The Covid-19 vaccine rollout in England has entered its next phase, with the health secretary telling the BBC a jab has been offered to everyone in the UK’s top four priority groups.
In total, more than 15 million people in the UK have had their first dose.
The rollout in England has officially been expanded to those aged 65 and over and younger people in at-risk groups.
But Matt Hancock said there was still “some way to go” before easing lockdown.
Mr Hancock told BBC Breakfast: “At the latest count there are still over 23,000 people in hospital with Covid – that’s more than in the April peak.”
However, take-up of the jab varies, with only about two-thirds of social care staff receiving the vaccine, he added.
In a bid to encourage those in the sector to have the jab, Mr Hancock said: “It is the right thing to do.
“It is very important that you come forward and take up this vaccine. It’s important for you, it’s important for your patients and of course it’s important for the whole of society.”
This is an important milestone, but just that – a staging post in the race to vaccinate the vulnerable.
Most Covid deaths have come in the over-70s age group, but just over half of hospitalisations have.
It means there are a significant number at risk in the 50 to 70 age group as well as younger adults with health conditions.
They have been promised a jab by the end of April.
As always, everything depends on supply.
The UK is getting less supply of the Pfizer vaccine at the moment than it expected at the start of the year because of the problems with manufacturing in Belgium.
This, the company hopes, will be rectified in the coming weeks.
AstraZeneca supply lines remain strong and by Easter the first deliveries of a third vaccine made by Moderna should arrive. There can be no let up.
It is 69 days since the UK began its mass vaccination programme – and six weeks since Prime Minister Boris Johnson said he hoped “with a fair wind in our sails” to be able to offer a first dose to the four priority groups by 15 February.
That meant vaccinating all elderly care home residents and their carers; everyone over 70; all frontline health and social care workers; and everyone with a condition that makes them extremely vulnerable to the virus – a total of 14.6 million people.
Mr Johnson has hailed the vaccine rollout as an “extraordinary feat” and said the country can go into the next stage “with great confidence”.
He is due to set out his “road map” out of lockdown on 22 February.
But while the UK’s vaccination rate is third in the world, behind only Israel and the United Arab Emirates, there have been reports that some people in priority groups – including those who are housebound – are still waiting for their first dose.
As well as the over-65s, the next group to be offered the vaccine is the estimated 7.3 million people aged 16 to 65 with a range of health conditions that put them at risk from the virus.
It includes people with chronic heart disease, liver disease, kidney disease, diabetes, severe lung conditions, severe learning disabilities and mental health conditions such as schizophrenia and bipolar disorder.
Adult carers of disabled people with these conditions, and younger adults in care homes, are also part of this group.
The rollout will then be extended to the remaining over-50 age groups, with the aim of offering a first dose to another 17.2 million people before the end of April.
Mr Hancock said that 90% of the over-70s had accepted the vaccine – a “much higher uptake than we could possibly have hoped for”.
One in four adults were now starting to receive protection against Covid-19, he said.
The Department of Health says 88% of the UK’s coronavirus deaths occurred in the priority groups who have now been offered the vaccine.
A small number of the 15 million people vaccinated will have been outside these initial priority groups, however, as some NHS regions had already begun giving jabs to younger people.
Paying tribute to the “heroes” giving vaccine doses across the country, Labour’s shadow health secretary Jonathan Ashworth said it was crucial for ministers to “lock in the gains of vaccination”.
He said that meant further reducing the spread of the virus by offering “decent” financial support for self-isolation, new guidance on mask-wearing, and help for workplaces to be Covid secure.
“We have already seen the virus mutate, it’s urgent more is done to reduce its spread while vaccination continues at pace,” he said.
hana, like many of its counterparts on the continent, is contending with the fallout from the rapid spread of SARS-CoV-2 variants. Of particular concern is the B.1.1.7 variant first identified in the UK. It is estimated to be up to 70% more infectious and 65% more lethal than the ancestral strain.
Scientists at the West African Centre for Cell Biology of Infectious Pathogens have confirmed that B.1.1.7 is now the dominant variant in Ghana based on nationwide genomic surveillance. And that it is responsible for 88% of cases in the capital city.
The ongoing surge in new infections, hospital admissions and deaths has refocused public attention on a situation that the Ghana Medical Association describes as “dire”. Intensive care units are operating at the limits of their staff and space constraints. And more young people appear to be developing severe forms of the illness.
This means that the rollout of COVID-19 vaccines in Ghana cannot come quickly enough. But what is the country’s COVID-19 vaccination strategy? And how well advanced are plans to execute it?
At least 60% of Ghana’s 31 million residents will need to be vaccinated for the population to attain herd immunity. The goal of the president, Nana Akufo Addo, is that every Ghanaian will be vaccinated. But a timeline for this remains elusive as no plan has been made public.
The president has promised to procure and administer 17.6 million COVID-19 vaccine doses in the first half of 2021 as part of an initial push. But there is uncertainty even around this target.
Firstly, how the country will secure this number of doses is not yet clear.
Secondly, there are questions around how the doses will be stored and distributed, as well as the capacity of the country’s existing cold chain infrastructure.
And there will be a final major hurdle to clear – convincing many sceptical Ghanaians that the vaccines on offer are safe and effective.
A number of external factors are hampering Ghana’s efforts to secure the doses it needs to reach its mid-year target.
Unlike developed nations, countries like Ghana have limited bargaining power to negotiate directly with manufacturers. As a result, it is principally relying on two multilateral initiatives to procure COVID-19 vaccines – the COVAX facility and the African Vaccine Acquisition Task Team. Combined, they have secured 1.27 billion vaccine doses for African nations.
COVAX is a global initiative co-led by the World Health Organisation, Gavi and the Coalition for Epidemic Preparedness Innovations. It aims to develop, manufacture and distribute COVID-19 vaccines to all nations on a fair and equitable basis. It operates as a funding mechanism that uses the collective purchasing power of participating nations to obtain competitive prices.
Nevertheless, participating low- and middle-income countries will only receive enough vaccines to cover up to 20% of their populations.
Ghana expects to take delivery of up to 968,000 doses of the Oxford-AstraZeneca vaccine by the end of March 2021 as part of an initial batch from COVAX. These first doses have been earmarked for the nation’s healthcare workforce of about 108,000.
COVAX aims to deliver the remainder of this initial tranche of 2.4 million doses by June 2021. This should be enough to protect about 1.2 million Ghanaians with the two-jab Oxford-AstraZeneca vaccine. But reaching the president’s target will require about four times that amount.
This means that Ghana will have to lean heavily on vaccine supplies from the African Vaccine Acquisition Task Team – an initiative being driven by the African Union. It aims to bridge the gap between the 20% population coverage promised by COVAX to participating African countries and the 60% coverage they need to attain herd immunity.
The African Export-Import Bank and the World Bank are supporting the strategy with about $7 billion in cash advancements to vaccine manufacturers on behalf of AU member states. The African Vaccine Acquisition Task Team has so far secured 270 million doses of the Pfizer, Oxford-AstraZeneca and Johnson & Johnson vaccines. Deliveries are scheduled to begin later this month.
In early February the sirector of the Africa Centers for Disease Control announced that 16 African nations had applied to the task team for vaccine supplies totalling 114 million doses. While the final allocations are yet to be published, Zambia, Kenya and Nigeria are set to receive 42.7 million.
It is not yet known if Ghana is one of the remaining 13, nor how many doses it intends to order from the African Vaccine Acquisition Task Team.
Ghana’s Presidential Advisor on Health, Anthony Nsiah-Asare, recently hinted that the country was also procuring vaccines through bilateral deals with some of its development partners. But these supplies are likely to be a negligible fraction of the 15.2 million additional doses required to meet the June target.
This means that Ghana’s supplies from the African Union initiative is likely to determine the nation’s ability to reach its mid-year goal of 17.6 million doses.
Ghana’s COVID-19 vaccination drive will face other challenges that ought to be addressed urgently.
One is a storage and distribution plan that prioritises speed and minimises waste. Public health authorities have assured Ghanaians that a comprehensive plan exists – it has not yet been made public – to make use of the country’s existing cold chain infrastructure for vaccine distribution.
This infrastructure supports Ghana’s enviable record in immunisation coverage that has helped reduce infant mortality and the incidence of vaccine-preventable diseases such as measles. In 2019, immunisation coverage for essential vaccines was in excess of 90%. Ghana has not recorded a single death from measles since 2003. In addition, it was certified as having eliminated maternal and neonatal tetanus in 2011.
But there are gaps. Ghana’s current cold storage facilities lack the capacity to house vaccines like those manufactured by Pfizer and Moderna because of the arctic temperatures required to store them. Both use a technology known as mRNA.
This limits the COVID-19 vaccine options available to Ghana. It also matters because these vaccines can be adapted to target new SARS-CoV-2 variants relatively quickly compared with other vaccine technologies. Having access to them could therefore determine how fast nations are able to respond to the emergence of new variants.
Ghana faces a potentially bigger stumbling block: public scepticism about COVID-19 vaccines.
Anxieties and uncertainties about their safety underlies considerable hesitancy in Ghana towards the COVID-19 vaccines. The proliferation of fake news and misinformation on social media and in certain quarters of the popular press are fanning those embers.
To meet this challenge public health authorities will have to be laser-focused on identifying and addressing both legitimate apprehensions and conspiracy theories. They will also have to be proactive in monitoring digital platforms because of the dynamic and viral nature of vaccine misinformation.
It will also be important to measure progress towards public acceptance of the vaccines. One route would be to conduct a series of public surveys to assess the evolving landscape of knowledge and attitudes. This would enable the government to identify specific misinformation that allows for more focused communication about vaccine safety and efficacy.
Much of that will also depend on media coverage. It is therefore crucial to engage the media on its role in combating misinformation.
Private Schools Reopen As Many Remain Closed Indefinitely
After an almost ten-month hiatus from classes, the initial joy of going back to school for many students in Ghana has since turned into a nightmare as the far-reaching impact of the COVID-19 pandemic has put over 222 private schools out of business as economic challenges led many proprietors to convert their facilities into residential apartments, hostels, and guest houses – leaving over 40,000 students and 3,496 teachers in academic limbo.
An added complication to an already complex situation for Ghana’s still-developing educational infrastructure.
The Headteacher of ASMAG International School, Ernest Ayaa Tagoe, has not been having an easy time, “I have four children, three are in school. For them to go to school I have to consult a friend to help me a little.”
Unaffordable and Inaccessible Private Education
Statistics from the Ghanaian education service show that private schools make up 49% of education establishments and 33% of all enrolments at the pre-tertiary level in the country.
However, they can often be inaccessible to low income earning households and the coronavirus health crisis has only made things even more financially challenging.
Emmanuel Oduro Darko, the proprietor of ASMAG international school, explains how many in the sector have been coping with the pandemic’s effects.
“The only way some of us in the private schools in community-based areas could survive is to double our fees. And over here when we double the fees they will move all the children so I decided to end the school.”
Private schools in Ghana are believed to both offer intangible benefits that go beyond mere academics and to be critical for national growth.
But perhaps the most concerning element in the recent play of events is that for some communities, these schools are the only educational facilities available and within proximity — leaving an academic void.
Decisions to Be Made to Save the Sector
Just as everywhere else in the world, the effects of the unprecedented coronavirus health crisis has left nations scrambling to respond to consequential challenges within their borders.
Ghanaian authorities will most likely have to respond to these emerging issues in the educational sector as the minds of the country’s budding youth are essential for Ghana’s continued progress.