Hira Bahadur Thapa

With only a fraction of global population having been administered COVID-19 vaccine and the spread of highly transmissible Delta virus in many parts of the world, the task of getting people inoculated quicker is becoming more challenging. This situation is more pathetic in low- and middle-income countries, where millions of people still remain unvaccinated despite the fact that the wealthy nations have started providing booster shots to their population at risk.

Misallocation
The rich nations justify their campaign to administer third dose of Pfizer-BioNtech and Moderna vaccines to those who were fully vaccinated eight months ago. Health experts view this as an example of misallocation of means at a time when millions of people in poor countries are denied even the first dose of the vaccine.

Amidst fast mutations in virus, the scarcity of vaccines in any part of the world is certain to reverse the progress of rich countries. They are also not unaware of this. This is the reason why some foreigners are denied entry into the US and a few European nations have re-imposed a ban on the arrival of American tourists into them. A recent surge in infections after the lull in June in the US has been the reason behind new restrictions.
In view of this, the US administration has re-mandated its fully vaccinated people to wear masks while in indoor activities. Studies conducted in rich countries like Israel and the US have concluded that some breakthrough infections are unavoidable. It means that fully vaccinated people can contract coronavirus infection and transmit it to others as well though such cases are rare. Therefore, face coverings regardless of vaccination status are necessary for protecting our health.

The new data released from 306 people by Pfizer and BioNTech have shown that a third dose given to eight months after the second caused a strong immune response. Immunity gets enhanced if the booster shots are administered. Israel has become the first country in the world where the senior citizens and other people considered to be at higher risk have received the third dose of COVID-19 vaccines. The US government has also promised to go ahead with the booster shots to those who received their final dose eight months ago beginning from the third week of September once US Food and Drug Administration, the federal agency, gives approval.
As vaccine makers set their eyes on boosters, new studies have revealed that Johnson & Johnson shots can also enhance the immune response as the Pfizer and BioNTech and Moderna vaccines. In Nepal, a significantly number of people has received Johnson & Johnson vaccine.

Johnson & Johnson is an American company which received emergency authorisation from the Food and Drug Administration (FDA) in February and whose shot showed 72 per cent efficacy against infection in the US clinical trial. But the study was conducted before more contagious Delta variant was widespread. Nepal had to rely on the former because of the existing logistical hurdles. Pfizer and Moderna vaccines require storage at very low temperature which poses a daunting challenge for Nepal, which has poor health infrastructures.
Dr. Dan Barouch. a virologist at Beth Israel Deaconess Medical Centre in Boston, who has conducted studies for Johnson & Johnson, has said that given the hyper infectious Delta variant, it is likely that people who received the Johnson & Johnson will be recommended for booster shot at some point in time.

The Delta variant seems to change the war against coronavirus. According to Dr. Rochelle P. Walensky, director of the Centre for Disease Control and Prevention (CDC), this variant is more aggressive and more transmissible than previously circulating strains. This variant has been reported in 182 countries and is now the most common in many of countries, including India and Britain. In May and June, Nepal suffered more than 200 casualties daily due to COVID-19. Infection rates were also alarmingly high. Nepal doctors blamed the Delta strain for the calamity.

At present, virus infection rate in Nepal is slowly declining. Any infection rising above five per cent is believed to be risky. Our vaccination rate is still low. Vaccines are effective but the latest research suggests that new dangers are emerging as evidenced by breakthrough infections. Available statistics show that in Nepal about 4 million people have been fully vaccinated which is not a high number given 30 million population in the country.
There are credible reasons to believe that community transmission is prevalent in the country. The infection curve goes up along with a higher number of tests conducted. We have not been able to conduct sufficient tests and, as a result, infected people are still in large numbers in the communities, whose contact-tracing remains an unfinished job. This part is more problematic as now we have relaxed most of the COVID-19 restrictions.

Expansion of testing
Many people have declined to go for tests despite being symptomatic due to high costs associated with PCR tests, which the government has failed to offer free of costs. Such tests should at least be made available in the government hospitals at lower costs, if not free, so that many with limited incomes could also afford to pay. Untested but infected people while moving around on public transport will always be the superspreaders. Until we sort out testing issue properly, our fight against coronavirus will hardly be effective.

We will continue to be vulnerable because of lack of tests and vaccination. The world’s coronavirus vaccine needs of 12 billion doses won’t be met at the current pace of vaccination manufacturing. Eight months into the year an estimated 5 billion doses have been delivered. The vaccine manufacturing countries and the international community should work in concert to address global vaccine needs with due focus on equitable distribution.

(Thapa was Foreign Policy Advisor to the Prime Minister from 2008-09. thapahira17@gmail.com)