The government’s National Recovery Plan, however, doesn’t appear to be much of an exit strategy out of the Covid-19 epidemic, since it doesn’t detail the actions needed to achieve the targets set to fully end movement restrictions by December.
Since vaccination coverage is one of the indicators set for transitioning out of lockdown measures, milestones should be tied to mortality and hospitalisation rates instead of infection rates. Hence, vaccination rates shouldn’t be defined as a target per se, but as a task – however much inoculation is needed – to achieve a specific reduction of deaths and hospitalisations.
Vaccine Minister Khairy Jamaluddin has stopped using the “herd immunity” term as he believes Covid-19 may end up as an endemic disease, but as a less dangerous threat in the time to come. Despite targeting 80 per cent vaccination coverage of the total population by year end, Khairy is saying that this isn’t a “herd immunity” threshold that will necessarily eliminate the virus once it’s achieved. Covid-19 instead may become like the flu with much fewer hospitalisations and deaths.
Our Covid-19 fatality rate has skyrocketed in the fourth wave of the epidemic. In the first 16 days of June alone, 1,346 deaths were recorded in Malaysia, exceeding the 1,290 fatalities reported in the month of May. More than 100 daily deaths were reported four days in June.
Although Malaysia’s Covid-19 intensive care unit (ICU) occupancy appears to have plateaued in the past few days, it is still high at 94 per cent as of June 15. The proportion of severe Covid-19 cases in Stages Four and Five increased to 31 per cent this month from 18.5 per cent in May; the Ministry of Health (MOH) has attributed the more rapid decline of Covid-19 patients to new variants.
The first 10 per cent vaccination coverage target to move into Phase Two of the government’s recovery plan – estimated by Prime Minister Muhyiddin Yassin to be early July – is challenging. As of June 16, only 4.5 per cent of Malaysia’s 32.7 million population have been fully vaccinated, or about 1.5 million people. Achieving 10 per cent population coverage means inoculating an additional 1.8 million people with their second dose.
In the past week from June 10-16, an average of 36,545 second doses were administered daily across the country. The average of total doses administered (both first and second doses) reached an impressive 166,280 daily shots the past week, surpassing Vaccine Minister Khairy Jamaluddin’s original target of 150,000 daily jabs for June.
Going by the daily average of 36,545 second doses administered, this will take about 49 days until early August to give the second dose to 1.8 million people – that’s assuming all 1.8 million people are scheduled to take their second dose by then. Malaysia currently practices a 12-week dosing interval for the AstraZeneca jab.
The government did not explain the rationale for setting vaccination milestones in each phase of its recovery plan based on 10 per cent, 40 per cent, and 60 per cent total population coverage.
Khairy told a dialogue with The Oxford & Cambridge Society Malaysia Wednesday – when CodeBlue questioned the basis of those vaccination targets was and if the milestones took into account the more contagious Delta variant – that Malaysia was monitoring the spread of the strain, particularly in Labuan that has seen a surge of infections and fatalities.
“That might have an impact on the vaccination threshold as we move from one phase to another. So that’s an ongoing thing,” he said.
The true spread of the Delta variant – which is 60 per cent more transmissible than the Alpha variant that is already much more contagious than the original version of the virus – is not known in Malaysia, due to limited genomic sequencing. The National Institutes of Health under MOH reported that only 509 successful genome sequences of SARS-CoV-2 have been carried out as of June 9, comprising 0.1 per cent of 520,881 new infections recorded this year.
So far, only data on the effectiveness of Pfizer-BioNTech and AstraZeneca-Oxford vaccines against the Delta variant is available. Both vaccines, according to Public Health England (PHE), are 17 per cent less effective against symptomatic disease from Delta compared to Alpha after one dose.
According to a new real-world analysis published by PHE on June 14, the Pfizer and AstraZeneca vaccines are 96 per cent and 92 per cent effective respectively against hospitalisation from the Delta variant after two doses. PHE estimates that the Delta variant now accounts for 90 per cent of new Covid-19 cases in the UK. Hospital admissions in the UK have risen along with new Covid-19 cases in the past few weeks.
We do not yet know the effectiveness of Sinovac and CanSino vaccines against variants of concern, including Delta. In Indonesia, more than 350 doctors and health care workers contracted the coronavirus and, disturbingly, dozens were hospitalised despite receiving the Sinovac vaccine. They were reportedly infected with the Delta variant.
Hence, Malaysia’s exit strategy has a potential blind spot. We don’t know exactly where our enemy – Delta – is. Our vaccination is racing against time to beat a virus that is quickly getting better at its job.
Boo Su-Lyn is CodeBlue editor-in-chief. She is a libertarian, or classical liberal, who believes in minimal state intervention in the economy and socio-political issues.