Covid-19 second jabs under threat

Developments on the international scene have created uncertainty about the arrival of 1.26 million AstraZeneca Covid-19 jabs for Malawi to administer the second doses of the vaccine.

In separate interviews yesterday, Ministry of Health Principal Secretary (PS) Dr. Charles Mwansambo and Society of Medical Doctors (SMD) president Dr. Victor Mithi expressed fears for the arrival of the new doses, noting that the country was running out of the 512 000 doses it earlier received.

Mithi said he has raised with authorities concerns over the uncertainty of the arrival of the second doses of the vaccines from the multi-donor facility, Covax while Mwansambo said he was keeping fingers crossed, especially in view of what is happening on the international scene with manufacturers.

Mithi said: “I had spoken to the PS and was saying they are working on it. Maybe in the next two to three weeks we can have the vaccine. For now, we still have some jabs, but you know that they are not as many.

“We look fine because the uptake of the vaccine is very low, but in real sense the vaccine we are remaining with can even be administered in a day. That’s where the challenge is.”

While acknowledging that the matter was diplomatic, he warned that if the third wave hits the country things will be chaotic on the ground.

Said Mithi: “It seems like it’s a diplomatic issues as well as one concerning manufacturers. At manufacturing level, everyone is scrambling for the vaccine and for us to get it we have to use some diplomatic channels.”

By Wednesday this week, the country had administered 357 015 jabs out of the 512 000 delivered for the exercise that started on March 11 2021. About 16 400 doses of the vaccine were destroyed after expiring in stock.

On his part, Mwansambo admitted challenges relating to the arrival of the new doses, saying he was keeping fingers crossed.

He said: “India [the biggest manufacturer of the vaccines] is looking at its own people and wants to vaccinate as many people. When the Covax facility was starting, the agreement was that 50 percent would be used in India and the rest would be exported.

“But because of the impact of the current wave [in India], they [India] put on hold all exports. That’s the main issue. That’s the major issue and that is why the Covax is looking at other sources and its going to affect us.”

Mwansambo further urged people to strictly adhere to all Covid-19 protocols, including social distancing, regularly washing hands or using hand sanitisers, use of face masks and adhering to public gathering restrictions recently adjusted from 50 to 100 for indoor meetings and 250 for outdoor activities.

Malawi targeted to vaccinate 11 million or 60 percent of the population with the Covax facility providing vaccines for 3.8 million people. Government and its bilateral and multilateral partners hoped to mobilise seven million to hit about 11 million.

The uncertainty over the second jabs comes after Malawi on Wednesday confirmed existence of the Indian variant (Delta) and the South African variant (Beta) before the World Health Organisation (WHO) yesterday announced existence of the Alpha or B.1.1.7 Covid-19 variant first identified in the United Kingdom (UK).

This means Malawi has three of the four variants classified by WHO as variants-of-concern.

On effectiveness of the vaccine on the new variants, Mwansambo said the observation in the UK and India was that AstraZeneca is effective against them.

He said: “Most of our second wave was mainly the variant identified in South Africa, but that should not be a reason to worry because a few people were infected. We did some tests in some urban areas and it was high as 66 percent of people who may have been exposed to that.

“We should worry about other variants that we don’t know about. In South Africa they didn’t do enough studies with AstraZeneca on their variant, so we can’t tell because they didn’t use many samples. It was just about a thousand.”

In an interview yesterday, Kamuzu University of Health Sciences epidemiology and public health professor Adamson Muula said each vaccine offers some protection against all variants. He encouraged people to get the jab and boost their immunity.

He said: “You never know, maybe the vaccine we are using will be even stronger against the new variants. The evidence available now is that the vaccines work.

“There is also misconception that Covid-19 spreads faster during cold weather, but that is because people like staying in closed areas and closer to each other. There is no scientific evidence that cold weather helps spread the virus faster. It is all about people’s behaviour during such weather.”

WHO posted on its website that there is no conclusive evidence that either weather (short-term variations in meteorological conditions) or climate (long-term averages) have a strong influence on transmission.

Commenting on the new variants, Mithi said the challenge with Malawi lies in its lack of capacity to conduct tests on its own. He said the country relies on the Centres for Diseases Control (CDC) programme laboratory in South Africa.

He said: “If you don’t have the capacity to test specimen as required, you don’t know what you have. You can see that we have been struggling with the Indian variant and now we are sure.”

On Wednesday evening, Minister of Health Khumbize Kandodo Chiponda said government has been collecting samples and 739 have been sent to South Africa for genetic sequencing since January 2021.

She said: “From this second lot, we have results for 84 samples. The results show that 14 samples have the Delta variant and 56 had the Beta variant. All the 14 of the Delta variant are from the Salima Sugar Factory and have since recovered.”

As a control measure, Chiponda said government has intensified screening in ports of entry and mandatory quarantine for all those travelling from the risky countries.

According to the WHO, variants-of-concern increase in transmissibility or detrimental change in Covid-19 epidemiology; or increase in virulence or change in clinical disease presentation.

Meanwhile, Physicians Assistants Union of Malawi president Solomon Chomba has stressed the need to ensure that all systems are put in place to prevent wanton spread of the pandemic.