A member of the Scientific Task Force on Covid-19, Professor Dr Javed Akram is a renowned general physician with more than 40 years of teaching and research experience in four countries.
He specialises in infectious diseases, blood pressure, heart diseases, diabetes and hypertension management. He serves as Vice Chancellor at the University of Health Sciences (UHS), Lahore and is also the medical advisor to the Royal College of Physicians, London. He is also President Pakistan Society of Internal Medicine. Dr Akram talked to Bol News recently about the threat the Omicron variant poses to the country, as well as other major medical issues confronting Pakistan.
How do we determine the ratio of Omicron? Are tests being conducted for it?
Tests are being done for Omicron in Pakistan; we are doing whole genome sequencing, but it is fair to say that it is not generally available. While performing PCR test, if it is seen with modification and if any spike gene drop out is witnessed, then it should be assumed that it is the Omicron variant of the virus.
Because none of the mutations, including Delta, have shown spike genes. If you want to confirm more, for quality analysis, you have to take the Next Generation Sequencing test which is available in Karachi, Lahore and Islamabad.
The country reported over 2,000 cases after a gap of more than 100 days. How do you see the outbreak of Omicron?
Outbreaks appear to be exacerbated but the mortality rate is lower because vaccinated people are less at risk of contracting the disease. The virus is just as deadly to non-vaccinated people. It’s just the beginning; because of our attitudes, it is feared that this wave will go too high. We have to be more careful at this time.
If we want to save precious lives then taking precautions is necessary. Any irresponsible behaviour can cause us serious harm. We must meet the goal of vaccination immediately. Wedding ceremonies should be held sensibly with 20 to 30 people only allowed at each event. Those who have been vaccinated should get booster shots. People should also maintain their vitamin D levels as it improves immunity. As this new variant has 10 to 12 times more transmissibility, people should increase precautionary measures by 10 to 12 times as well.
Is it possible that the Omicron variant is less lethal and may lead to an end to the pandemic?
The idea that Omicron is less lethal and ultimately will lead to an end to the pandemic is incorrect. The Omicron variant has been followed by the new variant Delta-Coron from Cyprus, with 11 mutations. Countries that vaccinate 80 per cent of the population also face Omicron, the United States and Israel also, many countries stand at 6pc, many in Africa have been able to vaccinate only 6pc of the population due to poverty and logistical problems.
Moreover, countries like the US and Israel have to realise that we cannot get rid of this pandemic by vaccinating our own people six times. Until global herd immunity is established, this pandemic will return with a new mutation. The WHO, as an institution, must take responsibility. Africa and other poor countries will have to be vaccinated.
What are the research outcomes of study on the post-Covid effects? How long may it take to recover completely?
Coronavirus side effects depend on age and intensity; it is more common in older people. Side effects of mild intensity do not last very long while in severe intensity the lungs are damaged and the ability to transfer oxygen is reduced. In addition, there is a risk of blood clotting for up to six months. We give medicines to keep the blood thin. If children have had the severe coronavirus, they are at risk of developing diabetes in the next 15 years.
National Institute of Health Sciences revealed in a report that Pakistan’s data collection, analyses and research related to Covid-19 was inefficient? What do you say about it?
Unfortunately medical journalism in Pakistan is not institutionalized; we have only four impact journals and we do not have medical specialist editors. It is necessary to work for this so that there are more impact research generals in Pakistan. We publish our research in international journals. The National Institutes of Health United States has never contacted us nor has it provided any assistance or guidance in this regard.
Indeed, countries with strong healthcare structures like the United States and England had a quick response to the pandemic but Pakistan cannot be compared to a developed country. During the pandemic, the United States and the World Bank did not support us. We did 13 vaccine trials, none of them were American funded and we did all these trials with the help of China and on our own.
Being VC of UHS Lahore, what is your take on Pakistan Medical Commission (PMC) and its policy of Medical and Dental College Admission Test (MDCAT)?
PMC is a federal regulatory body. Government medical and dental colleges and universities in all the provinces can offer admission on their own. According to PMC, students are required to obtain 65pc marks in MDCAT. Reducing merit to meet admissions to maximise profit of private colleges is highly inappropriate.
According to the Supreme Court (SC), only the federal legislation will prevail when a conflict comes between centre and province. If the issue remains, students will suffer a lot, medical education will fall into disarray, which is already in dire straits. Sindh government should talk to federal government and PMC if it has reservations, students’ future should not be jeopardised.
How was the MDCAT performance of the students in Punjab?
In Punjab, many students have qualified for MDCAT exam. A total of 33,000 seats are available in government and private dental colleges of the province. All admissions in Punjab are done on merit. We support the MDCAT test; not everyone should become a doctor nor can everyone become one. After all, this is a matter of saving human lives.
How do you see the Sindh govt’s move? Can good doctors be produced by bringing down merit?
Merit cannot be ignored in any field, especially in the health sector. Quality cannot be compromised to increase the number of doctors. Sindh has not been able to get admission till now; if colleges are left vacant then leave it. Private colleges are business. It’s not charity and in business we sometimes have to face loss. There are many medical colleges of media and industrial groups; they are for making profit. The hefty fees of private colleges cannot be afforded by poor children.
In order to produce good doctors, the government should set up medical and dental colleges so that even the children of the poor can study. After paying [millions in] fee in private colleges, from whom will all this money be recovered? Of course they will [recover it] from the common people. The burden of all this will have to be borne by the people in the end.
Students are suffering due to the clash between Sindh and PMC. What will be the solution?
The case will end as soon as it goes to court because there have been several such decisions made by SC in which federal legislation prevails. Sindh is really concerned about building quality public sector colleges and providing affordable education.
By reducing the merit at the time of admission, you will promote the business; how many people can spend millions on their education? PMC and Sindh government should come to the negotiating table to resolve the matter.
