Leslie Meade | COVID-19 – The path to normality

Jamaica is in the throes of the third wave of the coronavirus infection, most likely as a result of the Delta variant. To date, we have recorded over 74,000 confirmed infections and over 1,600 deaths. It is also true that some 49,000 persons have recovered from the virus.

A few medics are suggesting that the key to managing this pandemic is early tertiary prevention, which involves treating persons who already have the disease, in an attempt to improving quality of life by reducing disability, limiting complications and restoring function.

I, and many other medical professionals, on the other hand, have championed the policy of primary prevention through vaccination and adhering to the other public health measures of physical distancing, the proper use of face masks and regular hand hygiene.

Viruses need a host in order to replicate. The more unvaccinated persons there are, the greater the possibility that the SARS-CoV-2 can infect someone. Once the virus gets into the human body, it begins to replicate. As it replicates, changes occur in its genetic makeup leading to the development of variants. While it is true that most of these variants are weaker than the original virus, from time to time stronger, more infectious and more transmissible variants arise. The more people we have unvaccinated, the more likely that we will have stronger and more virulent strains emerging. Unfortunately, this coronavirus has placed us all in a biology class observing natural selection.

TRIGGER IMMUNE RESPONSE

None of the vaccines available can cause a coronavirus infection. When the vaccines are administered, they trigger an immune response specifically to the SARS-CoV-2. The body produces antibodies and memory cells so when SARS-CoV-2 comes in contact with a vaccinated individual, there will be a rapid and specific or targeted response to the threat preventing infection or severe disease. There is growing evidence throughout the world that vaccinated individuals are faring far better when it comes to infections, hospitalizations, and deaths than unvaccinated persons.

The Medical Association of Jamaica, in June 2021, hosted its annual four-day symposium in which it focused on the coronavirus. Among other things experts spoke about Long-COVID. Long-COVID is defined as persistent symptoms for more than 12 weeks after a SARS-CoV-2 infection. While the SARS-CoV-2 has a preference for the lung, its long term effects have been seen in every organ system. Some of the symptoms include extreme tiredness, shortness of breath, heart palpitations, chest pain and or tightness, problems with memory and concentration, anxiety and depression, changes in taste and smell, gastrointestinal issues, and joint pain. These symptoms are not just seen in persons with severe disease, but also those with mild and moderate disease. More than one year post-infection, persons are still complaining of the persistent symptoms, so it is not about being infected and then recovered, but a significant number of persons will have long-term medical challenges. Jamaica’s case fatality rate is 2.3 per cent, if we allow every Jamaican to become infected, then we stand to lose about 62,000 Jamaicans to this wretched virus.

AFFECTING YOUNGER POPULATION

Jamaica, like the rest of the world, has seen increased severe illnesses and deaths in the younger population, due to the Delta variant. Jamaica now has the ability to vaccinate persons from age 12 years and older, and we must move with alacrity to ensure that all who are eligible and willing are vaccinated in the shortest possible time. We need to confront vaccination hesitancy where it exists and counter it with factual information and science.

We need to get a larger number of our population vaccinated and achieve herd immunity. Herd immunity occurs when a large proportion of a population is immune to an infection, making the spread from person-to-person less likely. While this is possible by being infected with an infectious agent, such as SARS-CoV-2, the death toll, and the long-term sequalae, are too high to go this route. Vaccination is the safest and most effective way to ensure that a population is immunised in the shortest possible time.

I encourage everyone who is eligible to take the vaccinate, including pregnant women, as doing so will ensure that the virus will find it difficult to spread and mutate. Attaining herd immunity will allow all of us to return to normality, our children can go back to school, families and individuals can attend church, and businesses can get back to operating normally.

Dr Leslie Meade specialises in obstetrics and gynaecology and public health. He is the honorary secretary of the Medical Association of Jamaica. Send feedback to columns@gleanerjm.com