What a difference a week makes

By James Robertson 13 December 2019, 10:55PM

What a difference a week makes.

Though absolutely any sense of hope about the measles epidemic needs to be heavily laden with caveats and qualifiers, it does appear to be decreasing.

As Dr. Helen Petousis-Harris - the vaccinologist from the University of Auckland who first sounded the alarm about the 'inevitable' arrival of measles to Samoa - says in today's edition the epidemic that has swept through the country appears to be slowing down.

“[The infection rate] is like a mountain that’s coming down,” she told the Samoa Observer.

“It does suggest that [the virus] has had some time to run [but…] I think it’s waning; I started to think that maybe five days ago.”

We can only hope her cautious optimism and analysis bears out. 

The numbers certainly seem to support it. The average number of new cases infected on Tuesday to Thursday this week stands, when averaged on a daily basis, at just over 80. The corresponding period the previous week was just under 160.

What a difference a week makes. 

As Dr. Petousis-Harris makes clear that does not mean the national death toll will not continue to climb. And the strain on the hospital system will not be alleviated any time soon. 

At the time of writing, 17 critically ill children and three pregnant women remain in critical condition in the Intensive Care Unit. Their fates hang in the balance. 

The confluence of poverty, timely parental access to healthcare and the quality of healthcare will all play their role in determining the fate of those who remain afflicted and infected by this this terrible disease.

The role each of these and other contributing factors contributed in creating the conditions for the epidemic that has ravaged Samoa for two months deserve to be teased out in detail. 

But as we wrote in these pages soon after the state of emergency was declared it was, from that point, in the hands of the Government to determine how quickly this epidemic could be contained and whether it follow the trajectory of New Zealand 1991 six month measles epidemic or be contained more quickly. 

The Government's mass vaccination programme has indeed been an unprecedented approach to public policy and delivered extraordinary results. Extensive help from foreign partners from as far away as Norway, Britain and Hawaii have also helped. 

We will be feeling the effects of this epidemic in just about every sphere of life for a long time to come. 

After all, as we reported in Friday’s pages (“Horrible reality after measles epidemic”) those who have suffered from measles can remain susceptible to a condition known as subacute sclerosing panencephailitis for more than a decade later.

Measles is also famous for the toll wrought not just by the disease itself but by the complications that follow a weakened immune system. An entire British team of close to 15 medical specialists will work over the Christmas period exclusively on pediatric patients suffering from such complications. Our overworked nurses and doctors are unlikely to see any reprieve in the near future. 

As the President of the General Practitioners Association of Samoa, Limbo Fiu, said on Monday we are certainly are not out of the woods but there is a growing sense that there is a coincidence in the slowing of the virus that has ravaged the nation for two months and the week of Christmas. 

The complete shutdown of the entire nation’s commerce, transportation grid and Government sector last week gave the streets of Apia an eerie almost apocalyptic feel. 

The Prime Minister, Tuilaepa Dr. Sailele Malielegaoi, announced on Thursday that in all likelihood the state of emergency measures proclaimed by an emergency Cabinet meeting on November 15 would be allowed to expire next Tuesday. 

That may return a sense of life to Samoa that has not been seen for the past month right in the lead-up to Christmas.

In the view of the opinions expressed by experts such as Dr. Petousis-Harris, and Government statistics suggesting they have now vaccinated 93 per cent of the "eligible" population there may be few downsides to Tuilaepa's decision.

But it would be impossible to say that doing so would allow Samoa to return to a normal Christmas period. 

The events of the past two months will cast a long shadow over this nation for a long time to come.

But as the first small step towards returning to some semblance of normalcy after such a national trauma it may have some value. 

Have a good weekend, Samoa.

And God bless. 



By James Robertson 13 December 2019, 10:55PM

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