With the high vaccination rate achieved among the adult population, in addition to the improved Covid-19 situation in Malaysia , most states have been declared as entering Phases Three and Four of the National Recovery Plan, with the reopening of almost all economic sectors.
This means that the country is in transition from a pandemic to an endemic state of Covid-19. But what is meant by the word “endemic”? Does this imply that we will have to coexist with Covid-19? Will Covid-19 be successfully eradicated?
Before we answer some of these questions, let us briefly review the meaning of “epidemic”, “pandemic” and “endemic”.
An epidemic is when the number of cases in a specific geographical area increases unexpectedly. A good example would be the 2014-2016 Ebola outbreak in West Africa.
A pandemic is an epidemic that has spread over several countries or continents, usually affecting a large number of people, namely the current Covid-19 pandemic.
Lastly, endemic refers to the constant presence of a disease or infectious agent in a population within a geographic area, a good example being dengue fever in Malaysia. Since the dengue outbreak in the 1980s, the disease has remained endemic in this country, with no signs of complete eradication anytime soon.
Lately, there has been widespread belief among experts globally that the SARS-CoV2 virus will become endemic in their respective countries.
In order for a country to enter an endemic phase, a baseline number of Covid-19 cases should be achieved within the country, accompanied by occasionally unpredictable outbreaks(2).
Once Malaysia has successfully established this baseline, only then will the country shift from a pandemic into an endemic phase.
Will Covid-19 ever be eradicated? During the early phase of the National Covid-19 Immunisation Programme (PICK), herd immunity was a widely discussed goal.
Herd immunity is achieved when enough people within the community are immune against a disease, thereby conferring protection to individuals who are not protected against the disease.
This curbs the transmission of infection within the community. Polio is an example in which the virus was eradicated by achieving herd immunity through the means of mass vaccination.
In recent months, our government has shifted from the idea of herd immunity, and is set on preparing our country to enter an endemic phase.
Although there is growing evidence that Covid-19 vaccination reduces the risk of getting severe infection, prevent hospitalisation and deaths, it appears that the vaccine does not completely eliminate the risk of getting infected. This can be seen from the number of reports of breakthrough infections after vaccination.
However, it does not mean we have failed, as this largely depends on the type of immunity people acquire through infection, how the virus evolved, and the effectiveness of vaccines.
We are unsure if Covid-19 can be completely eradicated in the future. Nevertheless, this continues to be the main objective in the fight against the virus.
Several adjustments are expected to take place once Malaysia enters the endemic phase of Covid-19. Health Minister Khairy Jamaluddin has revealed that the government will be announcing simplified SOPs to prepare for the endemic phase.
Despite some changes that are to be expected, mandatory mask wearing will still be continued, due to the emergence of more contagious variants.
Regular testing may be required for specific events with mass gathering. Undoubtedly, it is highly likely that SOPs will be here to stay for an indefinite period of time.
As for the health care system, entering an endemic phase may mean fewer admissions to the wards, especially the intensive care units, which means that hospitals can cope better.
Additionally, once a baseline number of Covid-19 cases is achieved, the government may no longer report the number of daily cases. Instead, more focus may be put towards monitoring the number of more severe cases (Categories Four and Five), ICU admissions, and deaths. Vaccinations may also continue to be a priority.
To date, researches show that the benefits of Covid-19 vaccination overwhelmingly outweigh the risks and adverse effects. With the introduction of vaccines, the chances for Malaysia to win the fight against Covid-19 have substantially improved.
If the country does eventually enter the endemic phase with no signs of the virus disappearing, the rakyat should not lose faith in this uphill battle.
We urge everyone to continue observing the SOPs, maintain confidence in our health care system and frontliners, and to regularly keep informed with factual evidence provided by experts and reliable sources. Only with firm solidarity and resolve can we prevail.
References
2. Torjesen I. Covid-19 will become endemic but with decreased potency over time, scientists believe. BMJ. 2021;372:n494.
Written by fourth year medical students of Group 4B, Community Posting Project, Faculty of Medicine, University of Malaya (Chuah Ming Li, Khaw Kar Wei, May Esther Wong Sze En, Muhammad Fikri Mohd Fadhli, Muna Syazriny Izhar, Ngan Chun Hong, Nur Rafiqah Mohd Rosdi, Pane Malar Sivaganam) under the supervision of Prof Dr Moy Foong Ming, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
