Vaccine only answer to invisible spectre

AS the Government continues to push back against the local anti-vaccination lobby, family physician at Ruthven Medical Centre Dr Marc Ricketts wants Jamaicans to know that COVID-19 is real and that the jab is the only answer to the invisible spectre of the novel coronavirus that has dogged the country and the world for a year now.

“Yes, it [COVID-19] is real,” Rickets says emphatically. “Let’s just say that I have seen enough in my field of work that has convinced me without a shadow of a doubt, in particular the wide range of ways that it presents that nothing else explains,” he stated in an interview with the Jamaica Observer just over a week after receiving his first dose of the COVID-19 vaccine.

The family doctor says he has been seeing “strange things” in terms of symptoms and test results. “I’ve started to see rapid testing that is missing diagnoses, so you end up paying very careful attention to your clinical judgement because in some cases you almost have to ignore what you’re seeing on a test result because it’s almost like you know better. And when you finally get the PCR results, it shows that that [COVID] is what it was. I’ve just seen some strange things,” he explained.He said it is generally understood that a PCR test is the gold standard for COVID testing, given the differential in the accuracy between this and the rapid antigen tests, but that in some instances the rapid tests have missed the diagnoses altogether.

Dr Ricketts pointed to an instance in which, based on clinical assessment, a patient, having received multiple negative rapid antigen test results, had to be treated on a presumptive diagnosis for COVID-19 before being confirmed by a PCR test.

“Both myself and National Chest [hospital] had to go off basically what we know because that result would have gotten ourselves and the patient in trouble. I believe that some of the variants that are coming out of these mutations of the virus have a different antigenic structure and the rapid testing is not able to detect very well — and that could explain why I’m seeing more false negatives,” he said.

Dr Ricketts stressed that he has no supporting lab evidence or studies for this position but that what he does have is the evidence from and experience in dealing with COVID-19 cases.

He said, however, that he would not discount or do away with rapid antigen testing as it has its place in the testing toolbox. “There is still a role for the rapid test. Sometimes you need to make a decision in a relatively quick time and you don’t have the luxury of three or however many days to get test results, and not everybody can afford 20-odd grand,” he stated.Still, he noted that the rapid antigen test was not meant for asymptomatic patients and that it must be applied in the appropriate circumstances. At the same time, he pointed out that the virus is presenting with a wide spectrum of symptoms outside of the textbook manifestations. These include lone symptoms such as headaches, and even a rash, or just generally not feeling quite oneself. “Its [symptoms are] many and varied, it’s going to stretch the limits of your medical knowledge,” he said.

Dr Ricketts has not been shy about making known his position on COVID-19-related issues affecting the country – and most recently vaccines – on his social media platform.

He said he has had no side effects of note since taking the shot, outside of some minor aches on the first day. “It was nothing that some Panadol didn’t take care of. One of the questions I’m asked a lot is how safe is this vaccine…the answer is that the research to develop an mRNA [messenger ribonucleic acid] vaccine started when the SARS outbreak took place in 2003, so you’re looking at 18 years’ worth of research,” he said. This neutralises the argument that the vaccine was developed too quickly to be safe.

The US Centers for Disease Control and Prevention (CDC) on its website outlines that the mRNA technology is new, but not unknown, and does not contain a live virus nor carry a risk of causing disease in the vaccinated person.

Contrary to one school of thought, the CDC says, “mRNA from the vaccine never enters the nucleus of the cell and does not affect or interact with a person’s DNA”.

Dr Ricketts cautioned against misinformation and hysteria and an absence of the facts. He said studies show that the side effects profile of the COVID-19 vaccine is comparable to or better than that of other vaccines, such as the one for polio.

“Those had adverse side effects, those had some deaths associated with them, there is really not that much difference. The difference is that this vaccine emerged in the social media era, during a time when everybody has an opinion. Our parents never asked once, they just knew it was something they took their children to get. Now most people don’t read critically; most people see it and they take it as gospel and they run with it, especially if it agrees with their particular agenda at the time,” he said.

He pointed to recent reports that a handful of European countries were suspending the use of the AstraZeneca vaccine, and many who were already inclined not to take the vaccine were using this to strengthen their arguments.

“The entire anti-vaxxer campaign jumped on it,” he remarked. “I noticed that Britain hadn’t pulled it yet and I remember saying at the time that I wouldn’t be surprised if this thing is politically motivated, and days ago the articles started to come out saying that it was politically motivated and it had all kinds of Brexit politics behind it.”

Dr Ricketts stressed that if he harboured any fears about the vaccine he would not have taken it nor recommended it to his patients.

He said with discussions emerging about vaccine passports, people need to think ahead. “People are going to say it’s unfair because it’s forcing them to take the vaccine, yet when somebody is going to Asia or South America and they’re told they have to get a yellow fever vaccine they don’t question it,” he said.The physician noted also that there are questions about which vaccine to take but his advice is to, “Get the first one that you can.” He said initial data revealed the AstraZeneca vaccine was between 60 and over 80 per cent effective while Pfizer and Moderna possessed significant advantage, but the most recent studies show there is no significant difference.

Dr Ricketts also believes that because the novel coronavirus is mutating at a rapid pace, a number of the most common variants may be used each year to develop a vaccine against newer strains, similar to the protocol for the flu vaccine.

“The whole business of herd immunity is not even something that I necessarily agree with anymore because if this thing is mutating as fast as the flu virus, do we have herd immunity for the flu? We don’t, we have an outbreak every year — and I think the same thing is going to happen,” he said.He said the difference will be a lessening of the severity of symptoms and a reduction in severe illness and death.

The World Health Organization (WHO) says as of March 22 there were 123 million confirmed cases of COVID-19, including 2,711,071 deaths. Up to March 20 a total of 397,950,709 vaccine doses were administered.

The WHO says vaccination remains a critical tool to help prevent further illness and death and to control the pandemic.

The WHO Global Advisory Committee on Vaccine Safety COVID-19 subcommittee on safety signals related to the AstraZeneca COVID-19 vaccine, reported on Friday at a virtual meeting that more than 20 million doses of the AstraZeneca vaccine have been administered in Europe and more than 27 million doses of the Covishield vaccine (AstraZeneca vaccine by Serum Institute of India) have been administered in India.

The subcommittee, which met over two days to review information and data on blood clots and low platelets after vaccination with the AstraZeneca vaccine, concluded in a statement that the AstraZeneca COVID-19 vaccine (including Covishield) “continues to have a positive benefit-risk profile, with tremendous potential to prevent infections and reduce deaths across the world”.

The subcommittee said available data do not suggest any overall increase in clotting conditions such as deep venous thrombosis or pulmonary embolism following administration of COVID-19 vaccines. It pointed out that reported rates of blood clotting events after COVID-19 vaccines are in line with the expected number of diagnoses of these conditions and are not uncommon: “They also occur as a result of COVID-19. The observed rates have been fewer than expected for such event”.

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