Better safe than sorry

The emergence of the coronavirus pandemic has forced governments around the world to implement severe restrictions on human activity in order to control the spread of the virus.

Even so, more than three million people have died.

The pandemic has impacted almost every little corner of life, severely affecting global economies, changing the way we work and interact with others, and stretching healthcare systems to limits beyond the limit.

It is obvious that no country was fully prepared to handle the pandemic. SARS-CoV-2 has a unique ability to spread from asymptomatic people prior to the onset of symptoms which, combined with its long incubation time, makes it difficult for countries to prevent the spread of this disease.

The effect of COVID-19 on other health problems
The COVID-19 pandemic has overwhelmed healthcare systems around the world, as due to lockdowns and avoidance of medical settings, people have refrained from seeking help for other health problems, despite the problems still being there, with a dramatic negative effect on the diagnosis and treatment of other diseases.

As would be expected with reduced social contact, social distancing and lockdowns have reduced the rates of infectious diseases, like seasonal influenza.

In many diagnosed cases, treatment for conditions such as cancer had to be postponed due to the fact that health systems and their resources were consumed by the COVID-19 cases.

Even scientific research around the world has also focused on COVID-19, potentially delaying research and breakthroughs on other diseases.

Furthermore, other infectious diseases such as malaria, HIV and tuberculosis were put “on hold”. An assessment on vaccine coverage, from the first portion of the pandemic in September 2020, came to the conclusion that vaccine coverage in health systems had been pushed back around 25 years in 25 weeks.

Before the pandemic, around half of the world’s population did not have access to essential healthcare and this number was increased by the pandemic.

There is also a relevant impact on the mental health of both the general population and healthcare providers, with dramatic changes during the pandemic.

The physical and social distancing measures that have been introduced throughout the world have significantly affected how the general population connects to and interacts with others creating a sense of isolation.

Fear-related behaviours and financial distress have also increased the general negative impact on mental health.

Vaccination
COVID-19 vaccination is giving humans a way to escape this phase of the pandemic. Without it, many scientists and many health organisations, including the WHO, believe that natural herd immunity would not have been sufficient to restore the normality and it would have resulted in extreme fatality. In a scenario without access to vaccines, strict behavioural measures may have had to remain for the foreseeable future.

However, global COVID-19 vaccination faces several challenges which may impact its success. As viruses are exposed to environmental selection pressures, they mutate and evolve, generating variants that may possess enhanced virulence.

Not all mutations necessarily increase virulence, and in the majority of cases may in fact be inconsequential.

The ability to rapidly acquire new genetic characteristics can allow viruses to avoid vaccine-induced immunity and become more virulent.

Efficacy of COVID-19 vaccination
To be successful, vaccines must be effective at significantly reducing the spread of the virus.

Vaccines will allow society to get back to “normal” and for restrictions to be permanently eased, although there are some people that question the efficacy of the existing vaccines, especially considering the emergence of new strains of the virus.

Recently, the WHO has eased concerns, stating that current vaccinations have at least some protection against new variants. They also stress that data on new variants is being collected and analysed and, as our knowledge grows, our ability to modify the already approved vaccines will also grow, in order to make them effective against emerging variants. As more data is collected, researchers will, in the future, understand how to amend the current COVID-19 vaccinations, so that they will protect against the various strains.

Exactly as it is regularly done with the Influenza vaccines.

Booster shots may be administered to maintain the level of protection required to control the spread of the virus.

What is clear is that it is necessary to achieve herd immunity through global vaccination, in order to prevent SARS-CoV-2 from continuing to mutate, becoming more resistant to current vaccines and possibly causing more periods of mass fatality.

One major potential barrier to the success of COVID-19 vaccinations is a negative public opinion of the vaccine. If significant portions of the population were to reject the vaccine, this could have a serious impact on the vaccine’s potential efficacy at controlling the spread of COVID-19.

It is sad to say that there are people who have been refusing to be vaccinated, which is a terribly dangerous decision.

Helping people to build trust in the vaccines is crucial as, without enough people being vaccinated, the world will not be able to overcome the pandemic.

Measures despite the vaccine
The vaccine cannot “give” you COVID-19 infection, and a full course will reduce your chance of becoming seriously ill. It may take a few weeks for the body to build up protection as a result of the vaccine. Like all medicines, no vaccine is completely effective, so you should continue to take recommended precautions to avoid infection. Some people may still get COVID-19 despite having a vaccination, but it should be less severe.

It is still not accurately known how much it will reduce the risk of passing on the virus, so it is important to protect, not just yourself, but all your contacts.

Thus, after having had the vaccine, you MUST still:
▪ Practise social distancing
▪ Wear a face mask
▪ Wash your hands carefully and frequently
▪ Open windows to let fresh air in
▪ Follow the current guidances of the country

In Portugal, herd immunity is not yet a reality, so be careful to avoid infecting other people in case you are carrying the virus without knowing.

People tend to “relax” as things feel easier and safer and there is a strong desire to return to “normal life”, whatever that will prove to be!

But do not forget … better safe than sorry!

Best health wishes,
Dr. Maria Alice

By Dr Maria Alice
|| features@algarveresident.com

Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos