MANAGING THE PANDEMIC

Vaccine may not deliver relief from Covid-19 surge

We must continue to enforce with renewed fervor the tried and tested non-pharmaceutical interventions

In Summary

• Vaccine will not turn around the catastrophic global surge of Covid-19 infections.

• At least not in the next six to nine months.

The global burden of Covid-19 now stands at about 55 million cases and over 1.3 million deaths.

Last week, global daily infections reached 666,000. The pandemic is out of control in most of Europe and the Americas. Here in Kenya, daily cases are inching close to 1,500.

What is now a veritable second wave of Covid-19 is now ubiquitous across the country and is stretching a fragile public health system to breaking point. According to nursing unions, health facilities are overwhelmed and crippled by a biting shortage of healthcare workers. The doctor-patient ratio in Kenya is one to about 5,500 patients, way below the one to 1,000 recommended by the WHO.

 

The future looks grim as Kenya’s Covid-19 cases soar exponentially and fatalities surge since October. It is estimated that 800 doctors, 600 nurses and 320 clinical officers have contracted coronavirus. Thirty-one healthcare workers have succumbed to Covid-19 since the first case was reported in March. Moreover, it is disconcerting that despite widespread public awareness about how infectious and potentially fatal Covid-19 is, adherence of preventive measures like use of face masks and social-distancing remain disappointingly low.

Unabated, the pandemic deaths could surpass the 50 to 75 million death toll of the 1918 Spanish flu. But there is a glimmer of hope after phase 3 clinical trials found a promising coronavirus vaccine candidate.

If all goes well, the Federal Drug Administration will authorise the public use of the first vaccine, a product of a collaboration between Pfizer and BioNTech. Data indicates a vaccine efficacy of rate of above 90 per cent with protection against Covid-19 symptoms achieved 28 days after vaccination that is administered in two doses.

While there is reason to be optimistic, the data is far from complete. It is not clear if the vaccine can protect one from severe Covid-19 illness. Data shows the vaccine prevents clinically symptomatic infection. There is uncertainty whether the vaccine protects against coronavirus infection or against Covid-19 symptoms once one is infected. It likely that one can transmit the virus even after they have been vaccinated and are asymptomatic.

Mass immunisation, especially in Africa, will face huge hurdles. Minus 70 degrees Celsius is exceptionally low by medical standards and there is limited or no infrastructure to transport and store the Pfizer BioNTech vaccine.

Dispensing with the need for refrigeration is not in the horizon. Africa may have to wait for vaccines requiring less brutally cold storage conditions such as Moderna’s that only needs minus 20 degree Celsius. It is estimated that cold storage and transport accounts for up to 90 per cent of the total cost of public vaccination programs.

The vaccine breakthrough is a big deal. However, a vaccine will not turn around the catastrophic global surge of Covid-19 infections. At least not in the next six to nine months. We must continue to enforce with renewed fervor the tried and tested non-pharmaceutical interventions; use of face masks, sanitiser and strict observance of social distancing.

 

Alex O. Awiti is Vice Provost at Aga Khan University. Views expressed are the writer’s