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MALAYSIA Tanah Tumpah Darahku

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10 APRIL 2024

Thursday, June 17, 2021

Just-in-time vs just-in-case

 

From Howard Lee

The length of time one is protected from Covid-19, or “term of protection”, either through vaccination or natural infection, is something that no one knows authoritatively yet.

Antony Fauci, head of US’ National Institute of Allergy and Infectious Diseases (NIAID), has said that data so far shows the vaccines’ protection against the virus lasts at least six months.

Immunity developed naturally after being infected with Covid-19 can last for up to eight months, according to research published in the American Association for the Advancement of Science. According to some, protection given by vaccines can sometimes – but not always – be stronger and last longer, but there is simply not enough data to be definitive in these uncharted waters.

All this sounds confusing at best, contradictory at worst. All in all, the general term of protection bandied around by those qualified and prominent for vaccines currently administered in Malaysia might last around eight months to a year. It cannot be stressed enough though, that these are guesses, albeit by very qualified people.

Other experts in the field are also highlighting the possibility that future “escape variants” – or mutations – of SARS-CoV-2 will be stronger and more formidable than its current versions. It is also not impossible that these will even “escape” the protection afforded by current available vaccines altogether.

This is before we even consider reinfection after recovery and its level of disease, or “breakthrough cases” of severe disease despite vaccinations. In the last few days, there have been quite a number of Covid-19 fatalities in several countries of individuals who have received two doses of the vaccine. If these are still rare and isolated, are we prepared for them to become more prevalent?

While I would be the first to call out Big Pharma on its fearmongering and profiteering tactics through talk about “booster vaccines”, it really does beg the question of whether or not we are ready for the second round of vaccinations. Second round meaning, the next round of vaccinations for when the first cycle of protection ceases, bearing in mind that this current interval may only protect us for a year.

Imagine having to go through mass vaccinations and long queues outside PPVs again by the end of 2022, because the current round of protection by vaccines taken this year has lapsed.

Even more poignantly, are we even acknowledging that Covid-19 could turn, or is turning endemic? Most who have raised this concern are confident that Covid-19 will be in a less potent form in comparison with the current one. But is that something we can afford to be confident about, considering how badly the world is being hit by the velocity and ferocity of the most recent variants?

Until and unless we have a super pan-coronavirus vaccine that does not just mitigate serious illness, but actually eliminates the virus, or at least prevents infection and transmission, we really cannot be sure what is or is not possible.

Are we able to imagine a future where variants of the virus will emerge and attack in thicker and faster intervals? Do we have the research, development and manufacturing capacity for vaccines – whether it be variant specific boosters or otherwise – to keep up with prospective mutations? Will we have and are we willing to invest in formulation to fill-and-finish vaccine manufacturing and development capacity to prepare for these possibilities and/or eventualities?

Are we prepared to accept and plan for the new norm and tomorrow’s reality that involves vaccination centres being a permanent fixture of our cityscapes, urban constructs and rural settlements? Do we have the human resource to staff it all?

The minister for vaccine coordination, in a recent forum organised by the Oxford and Cambridge Alumni Network, admitted that Malaysia “probably cannot afford to do this a second time around” when asked about procuring and providing free vaccinations if the virus goes endemic.

Therefore, there is at least an acknowledgement that the risk of Covid-19 turning endemic is real, yet there is not yet a Malaysian strategy and a plan – whether it be on procurement, administration or fiscal – to gear up for a second round of vaccinations.

It must be disclaimed here that we might have already seen the end of new stubborn lethal variants of SARS-CoV-2 rising and terrorising the world.

We might find, further down the line, that the existing vaccines may prove to have much longer terms of protection with sustained efficacy than anticipated. It might even be that within months someone develops a new vaccine that can eliminate infection and transmission altogether.

We might see a sudden and steep climb in vaccinations rates, and a correlating nosedive in infection and mortality rates come the end of the year. We might even be back to our pre-Covid-19 lives this time next year.

All that I have put forward here might be just a dark, bleak and doomsaying trajectory that is too bleak to all come true. We might live happily ever after.

Then again, we might not. Nobody knows.

Many of us assumed that governments around the world, including our own, would be able to pull off an action-movie-like “just in time” rescue of the world when the pandemic first broke out.

We all can see and are feeling the brunt of its failure. If what has happened to the world in the last 18 months has not taught us a lesson on the importance of mainstreaming a “just in case” governance mindset in the face of this seemingly unending pandemic, then we deserve to be and are doomed.

So better plan, act now to be prepared in time. Better be bold than to be broken; better be safe than sorry; just in case. - FMT

Howard Lee is DAPSY national chief and Pasir Pinji assemblyman

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

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