Photo courtesy of Twitter
Public health crises by definition are not going to grant much personal choice to individuals. It’s been 18 months now since the inception of the coronavirus pandemic and there’s just enough data available to be able to see some clear patterns. Each country deals with the virus and the challenges posed by the variants it is presenting in different ways, based on their specific population numbers, demographics and organizational infrastructure and the level of education and compliance (or resistance) of their citizens.
When we were dealing with the less transmissible and less fatal novel coronavirus in its original form, in 2020 many people were hesitant to get vaccinated; the vaccines were still in development, they were rushed through under emergency measures and not properly tested and their comparative efficacy was still being measured until recently because not enough of the global population had trialled them for conclusive results to be clear and indisputable.
Then came the vaccine power plays. Wealthy nations had more economic capability to secure large amounts of the most effective vaccines. These were also countries where most people enjoyed a high standard of living and economic and political stability. This also made them complacent, entitled and skeptical. Nations without those reserves of wealth had large populations who were particularly at risk. When 80% of a country’s work force are daily wage earners, extended lockdowns cause disproportionate socio-economic devastation to these workers and their families. The educated elite who work in the corporate, media, legal, financial or academic worlds, and who work digitally, are able to increasingly work from home and this privilege protects them from exposure.
The pandemic is exposing the flaws and inconsistencies in every system on earth from administrative blockages to inequitable distribution of goods and services to disproportional danger faced by lower economic groups working in service industries such as cleaning and catering and the areas in each individual household and community, where processes and support related to food provision and hygiene protocols and health and safety need to be improved.
Vaccine politics can be seen in the way countries like Australia require that anyone seeking to enter the country show proof that they have been vaccinated by specific vaccines which are approved by the Australian government. SinoPharm is not accepted, but Pfizer and AstraZeneca are, and Moderna has been approved most recently.
We will need to produce documentary evidence via vaccine certificates that we have been vaccinated, not only to travel internationally, but going forward probably as a pre requisite for entry to any large public space or venue within any country in which we reside to prove that we are not a threat to public health.
Rising numbers of infected people constitute a public health crisis and justify the taking of measures for public safety such as increased surveillance, checkups, police visits to citizens’ homes and random testing that would be felt to be intrusive under normal conditions.
Sri Lanka did an excellent job in 2020 of keeping the numbers of infected people and the number of deaths down. But since Sinhala and Tamil New Year this April/ May and the simultaneous rapid spread of the Delta variant, the hospitals are becoming crowded and the health care personnel are under heavy stress.
This new situation of crisis has resulted in many more people seeking to be vaccinated and countries like Japan have contributed thousands of doses of AstraZeneca and Pfizer. Those seeking the vaccines which are in less plentiful supply must apply to be given them, with reasons for their application, and letters of support.
Soon our vaccine card will be as essential a document as our NIC card. We had better start keeping the card with its dates, times and updates in a strong protective plastic wrapper so that the details remain clearly visible, protected against dirt, water and damage. We will be continually asked to produce this card over the next few years.
Sri Lanka’s public health system has braced itself for the crisis; many hospitals and health workers are being supported with needed equipment and facilities by private donations from families and community organizations such as Rotary, island wide.
The Colombo Municipal Council are providing the vulnerable groups of elderly and incapacitated citizens with a home visit service. This enables those who would not be able to access vaccines at the public vaccine centres in Viharamahadevi Park and other venues in Colombo city where 10,000 people wait in queues, supervised by the armed forces, to be vaccinated with maximum safety and dignity and a minimum of exposure to transmission in their own homes.
This service is a stellar example of public health care serving the needs of the community and many of the wealthier and better resourced countries can learn from this humane and well thought out initiative.
The most vulnerable until recently were clearly those in older age groups. The Delta variant is now showing virulence to citizens of younger ages and those in their twenties and thirties need to be vaccinated as well. Sri Lanka’s vaccination effort is rapid, efficiently administered and on track, and the ongoing compliance of the majority of citizens, who are aware of the pressures on hospitals and resources and the need to avoid personal hospitalization, makes it likely that the country can ensure that all eligible people will be vaccinated by October this year.
Dedicated doctors have made themselves available to be consulted via telephone monitoring packages with blood pressure machines and pulse oximeters and basic first aid kits, so that people can self monitor their symptoms and get the support they need from medical professionals while staying safe at home. This is an incentive to encourage people to be more proactive in their own self care, as a supplement to the government protocols and to free the hospital system to care for those most in need of urgent assistance.
MOH workers are travelling to remote areas of the country to ensure that disabled people of all ages are able to be vaccinated, in their homes. Entrepreneurs are offering oxygen equipment to be delivered to people’s homes, hopefully with training offered in how to administer it to family members in a non hospital environment.
Internal class politics are impeding and derailing this national effort. The non daily wage earners, largely urbanized and with better access to vaccines, those who have been partially vaccinated or who do not have to go out of their homes to work, and who actually consider themselves immune and set apart from the ‘hot struggles of the poor’, have continued to socialize, travel across interprovincial borders, attend weddings and large gatherings and conduct themselves as if the pandemic was not happening.
It takes up to five weeks for the human body to develop immunity after each vaccine shot. Those who think that getting the jab is an immediate passport to a return to their normal social life before March 2020 are fatally mistaken. They still need to continue mask, gloves and shield wearing, washing their hands, avoiding crowds and social distancing for weeks and months after receiving the double vaccination, until about 80 to 90% of the country has been vaccinated. Public awareness and a sense of civic responsibility are required.
People who until now have been accustomed throughout their lives to find that their wealth and privilege have bought them exemption from restrictions of all kinds will need to embrace a new and more realistic approach to the way they conduct themselves in public. All are susceptible and money and status are no shield.
In the regional areas of the country, the inequitable access to vaccines has been protested in colourful and creative ways, with mannequin parades in areas such as Puttulam making the case for vaccine equity with no possibility of transmitting the virus or being accused of endangering others or disrupting the peace.
The threat posed by the pandemic is causing us to evolve. We can beat the numbers that currently horrify us by personalising our approach. It may not feel like it but the odds are actually in our favour if we adapt our ways of thinking and behaving well within the time frame that we have been given.
However, a pandemic is a public crisis. Everyone who is in contact with any other human being will be exposed to the virus over time through the sheer accumulation of numbers and community spread.
If this threat to our community as a whole doesn’t make us realise that seeing beyond ourselves to the impact we have on others is urgent and mandatory, nothing will.