Total lockdown? It’s now or never

 

From Dr Venugopal Balchand

As of yesterday, we had 541,224 Malaysians diagnosed with Covid-19. A total of 69,408 are still grappling with the disease, 771 are in the ICU, 392 ventilated and 2,491 dead. There have been 243 deaths in the last four days alone.

These are statistics that should make everyone’s blood boil. And yet, first thing in the morning, we still have not got a handle on the situation.

We seem to have forgotten that, at the very core, this is a medical emergency. It is not an economic crisis, and certainly not a political one.

A medical emergency with far-reaching economic and other repercussions such as this Covid-19 pandemic is best handled with predominant input from the medical fraternity. God help the chap who goes to see a plumber just because he has diarrhoea.

I do not understand this argument about lives vs livelihoods. Let me reiterate that for you to even have a livelihood, you need to be alive first. Life always wins. And half-baked, half-hearted, timid measures will never be able to sustain life.

It is a documented fact that in cases per million population, we are now worse off than India. We have been told of a “vertical surge” and to “prepare for the worst”. But amazingly, the apathy both from the decision-makers and the public seems to be appalling. We behave like there is light at the end of the tunnel. But remember, it could also be the headlamps of an oncoming train.

In medicine, they talk about the golden hour – the hour immediately following traumatic injury in which medical treatment to prevent irreversible internal damage and optimise the chance of survival is most effective. With Covid-19 in Malaysia, that ship sailed a very long time ago but we still have a fighting chance to do a decent salvage operation.

So, let bygones be bygones. Let us live and let live. All that matters is, as soon as possible, it’s the virus who should be saying “I can’t breathe”!

First, we have to break the chain of transmission. Now. Firm, decisive leadership is the need of the hour but the biggest role here will be played by us, the general public.

Please stay at home. Traffic snarls during an MCO belittles our collective intelligence and integrity. Or have we lost that, too? Let us build mosques, churches and temples within our own hearts. We don’t need to go out to pray. I am sure He will understand. Any kind of social gatherings are unnecessary. Especially funerals.

Second, we need a strict military style complete lockdown for a minimum of three weeks. Nothing else will break the chain of transmission. For God’s sake, what else needs to happen to justify a complete lockdown? Fifteen thousand cases a day? Two hundred and fifty deaths a day? Doctors and nurses on ventilators?

Believe me, if we continue to pussyfoot like this and stumble from one catastrophe to the next, that will happen by mid-June.

Third, there is no question about governmental aid for the financially challenged. All possible mechanisms need to be explored and put into action so that this vulnerable section of our society is fed, clothed, sheltered and their medical needs looked after. This includes our army of migrant workers.

Fourth, our medical infrastructure is bursting at the seams and our frontliners need some breathing space, urgently. Unfortunately, we doctors, nurses and other allied medical staff cannot manage the pandemic working from home. Those of you who can work from home, please do that.

More than 7,000 medical staff have tested Covid positive so far. Each time that happens, there is also a seven to 10-day quarantine for fellow professional close contacts. You can just imagine the strain on the system. And, remember, people still get heart attacks, strokes and cancer. They need to be looked after as well. Diligently and with the same standard as the pre-Covid days.

Finally, urgent, mass vaccination is the only weapon we have currently to dramatically alter the course of this pandemic. Look at the US and the UK, they struggled, probably worse than us, with their first wave. But they got their act together very quickly. Both countries have vaccinated substantial segments of their population, and life there promises to return to a semblance of normalcy.

The fiasco of the AZ registration on Wednesday shows very clearly that our efforts can and should improve. We have no choice but to think outside the box now.

Do we really need such poorly executed, elaborate registration exercises? Can we do home vaccinations in certain areas and communities? Can we open vaccination centres for the walk-in public like in Indonesia and India? Can we rope in the extensive network of general practitioners?

Both the Sinovac and AZ vaccines do not need the cold chain integrity of the Pfizer vaccine. They should be rather easy to transport, store and administer.

Our initial target was to vaccinate between 22 million and 24 million people. After three long months, only a million have been fully vaccinated and another two million have got their first dose.

Even a single dose of all our current vaccines provide 60% to 80% protection. That’s certainly better than no protection. If we are to reach anywhere close to herd immunity by the end of this year, we should be doing around 200,000 doses a day.

According to the Reuters website, Malaysia administered 85,000 doses last week. But there are always two sides to a coin. Fifty-two thousand no-shows for vaccination is utter disregard and disrespect for those coordinating our vaccination programme. As much as they have an obligation to give, the onus is on us to receive.

It is an unmitigated disaster that the biggest surge in infections and, sadly, deaths, have occurred after the proclamation of the emergency. As the narrator says in every episode of Seconds from Disaster, “Disasters don’t just happen. They are the result of a critical chain of events, locked together in time.”

Now is NOT the time for partisan politics, games of one-upmanship, commissions, kickbacks, nepotism, cronyism, etc. Malaysians are dying in never before seen numbers. It is time to unite. A chain is only as strong as its weakest link. Let us give this fight our best shot. For now, maybe our only shot.

Let us seriously adopt a war mentality. The best of Malaysian minds and intelligence need to understand the science of what is going wrong and work together without fear or favour to put the brakes on this runaway train. Otherwise, we certainly will be kissing this country goodbye. - FMT

Dr Venugopal Balchand is an FMT reader.

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.