BY JOHANNES MARISA
PANDEMICS are very stubborn and collaborative efforts are required from all citizens if the public health war is to be won easily. Public health plays an important role in curtailing the spread of viruses like COVID-19. Public health is the science of protecting and improving the health of people and their communities. This work is achieved through promoting healthy lifestyles, researching disease and injury prevention, detecting, preventing and responding to infectious diseases. Many people do not seem to understand that in times of outbreaks, there must be robust and sometimes extraordinary responses in order to reduce both morbidity and mortality. Social media has been awash with negative and retrogressive news about the availed vaccines and the extended lockdown announced by President Emmerson Mnangagwa on Monday.
During this century, the world has been hit by at least four pandemics which claimed about 60 million people. The Spanish flu of 1918-20 was caused by H1N1 influenza A virus and it went on to infect about 500 million people, a third of the entire population by then. About 50 million people died. In 1957, the Asian flu struck, killing about four million people. It was realised that mass vaccination was necessary in order to contain the virus and an American microbiologist, Maurice Hilleman began the vaccine manufacturing process in May 1957 and within four months, a vaccine was available for human use. The pandemic was halted and order returned to the world. What was to follow was the 1968-69 Hong Kong flu which again receded with the introduction of a vaccine. Vaccination has been one of the potent public health interventions to curtail outbreaks as communities develop herd immunity to a specific disease.
COVID-19 has been tormenting the entire world since December 2019 when it was first reported in China. So many scientists have been trying to come up with specific drugs and vaccines. Pharmaceutical companies came up with vector and messenger RNA vaccines. Messenger RNA vaccines like Moderna and Pfizer do not contain any viruses but they may be difficult to administer in low-resourced countries as their maintenance is difficult. Moderna vaccine needs to be frozen at -20 degrees celcius while Pfizer needs about -70 degrees celcius. These temperatures are difficult to achieve in low-resourced countries. This is one of the reasons why many countries in Africa have turned to vector vaccines which include SinoPharm (Chinese vaccine), AstraZeneca (Oxford), Sputnik V (Russian) and Johnson Johnson. Their storage temperatures are favourable, between 2-8 degrees celcius which is feasible with our simple refrigerators and cooler boxes. We are left with no option except to accept some of these vaccines.
South Africa had a mutant strain of the COVID-19, B.1.351, which seemed not to respond to the Oxford vaccine, AstraZeneca hence the suspension of the rollout.
Their trials revealed the poor efficacy, hence the quandary about the vaccination programme in the country. What everyone should know is when there is something new, there is always scepticism, speculation, myths and conspiracy theories.
Some of the myths start as mere beerhall talk then spread like veld fire to all corners of the country. False theories may result in fear being instilled in many people with the resultant shunning of public health initiatives like vaccination. That would be detrimental to the entire nation since for pandemics to go away, we need at least 70% of the population to be vaccinated if we are to achieve herd immunity. Failure to beat the immunisation target may mean failure to achieve herd immunity, which is a failure on the broad objective of the project.
Trials have not been done yet on our fellow countrymen for the Sinopharm vaccine from China. The vaccine received approval for distribution on January 4, 2021 after reporting a 79% efficacy rate in interim late stage trials. However, many countries have already started administering the Sinopharm vaccine and these include Peru, Phillipines, Jordan, Indonesia, Turkey and Morocco. Side effects can occur anytime and we should be alert about the serious adverse effects which may be life-threatening. Both formative and summative evaluation should be done as the vaccine is rolled out. With the way COVID-19 is spreading, it may not be good to delay the rollout of the vaccine as waiting further will only result in increased morbidity. It was noble on the part of government to start with only 200 000 doses of the Chinese vaccine. If the efficacy of the vaccine is doubted after the first sample is given, then the nation has no reason to waste money on procuring it.
Let us all keep our fingers crossed as the vaccination process commences today.
We need to put our heads together if we are to succeed as a nation. We also need dedicated medical staff to administer the vaccine. We need resources to maintain the cold chain of the vaccines. Refrigerators, cooler boxes, vehicles and enough fuel, food and allowances for staff are all needed if we are to win the war. Together, we will conquer!
- Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes in his personal capacity.