Poliovirus, amid Coronavirus

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Poliovirus, amid Coronavirus

According to WHO, Pakistan reported 60 polio cases in 2020 so far; the number was 8 in 2017 and 12 in 2018, and 147 in 2019.

While Covid-19 was posing a threat throughout the year, polio vaccination drives in Pakistan have stopped due to numerous challenges.

This is not the only pandemic. Last year, religious hard-liners also triggered the backlash in the conservative northwestern Khyber Pakhtunkhwa province.

It was stopped due to the rumors of children falling sick due to the vaccine being spread, so don’t forget that this part of Pakistan has a history of polio cases. To stop the vaccination drive, mobs burned the village’s health center, pelted cars with stones, blocked a highway, harassed and threatened medical workers, and shot a woman vaccinator, and two policemen.

After February 2020, there was supposed to be a nationwide anti-polio campaign, but in April, it was put off due to coronavirus. Due to a pause in the vaccination drive, more than 40 million Pakistani children (under the age of five) missed their most imported vaccination.

Thankfully, vaccination drives have restarted but this time around, the things will a little differently; according to a vaccinator, “We will not be able to stay anywhere for too long, or go inside any rooms of any of the houses that we go to, or accept food or drink that people usually offer when one visits.”

The campaign from July 20th, which lasted, in Karachi and Quetta, for four, and covered a total of 169 union councils – 78 in South Waziristan, 44 in Faisalabad, 23 in Karachi, 14 in Attock, and 10 in Quetta; the team of 800 vaccinators vaccinated up to 767,000 children.

According to a senior pediatrician, Dr. D S Akram, “Polio is a much bigger danger to our children than Covid-19.” she shared that for every paralytic polio case, there will always be more than ten non-paralytic infections in other children. For that matter, the resumption of the anti-polio campaign in some union councils is considered an emergency.

She says that if these “focused” campaigns would not be conducted, “we will have outbreaks of polio in many more tehsils”, adding the fact that the environmental samples that were taken from the sewerage system had already shown the widespread incidence of the virus — both the vaccine-derived and of the wild variety.

The point to be noted is that there are the only two countries in the world – Pakistan and Afghanistan – where polio is still endemic; reportedly, Pakistan reported 147 new cases in 2019, only 12 in 2018, and eight cases emerged in 2017.

In 2019, the share of a challenge for the Pakistan polio eradication cell also witnessed a resurgence of vaccine-derived poliovirus type-2 (cVDPV2), which the country claimed to have been eliminated.

The situation is worse this year. In the last six months, 59 children have already been reported with the poliovirus.

Dr. Rana Muhammad Safdar, National Emergency Operations Centre, shared, “We saw a peak in 32 cases last December followed by month-on-month decline till March.”

The suspension of vaccination drives due to COVID-19 sets back the goal of eradicating polio.

Talking to a news channel, a vaccinator explained that following SOPs will be critical. Still, we will also require parents’ cooperation, the very purpose of restarting the campaign is to mitigate the worsening situation and target the more high-risk areas.

Since vaccinating in the time of COVID-19 requires a different approach, all the vaccinators are given proper training on how to operate a vaccination campaign during the coronavirus outbreak.

Aasia Panezai, a vaccinator from Quetta, says, “I shower, wear fresh, clean clothes before I report for duty, and in the field we wear gloves and a mask (that we change every four hours), adding that we keep using sanitizers before and after visiting every home.”

She added, even after knocking the gate or to ring the doorbell, vaccinators use a marker or a pen, not their hands.

She also suggested local workers employ so that they do not need to travel too far.

Dr. Akram, head of the Health Education & Literacy Programme (Help), says, “If proper SOPs are followed, and polio workers wear adequate personal protective equipment (PPE), it should be safe.”

One of the SOPs was to request parents to hold their children and open their mouths as vaccinations have been instructed not to go close to kids and not touch the child. “We have been asked to keep to at least a metre’s distance,” says a vaccinator. They were allowed to hold the child’s thumb only for marking the fingers.

Dr. Safdar says, “When there is too big a gap in immunization, not just for polio, but for any other vaccine-preventable disease, chances of outbreaks increase.”

“Our routine vaccination has also suffered,” admits Dr. Akram, adding that that was why doctors were witnessing “cases of measles, and Diptheria in all the provinces,” emphasizing to ensure vaccination of all eligible children both in routine and in the door-to-door campaigns.

Resuming the move to restart the anti-polio campaign even when it cannot be possible nationwide, it is believed that precious time is still wasted on the polio front. She says that it’s been weeks the government ended the lockdowns, that time could have been used to vaccinate children who were vaccinated as if the government can open malls and markets, so why not the vaccination drives, especially when children are still at home.

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