B-FAR calls upon government to rethink COVID-19 response strategy
Correspondent | Friday February 12, 2021 16:30
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 for Botswana that time is now.
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 is 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.
That is not the case anymore and 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 the availability and accessibility of the vaccine, the timing of its delivery and the quantities that will become available for our people, if indeed there ever will be. Based on the South African experience, there are red flags on the suitability of the available vaccines and indeed a lot has surfaced around the integrity of the experimental vaccines in general – a feat which our Honourable Minister of Health and Wellness Dr Dikoloti chose to term ‘limitations’ in his statement released on the 4th February, 2021. In his own words,“the vaccine ... IT IS NOT A CURE, but a protection with limitations”.
The limitations around the vaccine are in the public domain even with the reluctance of mainstream media to share them and can easily be checked and confirmed. One such source is the US Centre for Disease Control and Prevention (CDC) which 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 in the latter part 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 a possibility these are a small fraction of actual figures. Adverse events related to the Covid-19 vaccines are reported in all the countries currently administering the vaccine and include reports on people with no prior medical conditions and evidently more adverse events on the elderly.
B-FAR further notes 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 recent 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, answering questions presented by Vismita Gupta-Smith of WHO Communications, said the following, among others;
l “we don’t know yet how long immunity lasts from the vaccines”,
l “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”,
l “we really need to continue these precautions while we are still learning about what the vaccines can do”,
l “but remember that we don’t actually have the evidence yet for using the vaccines in some age groups”,
l “the vaccines are in short supply, so we don’t have enough vaccine yet out in the community to protect everybody”. This is the reality we face, one we must confront, and 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. On the basis of the above background, 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, and it is the responsibility of our government to tell us what else we should do. We strongly propose that government considers the following measures in addition to those we already have:
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 vaccines do. It is about immunity, and the vaccine is not the only source of immunity. It is now well established that 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? It should not be difficult for our government, through her many qualified nutritionists, scientists and health practitioners, to come up with a list of foods that most Batswana can afford which can help boost our immunity whilst we wait for the vaccine.
l Healthy living measures; Likewise, washing of hands is a hygienic measure and a good practice to keep the virus at bay, but we must not overlook the well-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. It would be the responsible thing to do, for government to step forward to encourage people to exercise, sleep well, drink lots of water and so on. The times we are in call for that responsibility.
l Behavioural measures; Avoiding groups is a behavioural measure that is only externally preventative to Covid-19. We have heard conversations around such behavioural practices associated with the body such as exposure to the sun for limited times, steaming and similar. Our Government passed messages in support of similar behavioural changes in relation to non-communicable diseases (NCD), and the same principle must be extended to the fight against Covid-19. It will make a big difference if we heard about them officially from Government, especially since they are based on credible data.
l 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 should not accept to die whilst waiting.
l At the same time we read about countries that have turned the corner after using available medicines, in particular Ivermectin. Amongst these countries are most of Latin America, India, some parts of Africa, Australia, and recently (26th January,2021) Slovakia as the first EU nation to fully adopt Ivermectin, having used it on compassionate basis - the same level of use as recently agreed to by South Africa, clearly belatedly, reluctantly and only after immense public pressure.
l We challenge government to peruse the case charts of these countries to confirm clear evidence of real-life efficacy and saving of lives. Ultimately, the real issue and our only concern should be about saving of lives. 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 and a viable ‘cure’.
l 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 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. 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. Clearly its safety is unquestionable. It becomes a case of ‘what do we have to lose?’
The politics (surely not science) behind its use on Covid-19 patients being disallowed in August 2020 are neither here nor there and they should not matter as much as our lives matter. In fact, for the sake of its people, government must establish the truth around anything that relates to life and death and to public health in these trying times rather than ignore it.
We also hear that Ivermectin is not only completely safe, but also off-patent (not owned by anyone), cheap and widely available and of course, the many claims on its effectiveness against Covid-19, as both prevention and treatment. 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 plan of action to promote its use against Covid-19 in Botswana at the earliest possible. It is regrettable to note the negative attitude by BOMRA in calling it ‘veterinary Ivermectin’. Now is not the time for attitude and professional egotism. Batswana need sincere guidance. Hydroxychloquine (HCQ) 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 directly saves lives but also helps build herd immunity and prevents contagion and spread. We do not own any of these medicines and vaccines, but we own our lives. The same bodies that condemned HCQ are now retreating, but after immense and needless loss of life. We can not afford to wait for such a regrettable outcome with Ivermectin. We must protect our lives. We must investigate ‘cures’ and introduce prophylactic and treatment protocols as they are already available and seek to empty Sir Ketumile Hospital.
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 and must earn our trust to keep us safe and alive. We have lost too many people already and do not have the 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 and undesirable 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 and is deteriorating even quicker. 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 aim only not to lose any more people, by any means possible. We should not be distracted by the many controversies around vaccines and medicines but confidently share information on them 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 manner 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. Above all, we should wait for the vaccine, not folding our hands and closing our minds whilst more of us perish, but proactively seeking ways and means to take us into another day.
We 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, social distance, wash your hands regularly, sanitize and stay safe. Fatshe leno, la rona.
*Botswana Forum for Action and Reform (B-FAR) is a lobby, pressure, advocacy or interest group established by a group of concerned Batswana to advocate for an accelerated and radical socio-economic, structural (and quasi-political) transformation agenda