MAR DE MIGUEL
@MarJungle
Madrid
Updated on Friday, 8 January 2021 - 16:08
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Last minute on coronavirus
Covid-19.
"Public Health in Spain has to stop being a pending issue"
December 1 marked a year since the infection in humans by SARS-CoV-2, the coronavirus commonly known as COVID-19.
The first cases were identified in the Chinese city of Wuhan, the origin of the pandemic that today devastates all the countries of the world and that has taken the lives of at least 1,695,606 people.
To this day, although progress has been made in the treatment of symptoms, there is no drug that eliminates viral particles from our body as an antibiotic would against a bacterial infection.
All hopes are pinned on the development of a drug that prevents infection.
The pharmaceutical companies Pfizer, Moderna (from the United States) or Astra-Zeneca (in collaboration with Oxford, United Kingdom) have obtained the first vaccines.
Humanity is preparing for a new phase of the disease, its overcoming.
However, the World Health Organization (WHO), the body that watches over international public health from the United Nations, calls for prudence and alerts of the difficulties of the new stage in which we are entering.
In a telephone interview with this medium, Dr. Siddhartha Datta, program director of the Immunization and Preventable Diseases Unit of the WHO Regional Office for Europe, shows optimism and caution.
The vaccine is good news, but it should not be seen as "a silver bullet," he says.
There is still a difficult way to go.
The European Medicines Agency has already given the green light to two vaccines against SARS-CoV-2, first from Pfizer and then from Moderna.
Its distribution represents a new challenge.
What difficulties does each country face? As we learn about the specific characteristics of each manufacturer's vaccines, we see that some of them must maintain a cold chain to be preserved.
The Pfizer vaccine should be kept between -70 and -80 degrees centigrade.
However, for transportation, from where it is stored nationally (in a freezer at minus -70 or -80 degrees) to the furthest point, boxes with dry ice can be used.
In this way, the roads can maintain a particular temperature range, all of which produce different challenges for countries.
On the one hand, they have to get the vaccine and be aware of the different needs they have.
On the other, they must plan the distribution of the vaccine to the end user.
And since the number of vaccines available and the demand are not the same, the WHO has recommended that countries start prioritizing population groups for vaccination.
What are the WHO recommendations for vaccination? In late September and early October, WHO shared with its members in the European region a guidance document that includes the critical areas they must implement to be ready for vaccination.
Within these critical areas, is the logistics of vaccine supply distribution.
We consider that the problem is not only acquiring a vaccine with certain characteristics, but that there must be a system for it to be stored.
It should also be ensured that the necessary personnel are available to administer it, to monitor its safety and for what may happen after vaccination.
From the WHO we monitor how countries prepare to receive the vaccine and to know if they are really ready or not.
This information is part of the National Vaccine Implementation Plan for each territory, which outlines the strategies for receiving, distributing and using the vaccine.
Who sees to it that lower-income countries access the vaccine? In late September and early October, the WHO shared with its members in the European region a guidance document that includes the critical areas they must implement to be ready to vaccination.
Within these critical areas, is the logistics of vaccine supply distribution.
We consider that the problem is not only acquiring a vaccine with certain characteristics, but that there must be a system for it to be stored.
It should also be ensured that the necessary personnel are available to administer it, to monitor its safety and for what may happen after vaccination.From WHO we monitor how countries prepare to receive the vaccine and to know if they really are ready or not.
This information is part of the National Vaccine Implementation Plan for each territory, which outlines the strategies for receiving, distributing and using the vaccine.
In mid-November, the highest-income countries (including those of the European Union and which only represent 14% of the world population) reserved 51% of the doses of the different vaccines.
For this reason, an article published in The BMJ (the scientific journal of the British Medical Association) warns that a quarter of the planet's population may not receive the COVID-19 vaccine until 2022. This study also indicates that only six of the 13 vaccine manufacturers have agreements with low- and middle-income countries.
On the other hand, WHO experts assure that to eradicate the virus, 70% of the world's population should be vaccinated.
Many insist that if it does not reach everyone, the pandemic would persist.
Who ensures that countries with lower incomes access the vaccine Some countries have already started their vaccination campaigns, because they were able to access the vaccine.
But I think it's important to remember that until everyone is safe, no one will remain safe in this global world.
All countries need access to the COVID-19 vaccine, which is a global public good.
Everyone should have access to this vaccine, regardless of their income level, the income level of their country or where a population is located.
Within the concept of global solidarity, the mechanisms in place for COVID have been advanced so that low- or lower-middle-income countries have direct access from a global platform to which other countries contribute.
More protection with vaccines
The most effective vaccines so far, Pfizer's (95% effective) and Moderna's (94.1%) require administration in two doses.
The recommended waiting time between each injection is 21 and 28 days respectively.
This aspect seems a critical point, since health authorities must ensure that each person completes the vaccination with two injections spaced almost a month apart, while maintaining the safety standards of this pandemic (hand washing, masks or social distance) .
Furthermore, although clinical trials have been carried out under strict research protocols, the urgent need to obtain results has not allowed to verify the long-term efficacy of vaccines.
Manufacturers know that it works and that it lasts over time, but they cannot guarantee how long, beyond what has elapsed until now.
For this reason, some experts warn that sanitary precautions must be maintained during the vaccination period and even afterwards.
Is there a risk of a new wave occurring during the vaccination period if we do not complete the doses or if we relax the protective measures between them? Each and every vaccine will require two doses.
It is important that governments (or national health systems) establish a mechanism for each individual who is vaccinated to complete the second dose.
According to clinical trials, this is closely related to the effectiveness of the vaccine.
But it is important to say that the vaccine by itself is not going to solve the problem of the pandemic, at least in the short term.
Public health measures of hand washing, the use of masks or physical distancing must continue. People think that by receiving the vaccine they can forget about the other party and the vaccine is an additional tool in the fight against the pandemic .
I want to make it clear that the availability of the COVID-19 vaccine should not be understood as a miracle solution, that people do not think that everything will be solved tomorrow because now we have a vaccine.
The vaccine has to reach the population and for this it is necessary for governments to pass certain level tests to make sure that things happen.
On the other hand, the people themselves, who are the recipients, will play an important role in this. The WHO promotes the creation of an electronic certificate of vaccination on COVID-19.
What is it? We work with several member states and it is a broad initiative.
Several of the countries in the European WHO region use an electronic registry for routine vaccinations of children.
We want to see if that can be used or expanded for the COVID-19 vaccine, to find out who is getting the vaccine.
This is what we call Electronic Vaccination Certificate or Electronic Vaccine Record.
What we want to see is how those digital platforms can be used in the response to COVID-19 efficiently and if that information is useful for a government to make different decisions.
To get it started, we have to consider what are the different legal frameworks in each country and what are the different implications of obtaining that information from them.
We also have to consider the infrastructures available in the countries to make sure they can put a system in place in this short period of time. It sounds complicated, if you want to have it already, because there are many countries involved, with different laws and capacities.
Maybe it could be something long term.
What situation is this project in? That is precisely the critical point, which is difficult and time consuming.
From the WHO, through a consortium, we study different startups, with different technologies and innovations, already existing or in use, so that we can bring that knowledge to a central point and see what are the different solutions that exist at this time for the implementation of an Electronic Certificate of Vaccination.
The problem is that for the countries, the assessment of the use of a technology or the design of a system has a federal character, they are decisions for a national government, since they have to consider all the parameters as a whole.
Digital solutions are fine, but they have to be context specific.
In order for us to help countries do this, they need to assess its usefulness and see what other systems they already have.
It is important that we remain engaged with Member States in this regard and see what is the best solution for each country.
There is no one-size-fits-all solution.
Countries must work individually, analyze it and maintain a dialogue with WHO.
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