THE DELTA VARIANT AND WHAT WE NEED TO KNOW

Dr. Shivani Samlall. MBBS, Specialist in Obstetrics and Gynecology with a sub-specialty in Gynecology Oncology, with over 10 years of practice. She also holds a Post graduate diploma in Clinical Trials and Research. Dr Samlall can be contacted at drshivanisamlall26@gmail.com

I HAVE noticed many concerns on social media, the majority of which have questioned the safety and effectiveness of the COVID-19 vaccines and, more so, the effectiveness of the vaccines against the COVID-19 Delta variant. My column this week therefore aims to address some of these issues, with the hope that I can assist my readers to make informed decisions with regards to the vaccines.

While it is understandable that we question the science with regards to the vaccines, and are hesitant to take same, we must remember that we are in a pandemic, one which, in over a year, has affected more than 222 million people worldwide and has caused over 4.59 million deaths. And in Guyana, as of September 9th, over 27,300 persons have been diagnosed with COVID-19 and over 659 persons have died from it. Importantly, these numbers will continue to increase unless we take the necessary steps in curbing the spread of this disease.
Thus far, the science has been clear on how we can go about achieving this: vaccines, face masks, social distancing, hand washing/ sanitising.

SAFETY AND EFFECTIVENESS OF THE VACCINES
First, some argue that only the Pfizer has been given FDA approval and therefore the other vaccines are not safe nor effective against COVID-19. But, for all the vaccines to have been given an emergency approval for usage in the general population, rigorous testing had to be done to ensure that they are safe and effective against the virus. Which meant that, like any new drug, all the vaccines had to be subjected to various phases of clinical trials before that could have happened.

HOW SAFE ARE THE COVID-19 VACCINES?
Most persons are fearful of the side effects of the vaccines. But before I discuss this, let’s have some perspective. So far, over 5.64 billion doses of these vaccines have been given worldwide, with over 2.32 billion persons having been fully vaccinated. How many reports of serious complications have you seen or heard? While some might argue that the side effects are not being reported by the vaccine companies, let me clarify this. It is not the vaccine companies but an Advisory Committee of Immunisation Practices (ACIP) which is responsible to report “ALL” side effects that are related to these vaccines.

The ideal scenario would be a vaccine without any side effects. However, the reality is that vaccines like any medication, all have side effects. Have you noticed all the side effects of Panadol, Ibuprofen and Vitamin supplements? Or even the herbal medication that we take or are advocating for use against COVID-19? If you haven’t, I encourage you to research them. Yet, most of us, take these medications daily without any hesitancy.

The fact is, for any medication or vaccine to be given approval for usage, the question that health organisations must ask is: “Do the benefits of the drug outweigh the risks of possible side effects?” In the case of the COVID-19 vaccines, the answer is undeniably a “Yes”! These vaccines prevent us from getting severe disease, being hospitalised and dying.

While most of the side effects of these vaccines are similar to any childhood vaccine (swelling, pain and redness to the injection site, fever, etc,) there have been reports of blood clots, myocarditis (swelling to the heart muscle), etc. However, these are rare and are treatable. Importantly, blood clots occur more often in pregnant women and with birth control pills than in persons who received their COVID-19 vaccines.

With regards to swelling of the heart muscle, a CDC MMMR report found that Myocarditis occurs more frequently among COVID-19 patients (150 per 100,000 cases as compared to nine per 100,000 cases) in persons who took the vaccines, which means that a person is 16 times more likely to have myocarditis with COVID-19 than if they take the vaccine!

Additionally, some argue, of the uncertainty of the long-term side effects of the vaccines. What I would like to highlight on that is, “If” we survive COVID-19, are we aware of the long-term complications that we would have to live with? While some of these complications are still unknown, studies have found that the patients who have recovered from the disease are having chronic fatigue, muscle and joint pains, chest pain, fast or pounding heartbeat, constant shortness of breath, to name a few, most of which occur as a result of permanent damage to the heart, lungs and brain amongst other organs. There are also reports of infertility after COVID-19. The next big question is…

HOW EFFECTIVE ARE THE COVID-19 VACCINES?
To begin with, I must make mention that no vaccine is 100 per cent effective in preventing a disease. Additionally, clinical trials and real-world data have shown and continue to show that all the COVID-19 vaccines are very effective in preventing symptomatic disease, hospitalisation and death. Granted all the vaccines do not have the same efficacy profile, with some being more effective than some, the bottom line is, you are at a lesser risk being vaccinated than being unvaccinated. In the US, before the Delta variant of the original SARS-CoV-2 virus was identified, there was a steady decline since January 2021 in the number of COVID-19 cases, of hospitalisations and deaths after the introduction of the vaccines.

Iceland, a country that had a high incidence of COVID-19 cases, has been able to reduce its numbers and had no COVID-19 death since May of this year, all due to widespread vaccination. Besides these countries, studies after studies are demonstrating that vaccinated persons are less likely to suffer severe disease, be hospitalised and die from COVID-19. Look at us in Guyana, for the months of July and August, 54 out of 56 persons and 87 out of 92 respectively, admitted in ICU were unvaccinated. Additionally, the number of persons who have died from COVID-19 that have been vaccinated are few, and their death according to the Minister of Health was as a result of multiple underlying comorbidities.
This brings me to the final big concern of many persons…

ARE THE VACCINES EFFECTIVE AGAINST THE DELTA VARIANT?
To date, several variants of the original virus have been identified. The most concerning of these is the Delta variant. This variant was first detected in India in December 2020 and by May 19, 2021 (in five months!) had been detected in 43 countries. This explains how extremely contagious this variant is! One infected person can transmit the virus to nine persons compared to the original virus whereby one person can transmit the virus to about two persons. It is also responsible for the surge in cases, in ICU admissions and in deaths as seen in many countries, including Guyana. Look at our stats, we have had a threefold increase in COVID-19 cases in May and in the last 10 days ? 44 persons have died!

This variant is one of the main reasons why Israel, despite having vaccinated over 50 per cent of its population, has not been able to experience a decline in its COVID-19 numbers.
However, the good news is, all the studies, including those from Israel have shown that all the vaccines are effective against the Delta variant.

WHAT MUST WE LEARN FROM THE DELTA VARIANT!
This variant if anything, has demonstrated the urgency in which we need to vaccinate to achieve herd immunity. Without herd immunity, we open the doors for more aggressive variants to emerge – variants which the current vaccines might not be effective against. We must also learn from other countries such as Israel that unless we achieve herd immunity, we cannot and should not relax our COVID-19 guidelines.

In Conclusion: The COVID-19 vaccines are safe and effective, even against the Delta variant. We need to achieve herd immunity if we are to, once and for all, end this pandemic. For that to occur, we must all play our part. The science shows that vaccination, along with other prevention strategies such as physical distancing, wearing a mask, handwashing/sanitising is our safest bet in surviving and ending this pandemic.