Lessons learnt for pandemic preparedness in Malaysia ― Chan Chee Khoon

1. Undocumented migrants in novel infectious outbreaks

‘Malaysia, sadly, is reaping the consequences of decades of corrupt mismanagement of the “supply chain” for foreign labour, viz. a persistently large pool of undocumented migrant workers, often in congested workplaces and dormitories, who have strong incentives to avoid contact with government agencies. 

‘Already fearful of detection, arrest, and deportation in pre-pandemic times, undocumented migrants’ insecurities were exacerbated by the policy reversals of the Majlis Keselamatan Negara (MKN) and its contradictory messaging over an offer of temporary amnesty to facilitate Covid testing, contact tracing, isolation & treatment, and vaccination.

‘This deeply rooted problem with undocumented migrants, which persists despite repeated rounds of amnesties, will prolong our catastrophic experience with Covid-19 (and future pandemics as well).’

2. Local manufacture of vaccines

‘The major bottleneck was vaccine supply.  The likelihood of further variants and endemic Covid emphasises the importance of local capacity for manufacturing vaccines and other pandemic essentials, as part of Malaysia’s pandemic preparedness.’

Read here (The Malay Mail, Sept 1, 2021) 

Beware the fifth wave of Covid-19 — Amar-Singh HSS

‘On 8th May 2021 I wrote about how to “Avoid a Covid-19 Disaster in Malaysia”. This crisis has washed over us and the toll in deaths and loss of livelihood has been and continues to be significant. I am now writing about the impending, massive fifth wave. This wave may be so big as to make the current one look pale in contrast. In a sense we have, in the fourth wave, experienced what Italy did last year. Now the fear is that we may experience what India, Peru and some other countries in South America are experiencing.

‘Some of our leaders seem to live in denial of the reality; one even saying that the pandemic in Malaysia is under control. Others have set a value of '4000 cases' as a benchmark to use, but in the face of a high positivity and limited testing this is fraught with problems. A good look at the data and trends suggest that the worst may be yet to come.’

Read here (The Malay Mail, June 25, 2021)

Should we vaccinate our children against Covid-19 in Malaysia? — Amar-Singh HSS

While we take every protective measure to prevent children from getting infected, we need to ask ourselves if we should consider vaccinating children against Covid-19. Some issues to consider the risk and the benefit are discussed below.

• How severe is Covid-19 in children? Will vaccines benefit children?
• Are Covid-19 vaccines safe to use in children?
• Are there benefits to the family and society?
• Remember that children cannot be a priority for vaccination until we first vaccinate all adults that are keen. This includes the elderly, those with chronic illness, younger adults who comprise our workforce and our migrant workers.
• What are other nations doing?

Summary

‘The pandemic impacts all of us, even those not infected. We will have to grapple with these issues as parents and a society as we decide about Covid-19 vaccination for children. How effectively we control the outbreak locally and the spread and impact of variants (mutations) will also determine our response and decision regarding this issue.

‘In Malaysia we have yet to make a serious impact on vaccination rates for those at high risk of severe illness and death (the elderly and those with chronic illnesses). No matter how much we want to support children, it is imperative that we push for those at highest risk to be vaccinated before we vaccinate children. In addition, it is vital to vaccinate young adults who are working and mobile as they are important drivers of the pandemic. However we should consider selectively vaccinating children with severe disabilities in residential care, especially if at high risk of exposure to Covid-19.

‘My personal preference would be not to subject our children to mass vaccination against Covid-19 however to control Covid-19 in the community we may have to vaccinate children aged 12-17 years. The recovery of our nation from Covid-19 means the recovery of our children from the severe mental strain that currently impacts them daily. Lives are currently being lived on a ‘pause button’ and vaccination is an important measure to return our society to a semblance of normality.’

Read here (The Malay Mail, June 6, 2021)

Some personal insights into the Covid-19 situation in Malaysia — Amar-Singh HSS

‘This article offers some personal insights into the Covid-19 situation in the country. One concern is that the public in some states behave as though the worsening outbreak is confined to the Klang Valley, or only to selected states. This is a dangerous assumption as the situation is worsening in the whole nation. The lack of adequate data hampers the public’s appropriate response to the deepening crisis.’

The following matters are discussed:

• ICUs bed occupancy is at critical levels nationwide
• Mortality rate is rising
• Younger persons are dying and mutations spreading
• When will the current outbreak peak?
• What are the implications of these trends?
• What is possibly going to happen?
• What can we do as the general public?’

Read here (The Malay Mail, May 23, 2021)

Avoid a Covid-19 disaster in Malaysia — Amar-Singh HSS

‘A Covid-19 disaster is looming in Malaysia as we watch the numbers rise. It is semantics to argue if we consider this a fourth wave or a resurgence of the third wave. What we know as a reality is that our control measures are no longer effective, deaths are increasing, younger persons are dying (some with no chronic illnesses) and our intensive care units (ICUs) are getting choked.

‘Our fear is not just death but Long Covid-19; i.e. 10-30 per cent of all adults that get infected, even with a mild illness, may suffer long term damage to organs and be debilitated for many months. It would be foolish to think that we cannot reach a state like India is in today. Don’t forget what happened to Italy early in the pandemic — they have much better health infrastructure compared to us and yet were overrun.’

Read here (The Malay Mail, May 8, 2021)

Is the first come first served vaccine rollout scientifically and ethically right? — Dr Musa Mohd Nordin

‘This narrative may not go down very well with the many young Malaysians who have successfully secured their AstraZeneca-University Oxford (AZ) doses. It was a frantic scrambling by the tech savvy for the 268,000 doses of the AZ vaccine. All vaccine doses were snapped within a space of four hours. Now that they have jumped the queue, some of them have even begun to rationalize the legitimacy of the first come first served vaccine roll out!...

‘The risk of being admitted to hospital and of dying from COVID in a 70 year old is 1786 and 906 times respectively, when compared to the risk of suffering from a blood clot.

‘Thus my suggestion to prioritize the AZ vaccine rollout in the high infection rate states, namely Sarawak, Kelantan, KL and Selangor, with the first right of refusal to the groups at the highest risk of severe COVID disease and deaths, i.e. those above 60 years old. Only when these high-risk elders have been protected, then the AZ vaccine can be offered to others. This makes medical sense and it is the ethically right response, within the context of limited vaccine supplies and the presently known risk benefit analysis.’

Read here (The Malay Mail, May 5, 2021)

Khairy: Next phase of Malaysia’s Covid-19 vaccine plan to start April 19, eligible recipients to get two weeks’ notice for appointments

‘Phase two of the National Covid-19 Immunisation Programme (PICK) will kick off on April 19, with appointment reminders sent out to eligible recipients two weeks ahead. Minister of Science, Technology and Innovation Khairy Jamaluddin said a total of 2 million people — senior citizens, high-risk groups, the chronically ill, and people with disabilities — have so far registered for vaccination under the second phase.

“We will begin issuing appointment notices through instant messaging, phone calls and MySejahtera to those who have been chosen to be listed under this second phase on April 5,” he told a press conference here. The second phase of the National Covid-19 Immunisation Programme is expected to be carried out from April to August.’

Read here (Malay Mail, Mar 29, 2021)

Covid-19 vaccination: Can we achieve herd immunity? ― Amar-Singh HSS

‘To achieve herd immunity against Covid-19, a substantial proportion of a population would need to be vaccinated but we are currently uncertain as to what this percentage is. In some diseases like measles 90-95 per cent of a population need to be vaccinated to achieve herd immunity; in others like polio we require about 80 per cent.

‘It is very likely that for Covid-19 we will require at least 75-85 per cent of the population to be vaccinated. This can be supplemented by those who had prior infection with Covid-19.’

Read here (Malay Mail, Mar 18, 2021)

March 18, 2020 and beyond: One year with Covid-19 and life under lockdown in Malaysia

‘A year has passed since Malaysia first went into a partial lockdown after the Covid-19 pandemic hit. This saw the public forced into complying with numerous unprecedented measures introduced by the government to contain the virus’ spread. Here is a recap of some of the ups and downs that the nation has survived.’

Read here (Malay Mail, Mar 18, 2020)

Khairy set to be first recipient of Sinovac Covid-19 vaccine this Thursday

‘Malaysia will start using the Sinovac Covid-19 vaccine this Thursday, with the Coordinating Minister for the National Covid-19 Immunisation Programme, Khairy Jamaluddin, becoming the first recipient of the Chinese-produced vaccine.

‘Announcing the matter in a press conference on the development of the National Covid-19 Immunisation Programme here today, Khairy said that he would receive the Sinovac vaccine at the Rembau Hospital, Negri Sembilan.’

Read here (Malay Mail, Mar 15, 2021)

Khairy: No charges for Covid-19 vaccination at private facilities

‘Individuals who get an appointment for Covid-19 vaccine injection at private hospitals or clinics involved in the National Covid-19 Immunisation Programme will not have to pay any charges, said National Covid-19 Immunisation Programme Coordinating Minister Khairy Jamaluddin. 

“The charges are borne by the government,” he told a press conference on developments involving the progamme here today. 

‘Elaborating, Khairy, who is Minister of Science, Technology and Innovation, said Covid-19 vaccination centres (PPV) are set based on the address registered by the individual through the MySejahtera application. 

“If the vaccination centre near the address given is a private hospital, then they will go to that private hospital. Everything is based on location because we want to facilitate this immunisation programme,” he said.

Read here (Malay Mail, Mar 15, 2021)

Fake news law is government’s attempt to silence voice of every citizen — National Union of Journalists Peninsular Malaysia

‘The National Union of Journalists Peninsular Malaysia (NUJM) expresses its grave concern over the  government’s move to gazette an ordinance purportedly to combat “fake news” relating to Covid-19 or  the Emergency proclamation. NUJ Malaysia is not agreeing to this kind of step backwards action taken as it seems like the ruling  government is trying to silent the voice of every citizen regardless of their race, religion or various  background.

‘We called on the government’s plan of setting up the Media Council to be revived and accelerate just to tackle any issues regarding to media practitioners especially journalists who are in the frontline. The union is in the view that Media Council can also be in charge of looking into the alleged fake news crime committed instead of the government having to gazette new laws to tackles this. This in turn will  display transparency over the alleged crime committed.’

Read here (Malay Mail, Mar 12, 2021)

I’m alive today because of our healthcare frontliners! — Joseph Ong See Sung

‘While at the hospital, I also made many friends among the patients. I was touched by what I saw. Everyone in the ward was helping one another. There was no racial barrier. Everyone took turns to look out for one another. I told myself — this should be the Malaysia that we should have, not one that’s divisive and ruined by people with selfish interests! 

‘I saw one very filial son who was with his father. Both had Covid-19. But this young man, despite being down with the virus, made all efforts to care for his father, who even suffered a stroke there! 

‘Every minute of my waking hour there, I saw people putting aside their personal and ethnic differences to help anyone within their sight! It warmed my heart and spurred me to get better so that I can tell the outside world that people were so caring at the hospitals. Both frontliners and patients! Why can’t more people be like that?’

Read here (Malay Mail, Mar 5, 2021)

Don’t let private hospitals jump the vaccination queue ― no special privileges for the rich! ― Suaram

‘Suara Rakyat Malaysia (Suaram) believes that the commercialisation of the Covid-19 vaccination by the private hospitals would only encourage “queue-cutting” where the rich and powerful stands to gain and potentially undermine the government's national programme and weakens social solidarity.

‘Furthermore, allowing private hospitals to procure vaccines and subsequently running their own vaccination programme also contradicts the principles of giving everyone an equal opportunity in the country’s largest vaccination programme ever.’

Read here (Malay Mail, March 3, 2021)

Don’t rush vaccine passports, address fundamental issues ― Ameen Kamal

‘As it would take time for nations to reach herd immunity, mechanisms to help re-open the economy and international borders such as health passports have been met with increased enthusiasm and strong support from economic sectors.

‘However, issues related to immunological uncertainties, social-ethical concerns related to its implementation as well as operational challenges in global standardisations have to be addressed in order for vaccine passports to be effective.’

Read here (Malay Mail, March 2, 2021)

Malaysian company develops Covid-19 rapid test kits that can deliver results under 20 minutes

‘A homegrown diagnostic solution start-up has developed a digital rapid Covid-19 test kit — dubbed APTSENS — that can upload test results in real-time with geo-location data to cloud servers via a mobile app.

‘Biogenes Technologies, a startup in the field of molecular diagnostics and genomics, said that APTSENS is a simple-to-use kit consisting of Covid-19 single-use sensor chip, portable electronic reader and collection swab that can produce test results in under 20 minutes.’

Read here (Malay Mail, Feb 26, 2021)

Pre-empting the anti-Covid-19 vaccine propaganda ― Amar-Singh HSS, Alan Teh Kee Hean, Lim Joo Kiong, Nor Azmi Kamaruddin and Lim Swee Im

‘This is a brief article to help us understand that there will be some expected deaths after receiving Covid-19 vaccination, especially in the elderly. The aim of the article is to pre-empt the anti-vaccine lobby and any attempt to damage our national Covid-19 vaccination programme. We will use data from the United Kingdom (UK), United States of America (USA) and the European Union (EU) to explain what we mean...

‘It is important for the public to understand this as we embark on our national Covid-19 vaccination programme. Some of our loved ones may die after the vaccination but this will likely NOT be due to the vaccination. As members of the public we should stay abreast of the science and data as it emerges and not fall prey to rumours or anti-vaccine propaganda.’

Read here (The Malay Mail, Feb 23, 2021)

Malaysia’s National Covid-19 Immunisation Plan: The missing details — Ezzaty Hasbullah

‘The Malaysian Government has recently published its National Covid-19 Immunisation Programme (NIP) outlining its strategy to achieve coverage by February of 2022. Though the document gives a good overview of the country’s vaccination plan from procurement to vaccination, it omits the minute execution details on several aspects along this value chain. The missing details:

• Trust building and outreach
• Ensuring equity in access
• Task-shifting and training
• Strengthening digital infrastructure

‘What the NIP gives is a general overview of the immunisation efforts in the months to come. What it does not give are the particulars in each step towards achieving this goal. More information on the actual particulars in realising this strategy has to be made available for public scrutiny — if such particulars are even available. These details could be the differentiating factors in determining Malaysia’s success or failure to achieve its 2022 immunisation targets because, as always, the devil is in the details.’

Read here (Malay Mail, Feb 17, 2021)

Khairy: Non-citizens to receive free Covid-19 vaccines to ensure everyone is safe

‘Malaysia will only be safe from the Covid-19 pandemic if the people, including foreign citizens living here, receive the vaccines, said Science, Technology and Innovation Minister Khairy Jamaluddin. He said that even if Malaysians were to receive the vaccines, it would not mean they are safe because Malaysia has about three million foreigners who are likely to cause the virus to spread and infect Malaysians.

“That is why this (giving free vaccines to non-citizens) needs to be done because we are not safe until everyone is safe. In vaccine science, if there are more vaccine recipients, then we are safe and the virus cannot infect others. As such, we are targeting 80 per cent of the population to create group immunity and form enough antibodies so that the virus does not infect people in the country. If we (locals) are the only recipients, we will not be safe because they (foreigners) may still infect us, or the virus could spread among the foreigners. That is why it is important that we protect everyone. This is the right decision for the sake of humanity,” he said.’

Read here (Malay Mail, Feb 12, 2021)

Khairy: Registration for Covid-19 vaccination to start in March

‘Registration for Covid-19 vaccination to members of the public is expected to kick off in March and this will be on a volunteer basis, said Science, Technology and Innovation Minister Khairy Jamaluddin. 

He said there are five ways for the public to sign up for the vaccine, including via the MySejahtera application. “If they have no access to MySejahtera, they may go to the JKJAV (Covid-19 Vaccine Supply Access Guarantee Special Committee) website, which will be launched by the prime minister next week.

“In addition there is the hotline (number to be fixed later), manual registration at public and private clinics and hospitals, and lastly, for people living in the rural areas, we will be working with the state government to get them to register the recipients including senior citizens,” he said during the Ruang Bicara programme aired on Bernama TV, yesterday...

‘The first phase, from February to April, is for the 500,000 frontliners who are directly involved in the fight against Covid-19, while the second phase, from April to August, for the high-risk group, comprising senior citizens aged 60 and above and the vulnerable group with morbidity problems, such as heart disease, obesity, diabetes and high blood pressure, as well as persons with disabilities (PwD).

‘The third phase is from May to February next year and it is for those aged 18 and above.’

Read here (Malay Mail, Feb 12, 2021)