Getting boosted important: now more than ever

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It doesn’t seem fair that news of the latest sharp rise in Covid-19 cases is coming right at the most difficult time in the economic and fuel crisis in Sri Lanka. Yet it also seems inevitable, given that we are still only about 2.5 years through what seems to be a five year pandemic.

How can I cite such clearcut numbers? They are merely estimates, based on research done into the major pandemics that have afflicted the world over the past several centuries. SARS (2002-2004) was the most recent one. But there has also been Ebola. And HIV AIDS, which first emerged in the mid 1980s.

History of pandemics

The most severe global impact was by a pandemic which happened a century ago, just after WW1, popularly called The Spanish Flu (1918 to 1920) which affected 500 million people (about 30 per cent of the world’s population) and killed about 50 million people. And further back in time, when population size was far lower, in the years of the Bubonic Plague aka ‘The Black Death’, (peaking between 1347 to 1351) and again emerging in the Elizabethan era (1589 – 1593) in England, virally transmitted disease decimated the population of Europe. So there are certainly enough of these traumatic mass events to study, and from which to draw certain conclusions.

Now the global population level is higher than it has ever been, and international transport has improved in efficiency and rapidity, through industrialisation. The population is far more mobile, and so the risks of transmission are greatly increased today. An epidemic breaches borders very quickly, and becomes a pandemic.

“Toddler level thinking”

The noticeable trend is that people get tired of masking, social distancing, and having their social lives disrupted indefinitely. Quite apart from the concerns about infringements of personal liberties and freedoms, vaccine politics and the mass marketing of vaccines, there is a sense that if we are tired of being impacted by it, it should no longer be a threat.

This is of course, although very understandable, toddler level thinking. If we close our eyes because it’s all too much, it won’t go away!

In fact, we need to ensure that our masks are in good supply, social distancing protocols are once again in place, and that we are vaccinated appropriately, as there is now evidence that current vaccines largely prevent the severe outcomes that Covid imposes, providing a shield; and that even when people do test positive to the latest variant, they are able to avoid hospitalisation.

In Australia, cases of the Omicron variant B.A. 5 have been surging over the winter flu season and we are told are now peaking. Sri Lanka generally over the past 2.5 years has seen the commensurate rise about three months after Australia.

Reluctance to get boosted

Epidemiologists are requesting members of the public take themselves to the nearest vaccination centre and get their third or fourth booster shot ASAP. There are several medical teams, supervised by the armed forces, administering boosters every morning between 9 a.m. and 1 p.m. in Colombo. But very few people are so far getting these vaccines, despite the fact they are effective, and very accessible.

Why is this reluctance? Is it difficult to travel to vaccination centres due to fuel shortages? This is a matter of priority and the QR system seems to be working efficiently for even fuel distribution now.

Can shots get expired?

Some people believe the Pfizer vaccines are past their best date. I checked with doctors in Colombo, and was told this:

“The Pfizer vaccines expire at the end of July. For vaccines and many other drugs, “expiry” means the efficacy goes down. As a rule of thumb we say the efficacy diminishes at a rate of about 10 per cent per month.

The manufacturer has announced that current tests indicate efficacy is maintained at 100 per cent one month afterwards. (This is called the ‘extended expiry date’, and is determined by lab testing. We need to wait another month to determine efficacy at the end of two months).

It is important to recognise that vaccine cold chains are strictly maintained, with checks done at least three times a day including weekends.”

So getting the booster vaccines sooner rather than later, while the supply is still plentiful, would be the best plan.

The other concern that people have is whether they can take Pfizer after having initial shots of Sinopharm last year. Anecdotal reports support the doctors when they say yes, it should be fine. Also, keep in mind that most people were vaccinated initially almost a year ago now, and immunity diminishes over time.

If you want your immunity to be robust in the months ahead, with the intensely transmissible Omicron variant now just starting its impact, act now. Our everyday food intake, vitamins and nutrition should be our basis of natural immunity; but the vaccination will ideally add the shield to this. It takes about two to three months for immunity to build after the vaccine is administered.

It will be 2025 before this ordeal is truly over, based on pandemic patterns. It is far too early to give up on taking precautions and valuing our lives and our well being.

At any one time, there are only five to 10 people observable in the queues even at Viharamahadevi Park for vaccination. While this is welcome in one sense, it is worrying if it shows that members of the public have become indifferent to the situation.

Could it be that they haven’t read the data? Certainly the country as a whole has been preoccupied with other matters since the Sinhala and Tamil New Year. But now is the time to start focusing on building ourselves up again. What use is economic improvement if we don’t live to enjoy its benefits?

Have we forgotten the devastation caused by the Delta variant last year? And this year, due to the additional economic crisis and the resulting shortages in medical supplies, the health system will be even more challenged over the next few months.

I say five years from late December 2019, or January 2020 because of the increased numbers of people in the world today, and their greater congregation in cities due to mass urbanisation. It is difficult to clearly look at and analyse the surges and declines in numbers, which occur in waves, because of the differences in testing protocols in different countries.

It is best to pre-empt an impending wave like this. Please everyone – consider your own situation and take action in the next few days, as a service to the community as well as your own family and yourself.

By Dr Devika Brendon