Just one death was recorded from Covid yesterday, one too many, but a most encouraging sign that the worst may be past. Far too many lives have been lost but the vaccination programme has now protected the most vulnerable and reduced the load on the NHS; its primary goal. Bur as half of the adult population still needs vaccination, does the vaccination programme needs a new and clearer focus to face the remaining challenges to its completion?
Vaccinating the young:
Different flu viruses have affected different age groups over the years. The flu of 1918 which claimed tens of millions of lives, disproportionally killed young people. In the US it killed more soldiers than those killed in the war which had just ended. A flu in 1968 also killed young people disproportionately. But there is research which shows an interrelationship between viruses to which we have gained immunity in early life and the effect in later life of a variant of the same virus, which may explain why a particular age group can be disproportionately affected. In other words, those not affected in one epidemic may succumb in the next because they do not have antibodies.
Today the young generation seems to have become complacent viewing Covid as a disease of the aged and are understandably anxious to resume social life believing that it may not have much impact on spread of the disease.
Exposure by vaccination to the Covid virus may give them protection to a future variant of Covid which from the experiences from 1889 and 1918 may have a serious impact on them.
The next challenge is to counter the antivax theories.
I had a conversation with an acquaintance the other day and was amazed when he told me that he had not been vaccinated and was reluctant to do so. He did not have any background scientific knowledge so although he could list many of the antivax theories he had no foundation from which to question or evaluate their authenticity.
Many of us are inclined to only seek and read material which reinforces our opinions and this seems to be particularly the case in social media where opinions which we explore continuously feed into our devices by default. The person to whom I was speaking had been hospitalised during the first lockdown because of a non-covid related respiratory crisis due to COPD. He seemed unaware of his vulnerability and the effectiveness of the vaccine in preventing serious illness in patients like him.
Changing false opinion can be very difficult. This can be more likely during the pandemic where someone blames the government for decisions which have adversely affected their families, their income or employment. They will be less likely to trust the advice from ministers of the value of vaccination.
As examples; the recent ‘disruptor’ who threatened security at local vaccination sites and the protester outside Debenhams accusing those inside of murder, will be difficult to bring on board. But every avenue should be tried.
The third reason is potentially the most important; Long Covid
In 1889-90 a pandemic called the Russian flu which is now thought to have been a coronavirus rather than influenza, was followed by many resurgences of the virus over subsequent years. What is striking is that the disease caused lasting neurological disorders and nervous conditions of depression and fatigue. These conditions persisted through the resurgences and occurred again following the next pandemic of 1918; the Spanish Flu, which is said to have affected up to 500 million people worldwide and killed up to 50 million.
In the extreme, the residual mental and emotional effects were so profound that a famine resulted in Tanzania because farmers were unable to plant their crops due to fatigue but similar conditions were reported across the world. It is hard to compare 2021 with 1918 following the slaughter of the war and the subsequent grief of 50 million deaths from flu. The ‘melancholy’ was multifaceted, impairing the economic recovery. Every plague from earliest times has provoked social change, sometimes very profoundly. Historians will record how we respond this time.
But the lessons must be to protect as many as possible from long-covid and to vaccinate the young so that they have some immunity which may help them when this or a similar virus strikes again.
Vaccinating the older early group was an emotional time for the vaccinator and patient alike and the relief felt by the patient was tangible. How can we instil this urgency in the young not only because it is they who suffer worst from the immediate dreadful effects of Long-covid, a condition which may have a lasting impact.