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A similar variant, B117 strain, was detected and restricted around January
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Variant detected on 8 April, but authorities required two weeks to confirm
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Research ongoing on mixing and matching Covid-19 vaccines
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SPC looking at importing oxygen stocks to increase local supply
State Minister of Primary Healthcare, Epidemics, and Covid-19 Disease Control Dr. Sudarshani Fernandopulle[/caption]
Will any travel restrictions be implemented across provinces in the areas where a large number of people are infected with the new strain of the virus?
I don’t think so, because the policymakers feel that travel restrictions will affect the economy and the livelihoods of the poor. Therefore, restrictions won’t be imposed across provinces. However, based on the number of cases, we asked grama sevaka officers to impose local lockdowns.
Even with the local lockdowns, we see people moving around in that particular lockdown area. By imposing the lockdowns, what we expect from people is to remain indoors with only one person permitted to leave home, if they have to go out. People are trying to enjoy this period even with the lockdown and this is not a time to enjoy. This is a pandemic and it’s spreading in the worst manner.
There are reports that the UK variant of the virus was detected on 8 April. Why were health regulations not stepped up and movements restricted during the Avurudu period?
A similar variant, the B117 Covid-19 strain, was detected and restricted somewhere in January. We found this variant from 20 people in January and the majority of them were returnees from overseas. In April, doctors say they identified this new variant but it was not confirmed as B117. However, we had requested the public to celebrate Sinhala and Tamil New Year by adhering to health guidelines.
The UK variant was confirmed 10 days back and it was also identified because of our surveillance system. If we do not have a surveillance system, we would not have detected the new variant. This was identified by the samples taken from Colombo and the North Western Province. So as per the new strain, the majority of the patients were detected from quarantine centres, those who had come from overseas, except two patients, who we could not locate earlier.
Since surveillance was continuing, Sri Jayewardenepura University detected the new variant on 8 April but they said they need two weeks to confirm. By the time they confirmed, we were also seeing increasing numbers in the community. Accordingly, we immediately issued guidelines and warned the public.
With the rising number of the patient count, are there any plans underway to convert hotels into hospitals as treatment centres for Covid-19 patients?
Of course. Right now, we have already taken steps to increase the bed capacity. In major hospitals, directors were requested to cut down the normal services, such as normal medical wards. We asked them to reduce it and convert wards into Covid-19 treatment centres. Underutilised hospitals have been converted into Covid-19 treatment hospitals and intermediate centres are also being established. Brandix is also converted into an intermediate Covid-19 treatment centre which can accommodate nearly 1,000 patients and chosen factories are also being converted into intermediate centres. We also requested Ayurveda hospitals to function as intermediate centres because they also have a bed capacity of around 5,000.
Given the increasing number of infected persons, will the health authorities permit home isolation for those who test positive and don’t require medical assistance?
We may have to resort to it, because if we don’t find enough beds, we may have to carry out home isolation and get the general practitioners (GPs) to monitor those cases. We are planning on that as well and the protocols have been developed.
Right now, around 12,000 people are being quarantined. So, the Government wants them to be released. Some were already released after the seven days quarantine at the centres to continue the balance seven days at home. We also had 11,000-12,000 returnees from overseas, and again we have to use these quarantine centres as intermediate treatment centres.
We also have to increase the intensive care units (ICU) and high dependency units (HDU) capacity. Also, half of the normal ICUs, which functioned for medical and surgical emergencies, will have to be reserved for Covid-19 patients.
Reports have been circulating that a number of patients who got the first dose of the Oxford-AstraZeneca vaccine also got infected with the new strain. Is it a failure of not administering the second doze on time?
Yeah, actually the Oxford-AstraZeneca covers the B117 variant, but we said vaccines will not be 100% effective against infection. The vaccines will reduce mortality, reduce the severity of the disease, and if people do get the disease, they can transmit the infection to another. So, that is why we requested the public to follow the health guidelines, even though they got the vaccine.
Even with both doses, people can still get the virus if they do not follow the health guidelines. Of course, infection rates have been cut down among those who got the vaccine but there is a possibility. For the B117 Covid-19 variant, Oxford-AstraZeneca has protection.
Is there any research being done on the possibility of mixing one Covid-19 vaccine with another brand?
Yes. The doctors are still researching about giving a cocktail because of the limited supply of the vaccines. However, results are yet to be released.
The administering of the second dose of the Oxford-AstraZeneca began on 28 April and frontline workers were the first to receive the second dose. There is a shortage of 600,000 vaccines according to the reports. When can we get more consignments of AstraZeneca vaccines from India?
We can’t give an exact date because it is beyond our control. In the first instance, we ordered 1.5 million Oxford-AstraZeneca vaccines from the Serum Institute of India, and we were promised those would be delivered in batches of 500,000. The COVAX facility also assured us about 1.6 million doses of which we received only 264,000. We were supposed to receive the balance in early May but because of the outbreak in India and on the manufacturing issues, they are not in a position to supply.
This was an unanticipated issue which is beyond our control. We had been trying hard to get the vaccine stocks from elsewhere. Even UNICEF, they are agents who were responsible to procure under COVAX facility. They are also struggling to get the vaccine from other countries and they said they found a stock in Afghanistan but there was also an issue. So, these issues are beyond our control.
We also took steps to order Sputnik V and Pfizer vaccines. Agreements had been signed and five million doses would be purchased from Pfizer. We are still struggling to get Oxford-AstraZeneca from other countries such as Korea and Sweden, and we are still hopeful.
What will happen to the 600,000 persons who require Oxford-AstraZeneca second doses?
We can’t give a new vaccine until scientific evidence is proved. Our technical advisory group on vaccination decided to have an interval and shifted the second dose for 14-16 days based on international evidence. In Canada and France, they delayed the second dose for four months. Still, we have time and with all these constraints, we are trying our maximum to get the vaccines.
If the people do not receive the second dose of the Oxford-AstraZeneca vaccine by the stipulated date, how vulnerable would they be, especially those over 60 years with health complications?
With the first dose, infection rate was reduced by 57%, and until three months, 74% had antibodies. Technically speaking, the body has already identified the virus and has started producing antibodies. If any person who got the vaccine got infected, the body will identify the virus and produce antibodies.
Are there any plans to involve private sector hospitals in future to provide the vaccine?
Not right now, because globally, the manufactures also prefer government-to-government negotiations in the purchase of the vaccine, but maybe in the long run, we will think about it. The Government plans to vaccinate 63% of the population free of charge.
Will the private sector be permitted to import Covid-19 vaccines in order to ease the pressure on the Government and expand access to the vaccines among the public?
I don’t think it will happen, because manufacturers prefer government-to-government negotiations. Because there could be other motives involved in the private sector. They can purchase it and sell it on the black market, etc.
It was reported that there is a nurse shortage for new ICU beds. How are we going to overcome this matter?
The nurses have been already appointed and transfer orders were suspended. Right now, the Ministry has deployed the necessary nurses and they have recruited around 600 nurses who have completed their finals.
With the spike in young Covid-19 patients in the country, are there plans on changing the vulnerable groups who would receive Covid-19 vaccines in future?
We changed that anyway. The WHO had asked us to give the priority for persons above 60, but in Sri Lanka, looking at our data, we vaccinated those 30 and above. So, once we complete this group, we will consider 18 and above. Currently, 35% of the population are not eligible to receive the vaccine because either they are less than 18 or are pregnant.
Despite claims that over 60% of the population will be vaccinated by the end of the year, how will this target be met, given the delays in securing vaccines?
Vaccination is not an issue, provided the vaccines are available as and when required. Issue is with the supply. That is beyond our control and we are at the mercy of manufacturers.
Has Sri Lanka initiated discussion on securing other Covid-19 vaccines registered with the WHO?
The WHO has registered Pfizer, Moderna, Oxford-AstraZeneca, and I think Johnson & Johnson vaccines. Sputnik V is yet to be confirmed by the WHO. We also received the Sinopharm vaccine, which the National Medical Regulatory Authority (NMRA) has not approved, because the vaccine had not completed safety trials.
Do you think our medical oxygen capacity is enough to battle the third wave?
Right now, we need about 25 tonnes of medical oxygen per day and manufacturers said that they can increase it up to 80 tonnes per day. The State Pharmaceutical Corporation (SPC) is also looking at importing oxygen from Singapore to keep the stocks ready.