Experts question relevance of SafeEntry, TraceTogether amid endemic Covid-19

‘Infectious diseases experts have questioned the need for continued widespread enforcement of TraceTogether and SafeEntry rules as Singapore moves towards more targeted contact tracing and living with endemic Covid-19. They noted that while daily new cases continue to number in the thousands, the vast majority of the population eligible for vaccination – 94 per cent – is fully vaccinated and most will show mild or no symptoms if infected. Extensive contact tracing, as was done in the early days of the pandemic, is no longer practical or necessary, they added.’

Read here (Straits Times, Nov 22, 2021)

Covid: The countries that nailed it, and what we can learn from them

‘I have reported on Covid for the past year - now my mission was to find out from global leaders and senior health officials across four continents what their priorities were in tackling the virus.

‘What has emerged strongly for me are four key areas which have been most effective in containing the spread of the virus and preventing deaths.

• Early and effective action to control borders and monitoring of arrivals
• Testing, tracking and tracing everyone suspected of being infected
• Welfare support for those in quarantine to contain the virus
• Effective leadership and consistent and timely public messaging

Read here (BBC, Mar 22, 2021)

Coronavirus fact-check #10: Why “new cases” are plummeting... ‘It's not vaccines, it's not lockdown’

‘Essentially, in two memos the WHO ensured future testing would be less likely to produce false positives and made it much harder to be labelled an “asymptomatic case”.

‘In short, logic would suggest we’re not in fact seeing a “decline in Covid cases” or a “decrease in Covid deaths” at all.

‘What we’re seeing is a decline in perfectly healthy people being labelled “covid cases” based on a false positive from an unreliable testing process. And we’re seeing fewer people dying of pneumonia, cancer or other disease have “Covid19” added to their death certificate based on testing criteria designed to inflate the pandemic.’

Read here (Off Guardian, Feb 26, 2021)

How much testing is enough? It’s complicated

‘One of the key measures of a country’s Covid-19 response is how much testing is done. The more cases in the community, the greater the need to expand testing to keep pace with the outbreak. But just how much testing is enough?

‘At a press conference on Tuesday, Health Ministry director-general Dr Noor Hisham Abdullah said the benchmark set by the World Health Organisation (WHO) is to have at least ten negative tests for every person found to be positive. In other words, the test positivity rate should be no higher than about 10 percent. Any higher, it suggests many cases are being missed.

‘However, several sources including health experts quoted in previous Malaysiakini reports had instead cited a five percent figure as the benchmark to meet. One source, the website "Our World in Data", even cited WHO for setting it as the benchmark. So, who is right? And how did different sources attribute different numbers to WHO?’

Read here (Malaysiakini, Feb 17, 2021)

Safely reopening requires testing, tracing and isolation, not just vaccines

‘The Moderna and Pfizer vaccines were developed in record time. However, these announcements highlight significant challenges: delivering two-dose vaccines with stringent cold-chain requirements to almost eight billion people, many of whom reside in communities with underfunded and strained health systems, is no small feat. Even if we address the logistical challenges, the reality is that it takes time and funding to deliver vaccines, treatments and tests that reach everyone in need. It is a sobering reminder that when lifesaving antiretrovirals were introduced for HIV-positive people, it took seven years before the medicine reached the poorest communities. And during that time, millions of people died, and millions more were infected, and the HIV pandemic continued to grow.

‘Until we can overcome these obstacles and ensure equitable delivery of vaccines and treatments once available across the globe, the fundamentals of controlling this virus remain as important as ever.

‘For a long time, many countries will continue to rely on already proven tools to control the pandemic. The formula is simple: test, trace and isolate. This straightforward but effective process is key to safely reopening economies and societies. It is made possible through the rapid and equitable scale-up of diagnostics, which have proven to be the most important tool for limiting the spread of COVID-19. Test, trace and isolate—and ultimately test, trace and treat once more treatments become available—is an efficient, sustainable way to control the virus, especially in contrast to last-resort emergency lockdown measures, which can erode the public support and trust necessary for the success of many other helpful public health measures, including vaccination and mask-wearing.

‘We have seen this strategy implemented successfully around the world for decades with age-old diseases like tuberculosis. This strategy is also making a difference in the fight against COVID-19.’

Read here (Scientific American, Feb 9, 2021)

Four principles for urgent pharma action to combat Covid-19

‘Collaboration is needed between pharmaceutical companies and governments to combat the spread of COVID-19 and accelerate access to tests, treatments and vaccines. Norway, which co-chairs the Facilitation Council of the ACT-Accelerator, is committed to ensuring the global vaccination effort is managed effectively. Here are four principles which could ensure equitable access to COVID-19 tools and health products, particularly for low and middle-income countries:

• Principle 1: File for registration rapidly, widely and on the basis of the most rigorous standards
• Principle 2: Price health technologies fairly
• Principle 3: Expand production and supply capacity
• Principle 4: Transparency

Read here (World Economic Forum, Feb 9, 2021)

MCO 2.0 should have been tool of last resort, says ex-deputy defence minister Liew Chin Tong

‘The current movement control order (MCO) would not have to be implemented if the Health Ministry (MOH) had properly conducted Covid-19 tracing and screening as far back as April last year, according to deputy defence minister Liew Chin Tong. The DAP senator said a whole-of-government approach from the start, rather than one that placed the burden solely on the MOH, would have prevented the current high number of infections in the country.

“To put it into context, it doesn’t inspire confidence if halfway into a war, the army general (in this case, the Health DG) complained to the media that the air force (the other health institutions/labs) has forgotten to provide for air cover,” Liew said on his Facebook page today. He was referring to Health director-general Tan Sri Dr Noor Hisham Abdullah’s recent statement that MOH labs have nearly reached their maximum capacity of 76,000 Covid-19 tests daily, even as there is a need to increase screening to between 150,000 to 200,000 tests daily.

“Dr Noor Hisham lamented that so far the testing capacity at university hospitals was at 27 per cent, private laboratories (31 per cent) and laboratories in the Malaysian Armed Forces hospitals (24 per cent). These facilities are underutilised and could increase their capacity up to 100 per cent to achieve the daily test target.’

Read here (Malay Mail, Feb 7, 2021)

Covid-19: It’s all doom and gloom unless… — Dr Musa Mohd Nordin

‘There is much misunderstanding about the Covid-19 situation in the country. In particular, the high rates in the Klang Valley and the role of the only state task force, the Selangor Task Force on Covid-19 (STFC)...

‘In many ways, if the STFC had not stepped in, did mass testing, rolled out POIS (Prevention of Outbreaks at Ignition Sites), allocated Z millions for FTTIS (find, test, trace, isolate, and support), the situation in Selangor would be far worse, critical even...

‘And other states, industries, agencies, etc, are buying in STFC’s POIS programme and implementing it. This tripartite initiative between government-industry-NGOs pivots on three preventative strategies namely, enhanced public health measures, early detection testing regime and health education. So STFC doesn’t just talk but rolls out programmes, mass testing, POIS, procuring vaccines, etc, to end the pandemic...

‘At the end of the day, we are in it together. If we refuse to learn from each other and operationalise the best public health practices, we are in for a rough ride.

‘I hope the national task force, as petitioned by the 46 top physicians, is rapidly recognised, accepted, and formalised to empower it to immediately re-strategise and transform the mindset, and policy at the top end of the Health Ministry, so that the operations at ground zero will be a truly rapid-response FTTIS which has zero-tolerance for cases, clusters or outbreaks.

‘MCOs are the blunt tools of those who have failed to operationalise the back-to-basics of pandemic management and in my opinion, they should either seek a second opinion from the task force and/or gracefully exit to minimise further harm to the nation and allow the task force to steer the nation out of this Covid-19 conundrum and to protect the lives and livelihood of its rakyat.’

Read here (Malaysiakini, Jan 30, 2021) 

Vaccines have been oversold as the pandemic exit strategy

‘Covid will be around for a long time — virus suppression is the right policy...

‘If regions with raging transmission do act as breeding grounds for resistant variants, then failing to control spread will prolong the pandemic. Prof de Oliveira stresses that Taiwan, China, Australia and New Zealand, which have chased elimination, are the role models to follow. “This should be a wake-up call for all of us to control transmission, not just in our own regions but globally. This virus will keep outsmarting us if we don’t take it very seriously,” he says.

‘That means not just vaccinating but fast testing, accurate and quick contact tracing, quarantine and isolation. In short, vaccination must go hand-in-hand with virus suppression, not become a substitute for it. A successful vaccine rollout will count for little if the country then becomes a crucible for resistant variants.’

Read here (Financial Times, Jan 26, 2021)

FTTISI:The bedrock of Covid-19 infection control — Dr Musa Mohd Nordin and Dr Mohammad Farhan bin Rusli

‘The key element in the blueprint of action to mitigate this Covid-19 national emergency, must surely be a well executed Find, Test, Trace, Isolate and Support (FTTIS) system recommended by the WHO, which has fallen terribly short in national implementation.

‘The FTTIS system Finds and Tests hotspots of Covid-19 outbreaks. Rapid Isolation of cases and quarantine of close contacts through Tracing is extremely critical. Isolation will only work if the rakyat, especially the B40, receive Support during the MCO period with food security and financial Support.

‘The government through its relevant ministries and agencies must provide this social security net and support to this new policy of home isolation to ensure its success. Otherwise, the rakyat will fail to comply with home isolation, in order to search for and put food on the table and scour for basic home essentials. The government already has in place Low Risk Isolation Centres for households who are unable to effectively isolate at home.

‘Clinical support is also vital for monitoring the health of cases and contacts who are undergoing home isolation in the community.’

Read here (Malay Mail, Jan 15, 2021)

As system buckles, MOH cuts down testing of close contacts

‘With the healthcare system at breaking point due to the surge in the number of Covid-19 patients, the Ministry of Health is trying several new approaches to ease the burden. Yesterday, the ministry issued a new circular containing changes in contact tracing and priority for swab tests.

‘According to Health Ministry sources, they would no longer test every individual identified as close contacts to Covid-19 positive patients and instead only test those with symptoms. "All close contacts must be identified, ordered to undergo isolation and monitoring at home. However, Covid-19 screening test would be done only on close contacts who are symptomatic," said the notice sighted by Malaysiakini.’

Read here (Malaysiakini, Jan 14, 2020)

Inside Britain's test-and-trace: How the ‘world beater’ went wrong

‘The name NHS Test and Trace sounds like it is one whole service that is part of the NHS. Nothing could be further from the truth. It is a complex web of different programmes, led by the civil service, that have been bolted together rapidly. Private firms play a key role in terms of both testing and tracing, which has meant some of the local expertise available in the NHS, universities and councils has been bypassed.’

Read here (BBC, Nov 20, 2020)

Three Australian kids baffle doctors after developing Covid antibodies without ever testing positive: Study published in Nature Communications

‘The kids – aged six, seven and nine – took the COVID-19 test and the results were negative. “It was jaw-droppingly amazing because they'd spent a week and a half with us while we were COVID-positive,” added the mother. While two kids had mild symptoms, one daughter remained completely asymptomatic. They were tested again, just to get negative results. This continued for several weeks, until everyone in the family tested negative.

‘What surprised the doctors was when the results came negative despite the polymerase chain reaction (PCR) tests of the kids showing antibodies of Sars-CoV-2. This definitely caused curiosity as the kids never tested positive for the virus. While the researchers are keen to do a further study on the immune response of the kids, paediatrician Shidan Tosif from the University of Melbourne said, “The fact these children were able to shut down the virus and without even showing a positive test result suggests they have some level of their immune system which is able to respond and deal effectively with the virus, without them ever becoming very unwell.”

Read here (Yahoo News, Nov 19, 2020)  

How Biden plans to change the US pandemic response

‘President-elect Joe Biden and Vice President-elect Kamala Harris say they will move the US Covid-19 pandemic response in a dramatically different direction... Here are five ways Biden says the US coronavirus response will change when he's President. (1) Increased testing and contact tracing. (2) Additional investment in vaccines and treatments. (3) Mandatory masks and more PPE. (4) A push for 'clear, consistent, evidence-based guidance'. (5) Rejoining WHO and searching for future threats.

‘There were dauntingly high new case numbers last week, and by the time Biden takes office January 20, the influential University of Washington Institute of Health Metrics and Evaluation model projects there will be more than 372,000 Covid-19 deaths -- that's 135,000 more than the current total...’

Read here (CNN, Nov 9, 2020)

Coronavirus: The Swiss Cheese Strategy -- Tomas Pueyo

‘There are the four layers to stop the spread of the virus: Fences, Bubbles, Contrafection, and Test-Trace-Isolate. None of them is perfect. All have holes that let infections pass. But together they form an impenetrable defence.

‘An infection might be able to pass one layer, or even two. But if there are several, the odds that the infection goes through every layer undetected becomes minuscule. Imagine, for example, that a country has a Fence that catches 80% of infections, no Social Bubbles, Reduced Contagiousness that eliminates 95% of infections, and a test-trace-isolate that neutralizes 50% of infections. Together, these layers catch 99.5% of cases. If the transmission rate R is 3 (the number of people infected by a source), it will be reduced to 0.015! Every infected person only infects an additional 0.015 people, killing the epidemic within a few weeks.’

Also...

• How the US and the EU failed to control the virus, and how comparable countries succeeded.
• How you can make sense of all the necessary measures with one simple idea.
• Why the West’s testing and contact tracing is largely useless — and what they can do about it.
• The questions that journalists and the People must ask politicians to keep them accountable.
• How you can stop the virus in your own community, without the need of your government.

Read here (Medium, Nov 9, 2020) 

Taiwan just went 200 days without a locally transmitted Covid-19 case. Here's how they did it

‘As much of the world struggles to contain new waves of the Covid-19 pandemic, Taiwan just marked its 200th consecutive day without a locally transmitted case of the disease. Taipei's response to the coronavirus pandemic has been one of the world's most effective. The island of 23 million people last reported a locally transmitted case on April 12, which was Easter Sunday. As of Thursday, it had confirmed 553 cases -- only 55 of which were local transmissions. Seven deaths have been recorded.’

Read here (CNN, Oct 30, 2020)

Artificial intelligence model detects asymptomatic Covid-19 infections through cellphone-recorded coughs

‘In a paper published recently in the IEEE Journal of Engineering in Medicine and Biology, the [MIT] team reports on an AI model that distinguishes asymptomatic people from healthy individuals through forced-cough recordings, which people voluntarily submitted through web browsers and devices such as cellphones and laptops.

‘The researchers trained the model on tens of thousands of samples of coughs, as well as spoken words. When they fed the model new cough recordings, it accurately identified 98.5 percent of coughs from people who were confirmed to have Covid-19, including 100 percent of coughs from asymptomatics — who reported they did not have symptoms but had tested positive for the virus.’

Read here (MIT News, Oct 29, 2020)

More mass testing in China after 137 Covid-19 cases in Xinjiang: All new cases asymptomatic

‘Mass testing began on Saturday evening to cover 4.75 million residents in and around Kashgar, Xinjiang province, after a 17-year-old garment factory worker tested positive for the virus. The new cases - all asymptomatic - were linked to a factory in Shufu county where the girl and her parents worked, the Xinjiang health commission told a press briefing on Sunday.’

Read here (Channel News Asia, Oct 26, 2020)

Early tests mean Covid-19 patients detected at ‘more infectious’ phase: Noor Hisham

‘Health Ministry director-general Dr Noor Hisham Abdullah said swift action to detect Covid-19 cases may have led to patients being detected at an earlier, highly infectious phase of the disease. However, he does not rule out the possibility that the high level of infectivity may be due to the virus’ D614G mutation. He said this in response to a question from the media asking why patients’ samples from the current third wave have a lower cycle threshold value (Ct) when tested, compared to samples from the first two waves of the outbreak in Malaysia.’

Read here (Malaysiakini, Oct 16, 2020)

China's Qingdao orders citywide Covid-19 testing following new infections

‘China's Qingdao city said on Monday (Oct 12) it will conduct Covid-19 tests for the entire population of more than 9 million people over five days after new cases appeared linked to a hospital treating imported infections. The city reported six new Covid-19 cases and six asymptomatic cases as of late Oct 11. Most of the cases were linked to the Qingdao Chest Hospital.’

Read here (Straits Times, Oct 12, 2020)