[caption id="attachment_118422" align="alignright" width="650"]
"We were advised by the epidemiologists to prioritise the high-risk areas, so as to control the spread of the virus. When we look at the number of cases, the majority of those cases have been reported from the Western Province. Therefore, we will identify the high-risk Grama Niladhari divisions and the vaccinations will be given accordingly" State Minister of Primary Healthcare, Epidemics, and Covid Disease Control Dr. Sudarshini Fernandopulle[/caption]
Deviating from the initial plan of the Covid-19 vaccination programme has raised a myriad of questions as to whether the country would be able to meet the demand with the limited supply of vaccines in the world pharmaceutical market.
As per statistics available, more than 720,000 people have been vaccinated as of now in Sri Lanka, and it received the first batch of Covid-19 vaccines from the COVAX facility last week.
According to the World Health Organisation (WHO), the delivery of 264,000 doses is part of the first wave of arrivals that will continue in the coming weeks and months – culminating in 1,440,000 doses arriving through May, while the additional doses to cover 20% of Sri Lanka's population will arrive in the second half of 2021.
All these doses are donor-funded and provided at no cost to Sri Lanka.
With the limited number of vaccine availability around the world, the continuous supply of the vaccines necessary for the country is a question, as the stocks to be received from India have also seen a little delay.
However, speaking at a public forum last week, Principal Advisor to the President and Chief of the Presidential Task Force on the Procurement of Covid Vaccine Lalith Weeratunga assured that the second consignment of 500,000 Covishield vaccines from the Serum Institute of India is expected to arrive in Sri Lanka within the next two weeks. He said Sri Lanka had made a payment for 1.5 million doses of the Covishield vaccine.
In the meantime, it is reported that China has promised to give another 300,000 doses of its Sinopharm Covid-19 vaccines to Sri Lanka, in addition to 300,000 pledged previously.
According to Sri Lankan Ambassador to China Dr. Palitha Kohona, who held talks with Chinese Vice Foreign Minister Luo Zhaohui on 3 March, China had promised to dispatch 600,000 doses altogether. The Chinese vaccine has been delivered to 56 countries as of now.
However, the National Medicine Regulatory Authority (NMRA) is yet to give clearance for the Sinopharm Covid-19 vaccine for local emergency usage.
When queried about the delay in regulatory clearance, State Minister of Production, Supply and Regulation of Pharmaceuticals Prof. Channa Jayasumana said the NMRA is awaiting more details from the manufacturer of this vaccine.
He said he was hopeful that the problem could be addressed in a week’s time. Sri Lanka has so far approved only two vaccines – Oxford/AstraZeneca and Sputnik V.
Changing plans
In a backdrop where the country is yet to receive or at least order the requirement to ensure a continuous supply, the deviation from the initial plan was questioned by health experts, who claimed this is unacceptable at a time when the vaccination supply is limited.
As per the National Vaccine Deployment Plan for Covid-19 formulated by the National Advisory Committee on Communicable Diseases (NACCD) in January, the first priority identified was to vaccinate the frontline healthcare workers and those who directly involved in Covid-19-related activities, which was completed in the first round of vaccination. The remaining priority groups include those over 60 years of age and those suffering from non-communicable diseases.
The vaccination plan, which was also approved by the Ministry of Health, was conveyed to all stakeholders including the WHO, and therefore the deviation from the initial plan, prioritising the group between the ages of 30-60, including the Parliamentarians, and prioritising certain areas, have been criticised by health experts.
Even though the prioritisation plan differs from one country to another based on their social conditions, The Sunday Morning observed that almost all countries that have already started the vaccination programme have given the priority to those over 60 years, and those with critical medical conditions.
Nevertheless, as learnt by The Sunday Morning, Sri Lanka has changed its initial Covid-19 vaccine prioritisation plan, based on the recommendations of epidemiologists, and the main focus with immediate effect would be on areas where the highest number of cases has been reported over the past two weeks.
Despite the initial plan, epidemiologists have now advised the health authorities to prioritise those between 30-60 years of age, as the majority of cases have so far been recorded within that age category.
However, controversy arose after Parliamentarians, who were not in the initial priority groups eligible for the vaccine, were vaccinated last week, on the basis that they have frequent interactions with the public.
When contacted by The Sunday Morning, State Minister of Primary Healthcare, Epidemics, and Covid Disease Control Dr. Sudarshini Fernandopulle said the Government is now focusing on high-risk areas, especially areas in the Western Province, where the highest number of Covid-19 cases were recorded within the last two weeks.
“We were advised by the epidemiologists to prioritise the high-risk areas, so as to control the spread of the virus. When we look at the number of cases, the majority of those cases have been reported from the Western Province. Therefore, we will identify the high-risk Grama Niladhari divisions and the vaccinations will be given accordingly,” Dr. Fernandopulle said.
She further noted that the next vaccine batch is scheduled to arrive during the first week of next month.
The vaccination programme would be continued without any interruption, she stressed.
Public in the dark
At a time when the vaccine doses are limited, health experts claim that the ongoing vaccination plan has put the public in the dark, as they do not have an idea about when their loved ones would receive the vaccine, or whether they will ever be vaccinated against Covid-19.
The College of Community Physicians of Sri Lanka (CCPSL) was the first to ring the alarm over the vaccine prioritisation. It claimed the method of prioritisation is extremely important, as there is a limited supply of Covid-19 vaccines across the globe, with no clear timeline 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 outcomes in Sri Lanka.
The CCPSL pointed out that the decision of the Ministry of Health to initiate vaccination targeting the individuals of 30-60 years in a few selected communities is a clear deviation from the scientifically agreed prioritisation stated in the National Vaccine Deployment Plan.
As they claimed, the new strategy is neither an evidence-based practice nor a public health decision considering the wider public health and economic outcomes, adding that it 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 the virus.
They urged the Government to urgently implement the scientifically recommended vaccine priority list rather than taking ad-hoc decisions on vaccination policy.
Meanwhile, the Director General of Health Services Dr. Asela Gunawardana last week stated that the Covid-19 vaccine will be given to all citizens over the age of 30.
He further added that the highest number of patients in Sri Lanka is from those between the ages of 30 and 60; that they are the main transmitters of the disease; and that the number of patients over 60 is low, yet their mortality rate is high.
He further said that the Government has decided to vaccinate people over the age of 30, and to give priority to the Grama Niladhari divisions in Colombo and Gampaha Districts where the highest numbers of patients are reported. After covering the Colombo-Gampaha Districts, inoculation will be extended to other districts as well.
Dr. Gunawardana urged the Government to prioritise those over 60 years in queues, and to carry out the vaccination drive according to the quantity received. He also appreciated the commitment of the health sector officials in the inoculation process.
Reduction of PCR tests
Meanwhile, the concerns have also been raised over the reduction of the number of PCR tests conducted within the country.
Sri Lanka Association of Government Medical Laboratory Technologists Chairman Ravi Kumudesh alleged that per-day, PCR testing had come down to 7,000 as a result of the ongoing vaccination programme, whereas not increasing PCR tests and conducting Covid-19 surveillance systems might cause more spread in society and result in rapid deterioration of the present situation, leading to an instant boom in Covid-19 infections.
According to him, with the ongoing vaccination programme, it will take at least three years to control the virus in the country. For that, the country should go for a herd immunity development process. To develop herd immunity in society, at least 60% of the population should be vaccinated.
Sri Lanka has only received 1.3 million vaccines, and when compared to the population in the country, at least 13 million people should have been vaccinated to bring the situation under control, Kumudesh added.
The reduction of PCR was acknowledged by State Minister Dr. Fernandopulle on a television talk show last week, where she stressed that the number has been reduced due to the vaccinations given to high-risk areas, especially in the Western Province.
Vaccine priority in the UK and Australia
In the UK, the priority in the first phase of their vaccination programme has been given to residents in a care home for older adults and staff working in care homes for older adults; all those 80 years of age and over, frontline health, and social care workers; all those 75 years of age and over; all those 70 years of age and over and clinically extremely vulnerable individuals (not including pregnant women and those under 16 years of age); all those 65 years of age and over; adults aged 16-65 years in an at-risk group; all those 60 years of age and over; all those 55 years of age and over; all those 50 years of age and over; and the rest of the population (to be determined).
Similarly, in Australia, priority has been given to quarantine, border, frontline healthcare workers, frontline healthcare worker sub-groups, aged care, and disability care staff. Under the phase 1b of the vaccination plan of Australia, priority has been given to elderly adults aged 80 years and over, elderly adults aged 70-79 years, other healthcare workers, while the authorities were to begin vaccinating Aboriginal and Torres Strait Islander adults, adults with a specified medical condition, adults with disabilities who have a specified underlying medical condition, and critical and high-risk workers in sectors including defence, police, fire, emergency services, and meat processing.
"We were advised by the epidemiologists to prioritise the high-risk areas, so as to control the spread of the virus. When we look at the number of cases, the majority of those cases have been reported from the Western Province. Therefore, we will identify the high-risk Grama Niladhari divisions and the vaccinations will be given accordingly" State Minister of Primary Healthcare, Epidemics, and Covid Disease Control Dr. Sudarshini Fernandopulle[/caption]
Deviating from the initial plan of the Covid-19 vaccination programme has raised a myriad of questions as to whether the country would be able to meet the demand with the limited supply of vaccines in the world pharmaceutical market.
As per statistics available, more than 720,000 people have been vaccinated as of now in Sri Lanka, and it received the first batch of Covid-19 vaccines from the COVAX facility last week.
According to the World Health Organisation (WHO), the delivery of 264,000 doses is part of the first wave of arrivals that will continue in the coming weeks and months – culminating in 1,440,000 doses arriving through May, while the additional doses to cover 20% of Sri Lanka's population will arrive in the second half of 2021.
All these doses are donor-funded and provided at no cost to Sri Lanka.
With the limited number of vaccine availability around the world, the continuous supply of the vaccines necessary for the country is a question, as the stocks to be received from India have also seen a little delay.
However, speaking at a public forum last week, Principal Advisor to the President and Chief of the Presidential Task Force on the Procurement of Covid Vaccine Lalith Weeratunga assured that the second consignment of 500,000 Covishield vaccines from the Serum Institute of India is expected to arrive in Sri Lanka within the next two weeks. He said Sri Lanka had made a payment for 1.5 million doses of the Covishield vaccine.
In the meantime, it is reported that China has promised to give another 300,000 doses of its Sinopharm Covid-19 vaccines to Sri Lanka, in addition to 300,000 pledged previously.
According to Sri Lankan Ambassador to China Dr. Palitha Kohona, who held talks with Chinese Vice Foreign Minister Luo Zhaohui on 3 March, China had promised to dispatch 600,000 doses altogether. The Chinese vaccine has been delivered to 56 countries as of now.
However, the National Medicine Regulatory Authority (NMRA) is yet to give clearance for the Sinopharm Covid-19 vaccine for local emergency usage.
When queried about the delay in regulatory clearance, State Minister of Production, Supply and Regulation of Pharmaceuticals Prof. Channa Jayasumana said the NMRA is awaiting more details from the manufacturer of this vaccine.
He said he was hopeful that the problem could be addressed in a week’s time. Sri Lanka has so far approved only two vaccines – Oxford/AstraZeneca and Sputnik V.
Changing plans
In a backdrop where the country is yet to receive or at least order the requirement to ensure a continuous supply, the deviation from the initial plan was questioned by health experts, who claimed this is unacceptable at a time when the vaccination supply is limited.
As per the National Vaccine Deployment Plan for Covid-19 formulated by the National Advisory Committee on Communicable Diseases (NACCD) in January, the first priority identified was to vaccinate the frontline healthcare workers and those who directly involved in Covid-19-related activities, which was completed in the first round of vaccination. The remaining priority groups include those over 60 years of age and those suffering from non-communicable diseases.
The vaccination plan, which was also approved by the Ministry of Health, was conveyed to all stakeholders including the WHO, and therefore the deviation from the initial plan, prioritising the group between the ages of 30-60, including the Parliamentarians, and prioritising certain areas, have been criticised by health experts.
Even though the prioritisation plan differs from one country to another based on their social conditions, The Sunday Morning observed that almost all countries that have already started the vaccination programme have given the priority to those over 60 years, and those with critical medical conditions.
Nevertheless, as learnt by The Sunday Morning, Sri Lanka has changed its initial Covid-19 vaccine prioritisation plan, based on the recommendations of epidemiologists, and the main focus with immediate effect would be on areas where the highest number of cases has been reported over the past two weeks.
Despite the initial plan, epidemiologists have now advised the health authorities to prioritise those between 30-60 years of age, as the majority of cases have so far been recorded within that age category.
However, controversy arose after Parliamentarians, who were not in the initial priority groups eligible for the vaccine, were vaccinated last week, on the basis that they have frequent interactions with the public.
When contacted by The Sunday Morning, State Minister of Primary Healthcare, Epidemics, and Covid Disease Control Dr. Sudarshini Fernandopulle said the Government is now focusing on high-risk areas, especially areas in the Western Province, where the highest number of Covid-19 cases were recorded within the last two weeks.
“We were advised by the epidemiologists to prioritise the high-risk areas, so as to control the spread of the virus. When we look at the number of cases, the majority of those cases have been reported from the Western Province. Therefore, we will identify the high-risk Grama Niladhari divisions and the vaccinations will be given accordingly,” Dr. Fernandopulle said.
She further noted that the next vaccine batch is scheduled to arrive during the first week of next month.
The vaccination programme would be continued without any interruption, she stressed.
Public in the dark
At a time when the vaccine doses are limited, health experts claim that the ongoing vaccination plan has put the public in the dark, as they do not have an idea about when their loved ones would receive the vaccine, or whether they will ever be vaccinated against Covid-19.
The College of Community Physicians of Sri Lanka (CCPSL) was the first to ring the alarm over the vaccine prioritisation. It claimed the method of prioritisation is extremely important, as there is a limited supply of Covid-19 vaccines across the globe, with no clear timeline 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 outcomes in Sri Lanka.
The CCPSL pointed out that the decision of the Ministry of Health to initiate vaccination targeting the individuals of 30-60 years in a few selected communities is a clear deviation from the scientifically agreed prioritisation stated in the National Vaccine Deployment Plan.
As they claimed, the new strategy is neither an evidence-based practice nor a public health decision considering the wider public health and economic outcomes, adding that it 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 the virus.
They urged the Government to urgently implement the scientifically recommended vaccine priority list rather than taking ad-hoc decisions on vaccination policy.
Meanwhile, the Director General of Health Services Dr. Asela Gunawardana last week stated that the Covid-19 vaccine will be given to all citizens over the age of 30.
He further added that the highest number of patients in Sri Lanka is from those between the ages of 30 and 60; that they are the main transmitters of the disease; and that the number of patients over 60 is low, yet their mortality rate is high.
He further said that the Government has decided to vaccinate people over the age of 30, and to give priority to the Grama Niladhari divisions in Colombo and Gampaha Districts where the highest numbers of patients are reported. After covering the Colombo-Gampaha Districts, inoculation will be extended to other districts as well.
Dr. Gunawardana urged the Government to prioritise those over 60 years in queues, and to carry out the vaccination drive according to the quantity received. He also appreciated the commitment of the health sector officials in the inoculation process.
Reduction of PCR tests
Meanwhile, the concerns have also been raised over the reduction of the number of PCR tests conducted within the country.
Sri Lanka Association of Government Medical Laboratory Technologists Chairman Ravi Kumudesh alleged that per-day, PCR testing had come down to 7,000 as a result of the ongoing vaccination programme, whereas not increasing PCR tests and conducting Covid-19 surveillance systems might cause more spread in society and result in rapid deterioration of the present situation, leading to an instant boom in Covid-19 infections.
According to him, with the ongoing vaccination programme, it will take at least three years to control the virus in the country. For that, the country should go for a herd immunity development process. To develop herd immunity in society, at least 60% of the population should be vaccinated.
Sri Lanka has only received 1.3 million vaccines, and when compared to the population in the country, at least 13 million people should have been vaccinated to bring the situation under control, Kumudesh added.
The reduction of PCR was acknowledged by State Minister Dr. Fernandopulle on a television talk show last week, where she stressed that the number has been reduced due to the vaccinations given to high-risk areas, especially in the Western Province.
Vaccine priority in the UK and Australia
In the UK, the priority in the first phase of their vaccination programme has been given to residents in a care home for older adults and staff working in care homes for older adults; all those 80 years of age and over, frontline health, and social care workers; all those 75 years of age and over; all those 70 years of age and over and clinically extremely vulnerable individuals (not including pregnant women and those under 16 years of age); all those 65 years of age and over; adults aged 16-65 years in an at-risk group; all those 60 years of age and over; all those 55 years of age and over; all those 50 years of age and over; and the rest of the population (to be determined).
Similarly, in Australia, priority has been given to quarantine, border, frontline healthcare workers, frontline healthcare worker sub-groups, aged care, and disability care staff. Under the phase 1b of the vaccination plan of Australia, priority has been given to elderly adults aged 80 years and over, elderly adults aged 70-79 years, other healthcare workers, while the authorities were to begin vaccinating Aboriginal and Torres Strait Islander adults, adults with a specified medical condition, adults with disabilities who have a specified underlying medical condition, and critical and high-risk workers in sectors including defence, police, fire, emergency services, and meat processing.