Medical Corner: “The war against Covid Pandemic has changed”

/ Dr. Ramon Joel Seastres, covid19, medical corner

It has been almost 21 months now since the world started battling the pandemic from the first recorded Covid-19 outbreak in Wuhan China last December 2019.

Are we winning the war against Covid-19 pandemic?

Until today there is no specific treatment against the SARS-CoV2 virus infection, most common experimental pharmacotherapy given either by stopping viral replication (eg. Remdisivir), neutralising antibody (eg. Sotrovimab, a monoclonal antibody that act on spike proteins) and immunomodulating drugs (eg Dexamethasone IV, Tociluzimab IV, Baricitinib tablet ) which alter the abnormal immune response triggered by SARS-CoV2 virus. The most effective and remained proven public health measure are: wearing mask, handwashing, maintaining social distancing and Covid Vaccination.

Since the discovery and swift roll-out of novel Covid vaccine, there are high expectation that this will be the best defense against coronavirus and the key to end the pandemic. However there are many challenges which hampered the success of Covid vaccine such as vaccine maldistribution, ineffective vaccine messaging to community and emergence of highly infective Covid variants, the Delta variant. And this Delta variant had recently driven the surge in caseloads, hospitalisations and deaths and pushed back other countries into strict lockdown like Australia and New Zealand who did well during the initial waves of pandemic.

The world is moving into a critical period where we need imperative collective action and global effort from HIC (High-income countries) and LMIC (Low-middle income countries) to defeat the evolving and adapting Covid variants. According to WHO Director Tedros Ghebreyesus that 4.8 billion vaccine doses were rolled-out in the world, around 75% were concentrated in 10 countries mostly HIC nations. While rich nations have administered 100 doses for every 100 citizens it is only 1.5 among LMICs. The WHO target at least 10% of population from each country by end of September is unlikely to achieve and will be a major setback.

The coronavirus and its variants of interest (VOI) and concerns (VOC) are gaining momentum in this pandemic war due to uneven global vaccination coverage within country and around the world. Covid-19 Vaccine may prevent severe Covid illness, hospitalisation and death but it is not a silver bullet. There are reported increasing number of “vaccine breakthrough infections” (CDC defines as the detection of SARS-CoV-2 RNA or protein more than 14 days after a person has completed the full recommended doses of an FDA-authorised COVID-19 vaccine) in many countries and will likely impact public health policies including vaccine distribution.

The world has been in disarray and already losing the battle from other grounds such as liberty and freedom due to cyclical community lockdown, setback from gains in the WHO 2030 agenda for sustainable development, diverted resources from vulnerable group (eg minorities, children and elderly, poor and uneducated people) and neglect in non-communicable diseases such as heart condition, stroke, chronic lung disease, cancer, mental health illness and neonatal and maternal care.

According to WHO Dr Harris “we are now living in the time of coronavirus. Its the perfect pandemic virus of our time”. Yes this is a single pandemic but it is not a single story and it is our story and highlights the human to human connections over the planet. We must learn to live with virus and change the art of war against pandemic and prepare in the future zoonotic disease outbreak.

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