Let’s keep our eye on the ball

 

From Dr Venugopal Balchand

The first edition of MCO 3.0 concludes today. It has now been extended for another two weeks until June 28, ostensibly because the Covid-19 numbers have not dropped below 5,000 new cases per day.

Now begs the question, “Is it judicious to just keep extending the MCOs and total lockdowns when a lot of things can and should be done differently for a better outcome?

During the last couple of weeks, I have found that I am beginning to irritate myself and that cannot be a good sign. I sound like a broken record stuck on a two-word sad song, sung in D major. But, ironically, I am not the one breaking Covid-19 records in Malaysia. The first 13 days of June saw a total of 1,112 Covid-19 deaths when, in the whole of 2020, Malaysia lost only 471 patients.

We took one whole year to lose our first 500 patients at a mortality rate of 0.42% but we took just six days (yes, six days) to lose our 7th batch of 500 patients at a mortality rate of 1.34%.

We have consistently had 900 patients or more in the ICU this past week with at least half of them needing some kind of mechanical respiratory assistance. And, most worryingly, on June 11, almost one in five or 20% of those who succumbed were “Brought in Dead”. Felled from behind by an enemy they could not see. They had absolutely no clue what hit them. And they gave absolutely no chance for the tireless frontliners to even try stopping those human breaths from becoming just ordinary air.

These are records that should break every Malaysian heart as they are permanent testimonials to our collective less than stellar response to a battle which we fought so very well at least up to September 2020.

There are many words for doing the same thing over and over again but expecting different results every time. And, believe me, none of them are complimentary. It does not matter if the quote originated from Albert Einstein, Mark Twain or Rita Mae Brown. In our own national battle against this virus, two words stare at you in the face where we could have done things a lot differently: Priority and urgency.

Visit any hospital that has cutting edge technology to treat heart attacks and you will get a sense of the true meaning and importance of these two words. Visit any good trauma centre and see how they prioritise and urgently treat a patient with poly trauma.

Why go that far? See the relief on the face of a patient with acute urinary retention after prompt bladder catheterization. For that relief, however, you need to drain the bladder fully. Half-hearted measures like draining only a couple of hundred mls every time are a total waste of effort. So, indeed, are teasing reassurances that you will repeat the procedure every two weeks.

I must apologise for having said, on more than one occasion, that in the battle of lives vs livelihoods, life always wins. I have since, without reservation, realised that with these multiple MCO extensions, you do need a livelihood to continue staying alive.

According to a Bernama article on June 3, a total of 128,150 companies, with a workforce of 1.57 million, were given permission to operate during MCO 3.0. To lay a person off, this is an absolute abuse or total misinterpretation of the word “essential”.

Has this freely mobile workforce been vaccinated with even the first dose? You don’t need to be a scientist, but just common sense will tell you that here is a group of potential superspreaders. And I believe, a tiny fraction can essentially carry the virus in a popular brand of luxury handbags. At least you cannot fault us for being classy.

When science and world renowned scientists keep repeating the fact that spraying disinfectants on surfaces such as roads have absolutely no value in containing this virus, why is this exercise still carried out? Even if, as reported, less than RM1 million was spent on it, could that million have not been used for more valuable things like ensuring PPEs for the frontliners? A time will certainly come, if it has not already, when every ringgit spent will be much more precious than the previous one.

The process of vaccination has indeed taken important strides for the better. But a fortnight shy of four months since our programme began and two weeks into MCO 3.0, only 10% of Malaysians have received at least one dose and 4% of our population fully vaccinated. Compare this to the approximately 45% each in the US and UK and you begin to see how far behind we still are.

There are reports of vaccine shortages and delayed supplies. The vast network of general practitioners have not yet been fully integrated into the National Covid-19 Immunisation Programme. The private sector has still not been allowed to purchase the vaccines and even donating vaccines has had its own issues. I sincerely hope and pray that herd immunity by the end of the year is not just a utopian ideology.

Coming back to heart attacks, coronary angioplasty or coronary bypass surgery is just one part of the armamentarium in treating coronary artery disease. They are useless without lifestyle modifications, cessation of smoking, regular exercise and strict adherence to appropriate medication.

Similarly, a total lockdown or MCO is not a panacea for all our Covid ills. Both the number of new cases and our mortality will not drop by just extending the MCO and not paying essential attention to the multitude of other important factors.

Though there have been a lot of tears in the past 18 months, this pandemic is not a romantic tragedy out of a Mills and Boon novel. Time alone will never heal this heartache. In fact, time is so precious.

It is Euro 2020 season and already there is so much chatter out there regarding goalposts and shifting them. On Saturday, there was an extremely unfortunate cardiac arrest on the playing field. A very alert team captain and prompt and heroic medical attention saved the day.

If Novak Djokovic can come from two sets down to win an exhausting French Open against a much younger opponent, exasperated Malaysians may still be able to win the Covid war. We just have to keep our eye on the ball. - FMT

Dr Venugopal Balchand is an FMT reader.

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