By Geralyn Edward
If there was any reason for Barbadians to fear the Oxford-AstraZeneca COVID-19 vaccine, Dr Elizabeth Ferdinand would be the first to recommend a stop to the vaccination process.
In a very matter-of-fact tone, the co-coordinator of the national vaccination effort, says she is positioned to give that commitment based on her expertise and decades of experience, in guiding vaccine programmes in Barbados and the region.
The University of the West Indies (UWI), Mona Campus-trained physician and a Harvard University Masters graduate in Public Health, Dr Ferdinand feels right at home helping the country wade through the turbulent process of overcoming the COVID-19 pandemic.
But Ferdinand is not your ordinary front line worker. The respected physician put away her stethoscope and retired in 2014, after nearly 40 years of public service. She is happy to say she was enjoying a placid, happy life of part-time lecturing at the UWI, and other “bits and pieces”.
The mother of one son and a daughter, is also grand-mother of three girls – two recent university graduates, and an eight-year-old she swears keep her looking and feeling young at 70-plus.
Offering an insight into her lengthy background in public health, Dr Ferdinand started her medical career at the Queen Elizabeth Hospital (QEH), after relocating here from her homeland of Guyana following medical studies in Jamaica. She had a short stint in private practice, then pursued post graduate studies in the US, before her appointment as a Medical Officer of Health.
She was based at the St Philip polyclinic and later the Maurice Byer Clinic in St Peter. Along her career she became Senior Medical Officer and acted as Chief Medical Officer on several occasions.
Today, she still sits on a World Health Organisation (WHO) technical advisory committee that deals with immunizations in the Caribbean.
As Barbados’ battle with the deadly disease became more intense, and the COVID-19 cases rose steadily, Dr Ferdinand felt she could no long watch from the sidelines. So, she boldly stepped out of the comfort of retirement, to join her colleagues in the trenches on the front line.
She told COVID Weekly: “I felt I needed to assist Barbados at this time; and share my experiences and knowledge, to do the best we could to get over this COVID 19 pandemic.”
Fear of catching COVID
Dr Ferdinand, who may well be one of the island’s busiest retirees, joined forces with military man and co-coordinator, Major David Clarke to marshal the COVID-19 vaccination plan.
Asked if she was worried about exposure to the disease and illness, the medical doctor readily admits to having those concerns.
“Of course, I worry. In fact, my family is more worried than I am. When I trained to be a doctor all those years ago . . . I knew what I was getting into. I knew the risks and I don’t mind.
“I try to follow all the protocols as closely as possible and I only ask that other people who are around me, not only the people who are coming for vaccines, but those who I work with – members of the team, that they follow the protocols of social distancing, masking, and hand washing, all the time.
“I am not afraid. This is a way of life and it is going to be that way for quite a while,” she pointed out.
Ever prepared to be bold, Ferdinand revealed that in her younger years in medicine, she wanted to work in Africa during one of the epidemics on the continent but was dissuaded because of the young family she was raising at the time.
Today, a typical day for Dr Ferdinand can start as early as 4 a.m. checking overnight emails which may contain various updates. The day usually continues with sessions at St Ann’s Fort, The Garrison, and vaccine site visits. The evenings often run into nights with at least two virtual meetings.
“Our team, we are up from about 4 a.m. or 4:30 and we work late,” she declared.
“We often have sessions with the Chief Medical Officer (CMO) and internal meetings. Major Clarke and I divide up the sites. We can’t visit all of them, but we try to visit one or two that are immunizing on particular days.”
Last Wednesday, the public health specialist worked at the Globe Drive-in immunization centre, helping to register those seeking vaccinations, responding to queries and ensuring the process was going smoothly.
A few hours later, she was in St Philip at Bayley’s Primary School, undertaking similar tasks. That was followed by preparation for meetings with the island’s teachers the following day.
All this before she sat for the evening interview with COVID Weekly.
Then I crawl into bed after 10 p.m.” she said with her trademark laugh. “I feel fulfilled by the work I am doing; very much so. I am happy and I love it.”
Dr Ferdinand has every reason to be happy. In roughly four weeks, the team of public health officers, supporting staff and volunteers have vaccinated more than 58 000 people.
It has been a remarkable achievement, for which she credits Barbados’ well established and functioning public health system.
“We have a structure of good public health. Let no one fool you, Barbados is far ahead of a lot of countries with our public health infrastructure. The nurses are well trained, and we have public health-trained doctors. In the polyclinics, we have some good people.”
New Appointment System
She readily admits, though, that the COVID-19 immunization process was not a smooth one and there are many areas that require improvement.
The co-coordinator explained: “One of the main problems, and still is a problem, is the appointment system. Generally, [people] are not accustomed to following the appointment system, especially when dealing with some public institutions.
“Some people have an appointment for 2 p.m. and they come at 8 in the morning because some are old, they want to get the first bus out, or get a drop with a child or relative who is going to work.”
All this, however, is expected to change when a new and improved process begins for administration of the second doses of the AstraZeneca vaccine.
“We are coming back with a new system that will allow you to choose where you want to go to get the vaccine, even to a certain extent, what time you want to go.
“You will be able to book your appointment for . . . those receiving the second dose. We are trying to make this appointment system using the new app, as user-friendly and as convenient as possible. But we can’t put that in place yet because we have to get rid of the backlog of those persons who had registered early in the system but did not get an appointment.”
She admitted the crowds who flocked to vaccination sites without appointments, exacerbated the problems.
“It was not easy. It was overwhelming, not only for the people who were coming and had to wait for long hours, but also for our staff. When you get overwhelmed, you start to snap and so we had to do something very quickly about that. I think we are getting there now,” Ferdinand assessed.
Scepticism about vaccines
But even as her team powered through the immunization of over 61 000 people, the public health specialist is aware that the battle for public support of the COVID-19 vaccination is confronting disinformation, as well as recent scepticism in some European countries about the Oxford AstraZeneca vaccine.
Dr Ferdinand admitted that the process of vaccine trials was much faster than other vaccines. She explained that as with most new vaccines, consistent, global monitoring for all adverse effects is taking place.
Stressing that the vaccine was deemed safe by WHO, she urged Barbadians to continue taking it to protect themselves against the worst effects of the deadly illness.
“I am saying to the public, do not worry. I will be the first one to stop the vaccination programme if I felt there was a reason to worry,” she insisted to COVID Weekly.
Full vaccine doses
There is mystery surrounding the national vaccine process that the experienced health care professional addressed. That is, the number of people who have been vaccinated from the 100 000 doses of AstraZeneca, even though Barbados donated 10 000 of the doses to its neighbours in the region.
The answer is simple, Ferdinand said. “The doses come in small bottles called vials, and in each vial, there is supposed to be a minimum of 10 doses.
“We shared 10 000 doses with our neighbours and so we were left with 90 000 doses. But we are able to get at least one extra dose from each vial, not in every single case but generally speaking we are getting extra doses and that is how we have been able to vaccinate people.”
Under normal circumstances, the batch of 90 000 doses which Barbados retained should have served 45 000 people.
However, she made it clear that each vaccinated person is getting a full dose of 0.5 ml and nothing less.
She pointed out that administering less than the full dosage to people in order to stretch the supply “would be pointless” as it would be ineffective.
She added: “We are thankful for the extra doses because if a dose is $10, you can imagine the extra doses we are getting without having to pay.”
As the team gets ready to wrap up Phase One of the COVID-19 immunisation campaign, in preparation for providing persons with their second doses, she was a bit surprised at the rapid response by persons for the vaccine.
“Initially I was surprised because I did not know what to expect. When I was in the Ministry, we had our experiences with the annual flu vaccine for which the uptake was very poor. Even when we brought in the HPV vaccine for the children, it was relatively poor.
“I was preparing for the best and dreading the worst. But now that I see the response, I realised that Barbadians read, they watch the television, they follow the Internet and social media, and they are well educated. They talk among each other and I think they understand that one of the main pillars of stopping this COVID-19 epidemic is by vaccination.”
Proud of the achievements so far of the National Vaccination Programme, the doctor is still aware that the country is a long way from achieving the ultimate goal of herd immunity.
To get there, she said at least 70 to 80 per cent of the population or about 228 000 people need to be fully immunized.
According to the doctor: “We are only a quarter of the way. So, we still have a long way to go and with this particular vaccine, we need to give two doses to have maximum effect.”
“We are going through this in the first phase, but we also have to immunize those same people again for the second dose of the vaccine.”
Dr Ferdinand admits that this is a big task, but she is energised and motivated to see the battle through to the end, and to declare Barbados’ victory in the fight against COVID-19.
This article appears in the March 22 edition of COVID Weekly. Read the full publication here.