Issue link: https://maltatoday.uberflip.com/i/1395902
maltatoday | SUNDAY • 25 JULY 2021 10 NEWS NICOLE MEILAK GOVERNMENTS have had two primary aims when taking deci- sions to combat COVID-19: the first to keep the death toll as low as possible; the second not to overwhelm national hospitals. With over 80% of the population vaccinated, government has been able to do both while easing re- strictions considerably. The partial lockdown announced in March provided almost instant relief for Malta's hospitals. Two weeks after schools and non-es- sential shops closed down, hospi- talisations fell from 245 to 143. In just one month, they fell further to 64 patients. This sharp decline cannot be fully attributed to rising vaccina- tions. It was only between April and May that the vaccination drive went into full force. Those who took their first dose of the AstraZeneca vaccine in February were now eligible for their second jab, and vaccinations were rapidly opening to lower age groups. Hospitalisations before and after Hospitalisations are correlated with infections, so any drop in active cases would lead to fewer hospital admissions. However, the vaccine seems to be weaken- ing this correlation. The recent spike in cases isn't the first time Malta had 2,000 active cases on its shores, but hospitalisations were far higher back then. Last Wednesday, there were 15 patients being treated at Mater Dei Hospital. Last March, hospitalised patients numbered at around 250. This despite that the Delta var- iant is between 40-60% more transmissible than the Alpha (UK) variant, and that fewer measures are in place now com- pared to the winter months. However, it must be said that the Delta variant has not become the main strain among local cases yet. Public Health Superinten- dent Charmaine Gauci said on Wednesday that there have been 64 cases of the Delta variant in Malta. For comparison, Malta registered well over 2,000 new in- fections since June. Other factors may be keeping hospitalisations low. New cases are mostly being reg- istered in the 10-39 age group, where hospitalisations were nev- er too common. According to information from the health au- thorities, the highest proportion of cases is being seen among the under-19s. The effects of the current spike might be delayed slightly. Active cases started to rise exponentially two weeks ago, so a mild spike in hospitalisations could still be on the cards. Vaccine efficacy Vaccines appear to be working, but scientists don't yet know for how long vaccine immunity will persist, nor if booster shots will be required. Pfizer-BioNTech confirmed last April that the companies' COV- ID-19 vaccine showed a 91.3% efficacy up to six months after the second dose. Meanwhile Kate O'Brien, director of the Depart- ment of Immunisation, Vaccines and Biologicals at the WHO, said that there isn't enough data yet to inform a decision on whether booster doses will be needed. The vaccines work, and do so for long periods of time. Now, government must change its de- cision-making outlook away from rising cases and more towards hospitalisations. The closure of English-language schools and the introduction of mandatory quar- antine on unvaccinated travellers were more likely to have been knee-jerk reactions to the spike in active cases, rather than to what could have been a 15-person in- crease in hospital admissions. Any spike in cases ought to be avoided, especially given that some groups of the population are still unable to take the jab, including pregnant women and children. The situation gets more compli- cated in a country that depends on tourism. Incoming travellers provide a continuous influx of potential new cases that can put undue pressure on the health sys- tem. In this context, mandato- ry quarantine for unvaccinated tourists could well provide a nec- essary buffer against rising cases, as Malta would effectively only be open to fully vaccinated trav- ellers. However, there is scope for a country like Malta, with such a high vaccination rate, to toy with ideas that were unthinkable be- fore the vaccine came about – in- cluding controlled mass events beyond the 100-person limit. The blanket quarantine meas- ures, dubbed unreasonable by the Malta Chamber of Commerce last week, could also afford a re- vision from health authorities, at least in those cases involving fully vaccinated people. If government chooses not to budge in these areas, it risks un- dermining the message that vac- cines are the vehicle to normality. Being among the most vaccinat- ed countries in the world has its challenges, but it also offers an opportunity to get creative with policy and explore the new pos- sibilities offered by the vaccines. Additional reporting by Kurt Sansone Despite COVID spike, hospitalisations far lower now compared to the previous wave 0 0.5K 1K 1.5K 2K 2.5K 3K 3.5K Active Cases 0 50K 100K 150K 200K 250K 300K 350K 400K 18/01/2021 20/01/2021 22/01/2021 24/01/2021 26/01/2021 28/01/2021 30/01/2021 01/02/2021 03/02/2021 05/02/2021 07/02/2021 09/02/2021 11/02/2021 13/02/20 21 15/02/2021 17/02/2021 Fully vaccinated The data with yellow bars charts the rate of hospitalisations (red dots), and how these fell with the onset of the COVID-19 vaccine in 2021. The chart shows that as more Maltese got vaccinated, the rate of hospitalisation drastically fell; note the recent rise at the end of the chart owing to the recent influx of tourists Vaccines work: hospitalisations fell drastically as more got vaccinated The data with green bars charts the rate of active COVID-19 cases, and how these fell with the arrival of the COVID-19 vaccine in March 2021. But it also shows how hospitalisations fell at the same time of the arrivals of the vaccine, and despite the recent increase in active cases, hospitalisations are down because of vaccination Even with higher active COVID cases, hospitalisations are still down thanks to vaccine