COVID19 and Flu Vaccines


COVID19 and Flu Vaccines
Lt. Gen. (Retd) Mahmud Ahmed Akhtar

Winter has descended on the country. At the same time the Corona Virus is surging worldwide also alarmingly in Pakistan. Dr. Anthony S Fauci, the director of the National Institute of Allergy and Infectious Diseases USA said in June 2020 this will happen if aggressive action wasn’t taken to thwart the spread of the virus.

Last month following the wide spread failure to take such action, Dr. Fauci predicted that if USA did not do what was needed it could be facing as many as 400000 deaths related to Covid 19 by the end of the year. In Pakistan in most of the places basic precautions were not being taken.

Lt. Gen. (R) Mahmud Ahmad Akhtar

The political and religious parties held massive rallies resulting in an explosive second wave and an annual infectious disease the influenza virus appears to complicate the situation, causing its own surge of debilitating infections that each year claim tens of thousands of lives.

For more reasons like illiteracy, poverty etc., for poor health care system a non-availability of flu prophylactic injections even on payment though an essential medicine (WHO recommended list). Both flu and Corona Virus have the ability to spread more easily from person to person during colder dryer days of winters. The risk is not limited to the fact that in colder weather people spend more time indoors potentially exposed to others who may harbor and spread and infectious virus. The risk is also affected by lower temperatures and relative humidity that can increase the viral load of the air we breathe.

Of course far more is understood about the behavior of the influenza virus than about the behavior of the Novel Corona virus. Rossi A Hassad an epidemiologist and statistician at Merci College in Dobbs Ferry at New York reported this month (Nov) that both viruses “share key transmission characteristics” Dr. Hassad and other expert epidemiologists say that what is known about the Flu Virus can improve our understanding of how and why Covid 19 is more likely to become even more hazardous in the months ahead and that this knowledge can reinforce the advice that everyone adopt recently available measures to thwart it.

We cannot afford to wait six months or longer before the vaccine becomes available- more unlikely for the low middle income countries. In Pakistan this year even flu vaccine is not in the market though it should be in September every year. The fatality rate associated with Covid 19 infection is at least 10 times higher than from the flu and the Covid 19 virus is more contagious both by respiratory droplets and aerosols (smaller than the droplets. In colder weather the respiratory droplets loose water content and become smaller and lighter and thus able to linger in the air for longer periods, creating a perfect recipe for exposure to higher viral load, both indoor and outdoor.

Low humidity during the winter enables the influenza virus to live longer indoors and spending more time indoors and in closer contact significantly increases the risk of transmission and infection. Furthermore both the flu and SARS-COV-2 have fatty outer membranes that keep them structurally sound and protect RNA, they contain which infects cells causing disease. In temperatures at or near freezing this fatty membrane solidifies into a gel, forming a rubbery coat that helps the virus to survive and move more readily from person to person. Pakistan’s Northern areas are very cold during the winter season. This factor has to be kept in mind.

Characteristics of our nasal passages during the colder months enhance the risk of infection by these viruses. Nasal passages become dry and most susceptible to damage in drier months when the humidity is low making it easier for viruses to invade the body. These factors along with a high level of transmissibility (including asymptomatic transmission and virulence of SARS CoV2 create a perfect recipe for even more explosive Pandemic in the winter months.

Given the fact that the vast majority of the people have no immunity against Covid 19. Dr Hassad noted it has the potential to parallel the 1918 Flu Pandemic if we fail to comply with the protective measures recommended by WHO.

Dr. Stanley M. Periman a microbiologist studied at the University of Iowa who has studied the Coronavirus for more than four decades said in an interview that the key variables for a new explosion of Covid 19 infections are people spending more time in too well-ventilated places and not wearing masks according to Jane E. Brody. While air exchange in hospital unit takes place twelve times in a hour, indoor air in a private home exchanged only once or twice in a hr. on average.

Dr. Periman emphasized this is a highly contagious virus, things have gotten worse and will get worse still. People are losing respect for the virus and letting their guard down which is a bad idea. Even in the outdoor if you are standing 1 foot away from someone and not wearing a mask you will contract or transmits the virus. This is what is happening in Pakistan.

The nose and mouth are virus’s portal of entry. It is logical how a mask can be a barrier against an organism. There has been obvious difference in infections where masks are used consistently. It is common sense and cannot be a huge burden.

Countries like Vietnam, Cambodia, Taiwan, Hong Kong, Singapore, S. Korea, China, Japan, New Zealand, Ice Land, Fin Land, Denmark, Norway and many others who used masks had very low incidences and mortality due to Covid 19 while the USA occupying 4 percent of the planets land has nearly 30 percent of mortality and very high incidence because President Trump and many USA leaders politicized masks, a question of personal freedom and liberty. Pakistan is having high incidence in the 2nd wave because of not observing precautions, masking etc.

Sharing air with someone is primary mode of transmission. These are two protective approaches: physically (though not socially) distancing yourself from someone whose viral health you have no way of knowing or creating a bubble of people who remain highly faithful to safe practice.

In the winters the agent i.e. virus becomes more potent, wide spread, increased in number, the host(human) defenses become weak and the environment favorable to the Agent. All these factors combined lead to high surge in the Covid 19 Pandemic. There is no chance of vaccine availability in the near future in Pakistan. The salvation lies in taking precautions like masking, physical distancing, avoiding indoor gatherings.

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