The Overseas Situation Report Tuesday 7 December 2021

by Mike Evans

“Freedom and duty always go hand in hand and if the free do not accept the duty of social responsibility, they will not long remain free.”

– Anonymous

The news in the past week regarding Covid 19 has been full of reports on the latest variant to hit the world, the name is Omicron! Across the world we have seen countries banning arrivals from whole areas and adding new testing to people travelling around the world. All this at a time when people across the world were starting to feel that for the first time in a year they could, maybe have a Christmas holiday with loved ones! As the scientists continue to work on the data to ascertain if this new variant is worse than those before we all have to look at adjusting to yet another bout of restrictions in our daily lives in order to be safe and to help our communities remain safe from this disease.

In this report we look at the issue surrounding the anti-vaccine movement and the issues surrounding the emergence of the new variant in Southern Africa.

All governments across the world agree that the key to beating this pandemic is through Vaccination. Some have been able to vaccinate their citizens quicker than others and some have found that there are some who for any number of reasons will not get the vaccination. There is still the issue of vaccination equality to combat, especially as this new variant has started to arrive in many places around the world and it was purported to have started in Africa.

The emergence of the Omicron COVID-19 variant, which was first detected in South Africa and other southern African nations, is casting a harsh new spotlight on vaccine inequality. For months, health experts have warned that low vaccination rates in the developing world make it more likely for dangerous new mutations to form as the SARS-CoV-2 virus spreads unchecked. So far, just 7.3% of Africans are fully vaccinated against COVID-19, compared to 58% in both the U.S. and Europe, where booster shots are now being offered widely. Meanwhile, just 12% of the 1.9 billion doses promised to low- and middle-income countries had been delivered as of early November.

But to improve Africa’s vaccination rate, it will take more than just a flood of COVID-19 vaccine doses. A lack of coordination on vaccine shipments, weak health infrastructure and vaccine hesitancy sowed by mistrust and misinformation are already slowing vaccination efforts when doses are available, African health experts say.

Even South Africa, which has one of the highest vaccination rates on the continent with 24% of its population fully vaccinated, is struggling to get more shots into arms. While South African scientists rattled the world last week with their identification of the new Omicron variant, health officials in the country were telling U.S. drug manufacturers to delay delivery of more vaccine doses because demand is not strong enough, and they are concerned about looming expiration dates.

Across Europe the spectre of hospitals overwhelmed with unvaccinated patients has led to a slew of anti-Covid measures, with reactionary street riots everywhere from Amsterdam to Vienna. On Wednesday, Ursula von der Leyen noted that with 150 million people in the EU unvaccinated, mandatory vaccination should at least be discussed.

Such a suggestion led to waves of derision and rhetoric about freedom, but with the unvaccinated now driving the crisis, how we respond is an urgent vital question.

Much opposition to vaccination frames it as a solely personal choice. In this vaguely libertarian argument, the central thrust is that those who wish to get vaccinated should avail, and those with reservations abstain. This seems superficially reasonable but fails to understand what vaccination truly is: a critical public health measure.

Vaccination has undeniable life-saving individual boons, yet the rationale behind campaigns is to reduce incidence and ultimately the burden of disease at a population level. More than just a personal insurance policy against the ravages of Covid, vaccination protects the vulnerable, providing a firewall against mass infection.

Firstly, vaccination substantially reduces the chances one will become infected upon exposure. Even in cases of breakthrough infection, the vaccinated are much less likely to endure life-threatening consequences.

According to an article recently penned by David Grimes, who is an Irish science writer with professional training in physics and cancer biology, the case for vaccination is borne out in some recent Ireland ICU (Intensive Care Unit) statistics, – since late June almost 60 per cent of ICU admissions were unvaccinated, contrasted against a population uptake rate of about 90 per cent. This suggests the unvaccinated are about 13.5 times more likely to end up in ICU relative to the fully immunised.

This rough calculation is likely an underestimate given the vaccinated who fall ill are likely older with more health complications than the unvaccinated needlessly ill cohort. Similarly grim statistics manifest worldwide. The UK’s ICUs are clogged with unvaccinated patients, leading Sir Andrew Pollard to comment last week that “…this ongoing horror, which is taking place across ICUs in Britain, is now largely restricted to unvaccinated people”.

According to David Grimes, this has ramifications far beyond the immediate patients – utterly avoidable Covid infections not only put healthcare staff at risk, they also massively strain the resources of public health systems.

Every bed occupied by a Covid-stricken patient reduces the capacity for others needing urgent critical care or vital surgeries. Ireland’s long-standing shortage of ICU capacity means it is simply too easy for Covid surges to upend our national ability to care for the sick.

This consideration underpins the stringent national lockdowns Ireland has been forced to implement, and the straining of ICU capacity now by unvaccinated individuals. Further restrictions have now been announced.

That a small cohort would effectively hold society hostage seems profoundly unfair to many, and how this should be tackled is an open question.

This, of course, isn’t just something that Ireland is experiencing, – Austria’s decision to impose lockdowns on the unvaccinated in mid-November was motivated by alarming strain on ICU capacity, driven almost entirely by those shirking vaccination. In Slovakia, Greece, and the Czech Republic similar restrictions have been imposed on vaccine-refusing cohorts for the same reason. Germany has also now introduced strict curbs on unvaccinated people.

Such measures, however, raise passionate ire, frequently decried as an infringement of liberties. But such arguments fail to recognise that others have a reasonable expectation that they should not be needlessly exposed to avoidable dangerous pathogens, nor should selfish stances be allowed to imperil the freedom of others.

Such arguments also fail on another level – the unimmunised ultimately reduce the efficacy of vaccination, effectively functioning as human petri dishes. As the virus runs through them, random mutations eventually endow it with the ability to evade vaccines. The dominance of Delta and the emergence of Omicron variants are a sad testament to this reality.

Vaccine mandates by Governments are not new. History shows us that this has happened in the past. Prior to its successful eradication Smallpox was such a virulent and devastating illness that measures were enacted worldwide to halt its spread. In England and Wales, the Vaccination Act of 1853 mandated universal vaccination, fining those who chose not to comply. Vaccine mandates for schools in several US states were introduced by 1827.

Nor are examples only historical. In August this year US judge Frank Easterbrook upheld Indiana University’s right to mandate vaccination for returning students. This judgment echoes a 1905 supreme court decision on Jacobson vs Massachusetts, where the court ruled that the requirements of several states to be vaccinated or risk being fired was not an imposition on individual freedoms.

The noise that comes from the anti-vaccine activists still use the same old tired and debunked arguments about liberty suggests their grasp of history is on par with their understanding of medical science. Blame for sub-par uptake, however, cannot be solely placed upon all those reluctant to vaccinate. The pandemic has seen a dark renaissance of anti-vaccine propaganda, as virulent and infectious as the virus itself.

Vaccine hesitancy is a spectrum, and exposure to disinformation has a proven effect to nudge people towards fear and distrust. Such people are themselves victims of anti-vaccine disinformation and need compassion and encouragement to vaccinate.

Measures too must be taken to reach populations who may not be receiving the messaging on the importance of vaccination. Since the time of Jenner, however, a core of ideological vaccine-rejectors have been eager to spread fear and falsehood over an extremely life-saving endeavour. This anti-vaccine fringe constitutes a small but vocal minority, but one with a disproportionate impact on public health which must be vehemently resisted. For all the sound and fury around the topic, rights are not absolute and must be balanced with the rights of others.

Just as we accept the imposition of speed limits on public roads to protect everyone, vaccination is similarly crucial not only for individual wellbeing but the very functioning of health services. No measure to protect this should be off the table.

Although many experts believe stopping COVID-19 for good will require beating it in Africa and across the developing world, African authorities say that recent travel bans due to the Omicron variant will only hamper their ability to fight the virus. According to Thierno Balde, Incident Manager for COVID-19 Emergency Response at the WHO Africa regional office, “If people are not encouraged to share the information in a timely manner, then these variants will just continue circulating in many other countries,” he says.

One consequence of these bans, says Russell Rensburg, director of the Rural Health Advocacy Project at the University of Witwatersrand in Johannesburg, is that laboratories in the affected countries will struggle to obtain reagents to conduct COVID-19 tests, due to fewer inbound flights. That means less ability to track the spread of the Omicron variant—even in South Africa, which has advanced genomic sequencing facilities that detected Omicron and other variants.

Banning flights to and from the region might come back to bite developed countries anew—in the same way that being slow to share COVID-19 vaccine doses with the continent has done.

Until the next time Stay Safe.

Total Cases Worldwide – 266,326,934

Total Deaths Worldwide – 5,274,252

Total Recovered Worldwide – 239,925,628 

Total Active Cases Worldwide – 21,127,054 (7.9 % of the total cases)

Total Closed Cases Worldwide – 245,199,880

Information and Resources:

https://www.worldometer.info/coronavirus/

https://www.irishtimes.com/

https://time.com/6124974/omicron-africa-vaccines/

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