Dr Prakash Budhathoky

COVID-19 is a global health emergency. It took quite some time to develop the vaccines to curb the pandemic. However, COVID vaccines, in comparison to other vaccines in the past, have arrived quite quickly in Nepal. Thanks to our great neighbours India and China that respectively provided one million doses and 800,000 doses of vaccines to Nepal. It has also received 348,000 doses of Covi shield with the support of COVID-19 Global Vaccine Access Facility (COVAX).
The COVAX initiative established by the WHO in collaboration with GAVI and CEPI has held out a ray of hope for poor countries. However, the COVAX initiative has hit a snag. The WHO has planned to inoculate twenty per cent of the populations living in 92 poorer countries. The inability of India to supply Covi-shield vaccines to the COVAX facility has been a great blow to the WHO.
At present, vaccination is considered the last resort when it comes to developing herd immunity in most of the people to end the COVID-19 pandemic. It is encouraging to note that many kinds of vaccines are being developed and rolled out across the world. In this regard, the WHO deserves kudos for working relentlessly in the field of developing and distributing vaccines in collaboration with partners across the world.

Vaccine Diplomacy
Vaccine diplomacy is gaining currency in international relations. In February 2021, half a million doses of the Chinese vaccine, Sinopharm, first arrived in Pakistan and then in 13 other countries. India has also given the AstraZeneca/Oxford vaccine to its regional neighbours. Russia has likewise dispersed its Sputnik V vaccine to reaffirm its relations with the old and win new friends. China seems far ahead in exercising its vaccine diplomacy to build better relations with many emerging countries. The delay in the distribution of COVID-19 vaccines by the western donor countries, might lead to the loss of their connections with many nations in the long run.
Nepal then struck a deal with Serum Institute, India for the procurement of two million doses, out of which the country received one million doses. In the meantime, the Court and India hesitated to give the remaining one million doses to the country, citing a shortage of doses in their own country. This has left the vaccination programme in the country stranded.

Herd Immunity
COVID-19 has been wreaking havoc in the world for over 2 years. The viral disease has been considered the most formidable disease of the 21st century. It has proved to be more dangerous than SARS and Ebola virus. The disease has upended the world economy, challenging human capacity for coping with it in an effective manner. The whole world is pulling out all the stops to contain COVID-19. Vaccines against the disease have been developed in a short span of time. The global vaccination campaign has been going on . Still, there has not been any remarkable progress in putting a curb on the disease.
Developing herd immunity is one of the mechanisms for controlling COVID-19. If herd immunity can be developed, all people, including those who are not immune to the disease, can be protected. A certain proportion of the population needs to be infected to spread a disease. It is called the threshold proportion. If the portion of the person immune to the disease exceeds the threshold proportion, herd immunity can be developed. It is called the herd immunity threshold.
The percentage of the population that needs to be immune to a disease varies from disease to disease. It also depends on the nature of a disease. If a disease is very contagious, a greater portion of the population needs to be immune to it. In the case of COVID-19, experts say around 70 percentage of the population needs to be immune to it.

Containing COVID-19
The third wave of the COVID-19 pandemic was unavoidable and the reason for this is that the country had not reached the level of herd immunity with only a small percentage of the total population infected in the previous wave.
With slightly more than 5 per cent getting two shots of the vaccine and about 13 per cent getting only one shot, there was a large section of society that was susceptible to the virus.
People started becoming careless with the precautionary measures when the curve was coming down . People thought that we got rid of the virus. There were huge gatherings without any restrictions and in cities, people showed laxity in wearing masks, and maintaining social distancing.
It is advisable that the government may restrict gatherings and impose night curfews. The need of the hour is to educate people about COVID-19 appropriate behaviour and utilise community participation approach for practising.
Testing, tracing, isolation, and treatment of COVID-19 patients are the keys to checking the spread of the viral infection, but lockdown or strict blanket prohibitory orders are not the answer.
It is now clear that vaccines are having a more powerful impact during this pandemic than any fiscal or monetary stimulus, not only in terms of saving lives and protecting people, but also in laying a path to economic recovery. This is so because as long as the coronavirus circulates, reinfection will continue and efforts to resume trade, travel, and commerce will stall.
At last, nobody is safe until everybody is safe. So a large chunk of the world population needs to be inoculated against COVID-19 so as to develop herd immunity in the population. At the same time, adhering to health safety protocols like social distancing, avoiding crowds or gatherings or hand hygiene is also equally important.
There is a tendency on the part of vaccinated people to adopt a devil-may-care attitude towards the coronavirus, thinking that they will not contract the disease. In fact, they may contract disease but the disease will be mild.

(Dr. Budhathoky is a central treasurer of Nepal medical association)