Medical professionals warn that SL is nearing situation faced with Delta spread

Medical professionals yesterday urged the public to get vaccinated, warning that the situation in the country was worsening with the spread of Omicron.

According to College of Internal Medicine President and National Hospital of Sri Lanka (NHSL) Physician Dr. Harsha Satischandra, the country was nearing the situation faced with Delta spread.

He explained that there are currently 325 COVID-19 patients receiving treatment at the NHSL. Of this, 75 patients are dependent on oxygen. He added that the majority of patients depending on oxygen or intensive care were not fully vaccinated, having received none of the doses or only a single dose.

Of vaccinated COVID-19 patients who require intensive care, most are elderly persons or those with several other medical conditions.

He added that persons over 60 years are at a higher risk of developing complications. “Sri Lanka has 2.8 million persons over 60 years. Of them, only 1.5 million have received the booster dose. This leaves 1.3 million persons over 60 years who have not received the booster,” Dr. Satischandra explained.

It was thus extremely important for persons, especially those over 60 years, to get fully vaccinated.

The NHSL Physician added that there are other diseases, for instance dengue, that are currently affecting persons as well. While these diseases also have COVID-like symptoms, they could be Omicron patients despite a negative test.

“Even if we do a PCR or RAT, we cannot identify 100% of patients and can miss 30% of patients with a negative test result. This depends on the sample we collect,” Dr. Satischandra explained.

He thus urged persons to undergo quarantine if they experience symptoms.

Regarding Health Ministry guidelines that state fully-vaccinated close contacts need not undergo quarantine if they do not experience symptoms, Dr. Satischandra said a person who receives all three doses are less like to contract the disease as well as infect others.

“We must also live with the virus. To go forward, some of our actions may not prevent spread 100%. We sometimes use measures like lockdowns, but they are not practical,” he explained.

Sharing similar views was Sri Lanka Medical Association (SLMA) Vice President and paediatrician Dr. Surantha Perera. He said that measures like a lockdown or closing of schools are not practical and that it is instead vaccination that plays a key role in controlling the spread of COVID-19.

Noting a drop in the number of persons from the 16 to 19 age group getting vaccinated, Dr. Perera said this could be due to the ongoing A/L examinations. However, students can get vaccinated after their exams end.

“Amidst various issues in the country, it was with great difficulty that we reopened schools. It is extremely easy to close schools but reopening a school is difficult,” he added.

There is, however, an increase in COVID-19 infections among school children. This is due to the increase in COVID-19 patients in the country as well as the fact that it is easier for children to infect other children in a school. This is why it is extremely important that parents refrain from sending a child to school if they experience any COVID-19 symptoms.

According to Dr. Perera, 1.3 million persons between 16 to 19 years have received the first dose of a COVID-19 vaccine and administration of the second dose for this age group has begun. Discussions are also being held on the second dose for children between 12 to 15 years.

Medical professionals continue to stress the importance of vaccination and Medical Research Institute (MRI) Consultant Immunologist Dr. Rajiva de Silva explained that protection provided by COVID-19 vaccines against the BA.1 and BA.2 sub-lineages of Omicron are the same.

“Omicron has divided into BA.1 and BA.2. BA.2, which has been detected in Sri Lanka as well as other countries, is 50% more transmissible than BA.1. However, it is said that BA.2 is not as severe as BA.1,” he explained.

According to Dr. de Silva, the booster dose offers over 90% protection against the Omicron variant. He explained that this does not mean 90% of persons vaccinated are protected against the virus, but that, compared to persons who are not vaccinated, more than 90% of persons who received the booster do not require hospitalisation.

“There are people who have got Delta sometime in the past and it is quite probable that if they are infected with Omicron, they will get clinical symptoms. And the basic reason is that there is a big difference between the Delta variant and the Omicron variant. There are 50 mutations in Omicron compared to Delta,” Dr. de Silva went on to say.

He explained that there are different arms of the immune system: Antibodies and T-cells. When a virus enters the body, antibodies block it from entering cells, which is when the virus begins to cause problems and persons experience clinical features like a cold and cough.

When the virus enters the cell, antibodies cannot block them. However, T-cells destroy the virus-infected cells.

“Because of the difference in the two viruses, the antibodies that recognise Delta do not recognise Omicron or the recognition is reduced. That is why a person who has got Delta in the past can get Omicron today,” Dr. Rajiva de Silva said.

He added that antigens, which are the part of the virus recognised by T cells, are generally constant. There is no difference or very little difference between Delta and Omicron in this regard.

“So even if the virus gets into cells, there are T-cells that will destroy infected cells. This is why persons who got Delta in the past or are vaccinated will get symptoms that are mild,” he said, stressing the importance of vaccination.

The difference in the variants is also why the decision to administer the booster dose six months after the second dose was revised, with the booster dose now administered just one month after the second.

He explained that the booster dose was found to be effective against the Delta variant six months after it was administered, but the situation changed with the emergence of the Omicron variant.