Alarm bells have rung in local health circles after the revelation of a cluster of Delta variant COVID cases in Dematagoda, Colombo, recently. This is understandable, since the Delta variant, first detected in neighbouring India, is at least 60 percent more transmissible than the original Coronavirus found in Wuhan more than one year ago.
Now the World Health Organization (WHO) has confirmed the worst fears of health planners and policymakers everywhere, with its declaration that the highly contagious Delta variant is the fastest and fittest Coronavirus strain yet. Having already spread to around 90 countries including Sri Lanka, it is certainly looking for more hosts to attach to and replicate rapidly.
The WHO has also warned that it will “pick off” the most vulnerable people, especially in places with low COVID-19 vaccination rates. We certainly cannot be complacent on this matter, because only around 1.5 million people in Sri Lanka have been vaccinated so far, with less than half of that getting both doses of any vaccine authorised for Emergency Use here. The danger here is that Delta spreads very fast and becomes the dominant strain in a very short period, as seen in the UK and India.
In the words of Dr. Mike Ryan, Executive Director of the WHO’s health emergencies programme, Delta has the potential “to be more lethal because it’s more efficient in the way it transmits between humans and it will eventually find those vulnerable individuals who will become severely ill, have to be hospitalized and potentially die.”
Ryan says world leaders and public health officials can help defend the most vulnerable through the donation and distribution of Covid vaccines, the light of WHO’s assertion that “no one is safe until everyone is safe”. This is a moot point, since some advanced countries have secured enough vaccine doses to inoculate their entire populations several times over, while many African countries have not given the vaccine even to one person. These rich countries are inoculating even their 12-year-olds while developing countries are lagging way behind in immunizing their vulnerable adult populations. This is indeed a catastrophic moral failure at a global level as surmised by WHO Director-General Tedros Adhanom Ghebreyesus.
The WHO’s warning on Delta comes just one month after the agency declared it a “variant of concern”. A variant can be labelled as “of concern” if it has been shown to be more contagious, more deadly or more resistant to current vaccines and treatments. WHO officials have said there were reports that the Delta variant also causes more severe symptoms, but that more research is needed to confirm those conclusions.
Delta is already replacing Alpha, the highly contagious UK origin variant that swept across Europe and later the US earlier this year, in many countries and regions. No variant has really found the optimal combination of high transmissibility and lethality, but Delta is the most able, fastest and fittest of those virus variants, according to WHO officials.
It is in this context that many countries are debating about the real possibility of needing a third dose or a “booster shot” primed against the Delta variant. Since the original vaccines from Pfizer, AstraZeneca, Moderna et al were based on the original Coronavirus version, they could indeed be less effective against later, more powerful and evasive variants. But it is not difficult to engineer vaccines against particular variants – this is just what pharma companies do in the case of the flu vaccines year after year. In fact, these companies are researching and trialling such vaccines right now, to be submitted for regulatory approval.
Sri Lanka should keep an eye on these global developments. President Gotabaya Rajapaksa, who has taken a keen interest in ensuring that all Sri Lankans have access to COVID-19 vaccines, has urged health authorities to consider this possibility seriously and place orders swiftly should the need arise. A quick decision on this matter will also help avoid any supply bottlenecks, like the ones we experience now with certain brands of vaccines. After all, the vaccine suppliers are compelled to prioritize those who place prior orders. Our health authorities should also follow developments with regard to the approval of new vaccines from companies such as Novavax and countries such as Cuba, which is developing two new indigenous vaccines. Several countries have already expressed in the latter. Single shot vaccines, developed with the latest variants in mind, should also be considered as the logistics are easier.
As President Rajapaksa has correctly pointed out, vaccination is our way out of this pandemic. The authorities should make all efforts to procure vaccines for the entire population from a range of countries and suppliers, including for schoolchildren above the age of 12 (this category is already being vaccinated abroad). This translates to an estimate of around 40 million doses (at two doses per individual). The aim should be to vaccinate all eligible categories of persons possibly by year end. After all, we cannot perpetually depend on lockdowns and other restrictions in order to see the light at the end of the tunnel.
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