Ghanaian reseracher James Azam uses mathematics to model how different measures, such as vaccination and social distancing, impact on the spread of measles – but now there’s a new factor: the novel coronavirus Covid-19.
Azam studied actuarial and financial mathematics, but now he crunches the numbers on measles and is a Phd candidate at the Department of Mathematics at Stellenbosch University in South Africa.
Despite a measles vaccine being in wide use for decades, this highly infectious disease is still present across the world, often in vulnerable communities and Azam says that the response to Covid-19 will most probably have two distinct impacts.
“Measles transmission is by direct contact and since the Covid-19 measures are mostly to reduce physical contact, we should expect low levels of measles in the meantime if people obey the measures,” he said, “I expect low levels for now because even people with measles will not present at the clinics because the clinics are overwhelmed and these people are scared of contracting the novel virus.”
However, Azam says, with the slowing down or complete shut down of the routine vaccination services in most countries in response to Covid-19, measles vaccination coverage is going to plummet in many places around the world. In mid-July, the World Health Organisation warned at least 30 measles vaccination campaigns were or are at risk of being cancelled because of the pandemic.
“If you couple this with the high birth rate in these places, that is a recipe for large outbreaks following covid19 or when physical distancing restrictions are eased and the conditions are ripe – a similar effect was predicted after Ebola in West Africa,” he said.
Azam’s main work is modeling the implications of trying to use the measles vaccine when it has been exposed for a few days to temperatures of up to 40 °C, instead of the usual 2-8°C range.
“Other vaccines have been registered for use in the same way, so this is not new, however, the measles vaccine has never been used in this manner,” he said, “Hence, there is need for scientific evidence to support its use and my work involves using mathematical modelling to access the feasibility and operational implications of going this route.”
Azam’s passion for science started early on, as he grew up in the towns of Sunyani and Wa, in two different regions of Ghanam ending up competing in Ghana’s national science and maths quiz.
After studying actuarial and financial mathematics, Azam says a twist of fate saw him join a project modelling measles outbreak response dynamics in the Democratic Republic of Congo.
“It was by chance that I joined that group but soon grew to enjoy the topic and its immediate applicability, but I have since then pursued it passionately,” he said, “Everyone knows me as the measles guy!”
Azam says this experience was valuable because similar challenges are faced all round the world especially in places where children are hard-to-reach.”
“The biggest opportunity has been for me to work closely with the Médecins Sans Frontières (Doctors without Borders) to develop my work and the fact that it solves a real-world problem,” he said, “It is not often that you get to use mathematics to solve an immediate problem, even if the biggest challenge has been the inter-disciplinary nature of the work.”
Azam says his work involves knowledge of how vaccine supply chains work including the nitty gritty of vaccine logistics and supply chain.
Measle isn’t the only public health crisis that is continuing along during the Covid-19 crisis. Elsewhere in the developing world, high existing levels of hypertension, diabetes or obesity may be putting more young people at risk of Covid-19.
According to Casey Means, Chief Medical Officer of metabolic health company Levels, Mexican health authorities said in May that among Covid-19 deaths over forty percent of those patients presented with hypertension, diabetes or obesity.
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