come to know about several such ugly acts of politicians in Kurunegala and Galle as well during this vaccine roll-out. We have already protested against certain high handed actions of a powerful health sector trade union in relation to administration of the second dose.”
The vaccine doses received by Sri Lanka so far: January 28 – 500,000 doses of AstraZeneca’s COVISHIELD (donation from India) February 25 – 500,000 doses of AstraZeneca’s COVISHIELD (purchased from India) March 7 – 264,000 doses of AstraZeneca’s COVISHIELD (from COVAX)March 31 – 600,000 doses of Sinopharm (donation from China)May 4 – 15,000 doses of Sputnik V (purchased from Russia)May 26 – 500,000 doses of Sinopharm (donation from China)May 27 – 50,000 doses of Sputnik V (purchased from Russia)
Vaccines given to people –
AstraZeneca’s COVISHIELD: First dose to 925,242 (frontline workers and public) and second dose only to 341,962 people.
Sinopharm: First dose to 563,409
Sputnik V: First dose to 14,984
| No response from SPC Numerous calls and text messages to a high official of the State Pharmaceuticals Corporation (SPC) by the Sunday Times to get a timeline for when the different varieties of vaccines would arrive in the country proved futile.
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| Mucormycosis or black fungus With concern among the public about mucormycosis, clinicians have explained that this is not a new disease but has been around for decades. There is no evidence of an increased incidence of the disease up to now, assures the College of ENT and Head and Neck Surgeons of Sri Lanka. The ENT (ear, nose and throat) surgeons in Sri Lanka have the necessary skill and experience to manage rhino-cerebral mucormycosis with surgery and anti-fungal therapy, the college says. What is mucormycosis? Mucormycosis is a life-threatening fungal infection occurring in humans, according to the college. The Sunday Times understands that mucormycosis could be caused by exposure to mucor mould commonly found in soil, plants, manure and decaying fruits and vegetables. Pointing out that the commonest sites of involvement with this infection are the nose and paranasal sinuses, the college explains that the danger of the disease is its invasive nature which could lead to life-threatening complications or severe morbidity (disease) including blindness and other neurological complications. The college gives the following as causing an increased risk for this infection: Pre-existing diseases such as diabetes mellitus, hematological (blood and bone marrow) malignancies and HIV. Use of steroids – while steroids are proven to be effective in improving the cytokine storm in COVID-19, especially pneumonia, it could lead to immuno-suppression and secondary infections such as mucormycosis. This is why steroids should be used under the guidance of doctors. Severity of the COVID-19 infection as it suppresses or alters the systemic immune response to secondary infections. The college gives the early symptoms of sino-nasal mucormycosis as: Headache with nasal obstruction – especially if it is not responding to simple analgesics Nasal discharge which is brownish or bloodstained Fever Facial pain or facial numbness Swelling and/or discolouration of the face Swelling and/or discolouration of the palate Teeth becoming loosened |