Prepare For The Delta Wave Of Covid-19 Outside The Klang Valley — Dr Amar-Singh HSS

If we have good, strong regional leadership, we may just avoid the worst of the impending crisis.

Much of the recent focus on Covid-19 has been on the Klang Valley, including Negeri Sembilan, and rightly so. The outbreak in that part of the country continues to rage on, and the multi-sectoral task force set up to deal with the region, the Greater Klang Valley Task Force (GKVTF), is working hard to make a difference.

However, we may not be aware that other states outside the Klang Valley are gradually slipping into a crisis. If you track the intensive care (ICU) bed use by Covid-19 patients in Perak, Kedah and Pulau Pinang, for example, you can see a steep rise in the past three to four weeks.

Remember that this data does not show the full picture, since for every one Covid-19 patient documented in an ICU bed, there are perhaps one to two times as many Categories Four and Five patients in a non-ICU bed, often in casualty departments.

Much of the rapid change in the situation is due to the Delta variant, which is most likely the predominant strain spreading in the nation. The Delta variant is highly infectious as it has a very high viral load and infects more persons faster.

In addition, the fully vaccinated rate for many states outside the Klang Valley are lower due to limited vaccine supply. Data for July 25, 2021 shows that completed vaccination rates (two doses) for the states was 14.4 per cent for Perak, 11.5 per cent for Kedah, and 14.5 per cent for Pulau Pinang (as a percentage of the total population). With the Delta variant, two-dose protection is important.

What Can We Do To Prevent A Klang-Valley-Like Disaster?

We need to act now to prevent the situation from getting worse. We might have a narrow window of three to four weeks to act. Some summary suggestions are:

1. Advocate for an increase in vaccine supply and ramp up vaccinations. Leave no vials in storage. Avoid using large vaccination centres (PPV), and instead do drive-by vaccination and use the existing health care infrastructure (maternal and child health clinics, school health teams, GPs, private hospitals). We want to reduce the risk of mega PPVs being locations for Covid-19 transmission.

2. Reduce all non-critical social interaction to cut community spread of the virus. Avoid social, travel and religious activities. Avoid the use of vaccination passports at this time for travel, and especially avoid inter-state movement.

3. Use PCR testing only for hospital admissions, and expand RTK-Ag testing for all contacts, symptomatic or otherwise. Enable the public to self-test with the availability of reliable, cheap saliva-based RTK-Ag tests, which can be acquired from pharmacies, health centres and GP clinics. The state government should consider investing to subsidise these tests. Anyone who is RTK-Ag test positive should be considered a case and be isolated and monitored.

4.  Activate a state-level multi-sectoral disaster team, not unlike the Greater Klang Valley Task Force (GKVTF). Get the plans in place, teams activated and resources on standby as quickly as possible, so that when the Delta wave hits, we will be prepared. This includes increasing the number of hospital beds, oxygen delivery capacity and electrical power supply.

5. State-level disaster management teams must be empowered to act immediately (decentralised decision-making) and supported by state governments. Remember that the federal government has invested significant resources to support the Klang Valley, and may have limited funds for other states. Therefore, state governments must come together with business leaders to act for their respective states.

6. We need to send a clear message that vaccination alone will not stem the Delta wave; we need public health measures as well (masks, ventilation, physical distancing, etc). We need to encourage the public to be vigilant and maintain their SOPs, even after vaccination.

7. Finally, transparent data sharing with the public to comprehensively explain the true situation is crucial. We cannot say “Everything is under control”, when we know it is not. Granular data, down to the district level, will encourage an all-of-society involvement to reduce the impact of the Delta wave. A concerned public is one that acts.

We have an opportunity to avoid the anguish that Greater Klang Valley residents are going through. If we have good, strong regional leadership, we may just avoid the worst of the impending crisis.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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