COVID-19 Public Health Measures Are Essential Even with Vaccinations

Photo courtesy of Colombo Gazette

SHASHIKA BANDARA- 08/01/2021

On July 19, 2021, at a World Health Organization (WHO) press conference, COVID-19 Technical Lead Dr. Maria Van Kerkhove’s son asked a question that has been on all our minds “when will COVID-19 end?” Although Dr. Kerkhove knew the question was coming she had to hold back her tears as she answered, “I don’t know.” This is perhaps the emotion that we are all facing – regardless of who we are or what we do. While our level of privilege may change the impact of COVID-19, we all have had to face challenges during this period. As difficult as it maybe, it is important to realise that the pandemic is evolving fueled by vaccine inequity and with novel variants; thus, we should adjust accordingly, taking measures to remain safe and using available vaccines to build immunity.

The good news is that Sri Lanka is focused on rapidly vaccinating the population over 30 years of age. As of July 30, per WHO, of the total population, approximately 38% have had the first dose and only 9% are fully vaccinated. The bad news, however, is our public health measures remains ad-hoc, confusing and still lacks a long-term strategy. As many public health experts have pointed out vaccination alone will not be enough to curb the spread of the virus and safeguard populations. Delta variant which is increasingly being reported in Sri Lanka has a very high transmissibility rate, as seen in other countries with high vaccination rates such as United Kingdom (UK) and United States of America (USA). Delta variant is now the dominant strain now in both USA and the UK. Additionally, within Asia an increase in cases due to the Delta variant is seen in Pakistan, Bangladesh, Indonesia, Thailand while India is also gearing up for another wave. The WHO has warned the world that a third wave is impending, fueled by novel variants such as Delta and Lambda and the prevailing vaccine inequity in the world. Head of WHO has repeatedly warned countries against ‘vaccine euphoria’ where in the wake of vaccinating we throw caution to the wind.

As we enter yet another crossroads, though it may seem ideal to attempt to bring some relief, economically and psychologically, by declaring that once vaccinated we can resume our normal lives – such an approach will only bring temporary relief and cause harm. In fact, lifting many public health measures such as allowing indoor events with large gatherings, opening poorly ventilated spaces that tend to get overcrowded for business (e.g., betting centres) and lifting restrictions on inter-provincial travel will contribute strongly to the spread of virus and it will impact the health of our healthcare workers and those in the front lines weakening our valuable human resources.

Especially during this pandemic, half effective policy measures are not effective at all. As more variants with higher transmissibility and severe health outcomes emerge, countries that were successful in managing the pandemic earlier may face repeated challenges. The dynamic nature of the pandemic affecting prior successes can be seen in many countries including Vietnam, Australia and Chile. During this time, it is vital that we do not measure our success by the failures of other countries or belittle the measures that were successful before. At the same time, it is important to learn from mistakes of others and realise that a multi-layered approach that combine vaccination, public health measures, social support for the vulnerable, building capacity in the health system is the way forward for the foreseeable future. Failure to recognise the importance of implementing a multi-layered approach will result in rapid rise in cases despite vaccination. For example, United States lifted its mask mandate and other public health safety measures due to their rapid vaccination coverage and allowed many public gatherings to resume with an honour code where unvaccinated people were asked to wear masks voluntarily. However, USA is now facing a rapid rise in cases mainly due to the Delta variant and the Center for Disease Control and Prevention is asking people to wear masks again – even if vaccinated.

Sri Lanka despite its vaccination rate has vulnerabilities. First, our COVID-19 vaccination drive currently only focuses on those above 30 and the Delta variant has shown to infect the unvaccinated faster with severe outcomes. Even those who are vaccinated with one dose can be at risk. Second, as we have observed, our health system will be significantly challenged under a surge and can be further weakened by healthcare workers being infected. Thus, vaccination should not be considered a license to completely lift public health measures as we are doing now. As we applaud and support our vaccination drive in Sri Lanka, we will be doing a public health sector a favour by not ignoring the importance of public health measures. At minimum, Sri Lanka should ensure that the mask mandate is effectively observed in all businesses, limit indoor gatherings, cancel all large indoor gatherings such as weddings and conferences and not try to rush back to normalcy with abandon by lifting travel restrictions across the board. As we need countries to lift travel bans, to minimize the perception of risk so that we can succeed in trade and tourism, for our citizens to be able to gain access for education and work overseas and at home – ensuring the safety of Sri Lanka’s population via public health measures, while pushing the vaccination drive forward is essential.

We all want this pandemic, which has affected all aspects of our lives, created unparalleled economic hardships across the globe, challenged our educational systems, impacted our mental health, to end. We want our tourism to pick back up, to enjoy a beach sunset without worrying about the virus, to visit the national parks, to have a coffee or a drink with a friend. This is the sentiment that is felt by the public across the globe. You are not alone in feeling this and neither is it wrong to feel this way. This pandemic is difficult – psychologically, emotionally and physically it weighs on us.

Yet, rushing back to normalcy, ignoring warnings on ‘vaccine euphoria’ with more variants of concern spreading in Sri Lanka is a dangerous bargain that will jeopardize the progress we have made and are making.

The author is formerly a Policy Associate at the Center for Policy Impact at the Duke Global Health Institute and is currently a doctoral candidate focusing on global health policy at McGill University. He tweets at @ShashikaLB