Review Relaxed Restrictions For Fully-Vaccinated Persons — Malaysian Health Coalition

Suggested criteria for relaxation: fully vaccinated rate ≥70% of the total population; total critical care bed occupancy rate for Covid-19 of ≤90%; total daily new cases ≤4000 with share of positive tests ≤5%.

The Malaysian Health Coalition understands that we must reopen Malaysia as soon as possible and that we must provide some privileges for fully-vaccinated persons. However, we urge the government to reconsider the relaxed restrictions as announced by the Prime Minister on 8 August 2021.

We urge the following:

Postpone the relaxed restrictions to a timepoint defined by strict evidence

We understand that there is never a perfect time to relax restrictions for fully-vaccinated individuals. However, this decision is premature at this point in time for four main reasons.

· We are inadequately vaccinated. Only 27% of our resident population of all ages are fully vaccinated, and this excludes undocumented migrants. Chile only relaxed restrictions after 50% coverage, and Singapore is targeting relaxed restrictions at 70% coverage.

· There is vaccine inequality in Malaysia. The 27% average hides a wide range, from 12% in Sabah to 59% in Labuan. Indeed, only five regions are above 27% (Labuan, Sarawak, Negeri Sembilan, Lembah Klang and Perlis).

· We are still seeing thousands of daily cases and over-utilized intensive care units, general hospital wards, Emergency Departments and quarantine centres. These indices are currently not publicly available at a granular level, and must be used to guide the National Recovery Plan.

· The Delta variant is likely the dominant variant in Malaysia (although genomic testing remains low). The Delta variant is more transmissible than the wild-type SARS-CoV-2, and current vaccines have reduced effectiveness against Delta. Breakthrough infections in vaccinated persons may be as transmissible as unvaccinated persons.

Therefore, we believe that these relaxed restrictions are premature and can be dangerous. We propose postponing the relaxation to a time determined by a clear set of publicized criteria. The scientific and public health criteria for relaxation must be built by health experts without interference. They can include “fully vaccinated rate ≥70% of the total population; total critical care bed occupancy rate for Covid-19 of ≤90%; total daily new cases ≤4000 with share of positive tests ≤5%” and other criteria. These criteria must be publicized today so that any future decisions will be solely based on evidence.

Provide more clarity on relaxed rules

In any case, the government must clarify the specifics of these relaxed restrictions, because blanket vaccine privileges will create loopholes that will impede the National Recovery Plan. For example, the government must answer questions like: What is the rationale to allow home quarantine for vaccinated travellers, how long is the quarantine, and how will we monitor? How do we close the loopholes that may allow “inter-state vacations on the pretext of visiting our children”?

Implement evidence-based policies for the National Recovery Plan

We urge the government to publicize their evidence and projections and explain their rationale for decisions. Otherwise, the Rakyat will be left guessing if we are truly making policies based on evidence. Markers of the National Recovery Plan must be grounded in science and must be predictable. Although the pandemic is dynamic, changing the NRP markers too frequently and without good explanations may lead to concerns that decisions are political instead of evidence-based.

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

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