Living with Covid-19 – Is Malaysia ready? — Dr Amar-Singh HSS

‘In recent days and weeks, there have been statements made about moving from a Covid-19 pandemic state to an endemic phase by the end of October 2021. The argument for this is that higher adult vaccination rates will be achieved nationwide by that time. So we need to ask this question: Is Malaysia ready to move to an endemic phase by the end of October 2021? I would like to describe some ‘movements’ we need to make as a nation for us to be ready to enter an endemic phase, as well as offer you a ‘report card’ of our preparedness measures.

• Move from looking at adult vaccination rates to total population vaccination rates
• Move away from herd immunity concepts to mitigating outbreaks
• Move from vaccinating adults to vaccinating children (before reopening schools)
• Move from SOPs to a sustainable change in lifestyle, move from external enforcement to societal checks, and move from dependence on vaccines to using all tools and mitigation measures
• Malaysia’s report card on its preparedness in entering a Covid-19 endemic phase

Three possible ‘phases’ impending

‘Finally, a note about what is to come. No one can predict what will happen with Covid-19, but after hearing international experts and looking at our situation, I would like to offer some ideas.

‘We are currently in what I call the primary protection phase, whereby we are racing against Delta and trying to complete adult vaccination. Many states outside the Klang Valley are in trouble, and we are starting to see rising cases of children hospitalised nationally.

‘We will then move to what I call a consolidation phase, where we try to increase societal protection and reduce the spread of Covid-19 by vaccinating teenagers. Meanwhile, we have to look at the data carefully for any signs of waning immunity, and if adult boosters are required.

‘We then enter a phase I call the long-term danger phase. Here is where we must not let down our guard and risk more outbreaks, especially if worse variants appear. We can do this by a change in lifestyle to address the long term Covid-19 journey. There may be a need to invest in new vaccines.’

Read here (Code Blue, Sept 6, 2021)

When will the Covid-19 pandemic end? McKinsey & Co update August 2021

‘This article updates our perspectives on when the coronavirus pandemic will end to reflect the latest information on vaccine rollout, variants of concern, and disease progression. Among high-income countries, cases caused by the Delta variant reversed the transition toward normalcy first in the United Kingdom, during June and July of 2021, and subsequently in the United States and elsewhere. Our own analysis supports the view of others that the Delta variant has effectively moved overall herd immunity out of reach in most countries for the time being. The United Kingdom’s experience nevertheless suggests that once a country has weathered a wave of Delta-driven cases, it may be able to resume the transition toward normalcy. Beyond that, a more realistic epidemiological endpoint might arrive not when herd immunity is achieved but when COVID-19 can be managed as an endemic disease. The biggest overall risk would likely then be the emergence of a significant new variant.’

Read here (McKinsey & Co, August 23, 2021)

How the pandemic now ends: Ed Yong

‘Pandemics end. But this one is not yet over, and especially not globally. Just 16 percent of the world’s population is fully vaccinated. Many countries, where barely 1 percent of people have received a single dose, are “in for a tough year of either lockdowns or catastrophic epidemics,” Adam Kucharski, the infectious-disease modeler, told me. The U.S. and the U.K. are further along the path to endemicity, “but they’re not there yet, and that last slog is often the toughest,” he added. “I have limited sympathy for people who are arguing over small measures in rich countries when we have uncontrolled epidemics in large parts of the world.”

‘Eventually, humanity will enter into a tenuous peace with the coronavirus. COVID-19 outbreaks will be rarer and smaller, but could still occur once enough immunologically naive babies are born. Adults might need boosters once immunity wanes substantially, but based on current data, that won’t happen for at least two years. And even then, “I have a lot of faith in the immune system,” Marion Pepper, the immunologist, said. “People may get colds, but we’ll have enough redundancies that we’ll still be largely protected against severe disease.” The bigger concern is that new variants might evolve that can escape our current immune defenses—an event that becomes more likely the more the coronavirus is allowed to spread. “That’s what keeps me up at night,” Georgetown’s Shweta Bansal told me.

‘To guard against that possibility, the world needs to stay alert. Regular testing of healthy people can tell us where the virus might be surging back.’

Read here (The Atlantic, August 12, 2021)

When will life return to ‘pre-Covid normal’?

‘A majority of people expect life to return to something like 'normal' within the next 12 months, according to a new World Economic Forum-Ipsos survey. There are large differences between countries on this, though. The pandemic has also impacted people's emotional and mental health...

‘Differences emerged around the world about the return to something like a pre-COVID normal. Although more than half think it'll happen within the next 12 months, one-in-five think it will take more than 3 years, while 8% don't think it'll happen at all. Opinions on when the pandemic will be contained also closely matched opinions on a return to normal - suggesting that people believe the two to be closely linked.

‘On average, 58% of those surveyed expect the pandemic to be contained within the next year. Some countries - India, mainland China and Saudi Arabia, for example - are more optimistic. But, four-in-five in Japan and more than half in countries including Australia and Sweden expect it will take more than a year for the pandemic to be contained.’

Read here (World Economic Forum, Apr 12, 2021)

The “unvaccinated” question

‘So, the New Normals are discussing the Unvaccinated Question. What is to be done with us? No, not those who haven’t been “vaccinated” yet. Us. The “Covidiots.” The “Covid deniers.” The “science deniers.” The “reality deniers.” Those who refuse to get “vaccinated,” ever.

‘There is no place for us in New Normal society. The New Normals know this and so do we. To them, we are a suspicious, alien tribe of people. We do not share their ideological beliefs. We do not perform their loyalty rituals, or we do so only grudgingly, because they force us to do so...

‘No, the Unvaccinated are not the Jews and the New Normals are not flying big Swastika flags, but totalitarianism is totalitarianism, regardless of which Goebbelsian Big Lies, and ideology, and official enemies it is selling. The historical context and costumes change, but its ruthless trajectory remains the same.

‘Today, the New Normals are presenting us with a “choice,” (a) conform to their New Normal ideology or (b) social segregation. What do you imagine they have planned for us tomorrow?’

Read here (Off Guardian, Mar 29, 2021)

The new normal (Phase 2)

‘So, we’re almost a year into the “New Normal” (a/k/a “pathologized totalitarianism”) and things are still looking … well, pretty totalitarian. Most of Western Europe is still in “lockdown,” or “under curfew,” or in some other state of “health emergency.” Police are fining and arresting people for “being outdoors without a valid reason.”  Protest is still banned. Dissent is still censored.

‘The official propaganda is relentless. Governments are ruling by edict, subjecting people to an ever-changing series of increasingly absurd restrictions of the most fundamental aspects of everyday life.

‘And now, the campaign to “vaccinate” the entirety of humanity against a virus that causes mild to moderate flu-like symptoms or, more commonly, no symptoms at all, in over 95% of those infected, and that over 99% of the infected survive (and that has no real effect on age-adjusted death rates, and the mortality profile of which is more or less identical to the normal mortality profile) is being waged with literally religious fervor.

“Vaccine passports” (which are definitely creepy, but which bear no resemblance to Aryan Ancestry Certificates, or any other fascistic apartheid-type documents, so don’t even think about making such a comparison!) are in the pipeline in a number of countries. They have already been rolled out in Israel.’

Read here (OffGuardian, Mar 9, 2020)

Late-stage pandemic is messing with your brain

‘This is the fog of late pandemic, and it is brutal. In the spring, we joked about the Before Times, but they were still within reach, easily accessible in our shorter-term memories. In the summer and fall, with restrictions loosening and temperatures rising, we were able to replicate some of what life used to be like, at least in an adulterated form: outdoor drinks, a day at the beach. But now, in the cold, dark, featureless middle of our pandemic winter, we can neither remember what life was like before nor imagine what it’ll be like after.

‘To some degree, this is a natural adaptation. The sunniest optimist would point out that all this forgetting is evidence of the resilience of our species. Humans forget a great deal of what happens to us, and we tend to do it pretty quickly—after the first 24 hours or so. “Our brains are very good at learning different things and forgetting the things that are not a priority,” Tina Franklin, a neuroscientist at Georgia Tech, told me. As the pandemic has taught us new habits and made old ones obsolete, our brains have essentially put actions like taking the bus and going to restaurants in deep storage, and placed social distancing and coughing into our elbows near the front of the closet. When our habits change back, presumably so will our recall.’

Read here (The Atlantic, Mar 8, 2021)

The end of Covid-19 pandemic? Johns Hopkins’ Dr Makary says probably

‘A February 18 Opinion piece in the Wall Street Journal is raising hopes, and possibly healthy skepticism, with its title and thesis being: “We’ll Have Herd Immunity by April.” The author is Dr. Martin Makary, a professor of health policy and management and public health expert at Johns Hopkins University. He notes that the media is under reporting on the dramatic fact that COVID-19 cases are down 77 percent just in the last six weeks. Largely this is, “because natural immunity from prior infection is far more common than can be measured by testing.” 

‘Applying some statistics to the case data, we could deduce the around 55 percent in the US have natural immunity. At the same time, vaccinations have been rolling out, and 15 percent of Americans have gotten a vaccine with the percentage rising fast. Based on these factors, “There is reason to think the country is racing toward an extremely low level of infection. As more people have been infected, most of whom have mild or no symptoms, there are fewer Americans left to be infected. At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life.”

Read here (TrialSiteNews, Feb 20, 2021)

Even with a vaccine, Covid-19 will last for years in the US, expert says

‘I think, even if the vaccine or several vaccines are invented in the next few months, which is likely, we still have challenges in manufacturing, distributing and persuading the public to accept the vaccine. And those challenges will take about a year. And, meanwhile, the virus is still spreading, and it will continue to spread until we reach a threshold of about 40 to 50 percent of Americans who are infected. Right now, we're only at about 10 percent. That threshold is known as the herd immunity threshold.

‘So, that will take us into 2022. So, from my perspective, the first period during which we're confronting the biological and epidemiological impact of the virus, and we're living in a changed world, wearing masks, physical distancing, school closures, and so on, will last until sometime in 2022. And then we're going to begin a second period, when we are recovering from the psychological, social and economic shock of the virus. And this has been seen for thousands of years with other epidemics. And that will take a couple of years for us to rebuild our economy and recover.

‘And so, sometime in 2024, I think, life will slowly begin to return to normal, with some persistent changes.’

Read here (PBS News Hour, Nov 12, 2020)

The long shadow of the pandemic: 2024 and beyond

‘Even when the world returns to ‘normal,’ the legacy of Covid-19 will transform everything from wages and health care to political attitudes and global supply chains...

‘One impact of the Covid-19 pandemic may be that society will begin to take scientists and scientific information more seriously. In medieval times, the manifest inability of rulers, priests, doctors and others in positions of power to control the plague led to a wholesale loss of faith in corresponding political, religious and medical institutions, and a strong desire for new sources of authority.

‘It is possible that the inability of our political institutions to fight the virus will have similar implications. The public’s expectation of effective state action will likely rise in the immediate and intermediate periods, if deaths continue or accelerate. And if the response continues to be incompetent, confidence in existing political institutions will fall. The many failures of American government at every level in confronting the pandemic, especially when compared with other countries, may result in a shift in political preferences aimed at undoing the existing order.’

Read here (Wall Street Journal, Oct 16, 2020)

Young and healthy? You may have to wait until 2022 for a Covid-19 vaccine, experts warn

‘Young and healthy people should be prepared to wait their turn for immunization, experts warned this week. The World Health Organization’s chief scientist suggested that the delay could last well over a year for some among the young and healthy. “People tend to think, ah, on the first of January or the first of April, I’m going to get a vaccine and then things will be back to normal,” Soumya Swaminathan said in an online WHO question-and-answer session on Wednesday. “It’s not going to work like that."

Read here (Washington Post, Oct 16, 2020)

When will the Covid-19 pandemic end?

Normalcy by spring, and herd immunity by fall? This McKinsey & Co article assesses the prospects for an end to the pandemic in 2021.

‘More than eight months and 900,000 deaths into the COVID-19 pandemic,1 people around the world are longing for an end. In our view, there are two important definitions of “end,” each with a separate timeline:

• An epidemiological end point when herd immunity is achieved.
• A transition to a form of normalcy. 

‘Both the epidemiological and normalcy ends to the COVID-19 pandemic are important. The transition to the next normal will mark an important social and economic milestone, and herd immunity will be a more definitive end to the pandemic. In the United States, while the transition to normal might be accomplished sooner, the epidemiological end point looks most likely to be reached in the second half of 2021. Other advanced economies are probably on similar timetables.’

Read here (McKinsey & Co, Sept 21, 2020)

As more local lockdowns begin, the hard truth is there’s no return to ‘normal’ [comment on Britain]

‘As well as the risk Covid poses to individuals, our actions affect others including vulnerable and elderly people. Think of it as a chain of infections – if you are a part of this and it gets passed on, others may become ill and die because of your role in that chain. A wedding in Maine resulted in more than 170 people contracting the virus, and seven people dying. None of those who died attended the wedding...

‘Nine months after South Korea and Senegal started building diagnostic capacity, it is comically depressing that the UK government, one of the richest in the world, does not have a functional testing system that returns results within 24 hours. In addition, given that we know the virus spreads easily through households, those who test positive should have the offer to isolate in external facilities (such as hotels). The “14-day isolation” measures for people entering the UK are also a box-ticking exercise where given the lack of screening or monitoring, a constant stream of infections keep coming into the country. It’s like trying to empty a bucket under a tap.’

Read here (The Guardian, Sept 21, 2020) 

There is no ‘new normal’: We were not normal to begin with

‘We would like to say that there is no ‘new normal’ because we were not normal to begin with. We have been abnormal as a society for a very long time. The coronavirus has helped to unmask our sick society and systems that we have developed and evolved over many decades. Greed, corruption, power hunger, control, oppression, lies and self-interest have become the hallmarks of our present society, and in most nations. While there are altruistic individuals and some who are trying to improve the situation, many are caught in the chase for wealth and power. Most have become cynical, hope-less and weary.’

Read here (The Malay Mail, August 30, 2020)

Beijing's partial coronavirus lockdown a sign of the world's new normal

‘Party officials in charge of Beijing, including the city's party secretary, Mr Cai Qi, have sounded chagrined about the flare-up. "The lessons run very deep, the situation for epidemic control is very grim, and this has sounded a warning to us," said an official summary of a city leaders' meeting carried by The Beijing Daily on Wednesday.

‘Most Beijing streets flowed with traffic on Wednesday, though less than usual, and the public mood appeared resigned rather than panicked. Restaurants still opened, though the government has ordered them to disinfect and check employees.’

Read here (Straits Times, June 18, 2020)

Working life has entered a new era: Farewell BC (before coronavirus). Welcome AD (after domestication)

‘Without the Monday-to-Friday commute, the weekend seems a more nebulous concept, as does the 9-to-5 working day. In future employees may work and take breaks when they please, with the company video call the only fixture. The downside, however, is that the rhythm of life has been disrupted and new routines are needed: as Madness, a British pop group, sang about school in “Baggy Trousers”, people are reduced to “trying different ways to make a difference to the days”.’

Read here (The Economist, May 30, 2020)

Coronavirus may never go away, even with a vaccine

‘It is a daunting proposition — a coronavirus-tinged world without a foreseeable end. But experts in epidemiology, disaster planning and vaccine development say embracing that reality is crucial to the next phase of America’s pandemic response. The long-term nature of covid-19, they say, should serve as a call to arms for the public, a road map for the trillions of dollars Congress is spending and a fixed navigational point for the nation’s current, chaotic state-by-state patchwork strategy.’

Read here (Washington Post, May 28, 2020)

Coronavirus is the practice run for schools. But soon comes climate change

‘By finding ways to continue learning through the pandemic, the education system will be better equipped for a future marked by severe weather emergencies... Schools are still scrambling simply to cope with the immediate coronavirus crisis and meet students’ basic needs, but the next school year could present opportunities to rethink how remote learning happens... One big step forward would be universal broadband access... Another is making sure teachers receive training on distance learning, through programs that prepare them for the profession as well as through ongoing professional development... Education systems will also have to adjust how they assess students and schools. Measures like seat time and attendance just won’t work the same way in a world facing so much disruption.’

Read here (Huffington Post, May 23, 2020)

8 ways Covid will transform the economy and disrupt every business

‘In this report, we look at eight major trends underway in the world, and pinpoint the possibilities for savvy business operators, investors and innovators. We all know how much our lives have changed, and how we’re not likely to go back to our old ways. We’ll be more cautious but we also may be more creative. As history likes to remind us, with unprecedented times come unprecedented opportunities.’

Read here (RBC Thought Leadership, May 22, 2020)

‘Normal’ life failed us. The coronavirus crisis gives us the chance to rethink a new economy

’The basics hardly involve a huge leap of imagination: to some extent, they mix what might be salvaged from recent Labour politics with ideas that have long been in circulation way beyond the traditional left. The lives of people at the bottom of most socio-economic hierarchies will soon need to be lastingly improved, perhaps via an initial minimum income guarantee of the kind embraced by the coalition government in Spain. Given that we are unlikely to be able to revive a featherweight labour market based around retail and services, the time ought to be ripe for the economy to be pushed at last towards a green new deal, and the revival of manufacturing.’

Read here (The Guardian, May 17, 2020)