Queue Jumpers Put Vaccination Drive in Chaos
By Methmalie Dissanayake
A few months ago, Sri Lanka had little or no hope of obtaining a vaccine for its citizens, despite a majority in the world being hopeful of gaining access to a vaccine against COVID-19 developed by the UK, China, Russia or India. Therefore, not only its common citizenry, but even those who were considered as belonging to the so-called elite groups, were seen chasing after concoctions made by witchdoctors and self-proclaimed descendants of the mythical King Ravana.
With a handful of sensible officers, political authorities and best neighbours in its favour, the country was able to begin its vaccination drive against COVID-19 as it completes one year of recording the first confirmed case in the country.
The excitement however, did not last long as the entire vaccination process appeared to be marred by confusions, contradictions, inefficiency, lack of procedures and myths.
According to the ‘Guidelines for COVISHIELD Covid-19 Vaccination Campaign 2021’, issued by the Health Ministry in January, target groups for vaccination had been identified as follows for January and February:
All healthcare staff in the country (government and private) Non-health support staff considered as frontline workers directly in contact with Covid -19 patients in Covid-19 control and prevention activities (Defence Services, Police/STF, Civil Defence etc.)
Selected staff at Ports of entry who come directly in contact with possible Covid-19 import cases.
On 30 January, Primary Health Care, Epidemics and COVID-19 Disease Control State Minister Dr. Sudarshini Fernandopulle said they expected to start vaccinating citizens over the age of 60 within the first week of March.
However, it seems that this initial plan was diverted after the Parliamentarians were offered the vaccine at the Army Hospital in Narahenpita. The logic, some Parliamentarians presented here is they should be vaccinated as they frequently meet the public in various areas in the country and their number of close contacts was higher.
It was observed that several famous figures, such as former cricketer Sanath Jayasuriya, were receiving the vaccine too.
But now, instead of giving priority to the citizens over the age of 60 and the ones who are suffering from non-communicable diseases, it was seen that persons who are between 30 and 60 years were being given the vaccine in selected areas which are declared as ‘risk areas’ in the Western Province.
According to the health sources, these risk areas had been identified based on the number of COVID-19 patients reported from those areas.
This new decision taken by the Health Ministry placed the country in a state of confusion. Mass queues could be seen in front of the vaccination centres raising fresh fears as to whether that would lead to create new COVID-19 clusters, as basic health guidelines, given to prevent the spread of COVID-19, such as maintaining social distance were violated in such scenarios.
It was also reported that, in some areas, elderly people were turned away from the vaccination centres while the vaccines were given to those between 30 and 60 years.
Those who received the vaccine complained that they had to wait in the queues for several hours.
Furthermore, disputes were reported in Mahara and Narahenpita when the people arrived at the centres to receive the vaccine.
A person, who was present at the Mahara MOH during the dispute, told Ceylon Today the people started to complain alleging that people who did not belong to the area had come to get the vaccine.
“Finally, Police emergency line (119) was dialled and the Police had to intervene in the situation. Now, giving vaccines has been halted temporary in Mahara,” she said.
Those who had arrived at the vaccination centre on Kirula Road, Narahenpita, complained that they did not see any proper procedure being followed at the centre.
The people had been given numbers to receive the vaccine. The dispute erupted when some people who did not have numbers arrived at the centre.
When contacted, Deputy Director General of Public Health Services Dr. Hemantha Herath also accepted that confusion had arisen due to the new procedure.
“The Health Ministry identified several target groups to give the vaccine. We wanted to vaccinate the people in the Western Province who are most likely to contract the virus due to the nature of their jobs, because the virus could spread within the country when these citizens go outside the Province. Therefore, we tried to vaccinate them in parallel to those who are over the age of 60. However, large number of persons arrived at vaccination centres to receive the vaccine and as a result of this, those who were above the age of 60 had to face difficulties. Therefore, we decided to stop vaccinating those who are over the age of 30 in parallel to those who are over 60 and give the priority to the latter group,” he noted.
He said the main reason for this problem was the people, who feared that the stocks of the vaccine would be over before they receive it, visit the centres to get the vaccine.
“When we announced for certain groups, to visit the centres, large numbers arrived. Many of them did not belong to the target group. This caused massive queues and heavy congestion at the vaccination centres,” he noted.
Dr. Herath assured that all the eligible persons will receive the vaccine.
“There is no need to fear about that. Therefore, we urge the public to be patient until their time comes,” he said.
According to Dr. Herath, vaccinating the priority groups, which were recognised first, has not been finished as yet.
“Healthcare workers have been vaccinated. But majority of workers at border control are yet to receive the vaccine. We hope to vaccinate all of them before Sinhala and Hindu News Year,” he said.
What happened to the website?
A website was launched by the State Ministry of Primary Healthcare, Epidemics, and COVID Disease and to allow citizens to register for the vaccine.
The website, https://ehr.lk/, had been also designed to provide the public with information from the scientific community.
The website had asked several questions about the user’s medical history and they had been permitted to select either a government or private hospital to get their jab.
The website was officially launched on 10 February at the Health Ministry auditorium in the presence of State Minister of Indigenous Medicine Promotion, Rural and Ayurvedic Hospitals Development and Community Health Sisira Jayakody and State Minister of Production, Supply, and Regulation of Pharmaceuticals Prof. Channa Jayasumana.
However, the website was taken down within a few days. Even at that moment, thousands of Sri Lankans had registered. But now, when someone visits the URL, the website simply shows a message that the website is updating and it will be available shortly.
It is not clear as to why the authorities decided to take down the website suddenly as they did not give a clear answer to that.
When queried about this, Dr. Hemantha Herath said since the website is introduced by the State Ministry, the Health Ministry does not have much details on it.
He also said, the Health Ministry has not received data of the registered users of the website as well.
State Minister’s dismay
Meanwhile, speaking to the Media this week, Dr. Fernandopulle expressed her dismay over certain issues that erupted following the start of vaccinating the public.
Dr. Frenandopulle slammed Health Ministry officials over arbitrary decisions taken by them regarding the vaccination drive.
“It becomes really difficult to carry out the vaccination drive when such decisions were taken without prior notice. Some of the decisions we have taken before starting to vaccinate the general public were changed and communicated over the phone at midnight. Certain crucial decisions were not properly conveyed. Vaccination drive can’t be done in that manner,” she stressed.
“There should be a particular way of giving the vaccination and that’s what the Health Ministry had been doing. However, we don’t see such a procedure now,” she lamented.
“There are guidelines given by the technical committee. The President has also given certain instructions. However, those guidelines and instructions have been taken for granted when the vaccination drive is being manipulated in the country,” the State Minister added.
While expressing her dismay she said although she has been vested with the responsibility of COVID-19 Disease Control, she was not summoned for certain meetings, and even some vital decisions were not conveyed to her.
Meanwhile, when questioned as to on which ground the primary policy of vaccine drive was changed, former Chief Epidemiologist Dr. Nihal Abeysinghe said the vaccines should be given to prevent deaths due to COVID-19.
“Data shows that majority of deaths have occurred among those who are over the age of 60 and those who have non-communicable diseases. Therefore, this sudden change in the priority list is totally unacceptable,” he pointed out.
Moreover, the College of Community Physicians of Sri Lanka (CCPSL), the premier body for public health specialists in the country, also expressed its displeasure over the current way of vaccinating the public.
In a statement, the CCPSL said that they are gravely concerned about the non-adherence of the current COVID-19 vaccine programme to basic scientific principles.
The National Advisory Committee on Communicable Diseases (NACCD) which also performs as the National Immunisation Technical Advisory Group (NITAG), is the statutory body recognised locally and internationally to advise on the immunisation policy of the country, for all Vaccine Preventable Diseases including COVID-19. NACCD has approved the National Vaccine Deployment Plan for COVID-19 vaccination in January 2021. This plan was approved by the Ministry of Health and conveyed to all stakeholders including the WHO.
Considering the fact that there will be very limited quantity of vaccines in 2021, this approved vaccine deployment plan has listed the priority groups for vaccination. These priority groups included frontline health staff, frontline staff in the security forces and the Police, elderly over 60 years of age, those with co-morbidities and high risk groups in economically important and essential service/institutions.
The key objective of the vaccination programme for COVID-19 across the globe is to minimise severe disease and thereby the deaths due to COVID-19. Prioritisation is extremely important as there is a limited supply of COVID-19 vaccines across the globe (as indicated by the Vaccine Prioritisation Framework of the Strategic Advisory Group of Experts on Immunisation of the World Health Organisation) and no clear timeline is available for the delivery of the required doses of the vaccine to countries. Thus, it is mandatory to use the available vaccines in the best way to optimise the outcomes to our country.
Hence, the first priority as identified in National Vaccine Deployment Plan was to vaccinate the frontline healthcare workers and those who are directly involved in COVID-19 activities, which was completed in the first round of vaccination. The remaining priority groups include those over 60 years of age and specifically those suffering from non-communicable diseases in which severe diseases and deaths are happening on a daily basis in the country.
Therefore, that the decision of the Ministry of Health to initiate the vaccination, targeting the individuals of between 30 to 60 years was implemented in a few selected communities, is a clear deviation from the scientifically agreed prioritisation stated in the National Vaccine Deployment Plan, the CCPSL pointed out.
The current strategy Sri Lanka follows is neither an evidence based practice, nor a public health decision considering the wider public health and economic outcomes, and it totally derails the COVID-19 preventive activities in the country, dangerously undermining the public health response to COVID-19 especially with regard to the objective of reduction of complications and deaths due to COVID-19.
The College warned that disregarding the recommendations of NACCD at this stage of pandemic response may jeopardise the entire COVID-19 control activities.
“We, the CCPSL, earnestly request the Government to urgently implement the scientifically recommended vaccine priority list rather than taking ad hoc decisions on vaccination policy,” they requested.
Not only the CCPSL, the Government Medical Officers’ Association (GMOA) also raised concerns over the mess created after the non-adherence of the basic principles of the vaccination programme.
(Pix: Akila Jayawardana)