Slow vaccine rollout raises fears of COVID-19 third wave

• East Africa announces 98% fresh infections
• ‘We don’t have enough vaccines to stop imminent third wave’
• Virus gains ability to transmit more efficiently, says Agwale

The fear of a third wave COVID-19 pandemic is growing as new infections rise in Europe, Ethiopia, Kenya, and South Africa. Experts, while giving an update yesterday, on the COVID-19 situation in Africa, where more than 3.2 million people have tested positive, disclosed that the third wave has hit East Africa.

The African Union (AU)’s Centre for Disease Control and Prevention reported an increase in a number of countries with increased infections. The latest data on the AU CDC portal showed that almost 95,000 people had died in Africa after contracting the coronavirus, while close to 2.8 million patients have recovered on the continent.

Director of the centre, Dr John Nkengasong, said yesterday that the third wave was upon us. “When you look at East Africa, you see that clearly there has been an increase of 98 per cent over the last four weeks. It is fair so say that East Africa, as a whole community is now going through the third wave. In Kenya, new infections had shot up by 400 per cent over the past few weeks with its public facilities overwhelmed.”

Also, many countries across Europe are ramping up restrictions to stem a new wave of COVID-19 infections that has once again left hospitals struggling to cope. Due to the spring surge in the pandemic, propelled mainly by the spread of new more contagious and more deadly variants, European countries have been forced to impose new measures or delay the easing of restrictions. It also seems inevitable that COVID-19 passport would soon become compulsory for international travels.

The situation has raised lots of questions like: Is there a possibility of a third wave of COVID-19 in Nigeria? What are efforts in place to contain the disease? Can Nigeria’s fragile health system and lean budget for health withstand this? When is the next batch of COVID-19 vaccines coming into Nigeria to vaccinate more people?

A virologist, vaccinologist and leader, COVID-19 vaccine task team of the African Vaccine Manufacturing Initiative, Dr. Simon Agwale, told The Guardian: “There are no enough COVID-19 vaccines in Nigeria to stop a third wave, so it is possible that Nigeria may experience third wave of COVID-19 pandemic. In the absence of enough vaccines to vaccinate at least 70 per cent of our population, the magnitude of the surge will depend on the willingness of the public to abide by physical distancing and other non-pharmaceutical interventions and the extent to which variants of concern emerge.”

Agwale, who is also a Chief Executive of Innovative Vaccines Limited, Abuja and Innovative Biotech USA Incorporated, said the right thing to do is to build a resilient health system for proper management of patients and conducting clinical trials of new and repurpose drugs so that more lives will be saved. He said at least those that recover would build a substantial immune response that could protect them from re-infection.

The vaccinologist said recent studies have shown that reinfections are rare in people below 65 years of age and more in people above 65 years. He said this means that the country should take care of the elderly population and it is good that they are prioritised to receive the vaccines. Agwale said, across the globe, Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) that causes COVID-19 is evolving ways to evade the immune system and become more infectious.

He said the implications are that Nigerians are going to start seeing more cases because the virus has basically gained an ability to be transmitted from one person to another more efficiently.

Agwale added: “Secondly, we would see that the current diagnostics, drugs and vaccines could be less effective. The best way to prevent the emergence of variants is to stop them from spreading by implementing mass vaccinations. This again is not feasible because of acute shortage of vaccines globally and the situation may not improve in the next couple of months. In the short term, we’ll have to depend on getting existing vaccines, but there is no guarantee that we’ll get enough doses for our people because the wealthy countries have already bought most of the doses.

“We have to start working on manufacturing our vaccines and this is the best way that we can guarantee enough doses for our population. I am surprised that we are still not taking this seriously because we can make this happen for Nigeria.”
ONE person died in the country yesterday after contracting the coronavirus, while 214 tested positive for the disease. According to figures released by the Nigeria Centre for Disease Control (NCDC), total fatalities rose to 2,031 as of Tuesday, with confirmed infections at 162,076 after over 1.7 million tests were conducted in the country of more than 210 million people since March last year.

This is amid an ongoing vaccination campaign launched on March 5 that has so far seen 215,277 people receiving a jab against the virus, according to the National Primary Health Care Development Agency. The current phase covers health professionals and other frontline workers.

Director General of NCDC, Dr. Chikwe Ihekweazu, told The Guardian: “We are still learning a lot about the virus that causes COVID-19, in terms of its epidemiology. Globally, cases declined for about eight weeks between February and March, but have begun to increase in the last four weeks.

“The COVID-19 vaccines will contribute to progress in controlling the acute phase of the pandemic. However, the vaccines are being rolled out in phases and the entire population cannot be immunised at the same time.

“We will continue our response to ensure cases are detected early and managed, contacts are traced to reduce the risk of further transmission and risk communication to ensure that people are aware of protecting themselves.

“Importantly, we urge citizens to continue adherence to public health and social measures – physical distancing, use of face masks, regular hand washing are very important.”

On the implications of the emergence of more new strains/variants of COVID-19, Ihekweazu, who is also an epidemiologist, said: “The SARS-CoV-2, which causes the coronavirus disease, is an RNA virus. The RNA randomly mutates all the time and has been doing so since the virus first emerged. The more viruses there are circulating globally, the higher the chance of mutations arising. Over the last six months, a number of new variants have arisen, which have had an impact on the epidemiology of the pandemic. This is why they are called variants of concern. Scientists are still working on a better understanding of the impact of these variants, especially on vaccines, therapeutics and diagnostics.

“Currently, the message is still the same in adhering to known public health and social measures. There is no magic bullet with the variants of concern. Please avoid large gatherings, wash your hands regularly, wear a facemask properly and ensure physical distancing. This will reduce the risk of spread of the virus.”

On when the next batch of COVID-19 vaccines will come and if the country consider changing from AstraZeneca, considering the controversy surrounding it in recent times, Ihekweazu said: “Our sister agency, the National Primary Health Care Development Agency (NPHCDA), is leading on access to and distribution of COVID-19 vaccines in Nigeria. The NPHCDA is working very hard to ensure that we can access the vaccines we need.

“The European Medicines Agency (EMA) and World Health Organisation (WHO) have stated that they have not found any association between the Oxford/AstraZeneca vaccines and reports of blood clots among people who have received this vaccine.”

The epidemiologist said both NPHCDA and the National Agency for Food and Drug Administration and Control (NAFDAC) are closely monitoring for adverse effects among people who have been vaccinated in Nigeria. Ihekweazu said the NCDC is also supporting this process. “So far, we have not received reports of any severe adverse effect in Nigeria,” he said.

President, National Association of Resident Doctors (NARD), Dr. Uyilawa Okhuaihesuyi, said: “The discussion of possibility of a third wave of COVID-19 infection is not just possible, but a reality as Germany has already recorded its onset a few days ago. With the world now being a global village, and the continued migration of human beings around the world, and especially with our climate, Nigeria along with most of West Africa is unfortunately positioned for a third wave of this novel virus.

“Everything that can be done to contain a third wave is already being done with containing the current second wave being experienced. The roll out of the AstraZeneca vaccine aimed at decreasing incidence of severe disease, with ongoing vaccinations nationwide, along with government support and continued education of citizens using the media remains key.”

Okhuaihesuyi said despite Nigeria’s insufficient budgetary allocation to health for years on end, the health indices show a decline in infection rates with the amount of work being done and a progression towards normalcy, though this can be described as a new normal by many.