Early testing may help prevent being inadvertently injured by possible and potential aggravating factors in the early part of the infection
BY DR MANIMALAR SELVI NAICKER
I am a Consultant Histopathologist and Statistician. Hence, I am not a “frontliner”.
But, right from the start of the Covid-19 pandemic I have been actively summarising current research on my social media for the benefit of the public and doctors. I diligently practised masking, social distancing and hand-washing.
I shopped online as far as possible. In short, I avoided crowds. I was a “model citizen”!
Though I was very hesitant about the vaccines, some with new technologies, I registered for the vaccine anyway and was given an appointment for the end of March 2021.
In the middle of March 2021, I woke up one morning with symptoms of sinusitis. I thought nothing of it and went down to the kitchen.
After making breakfast, I sprayed the sink and counter-tops with my regular kitchen cleaner. Within a few moments I experienced mild difficulty in breathing.
I was puzzled but still did not panic. The same experience was repeated after the lunch wash-up.
By now I was worried. I decided to get tested for Covid-19. We, in Malaysia, are very very lucky that getting tested is both not expensive and is convenient.
My twin mission
At the doctor’s office, my saturation had dropped slightly. I hastily penned my last will and testament via email to my family members. Being a lawyer’s daughter and sister certainly helped with that task!
In the early hours of the next morning the hospital called to inform me that my test results were positive. I was shocked and distressed.
I was admitted to a private hospital for monitoring and spent 10 harrowing days wondering if I was going to walk
out alive. At that point in time, I knew with certainty that I would rather have taken the risk of the vaccine than get infected.
In the hospital, I was continuously monitored and enormous amounts of PPE equipment were used every time the doctors or nurses came into contact with me.
All this was going to land up in a landfill somewhere and cause pollution. Anyway, to cut a long story short, I was discharged well.
So, currently I am on a twin mission.
The first is to encourage early testing and for as often as needed for Covid-19 tests. This may help prevent being inadvertently injured by possible and potential aggravating factors (like the kitchen cleaning liquid fumes in my case) in the early part of the infection.
Three cardinal questions
The Government should do whatever it can to make testing cheaper, more reliable and more readily available.
The second mission is to encourage vaccine uptake. The cost (in terms of time, labour, PPE) to monitor a positive case in enormous. We will eventually run out of resources if the pandemic continues unabated.
So, how does one estimate the “risk” of vaccine vs the “risk” of infection for any particular disease?
As a physician-statistician I am aware that clinical research, including vaccine research, is often of poor quality. Hence, I have never been either a rabid pro-vaxxer or rabid anti-vaxxer.
When it came to vaccines, I still asked the three cardinal questions: Is it necessary (risk assessment)? Is it safe? Is it effective?
I am aware that there were many vaccines available in the market. Countries gave approval to some vaccines and not to others.
Medical bodies include some vaccines but not others in the Childhood Vaccine Schedules. So, accepting or rejecting vaccines cannot be over-simplified to being a pro-vaxxer or anti-vaxxer!
Estimating risks
Two factors come into play regarding vaccine acceptance. The first is the safety profile of the vaccine itself and the second is the likelihood of being severely ill after getting infected by the pathogen.
I have always been active in stressing that vaccines are essentially the pathogen either in whole, attenuated, killed, sub-unit or toxoid form. Hence, vaccines can have the same adverse reactions as the original pathogen but milder (qualitative) and for shorter duration (quantitative) and less often (quantitative at population level).
Hence, these should not be regarded as Adverse Events Following Immunisation (AEFI). Reporting thousands of the expected minor outcomes only serves to frighten and inflame the public. These should be classified separately.
To estimate “risk” one must have some idea as to how likely is one to come into contact with the pathogen. In an outbreak, endemic region or pandemic the answer would probably be very likely.
The second question is: if we come into contact, how infectious is the organism? The third question is: If one were to get infected, how likely is one to suffer from a severe form of the disease?
It is true that the Covid-19 vaccines have many worrying features such as being produced within an atypically short time and often using newer technology. However, in a pandemic situation, vaccine hesitancy can be classified as risky behaviour.
This is because one may very well find oneself desperately sick but unable to get medical care due to thousands of other equally desperately sick people occupying precious hospital beds. — The Health
