We need to put Sri Lanka first: Dr Ranan-Eliya

Even though the Directorgeneral of Health Services issued new health guidelines which will be in effect till December 15, international health researchers opine that Sri Lanka should further strengthen its defences against the new variant. Speaking to the Daily Mirror, Executive Director at Institute for Health Policy Dr Ravindra Rannan-eliya said that the necessary lessons to be learned are socio-political and not epidemiological.

Excerpts : HOW IS THE OMICRON VARIANT DIFFERENT FROM OTHER VARIANTS?

We still don’t know, but a range of evidence indicates it is much more infectious than Delta, has significant immune resistance and may be more lethal. It may also cause more serious illness in children than the elderly, although this is quite tentative.

HOW SHOULD SRI LANKA PREPARE FOR THE OMICRON VARIANT DESPITE AUTHORITIES SAYING THAT THEY COULD DELAY THE ENTRY OF THIS VARIANT?

Even if the virus is already here, we need to slow down and delay as much as possible the initial entry of Omicron, to give us time to strengthen defences. That means imposing immediately one week quarantine on all vaccinated arrivals, with the possibility of extending this to two weeks if data comes in that this is not enough.

We also need to strengthen our defences to reduce virus spread and protect lives and the economy if Omicron becomes established. That requires urgent investing in upgrading and expanding our PCR testing capacity.

ARE EXISTING VACCINES ADEQUATE TO KEEP PEOPLE FROM CONTRACTING THIS VARIANT?

None of the vaccines is effective in completely preventing infection by any of the variants, because they were never designed for that purpose.

Moderna may be the best, but even it appears only 57% effective in stopping Delta infection. The Moderna CEO recently said that their scientists expect performance to be significantly worse against Omicron, and this will also apply to Pfizer.

So it is likely that no vaccine will be able to reduce your chance of Omicron infection by more than 50% and for many, it will be less than 30%.

THERE’S A CONCERN THAT VACCINE MANUFACTURERS WILL HAVE TO KEEP UPDATING THEIR VACCINES TO BRING ABOUT RESISTANCE TO NEW VARIANTS. IS THIS TRUE?

Moderna CEO said that they likely would need to release an updated vaccine against Omicron. They have started work, but it will take many months before it is available at scale, and even later be available outside the USA and Europe.

That we might have to continuously update vaccines for new variants are always expected, so this is no surprise. Omicron only confirms what was predicted. Omicron is a particular problem because it has far more mutations in the spike protein than any previous variant, making it more likely that the vaccines need updating.

DOES THIS MEAN THAT PEOPLE WILL HAVE TO CONTINUE VACCINATING THEMSELVES WITH NEW VACCINES?

Realistically, the best vaccine protection will need longterm regular boosters. We have no idea how often—even Israel says it has no idea, but it could be yearly or twice yearly. And everyone would need this from children to

the elderly. But this was already expected before Omicron appeared , so nothing has changed.

SRI LANKA WENT THROUGH A SERIES OF LOCKDOWNS DUE TO INADEQUATE MEASURES TAKEN BY HEALTH AUTHORITIES. WHAT LESSONS SHOULD WE LEARN AT THIS POINT TO AVOID THE NEXT WAVE?

This is not easy to solve. Our policy of lax borders since early 2021, inadequate test and trace, and the lockdowns when cases mount clearly failed, did huge damage to the economy and killed thousands of Sri Lankans.

But this was all predictable from an epidemiological and economic perspective. I think the necessary lessons to be learnt are sociopolitical, not epidemiological.

The first is that if the government is intent on losing the next electtions, it should carry on with this approach - it is a very good strategy if the goal is to put the Opposition in Government next time.

The second is that if Government wants to limit damage to the economy and save lives, it needs to break free from the groupthink in the medical community which has consistently come up with an approach that does not work from either health, economic or political perspective.

The third lesson might be that the first two relate to leadership, and we should all appreciate the vital importance of wise leadership.

We need to put Sri Lanka first. We must impose immediate quarantine on all vaccinated arrivals as an emergency measure until we have a better idea as to how bad Omicron is, and we should use that time to improve our defences.