Living With Covid-19 Premature Without Addressing Fundamental Issues — Dr Kelvin Yii

The government must Implement a comprehensive National Testing Plan and draft clear policies on Covid-19 vaccine booster shots, especially for frontliners and high-risk groups.

The Ministry of Health (MOH) and Sarawak Disaster Management Committee (SDMC) must urgently expedite the current Covid-19 vaccination of our adolescents, in view of the current surge of Delta cases in Sarawak.

There has to be some form of Operation Surge Capacity when it comes to vaccinating our children, as the spillover of the current surge of cases may affect them, potentially causing the next Delta wave to hit unvaccinated children.

Sarawak might have high vaccine adult coverage, but the total population coverage is only about 64 per cent. Even though the rate of severe symptoms and hospitalisations among the Covid-19 cases in Sarawak is not high, but with a high infection rate and the infectiousness of the Delta variant, this leaves our children and those yet to be vaccinated vulnerable and exposed to the devastating effects of Delta.

While I am glad that vaccination among adolescents has started in Sarawak, this has to be expedited to make sure that more children get necessary protection as fast as possible.

This will require constant shipments of vaccine for Sarawak, in view of increased Delta infections and the decentralisation of vaccination centres (PPVs) for children in different schools all around Sarawak.

For convenience’s sake and to avoid congestion in specific PPVs, children should be allowed to be vaccinated in their own schools, or special PPVs should be open in as many schools as possible.

This will make it easier to track vaccinated children, based on school records. including capturing those who have dropped out from school.

If we can vaccinate all children between 12 and 17 years old this month, we will have a total population coverage of 83.4 per cent. We can then plan to vaccinate those below 12 years old, based on available data. especially in view of the reopening of schools.

We have seen in countries with high vaccine coverage such as Norway and the United Kingdom, which have experienced an increase of cases among children the moment schools reopened.

On top of that, I reiterate my call for the MOH and SDMC to be transparent with their plans and strategies with regard to Covid-19 in Sarawak. Merely talking about “living with Covid-19” is somewhat premature, and does not instil confidence in the public when cases are still so high.

Sarawak’s weekly Covid-19 infections saw an increase of almost 300 per cent or a threefold increase in the past few weeks, from 7,423 cases in the week of August 12 to 18 to 21,940 cases from September 2 until 8.

There has also been a significant increase in the last few days that will further increase this week’s count.

At the same time, Covid-19 fatalities in Sarawak also saw a sharp 200 per cent increase in the same period of time — from 20 deaths to 60.

It is to be noted that on September 5 and 6, more than 50 per cent of 27 patients in Sarawak who died of Covid-19 had been fully vaccinated.

That is why I have cautioned the MOH and SDMC from shifting into a full endemic (living with Covid-19) strategy in Sarawak prematurely, without first addressing some of the fundamental public health measures.

This includes the importance to invest in our public health system to continue the required Find, Test, Trace, Isolate and Support (FTTIS) approach by coming up with a comprehensive National Testing Plan which includes frequent testing at workplaces, factories, schools, and all social events.

This is more comprehensive and holistic than the plan to just test the symptomatic and stop testing the asymptomatic.

And more importantly, there has to be a clear policy on booster shots, especially for frontliners and high-risk groups, in view of the waning effectiveness of vaccines over time, which we have seen in other countries.

In Sarawak, about 77.7 per cent of fully vaccinated people received Sinovac, followed by Pfizer-BioNTech (18.7 per cent) and AstraZeneca (2.4 per cent).

We compare this with Labuan, which has relatively recovered after having one of the the highest prevalence of cases per population due to an outbreak of Delta. Based on data provided, 89 per cent of the population has been vaccinated with the Pfizer vaccine.

A recent study in Thailand that showed Sinovac’s efficacy against Delta dropped to 48.33 per cent six months after the second dose.

A real-world study in the UK showed that protection from Pfizer declined to 74 per cent after five to six months, and for AstraZeneca, protection dropped to 67 per cent after four to five months.

This is why I hope the government will ensure all these steps are in place, including my previous recommendations, before making the shift purely to a full endemic-style strategy.

If we make the shift too soon without preparing other fundamentals, I am concerned it will trigger a new wave, especially among high-risk groups and those yet to be vaccinated, including children, and overwhelm the hospitals.

Dr Kelvin Yii is the Member of Parliament for Bandar Kuching.

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