Opinion: Holistic approach needed in managing Covid-19

By Eva Mugisa

In the wake of a two year battle with the COVID19 pandemic, nations all over the world are seeking the most effective way to contain infections, and re-open all sectors of their economies.

At the helm of these interventions, World Health Organisation (WHO), National Institute of Health (NIH) and Center for Disease Control (CDC) have recommended a variety of approaches to this, with vaccination being the latest and of greatest interest, using the novel vaccines like the mRNA COVID vaccines.

Promising as it was at the onset of its rollout, the vaccination approach has however hit a stalemate, with the very core of biomedical ethics being challenged by mandatory governmental policies not just in Uganda, but at global level.

Multiple countries in the EU and Australia seem to be ablaze with protests against the "no-jab-no-job" policy, as well as the controversial "Green pass" or COVID vaccination certificate. With this mixed reaction from the public, it is therefore essential to review the vaccination approach from the context of a much larger and more holistic medical picture of COVID19 management.

While the concept of vaccination was noble at conception, it is dangerously presumptuous to label all vaccines as equal, and therefore bracket all vaccines as "safe and effective" before satisfactorily being proven so through appropriate tests.

Such tests include, but are not limited to, clinical trials, biodistribution and safety studies to identify short, mid and long-term side effects, as well as post-marketing surveillance over at least 10 years before validating the above claims on both efficacy and safety of the vaccine of interest.

This data is critical to give both health workers and the end-user all the  information they need to make an informed consent decision about whether or not they will accept the recommended vaccine or not.

Although both the CDC and WHO stress that COVID vaccines have been subjected to clinical trials, the accelerated manner in which they were carried out in under two years does not give the scientific community nor the end-user concrete information on the mid- and long-term side effects that can only be revealed on average within 10 years. Usually these side effects include effects on reproduction, effects on life-span and carcinogenicity.

The mRNA technology, used in the production of the covid vaccines, is particularly still new, with a lot still unknown about it, and the fore-casted efficacy and safety of the COVID vaccines is under scrutiny by the public, in real-world sample spaces of nations that have vaccinated a considerable fraction of their population.

The outlook of the mandatory vaccination approach in nations like Israel and Seychelles is unfortunately, very grim. The immune protection of the vaccines wanes after six months (as confirmed by the WHO). More booster shots are required and there is emergence of many cases of break-through infections among the vaccinated.

A recent study from the UK has shown that vaccination does not guarantee 100% protection from spread, as vaccinated people as well stand a 25% risk of infecting people within their households with the Delta variant.

The US Vaccination Adverse Event Report System (VEARS) has also reported record high incidence of adverse events associated with the COVID vaccines, including myocarditis, neuropathies, blood clots, acute severe anaphylaxis, permanent disability, miscarriages and even deaths.

Of greater concern is that of the 20 or more adverse effects associated with the COVID vaccine that are mentioned on the CDC website as essentials that health workers should tell the vaccinees about, none of them have been mentioned on the consent forms used in Uganda.

Only the mild immediate side effects are mentioned. Naturally, this poses the question: are the vaccinees being given all the information about the COVID vaccines that is required for informed consent?

With such a magnitude of research and demographic emerging from the global scientific community, it is imperative to realize that well-intended as a vaccine in principle may be, the mandatory vaccination approach may not be the ethically acceptable one and the vaccines are yet to stand the test of time (at least 10 years) to scientifically prove themselves as the "silver bullet" for subduing Covid-19 infections on a national or global scale.

This calls for wakefulness to a sobering reality that the vaccination route should just be one option among a multi-pronged approach to handling Covid-19 holistically.

This begs the question: are there not other options that can be considered?

The government must consider other options of treating and preventing COVID infection through cheap and effective therapeutic agents that are available on the local market, and that have been backed up by sound scientific studies over at least a decade of usage.

A star example of such drugs is Ivermectin 12mg- a broad spectrum antiparasitic that has been in human use for at least 50 years and has been proven by 64 scientific studies (of which 30 are randomized controlled trials) to be efficacious and safe in the treatment and prevention of corona viruses such as SARS-CoV2.

Countries such as Slovakia and India (Uttar Pradesh) have employed the usage of Ivermectin for curbing COVID infections with documented successful results. Other agents include Berberine containing medicines such as Covidex, as well as the Azithromycin/Zinc/Vit. C, combination/ steroid use.

A second approach is the path of Natural immunity, which is backed by at least 46 peer-reviewed scientific papers showing that natural immunity from a previous infection does give an immune protection that is at least as good as, or superior to, a COVID vaccine.

The best model for this has been demonstrated in Israel, where a 1 year long study conducted in 2021 with thousands of participants revealed that individuals who had recovered from a prior COVID19 infection had 27 times more immune protection than vaccinated individuals, 13 times less risk for adverse events and 8 times less risk of hospitalisation.

Natural Immunity has also been recognised by the WHO and has been incorporated into law in certain parts of the USA and Europe to allow persons who had a certificate of recovery from COVID to access amenities same as those who are vaccinated.

A third approach is the usage of covalescent plasma and monoclonal antibodies in treating active COVID19 infection.

This was the treatment given to President Donald Trump, when he was diagnosed with Covid-19 in 2020 and recovered fully after 3 days management in John Hopkins Hospital using Regeneron.

The more popular antibody cocktail in Australia right now is Regen-COV, and it has been attributed to saving hundreds of lives among the 60+ age bracket.

The US State of Florida has adopted the model of setting up free monoclonal antibody transfusion booths on the streets to tranfuse 60+ year old patients and those suffering from chronic illnesses that make them more at risk if they contract COVD19.

As result, Florida has reopened its economy and is managing Covid-19 infections better than many other states. Lastly, the holistic approach should also take into account religious exemptions from vaccine mandates, based on one's faith.

In spite being a medical emergency, the handling of Covid-19 must factor in the tenets of the Hippocratic oath as well as the basic principles of Biomedical ethics including respecting autonomy, consent and confidentiality.

Anything short of this wanders off into medical nihilism and/or over treatment that factors out patients' religious values that may hinder them from receiving particular therapy.

Such concerns may be about the vaccination formula containing aborted fetal tissue or being a transgenic therapy (as the case of adeno virus vector.

On these grounds, individuals must be given the complete buffet of benefits and risks of the vaccines, and non-vaccinated individuals should not be labeled a public health threat.

Additionally, people should be given the liberty to exercise their beliefs for spiritual intervention, spiritual healing and support from their places of worship.

If a more holistic perspective such as this were taken by the government and policy makers, instead of focusing only on vaccination and mandating it, the citizenry would become more responsible for their well-being and exercise their autonomy to make decisions about their healthcare.

The writer is a pharmacist