CodeBlue View On Covid Response: A New Approach For 2021

Federal authorities must start decentralising both the ongoing public health response and the national Covid-19 vaccination programme to states and the private sector.

Malaysia will end the year 2020 without any sense of control over the Covid-19 epidemic that continues to kill people in our country every day.

But the three solid coronavirus vaccine purchase agreements (Pfizer, COVAX, AstraZeneca) signed by the government — albeit late — gives Malaysia a glimmer of hope in ending the acute phase of the epidemic in 2021.

While Malaysia appeared to nearly suppress Covid-19 for three months in June, July and August — debatable without widespread testing — the explosion of multiple outbreaks nationwide since the Sabah state election in September shattered all illusions of the federal government’s ability to control a deadly virus through a conventional top-down approach.

Coronavirus is now everywhere. The Klang Valley is the new Ground Zero. And anonymous people, whom the nation is unable to mourn for, continue to lose their lives to Covid-19 every single day. These WN (warganegara)/ BWN (bukan warganegara) end up as blank case numbers, leaving behind just details of their gender, age, and history of medical conditions, forgotten in a deluge of statistics that numbs the nation.

More than 100,000 total Covid-19 infections, 446 deaths, nearly 19,000 active cases, 102 in ICU, 45 on ventilators, a daily average of more than 1,000 new cases for the past one month (1,598 daily cases the past week).

Some Covid-19 deaths may have been preventable. The collective failures of Malaysia’s public health response; double standards in SOP enforcement; federal authorities’ refusal to decentralise data and disease control measures; unwillingness to think outside the box during a pandemic; and individual fatigue in maintaining vigilance all contributed to the mess we’re in now.

For the year 2021, even with the promise of vaccines, Malaysia must radically change its approach in managing the epidemic to prevent more unnecessary deaths.

We cannot let our guard down even when we get vaccinated, but empowering ordinary people (both citizens and migrants) to continue following Covid-19 SOPs first requires reassurance of food on the table.

The social and economic costs of this year’s lockdown measures will continue to be felt in 2021. Malaysians, especially low-income and daily wage earners, cannot be expected to prioritise SOPs when they’re worried about feeding their families. Undocumented migrant workers fear detention if they enter the public health care system. So, some succumb to the virus, wherever they are, and get classified as “brought-in-dead” cases.

Malaysians will also be unable to continue vigilance against Covid-19 if they’re not in a proper state of mind. The psychological impact of the epidemic, especially on children and young people who have lost nearly a year of school, has yet to be addressed.

Federal authorities must start decentralising both the ongoing public health response and the national Covid-19 vaccination programme to states and the private sector. Data on the locations of new infections must be shared with at least every state government, if not the general public, so that state authorities can help with testing. Even if this pushes up daily case numbers, widespread testing will enable quicker isolation and prevent transmission of the virus by people who are unknowingly infected.

It is highly likely that the public health care system does not have sufficient capacity to carry out Covid-19 vaccination. We’re talking about jabbing 500,000 people twice (three weeks between each shot) when the first million doses of the Pfizer-BioNTech vaccine arrive in February.

Even before the pandemic, government clinics and hospitals were already understaffed. Covid-19 has stretched public health care workers even thinner over this entire year, as many fall sick (not necessarily from coronavirus) and face burnouts. But the Malaysian epidemic is expected to continue surging on, as the US-based Institute for Health Metrics and Evaluation (IHME) projects 5,000 new infections daily from February 25.

The management of a worsening epidemic must continue simultaneously with immunisation, as vaccines may not immediately reduce coronavirus infections in the population. So, the national Covid-19 vaccination programme must be decentralised and involve private general practitioner clinics that regularly immunise people for other things, such as the flu.

As Malaysia prepares for Covid-19 vaccines, political stability is crucial to ensure the success of the national vaccination programme. Any politicisation of Covid-19 vaccines — whether it’s over the price of shots procured directly from the manufacturer without middlemen, or vaccine safety and efficacy — risks contributing to misinformation and vaccine hesitancy.

The current administration made serious mistakes in the management of Malaysia’s Covid-19 epidemic that CodeBlue has consistently highlighted — such as the serious harms of arbitrary lockdown measures, the lack of widespread testing, and the potentially fatal impact of the virus on undocumented migrants in Sabah who seek treatment late.

However, we believe that political stability pending a general election, which can only be held after the acute phase of the Covid-19 epidemic, is necessary to prevent the economy from getting worse. Having said that, Perikatan Nasional must change the traditional Malaysian government-knows-all attitude, work with Opposition states and the private sector, and be transparent and accountable in its Covid-19 public health response.

Otherwise, more Malaysians risk getting infected and dying due to egregious missteps and failure to learn from past mistakes in the handling of a relentless virus.

Editorials represent the views of CodeBlue as an institution, as determined through debate in the newsroom. CodeBlue’s Editorial Board comprises editor-in-chief Boo Su-Lyn, and health writers Ashswita Ravindran and Kanmani Batumalai.

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