Challenges facing the control of endemic Covid-19

 

From Abdul Hamid Kadir

Much has been spoken and written about the Covid-19 pandemic and its economic and political implications when the situation is expected to reach the status of an endemic and herd immunity by the end of October 2021.

There is little doubt that Covid-19 will remain endemic in the world, building its own nest for years to come and beyond, like the influenza virus, Ebola, rabies, and polio in some countries.

I would like to address the need for the country’s preparedness for the projected inevitable endemic from another crucial point of view, by outlining a few strategic plans and challenges that need to be considered, if they have not already been formulated by the authorities.

The ICU capacity is bursting at the seams. It was reported on Sept 13 that the national ICU utilisation rate is currently at 84.8%. Two states have ICUs operating at overcapacity, namely Kedah (123.1%) and Kelantan (103.3%).

Firstly, the country’s ability at all times to provide comprehensive healthcare needs to be reviewed.

Some of the hospitals (mainly the public institutions but also the private ones) need to be specially designated to function as Infectious Disease Hospitals, with special ward arrangements, trained staff, equipment, diagnostic laboratories and medications, and disposal of clinical wastes, specifically catering to the flare-up of an epidemic, primarily of viral origin.

Such hospitals must be financially and administratively independent and available in all states in the country, including Sabah and Sarawak.

This strategy is pivotal if we desire to contain the endemic. This is because it is unpredictable in terms of flare-up and in intensity, and there is the possibility of a large number of people requiring life-saving hospital management all at the same time.

All these need to be done without compromising the management of critically ill, non-viral, non-communicable disease patients, and life-saving emergencies including of the cardiovascular and central nervous system, and pregnancy-related, throughout the country.

Hospitals catering for such non-infectious diseases would be general hospitals in the true sense of the terminology.

We must maintain an adequate supply of ICU monitoring equipment, and such essential items, and personal protective equipment (PPE) through our own production, with the ability to increase availability in emergency situations.

We must step up research (if need be, assisted by foreign expertise) in the production of vaccines in our country, as we cannot depend on supply from overseas in dire situations.

Benefits of vaccination

Next, the rakyat should be made to understand the importance of vaccination.

It is noteworthy that we have achieved full vaccination in nearly 56% of the population as at Sept 14, and hopefully, close to 100% vaccination will be achieved by October 2021.

The rakyat must be made fully aware of the benefits of vaccination, and clear the doubts and adverse reports that keep coming through foreign sources.

The government also has to prepare for booster doses in good time, as the vaccines currently in use confer diminishing immunity over time.

Besides vaccination, the education and awareness of the rakyat by themselves contributing to controlling the epidemic through personal effort must be stepped up.

This would include avoiding congregating in public places or events beyond a stipulated number of people, the need for managing a healthy and hygienic lifestyle (wearing mask, washing hands, whole-body bathing after coming home, laundering clothes worn out of the home, consuming healthy and wholesome food and supplements), and generally to limiting leaving the home except for essential needs.

This would mean a considerable application of common sense, cooperation and social etiquette by the rakyat, and awareness of the serious consequences of indifference thereof.

The people preparing food in restaurants and stalls, as well as other vendors, must be monitored for their status of vaccination, infectious diseases, and generally good hygienic habits.

Travelling by air or road must be controlled and regulated, as this has been shown to be the cause of the viral disease reaching worldwide pandemic proportions. House quarantines may need to be continued whenever there is an indication.

The rakyat must be reminded of avoiding accidents, especially but not exclusively by motorcyclists, by obeying traffic rules and speed limits.

The avoidance of industry-related accidents and diseases, through the failure of health considerations by employers and employees – abiding by safety rules and avoiding living in unhealthy crowded accommodations – must be stressed, as these, when serious or critical, will require institutionalised care and compromise on the availability of essential hospital facilities for other patients with serious non-communicable diseases. Enforcement must be strictly applied through constant vigilance by the authorities.

The statistics are compellingly disturbing. The health ministry has, in its daily Covid-19 updates, identified 32 new Covid-19 clusters on Monday (Sept 13), taking the active number to 1,444, and that 16 of the 32 clusters were workplace-related outbreaks.

To put it in a nutshell, the elimination of a large number of clusters of infections in the community and workplace, as we continue to see in the daily reports, deserves serious and priority consideration.

If we are to limit and control Covid-19 and its ever-mutating propensity in the next endemic stage of its nest-building in our country, these are just some of the first-line life-saving challenges that warrant our urgent attention and action. - FMT

Abdul Hamid Kadir is an FMT reader.

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