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Covid-19: Hospitals and GP clinics return to universal mask wearing as rates rise

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1712 (Published 11 July 2022) Cite this as: BMJ 2022;378:o1712

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COVID-19 Pandemic and Rising COVID-19 Rates even among ‘Fully Vaccinated’ Persons: A Further Imperative for Emphasis on the Non-Pharmaceutical Interventions; ‘No One is Safe Until Everyone is Safe’

Dear Editor

Increasingly, it is becoming more certain that there are ‘Unresolved Conversational Issues’ with the ‘Global COVID-19 Pandemic Control Strategies’. Possible ‘COVID-19 Pandemic Control Interventions’ include the ‘Pharmaceutical Interventions’ and the ‘Non-Pharmaceutical Interventions (NPIs)’. The former includes the ‘COVID-19 Vaccines’, ‘COVID-19 Convalescent Plasma/ Serum’, ‘COVID-19 Monoclonal Antibodies’ and ‘COVID-19 Antivirals’ and there several, and still evolving, ‘Unresolved Conversational Issues’[1-17]. Indeed, these increasingly evolving ‘Unresolved Conversational Issues’, bordering on ‘Response to Vaccines-Vaccination’, ‘Duration of induced Antibodies’, ‘Protection and Duration of Immunity following Vaccination’, ‘Mixed Vaccine Brands Issues’, ‘2nd Dose Uncertainties’, ‘Pervading Boosters Unfinished Matters’ and, of course, ‘What Constitutes ‘Full Vaccination’ against ‘COVID-19’’ among several others. These all point in a direction: Are the ‘COVID-19 Vaccines’ really effective? Can we take a more critical look at the ‘Meteoric Speed of the Vaccines Development and Consequent Vaccines Efficacy’? Can we be more thorough and more systematic, situate with ‘Strict Research Governance Principles’, with ‘COVID-19 Pharmaceuticals’? Can we be more scientific with ‘Full COVID-19 Vaccination’ (Number of Initial Doses and Number of Booster Doses’ to win back and garner ‘Populace Confidence and Trust’ which are critically determinant for ‘Vaccine Uptake’ to surmount ‘Vaccine Hesitancy’ undergirding envisioned successful ‘Global COVID-19 Pandemic Control’. The compelling imperative is possibly a ‘COVID-19 Programmatic Trajectory’ back to the ‘Non-Pharmaceutical Interventions’; back to ‘Masks Mandate’ for instance.

The recent ‘Communication’ on return to ‘Face Masks Use’ is, therefore, quite intriguing and timeously and programmatically apt[18]. It is reported that Staff, Patients and Visitors of Hospitals and General Practice Clinics are now mandated to comply with ‘Face Masks Use’ to address the unacceptable rising rates of ‘COVID-19’ in the United Kingdom (UK). Shortly after ‘COVID-19 Pandemic Control Measures Relaxation’, several Health Facilities are reported to be reinstating ‘Masks Mandates’[18]. In NHS England Midlands, it is also reported that there is increasing ‘COVID-19-related Staff Absenteeism’ and, therefore, ‘Masks Mandates’ are being reinstated! Indeed, ‘Face Masks Use’, ‘Social Distancing’ and other ‘Components’ of the NPIs are reappearing in the ‘COVID-19 Pandemic Control Interventions’. It is suggested that the responsibility for ‘COVID-19 Control Decisions’ over and above National Guidelines is a ‘Matter for Local Discretion’! This ‘COVID-19 Pandemic Control Approach’ is not likely to be productive and successful as ‘No One is Safe Until Everyone is Safe’. Therefore, it will be more appropriate for assuring uniform compliance with the ‘Interventions’ that work: The ‘Non-Pharmaceutical Interventions (NPIs)’[19]. For ‘Interventions’ that work, enforcement is a ‘Difficult Programmatic Issue’. Some have; in fact, suggested the use of ‘Sanctions’ for ‘Defaulters’ and ‘Violations’/ ‘Non-compliance’[20].

This ‘Communication’ is a modest ‘Contribution’ to the ‘Conversation’ to be excited on the ‘COVID-19 Control Interventions’ re: The ‘Return of Masks Mandates’. It is programmatically apt now, as an imperative, to reinstate the ‘Non-Pharmaceutical Interventions’ including ‘Face Masks Use’ as advocated in recent ‘Communications’[21-24].

REFERENCES
1. Mahase E. Covid-19: Vaccine brands can be mixed in ‘extremely rare occasions’ says Public Health England. BMJ 2021; 372:n12
2. Eregie CO. ‘COVID-19 Pandemic, beyond the ‘Vaccines Marathon Finish Line’ and ‘Post-Vaccine Approval Programmatic Haze’: The Evolving ‘2nd Dose Uncertainties’. https://www.bmj.com/content/372/bmj.n18/rr-12 of 24th January 2021
3. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and successful vaccination programmes: a further clarion call to observe research governance-related best practices and a critical look at preprints. https://www.bmj.com/content/376/bmj.o321/rr of 23rd February 2022
4. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and Boosters: More Unresolved Evolving Matters in the Works. https://www.bmj.com/content/375/bmj.n3011/rr of 17th December 2021
5. Ibarrondo FJ, Fulcher JA, Goodman-Meza D, et al. Rapid decay of anti-SARS-CoV-2 antibodies in persons with mild Covid-19. N Engl J Med 2020; 383:1085--7
6. Andrews N, Stowe J, Kirsebom F, et al. Covid-19 vaccine effectiveness against the omicron (B,1.1.529) variant. N Engl J Med 2022; 386:1532-46
7. Stokel-Walker C. How are vaccines being adapted to meet the changing face of SARS-CoV-2? BMJ 2022; 377: o1257
8. Moderna. Moderna announces clinical update on bivalent covid-19 booster platform. 19 April 2022. https://investors.modernatx.com/news/news-details/2022/Moderna-Announces...
9. Brierley C. Cambridge coronavirus vaccine enters clinical trial. University of Cambridge. 14 Dec 2021. https://www.cam.ac.uk/stories/DIOSCoVax_safetytrial
10. Manchester University NHS Foundation Trust. Early data for multivariant COVID-19 vaccine booster shows promise. 6 Jan 2022. https://mft.nhs.uk/2022/01/06/early-data-for-multivariant-covid-19-vacci...
11. Looi M-K. The BMJ Interview: WHO chief scientist optimistic for a pan-coronavirus vaccine in two years. BMJ 2022; 377:o1003
12. Yan W. Coronavirus tests science’s need for speed limits. New York Times 2020 Apr 14. https://www.nytimes.com/2020/04/14/science/coronavirus-disinformation.html
13. Eregie CO. COVID-19 Pandemic and the Value of Antibodies Testing: Still More Matters in the Works. https://www.bmj.com/content/370/bmj.m2655/rr-1 of 14th August 2020
14. Eregie CO. ‘COVID-19 Pandemic, COVID-19 Vaccines and ‘2nd Dose Uncertainties’: Still unresolved evolving matters’. https://www.bmj.com/content/372/bmj.n162/rr-3 of 8th February 2021
15. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and successful vaccination programmes: a further clarion call to observe research governance-related best practices and a critical look at preprints. https://www.bmj.com/content/376/bmj.o321/rr of 23rd February 2022
16. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and Boosters: More Unresolved Evolving Matters in the Works. https://www.bmj.com/content/375/bmj.n3011/rr of 17th December 2021
17. Eregie C.O. Covid-19 Pandemic, Reinfection, Reactivation and Covid-19 Rebound: Efficacy of Covid-19 Pharmaceutical and Non-Pharmaceutical Interventions; The Imperative to Guard Against Interventional Precocity in Downing Guards. https://www.bmj.com/content/377/bmj.o1365/rr of 15th June 2022
18. Wilkinson E. Covid-19: Hospitals and GP Clinics return to universal mask wearing as rates rise. BMJ 2022; 378:o1712
19. Iacobucci G. Covid-19: Face coverings and social distancing rules will continue in all healthcare settings. BMJ 2021; 374:n1810
20. Goh S. What stick is there for those refusing to wear a mask nowadays? https:/www.bmj.com/content/378/bmj.o1712/rr of 12th July 2022
21. Eregie C.O. ‘Covid-19 Pandemic, Reinfection, Reactivation and COVID-19 Rebound: Efficacy of Covid-19 Pharmaceutical and Non-Pharmaceutical Interventions; The Imperative to Guard Against Interventional Precocity in Downing Guards’. https://www.bmj.com/content/377/bmj.o1365/rr of 15th June 2022
22. Eregie C.O. ‘COVID-19 Pandemic, COVID-19 Vaccines and Rapidly Transmuting SARS-CoV-2 Variants/ Sub-variants: The Quest for Pan-Sarbecoviruses Vaccine Variants; A Further Imperative to Guard Against Global Interventional Precocity in Downing Guards’. https://www.bmj.com/content/377/bmj.o1257/rr-0 of 17th June 2022
23. Eregie C.O. ‘COVID-19 Pandemic, SARS-CoV-2 Transmission and Pandemic Control Interventions: The Unrelenting Bothersome Chameleonic Reality of COVID-19 Pandemic Specifics’. https://www.bmj.com/content/377/bmj.o1408/rr of 5th July 2022
24. Eregie C.O. ‘COVID-19 pandemic, Immunity and Infectivity: evolving facts support the imperative for sustained compliance with non-pharmaceutical interventions’. https://www.bmj.com/content/378/bmj-2020-061402/rr-1 of 23rd July 2022

Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria.
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer,
ICDC-Trained in Code Implementation,
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria,
*No Competing Interests.

Competing interests: No competing interests

11 August 2022
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria and Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria
Institute of Child Health, University of Benin, PMB 1154, Benin City, Nigeria.