The Sunday Mail
Professor Rudo Makunike-Mutasa
AS we approach the end of the Covid-19 pandemic third wave, we must remain vigilant in order to limit the possibility of a fourth wave, which has already been predicted.
Our prayer is that, given all we have learnt about the virus, the fourth wave will be much smaller and have fewer fatalities.
Covid-19 is caused by the SARS Cov 2 (severe acute respiratory syndrome coronavirus 2) virus.
It first broke out in Zimbabwe in March 2020 when the first case was detected.
Since then we have had three waves.
The first one was in June 2020, while the second one came in December.
The third wave came in June 2021.
The first wave broke out during the traditional flu season (June), whilst the second wave was driven by high mobility of people within and beyond borders during the festive season.
The third wave broke out during this year’s flu season.
Unless we utilise the lessons learnt during these preceding waves, we should expect the fourth wave in December.
What are the lessons?
The SARS Cov 2 virus is elusive and mutates into different forms.
The original virus, B.1.1.7, now referred to as the Alpha variant mutated into the B.501Y (Beta variant), and more recently it mutated into the deadly Delta variant.
Other variants (including Gamma and Lambda) have been detected since then, but are not yet of major concern.
The Delta variant
The Delta variant has proven to be twice as infectious as the Beta variant.
Patients infected by the Delta variant develop much higher viral loads than was the case with previous variants and therefore it is much more transmissible.
The Delta variant brought with it new symptoms that include persistent headaches, diarrhoea, vomiting, abdominal pain, general aches and pains, and extreme fatigue in addition to the original symptoms of fever, cough, chest pain, loss of smell and loss of taste. This variant has also infected children and young adults, whereas the incidence of infection among young people was very low with previous variants.
Pillars of defence
Initially, we learnt that we had three pillars of defence against the disease which are social distancing, wearing face masks and washing hands.
These largely kept us safe.
In addition, we now know that vaccination is yet another effective protective layer. A study that was undertaken in the Histopathology Unit at the University of Zimbabwe Faculty of Medicine and Health Sciences showed that 90 percent of Covid-19 related community deaths occurred in non-vaccinated people.
Vaccines
Zimbabwe has approved the use of five vaccines that include the Sinopharm, Sinovac, Johnson and Johnson Sputnik V and Covaxin.
The Sinopharm and Sinovac are both manufactured in China and are essentially the same vaccine made by different pharmaceutical institutions.
They are made using the dead whole virus technology. The Sputnik V is from Russia and is a vector-assisted virus, where the vaccine uses another flu virus to evoke the immune response.
All three vaccines available in Zimbabwe are two-dose vaccines.
Other vaccines not currently available in Zimbabwe include Pfizer, Moderna, Astra Zeneca and Johnson and Johnson, amongst others.
Other vaccines utilise new technology, such as nucleic acid (RNA or mRNA, or DNA) or proteins on the surface such as the spike protein as the immunogen to mount the immune response.
Vaccination in Zimbabwe has been mired in controversies and misinformation resulting in poor uptake among certain groups.
There is a great degree of fear that is making people hesitant to receive the vaccine.
Some of the fears are a result of a lack of information whilst others are caused by misinformation.
Will vaccination result in contracting Covid-19?
The vaccines administered in Zimbabwe are very safe because they use dead viruses.
The dead virus will cause your immune system to mount antibodies to help defend your immune system. You may get very mild flu like symptoms but not Covid-19.
Were the vaccines developed too quickly?
The Sinopharm and Sinovac vaccines were developed using old technology that has been in use for hundreds of years dating back to the development of the smallpox vaccine. We have been using similar vaccines such as the BCG (Bacillus Calmette–Guérin) for TB, and the polio vaccine.
So this technology is tried and tested.
The new technologies of using nuclei acid and vectors have been in the pipeline for some time.
The technology was being used to develop vaccines for diseases such as Ebola and AIDS.
What is in the vaccine?
You know much more about what is in the vaccine (dead virus and another chemical called an adjuvant that evokes the immune response) than about many other drugs that you take, such as your antibiotics or your antihypertensive etc.
So why worry about this particular one?
If you do get Covid-19 you are going to be treated with medicines that you have no clue about their contents!
Worried that the vaccine comes from China. The Chinese vaccines are perhaps the safest ones because the virus is dead.
In any case, what else in the world is not being made in China?
If you do contract Covid-19 and need treatment you are probably going to be treated with medicines and medical equipment that was made in China.
Misinformation
Will the leave me with the “mark of the beast”?
On the contrary, the discovery of the vaccine came as an answered prayer.
People prayed to God pleading for a way out of this pandemic.
God in his infinite mercy and compassion, provided us with the vaccine.
The Lord has a track record of answering the pleas of his children.
The vaccines are made from the very thing that is causing death, but is our hope.
Will the vaccine make me sterile?
There is absolutely no evidence to support this. Vaccines have been around for less than nine months so nobody in the world can claim that the vaccines have made them sterile! This is gross misinformation.
Will I develop an allergic reaction?
Indeed, a small percentage of people develop allergic reactions but this is a very small percentage and most will occur during the first few minutes.
Health care workers at vaccination centres are equipped to deal with this and they will ask you to sit for 20 minutes and observe you.
Do I need to get vaccinated if I have already suffered from Covid-19?
Yes! There is evidence that the immune response and protection offered by previous infection is slightly different from that resulting from vaccination
Can I get Covid-19 after I have been vaccinated?
Yes, unfortunately, the vaccines are not 100 percent effective.
The Sinopharm, Sinovac and Sputnik are thought to be approximately between 78 percent — 85 percent effective in preventing infection, and up to 90 percent effective against hospitalisation and up to 93 percent effective against death for the virus.
A percentage of people may still get quite sick, hospitalised or die, but this probability is very much reduced.
Can I be vaccinated if I am pregnant?
Yes! Initially, we were not sure. Now the advice is to go ahead and be vaccinated.
Can I be vaccinated if I am breast feeding?
Yes! Initially, we were not sure. Now the advice is to go ahead.
The risk and effects of Covid-19 far outweigh any other risks.
Can I be vaccinated if I have diabetes?
Yes! But make sure your blood sugar is well controlled before you go for vaccination. It is very important that you get vaccinated because diabetes is a risk factor for severe Covid-19.
Can I be vaccinated if I have high blood pressure?
Yes! Again, make sure your blood pressure is well controlled before vaccination.
People with high blood pressure and heart diseases are at risk of severe complication with Covid-19 and therefore must be protected. Can I be vaccinated if I am taking anti-retroviral drugs?
Absolutely! Continue to take your ARVS and get vaccinated.
Conspiracy theories
The biggest barrier to a successful global vaccination programmes are conspiracy theories. Are governments and organisations insisting on vaccination are infringing on my rights?
Perhaps, but when there is a global pandemic or a serious public health threat the rights of the group override individual rights.
You may want to exercise your right to get the virus, but that right is overridden by everyone else’s right NOT to get the virus.
You are required to switch off your cellphone on an aeroplane so that it does not interfere with the safety of the flight.
This is a right you have to give up in order to keep everyone on the plane safe.
When you have to have a swab shoved up your nose for a PCR test every time you want to travel, the right to your comfort is overridden by the need to keep everyone else you are travelling with and the country you are entering safe.
The requirement to have a yellow fever vaccination, when you visit certain countries, means governments in those countries override your own individual rights to keep their citizens safe.
The virus will be with us for a while, and may continue to mutate.
The only chance we have of fighting this deadly disease once and for all is for everyone to pull together in one direction for the common good.
Smallpox, another deadly disease that ravaged the world, has been eradicated through global vaccination, instituted by the World Health Organisation.
Professor Rudo Makunike-Mutasa is a professor of pathology at the University of Zimbabwe Faculty of Medicine and Health Sciences and consultant pathologist at Lancet Laboratories.
She currently serves on the Covid-19 National Experts Advisory Committee.
Parts of this article are excerpts of her presentation at the United Methodist Church RRW (Women’s) convention.
