It is difficult to understand the reasoning behind this decision
Prof. Tariq Rafi went to Khaliqdina Hall over the weekend to get in line for the COVID-19 vaccine in Karachi. He was denied it because he is over 60 years of age. Dr Rafi has been practicing for 30 years and is the vice chancellor of Jinnah Sindh Medical University.
A few months ago, DUHS Prof. of Orthopedics Prof Yunis Soomro, the pioneer of the limb-lengthening Illzarov technique in Pakistan, died of COVID. All across the country, in medical circles we have been receiving news of our colleagues and peers dying from it. Condolences just poured in on gynaecologist WhatsApp groups for Dr Aneela Naseer of Mansehra and a professor at Civil Hospital, Karachi Dr Ayesha Khan.
It is not possible to list all the names in this space, but to give you a sense of the loss, I mention a few of the other seniors who have died of coronavirus: A former director of JPMC, Prof. Rasheed Chaudhry, retired professor of Surgery Dr Sarwar Arain, senior anaesthetist Dr Khalid Khan of Liaquat National Hospital, child specialist and director of the National Institute of Child Health Prof. Nizam ul Hasan…
And doctors, nurses and other medical workers continue to get sick in the line of duty. Mercifully, many of them are recovering, such as plastic surgeon Dr Tahir Shafi, neurologist Dr Nadir Ali Syed, cardiologist Dr Shahid Sami, orthopaedic surgeon Dr AR Jamali. I myself contracted it from a patient in an emergency case about three months ago.
But what we are hearing now is that senior doctors are being denied the vaccine because they are over 60 years of age. I am not eligible because I am over 60.
The COVID-19 pandemic has been with us for almost a year now. Inadequate understanding of the virus and the disease it caused led to a high mortality rate and devastation of routine life all over the world. This year heralded the arrival of vaccines and with them, some hope of relief and control of the spread of the virus. In Pakistan, the Chinese Sinopharm vaccine was the first one to be administered to frontline healthcare workers.
The government of Pakistan and Special Advisor Dr Faisal Sultan issued guidelines, however, that it should not be given to individuals over 60 years of age. This effectively means that the frontline healthcare worker who is 61 and above will not get any protection from the virus and then run the risk of dying. It is difficult to understand the reason behind this decision.
The scientific fact, as evidenced by the multiple international publications, is, however, that the immune response of an individual who is more than sixty years old is only lower as compared to someone who is 18 to 59 years of age. (See this paper published in the Lancet Infectious Diseases February 2021 on the safety, tolerability and immunogenicity of the vaccine in healthy adults above 60). Immune response refers to the immunity that the body will confer on the individual. For people over 60, if they get the vaccine, they will become immune but at a lower level than someone younger.
When we think about the healthcare workers above sixty, this is a group of practitioners that is the most experienced but then at the same time is at risk because they still need to see and interact with patients.
Now whereas a physician can treat a patient via an online consultation, the surgeons cannot as they have to operate. Obstetricians have to deliver babies. Trauma surgeons have to operate in emergencies and cancer surgeons cannot postpone operations.
The unfortunate paradox is that while there is a paucity of trained doctors, nurses and paramedics in this country, the most experienced and senior of them are being denied protection against the virus, when there is ample scientific evidence that vaccinating them does not cause any harm. It only confers a reduced level of immunity that can be boosted via subsequent second and third doses. This makes it very difficult to understand the rationale behind this decision taken by the prime minister’s advisors and the experts.
The writer is a surgeon based in Karachi