Managing COVID in 2022: First Do No Harm



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As the world reaches its second year of life with the global pandemic, a grim picture looms.

More … than 119 million people have been pushed back into poverty by 2020, the equivalent of 255 million full-time jobs have been lost and the number of hungry people – which was already increasing before the pandemic – is expected to rise from 83 million to 132 million.

And that’s before considering the illness, death and stress on health systems that COVID-19 has caused. Nor the broader impacts of movement restrictions and social distancing.

The introduction and widespread adoption of vaccination in some countries is reducing symptomatic illnesses and hospitalizations, but even countries with high vaccination rates still face acute challenges with new viral strains; people are still infected, and immune protection decreases. the consensus is resolved: we will have to learn to live with the virus.

What is living with the virus? This means evaluating our mitigation strategies to ensure they are effective, proportionate, appropriate and sustainable. That they do not worsen the damage already inflicted by the pandemic.

Last year showed that containments do not meet these four requirements. The impact of the pandemic has been different depending on the continent. Contrary to the predictions of important global health experts, Africa has known the lowest burden of COVID-19 and death.

Even allowing for lower reporting rates and poor access to vaccines, the death rate in Africa remains much lower than in Western Europe or North America. Our studies and those of others indicate that several factors, including a younger and more rural population, have reduced Africa’s vulnerability to infections and disease.

When considering the wider indirect impacts of the pandemic on global economies, low- and middle-income countries have been the hardest hit so far because they have weaker defenses against economic shocks and tend to depend more on a few sectors, such as commodities and tourism. The blockages were disproportionately damaging to Africa because they have not played on the strengths and circumstances of the continent.

Locks stopped vaccination of children programs that protect african children diseases that are much more deadly for them than COVID-19, such as measles, pneumonia and meningitis. Schools, which are the center of so many health and child protection programs, have been firm, even where most of the teaching is outside.

Of those who die from the indirect effects of COVID-19 by 2030 in Africa, 80% will be children under 5. Analysis of the pandemic in the African region of the World Health Organization (WHO) did not find any benefit from the strict restrictions, such as social distancing and movement restrictions. Restrictions applied for a long time – or reintroduced late in the pandemic (for example, during an epidemic) – book, at best, a weaker and muted effect on the spread of the virus and the number of deaths.

The recent Wellcome Trust Global Monitor Report called for COVID-19 tests, treatments and vaccines to be available wherever they are needed, stressing that it will cost only a fraction of the economic losses the pandemic causes each week.

Where do we go from here?

The first thing is to make the best use of the tools we already have to secure interactions. Ordinary test before mixing with others, especially in large social settings, is recognized as an important tool for reducing transmission when people who test positive are self-isolating and not exposing others to infection. Lateral flow tests are now a credible alternative to PCR tests. Making them widely available at the point of care will improve adoption and public compliance.

Vaccination is a very effective tool that can secure contacts, but it is necessary to increase the availability of vaccines to allow better absorption. This requires a wider distribution of currently available vaccines and removing barriers such as restrictive intellectual property that prevent countries from being allowed to produce their own vaccines.

Additionally, if intellectual property and supply chain blockages are lifted, it would allow Africa to produce COVID-19 vaccines for the locally circulating variants. We know Africa can produce vaccines – as the Johnson & Johnson’s COVID-19 vaccine – so all obstacles to this must be removed.

In addition to intellectual property issues, several vaccine candidates are stranded on the shelves of African laboratories for lack of funding, mechanisms and supplies to move them to needed vaccines.

Efforts must be intensified to face vaccine hesitation, an important aspect in achieving individual and community protection through collective immunity. Reasons for reluctance or low vaccination rate are variable it is therefore necessary to put in place relevant strategies at the local level to deal with it.

Some countries do Compulsory COVID-19 vaccination, but the impact it has on vaccination rates can be modest and the controversy surrounding this approach is unlikely to wear off quickly.

There must be other ways to encourage membership. One approach is community engagement to construct confidence between health workers and the community. For example, engage local and religious leaders to get their approval for the vaccination, as happened with the Pope, sends a powerful message to communities.

Finally, health systems must be strengthened to serve those in need of care for COVID-19 as well as other community health needs.

The lifeline for critically ill COVID-19 patients is medical oxygen – we underlined its serious shortage in Africa from March 2020, a scenario that was repeated in other continents.

Health systems must serve all patients optimally, and not just part of the world’s population. The discovery racial bias in oximeters, devices that indicate when natural blood oxygen levels are extremely low, are a reminder of the work ahead.

Oximeters overestimate the amount of oxygen in dark-skinned patients and this is thought to have cost lives of ethnic minority patients during COVID-19 pandemic in the United Kingdom. Knowledge of this bias in oximeters is not new, many scientist papers have been published on the subject and discussed in the media.

Taken together, these interventions will help us mitigate the impact of COVID-19 in a more sustainable way that also minimizes the negative impact on progress towards the Sustainable Development Goals.

Originally published under Creative Commons by 360info â„¢.

Francisca Mutapi is Professor of Global Health Infection and Immunity at the University of Edinburgh, where she is also Deputy Director of the Tackling Infections to Benefit Africa (NIHR) TIBA Global Health Unit. She is a Fellow of the African Academy of Sciences, the Royal Society of Edinburgh and a 2021 TED and Aspen New Voices Fellow.

The underlying research supporting this publication was commissioned, in part, by the National Institute for Health Research (NIHR) Global Health Research Program (16/136/33) using of UK AID from the British government.

The views expressed in this publication are those of the author and not necessarily those of NIHR or the Department of Health and Welfare. Funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the article.

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