It is a little over a year since Covid-19 broke out and it continues to ravage the world with increasing devastation. Botswana is not spared yet there are rumours of an impending third wave of infections on the backdrop of uncertainties related to the vaccine. When there is a problem, it is helpful for one to take a step back and rethink his approach and strategies, and that time is now for Botswana.
From the onset the world was told to wait for the vaccine, which was initially anticipated to be available from around September 2020 and in sufficient numbers to serve the entire humanity. A compelling narrative ensued from abroad to the effect that ‘there can never be any normal until everyone was vaccinated’. Consequently, an equally pervasive message was drilled into the minds and conscience of nations to ‘wait for the vaccine’. Indeed, our response strategy was shaped by this narrative and consequently our actions, interventions and behavioural patterns. In July 2020, the Botswana Forum for Action and Reform (B-FAR) released a statement congratulating the Botswana government for having done relatively well in leading the nation towards precautionary behaviour that kept the pandemic largely at bay. We had few cases then and every hope for a quicker and easier solution. There is no doubt that the situation with the vaccine falls short of what was expected and this calls into question the continuation of the ‘wait-for-vaccine’ response strategy. In our case, the uncertainties continue around its availability and the timing and quantities of any deliveries if there ever will be. A lot has also surfaced around the integrity of the experimental vaccines currently available which our Honourable Minister of Health and Wellness Dr Dikoloti chose to term ‘limitations’ in his statement released on the 4th February, 2021, saying, “The vaccine … IT IS NOT A CURE, but a protection with limitations”.
The limitations around the vaccine are either in the public domain or can be checked if one wishes to find out what mainstream media is reluctant to share. The American Centre for Disease Control and Prevention (CDC) regularly dumps data into the Vaccine Adverse Events Regulatory System (VAERS), a US Government funded database that tracks injuries and deaths caused by vaccines. From the time the vaccines were administered in the US towards the end of December 2020 to the
29th of January, 2021, VAERS reports 11,249 adverse events including 501 deaths. These are figures
for the US alone and considering the many controversies around the vaccine and the need to fight vaccine hesitancy, there is reason to believe they are a small fraction of actual figures. Adverse events related to the Covid-19 vaccines are reported in all of the countries currently administering the vaccine, with evidently more adverse events on the elderly.
We further note that the above is happening against a very awkward admission by the World Health Organisation (WHO) that not enough is known yet regarding the effectiveness of the vaccines in taking nations back to ‘normal’. In one of the WHO’s ‘Science in 5’ Question and Answer
communication short series intended to brief people on what to expect after being vaccinated, Dr Katherine O’Brien, the WHO Director of the Department of Immunization, Vaccines and Biologicals who answers questions presented by Vismita Gupta-Smith of WHO Communications, says the following amongst others, “we don’t know yet how long immunity lasts from the vaccines”, “what we don’t know yet from the clinical trials is whether or not the vaccines also protect people from just getting infected with the SARS-CoV-2 virus and whether or not it protects against transmitting to someone else”, “we really need to continue these precautions while we are still learning about what the vaccines can do”, “but remember that we don’t actually have the evidence yet for using the vaccines in some age groups”, “the second reason is that the vaccines are in short supply, so we don’t have enough vaccine yet out in the community to protect everybody. Those are reasons why we have to continue the precautions”. This is the reality we face, and this is the reason we ask our government to go back to the drawing board and improve on the Covid-19 response strategy.
The first improvement is related to the precautions. With the background that we have provided here, it seems to us the precautions that we adopted from WHO were primarily the ‘whilst-you- wait-for the vaccine’ type of precautions. They have helped us a great deal and we must follow them even more religiously but we need more. No one is going to tell us what else we should do, but our government can and should. We strongly propose that government considers the following additional measures in addition to those we already have:
1. Dietary measures. A disease is fought from a distance (social distancing) and externally (washing of hands) but can also be fought internally. This is logical. In any case, that is what the vaccine will do. It is about immunity and the vaccine is not the only source of immunity. Everyone knows there are certain types of food that can boost immunity. The question is, why are we waiting, how many of us should die before we consider this additional preventative measure? How difficult is it for our government, through her many qualified nutritionists, scientists and health practitioners, to come up with a list of foods that most people can afford which can help boost our immunity whilst we wait for the vaccine.
2. Healthy living measures. Washing of hands is a hygienic measure and a good practice to keep the virus at bay, but why do we overlook the known fact that healthy living is helpful. Just like the dietary measures, these are for the strengthening of the body and improving its resistance to viral attack whilst we wait for the vaccine.
3. Behavioural measures. Avoiding groups is a behavioural measure that is only externally preventative to Covid-19. Our government passed messages in support of more internal body related behavioural changes in relation to non-communicable diseases (NCD) and we wonder what brought about the silence when it comes to Covid-19. We have heard conversations around exposure to the sun for limited times, steaming and such practices. It will make a big difference if we heard about them officially from government.
Treatment protocols. The ‘sanitise, wash your hands, social distance, avoid groups’ are all
preventative (or safety) protocols. We understand that at the beginning the narrative was
‘prevent, stay safe and wait for the vaccine as there is no cure’. We all believed the ‘no cure’ claim, but there have since been numerous claims at the availability of cures, including therapeutic and remedy combinations around Vitamins C and D and Zinc. We should wait for the vaccine, and indeed prevent, but our people continue to die, we continue to die. At the same time we read about countries that have turned the corner after using available medicines, in particular Ivermectin. Amongst these countries are India, Mexico and Australia, and South Africa is joining them albeit belatedly, reluctantly and only after immense public pressure. The ‘no cure’ stance does not seem to have been an accurate prediction, yet we don’t seem to notice this nor does it seem we will ever change our response strategy to reflect the possibility of treatment, of a viable ‘cure’. More specifically, we don’t seem to move an inch further from prevention protocols to include treatment protocols, even in light of increasing evidence. We should be able to do that (incorporate treatment protocols) without compromising on ‘prevention’ protocols. We should have a broader Covid-19 response strategy if we want to survive this menace.
Government understands that existing medicines can be repurposed to fight new and emerging diseases, and those already proven to be safe on humans as is the case with Ivermectin make it easier to fall back on. It becomes a case of ‘what do we have to lose?’. We hear that Ivermectin has been in use since 1975, that it is registered and approved for use on humans by the American Food & Drug Administration (FDA) and that at some point it won a Nobel Prize for its anti-parasitic impact. We do not care to find out the politics (surely not science) behind its use on Covid-19 patients being disallowed in August 2020 but that should not matter as much as our lives matter. In fact, that is why we have a government to establish the truth around anything that relates to life and death and to public health in these trying times and not ignore it. We also hear that it is completely safe, off-patent (not owned by anyone), cheap and widely available and of course, the many claims on its effectiveness against Covid-19. We are not doctors ourselves, but wonder at the wisdom of letting people die when there is something that can be tried, at no known risk to people, especially if such is being applied by more advanced economies such as Australia. We call upon our government to make a concerted effort to investigate Ivermectin with a specific and deliberate aim to promoting its use against Covid-19 in Botswana. We condemn the negative attitude by BOMRA in calling it ‘veterinary Ivermectin’. Now is not the time for attitude, Batswana need sincere guidance. Hydrochloquine was condemned and banned too, but recent peer-reviewed journal reports indicate considerable early stage effectiveness and reduction of mortality in Covid-19 cases, albeit to a lesser degree than Ivermectin. Any anti-viral therapy that improves body response to Covid-19 not only saves lives directly but also helps build herd immunity and prevents contagion and spread. We do not own any of these medicines and vaccines, we own our lives. We must protect our lives. We must investigate ‘cures’ and introduce prophylactic and treatment protocols if and when available.
We have tried our level best to present this call without being alarmist or in any way countering well-intended government approaches. Covid-19 is a serious challenge that we all face. We have not experienced anything that even comes close to this monumental danger. We are in this together regardless of any of our usual differences as people. As a nation we typically obey our leaders and our government, but our government does not have to obey anyone else to keep us safe and alive. We have lost too many people already and do not have the liberty or laxity to sit and wait for the vaccine that we have no control over without doing anything else. There must be things we can do, and we must do them. It must have occurred to the minds of those in government that there exist a possibility that after borrowing to pay for the vaccine, we might be told immunity lasts only months, or a virus strain emerges that can withstand the vaccine. What would be done then? We have had a long State of Public Emergency (SOPE) and our economy is on its knees. We have tried debilitating lockdowns and curfews but the situation has gotten worse. There will come a time, if it has not already, when we should know we have brains and hands with which to survive as a people. No one knows what will happen the following day, or week, or month, or just how many people we will lose, and who amongst us it will be, before the vaccine comes and what the outcome will be after it arrives. It is not a situation anyone finds himself in and just waits. We should as Batswana, be concerned about one thing and one thing only – saving ourselves. We should ignore the many controversies around vaccines and medicines but aim only not to lose any more people. We should also confidently share information about the vaccine (it is not ours to protect but our lives are) and allow the public to know what is truthfully at stake for it is their lives that will be affected. Our government should be able to package wholesome messages to the public and present them in an honest and transparent matter whilst ensuring they do not lead to complacency. We should have nothing else to protect or speak for except that which will save our lives. We should wait for the vaccine, not folding our hands and closing our minds whilst more of us perish, but we should proactively seek ways and means to take us into another day.
We must end by congratulating government on the flexible work times. This is still in keeping with the ‘social distancing’ regime but it came as a refreshing indication that more can be done. Give us more and let us do more, we must.
Please obey the curfew and follow safety protocols: wear a face mask, wash your hands regularly, social distance, sanitize and stay safe. FATSHE LENO, LA RONA.