- The day before, I had my booster jab at a polyclinic near Mid Valley mall accompanied by my 30 years old son, Abdul Haq, as my significant other had to attend a Board meeting.
- I have always felt going for a jab in this time of pandemic, it is always a good practice to be accompanied by one other person so that in case of unforeseen circumstance, someone close is always there to give a helping hand.
- Although the venue for my booster jab was a private polyclinic, it is very spacious and has the air and ambience of a mega PPV (vaccination centre or in Malay, Pusat Pemberian Vaksin), which I’m so very familiar with, after getting my first two jabs.
- The whole process of getting my booster shot was very fast and efficient, similar to the first two jabs at a mega PPV.
- However, the one that I accompanied wifey for her booster shot was a small polyclinic located at a row of shophouses. Yet, I witnessed the same fast and efficient process.
- This is all the result of scheduling and timing that the committee on vaccination had meticulously planned with the participating polyclinics, which all began for me with a notification on my MySejahtera app indicating an appointment for a booster jab at a specified venue and time.
- Now back to the day when I accompanied my wife for her booster jab … when the Grab car arrived, and we were inside the car, the driver didn’t immediately drive his car.
- He waited for us to scan the QR code at the back of the front passenger seat, and once we have scanned indicating we are checked-in for the grab drive, the driver insisted on seeing our vaccination status and risk profile on our MySejahtera.
- “I have to do this because if you’re not fully vaccinated or your profile isn’t a low risk one, then I’m afraid I cannot take both of you for a drive to your destination. This is the standard operating procedure (SOP). I hope you understand,” the driver explained.
- Both of us told him of our support for what he did, and I went on to narrate the day before when I also took a Grab car for my booster jab appointment, the driver just told me to scan the QR code and started driving immediately without bothering to check whether I’m fully vaccinated and/or have a low-risk profile.
- I was even afraid then to insist that the driver checked my status on my MySejahtera app because of the fear when he turned his head to look at my smartphone, it may cause an accident, as he was driving.
- “It was very good of you to start driving only once you are satisfied that your passengers are fully vaccinated and have a low-risk profile unlike the driver who just started driving off after asking his passenger to scan the QR code without bordering to check their vaccination status and Covid-19 risk profile.
- “You are helping in breaking down the rate of transmission of the disease and that’s the reason why the authority has imposed such an SOP on e-hailing vehicles,” I complimented him.
- And the driver seemed to be aware too that the potential loss of income from rejecting one ride with passengers who are not fully vaccinated and/or have a high risk profile is worth it because with a new wave, his livelihood, and hence his income will be affected BIG time.
- Way back on Oct 10 on the eve of Malaysia lifting the interstate travel ban the following day, flamboyant Health Minister Khairy Jamaluddin made a wise remark in urging Malaysians to travel safe because he cannot rule out another Covid-19 wave.
- “I know everyone is going to be rushing to the borders tomorrow but in the back of my mind as the Health Minister, my biggest worry is another wave and that’s not something that is out of the realm of possibility,” he said back then.
- If the system can’t handle the surge, ICU cases, ventilators, oxygenated beds and admissions into hospitals, then it will put a tremendous stress not only on the public healthcare infrastructure but also on our frontliners.
- We can’t afford that anymore. With the Health Ministry, I have made early preparations to ensure we can deal with the surge if it happens, but we don’t want to deal with a surge
- Today of all days, on Doctors’ Day, we ask Malaysians to be responsible and if you really value and appreciate what the frontliners have been doing for the past one-and-a-half years, you will be responsible, you will be self-aware and take care of your own health and health status to ensure that a surge does not happen,” said Khairy during the Doctors’ Day celebration organised by the Malaysian Medical Association (MMA) on Oct 10.
- Meanwhile on Nov 12, the Director-General of Health, Tan Sri Dr Noor Hisham Abdullah revealed the infectivity rate otherwise known as the R- naught has increased to 1.0 on Nov 11, about five weeks after the ban on interstate travel was lifted. And this was just 17 days when it was at 0.88 on Oct 25 as mentioned in a Let’s Talk! op-ed on Oct 29 (see Sustaining endemicity in pre-endemic time).
- Dr Noor Hisham also revealed last year it took about five to six weeks after interstate travel ban was lifted on Dec 7 for the daily infection to go on an increasing trend.
- This is an early reminder for us all to act in ensuring Covid-19 cases won’t increase instantaneously by, among other things, intensifying the administration of booster shots among the population,’’ said the good DG.
- Malaysia has started giving booster shot in early October after 80% of its adult population has been fully vaccinated on Sept 21.
- After the DG Health’s statement, the next day on Nov 13, a public health expert Dr Farhan Rusli warned the country could see an increase in Covid-19 cases, which will result in a new wave by the end of the year if many refuse to get their booster shots.
- The people, he said, should take booster shots seriously because it could give more immunity to them as the immunity afforded by the earlier two primary doses started to wane.
- Three days later on Nov 16, Dr Azfar Kamal, a medical official at the Sungai Buloh Hospital posted on Twitter to advise Malaysians to be cautious of the next COVID-19 wave in December.
- According to his tweet, active wards and ICUs at the hospital are occupied by Category 4 and 5 (symptomatic and critically ill) patients.
- This resulted in a rejoinder by Selangor health director Dr Sha’ari Ngadiman who said the increase in the number of Covid-19 cases at Hospital Sungai Buloh’s ICU is due to it being a full Covid-19 hospital and a reference hospital for the Klang Valley.
- Sha’ari added Hospital Sungai Buloh received Covid-19 cases from other hospitals so that those hospitals could make more ICU beds available for non-Covid cases.
- But this does not detract from the fact that we all must be mindful of the important and timely advice given by Dr Farhan and Dr Azfar to be always on guard against an impending wave.
- In fact, on Nov 18 the DG Health himself said the Covid-19 infectivity rate in Malaysia on Nov 17 stood at 1.03 – from 1.0 on Nov 11, barely a week later.
- And on that same day, Labuan recorded the highest infectivity rate at 1.29, followed by Putrajaya (1.12), Kuala Lumpur (1.09), Negri Sembilan (1.07), Selangor (1.06), Kelantan (1.05), Pahang (1.03), Kedah and Johor (1.01 each), Perak (0.99), Sabah (0.98), Penang and Melaka (0.95 each), Perlis (0.91) and Sarawak (0.85).
- The infectivity rate has been on the rise starting Nov 6, five weeks after the government lifted the ban on interstate travel.
- Dr Noor Hisham had previously said that an infectivity rate above 1.0 indicates the possibility of a new Covid-19 wave, like what Malaysia experienced in the beginning of the third wave.
- He had since reminded the people to comply with SOPs and told vulnerable groups to immediately get their Covid-19 booster shots when they receive their appointments.
- When Covid-19 vaccines made their appearance and were administered to millions of people globally since early this year, the ensuing data worldwide showed the majority of those who were fully vaccinated were spared from Covid-19 infection, while for a small number of those infected known as breakthrough infection, the majority were spared from hospitalisation, and a very small number who were hospitalised were spared from a state of critical illness.
- The only exception of critical illness and death among the breakthrough infection were the senior citizens whose immunity is low to begin with, and those with comorbidities, defined as a disease or medical condition that is simultaneously present with another or others in a patient.
- It has since been proven by data worldwide that among Covid deaths, the majority comprises those who were not vaccinated at all and those with only one dose of vaccination, hence the endemic policy of relaxing restrictions only on those who were fully vaccinated.
- But as with all vaccines, the immunity they afforded wanes over time, and that is why we are beginning to see an increasing number of breakthrough infection being hospitalised, and those hospitalised regressed to critical illness.
- With the number of severe Covid-19 cases among vaccinated people increasing in Malaysia, Health Minister Khairy Jamaluddin has called on all to take booster shots.
- He said the effectiveness of vaccines would start to wane after a few months, with the Sinovac vaccine being the quickest to lose its effectiveness.
- “While Sinovac is effective, there is evidence its effectiveness wanes sooner. That’s why we want you to take whatever booster is on offer,” Khairy tweeted on Nov 20.
- He further explained the faster waning period is the reason why the interval for Sinovac booster shots is three months, compared with six months for Pfizer and AstraZeneca.
- In his tweet, the Health Minister shared a graph showing data for Covid-19 admissions in Hospital Sungai Buloh in the state of Selangor, which revealed that most of Category 4 and 5 patients are Sinovac recipients.
- The last epidemiology week (week 45) for instance, saw 165 Sinovac recipients admitted to Hospital Sungai Buloh as Category 4 and 5 patients.
- Both categories refer to seriously ill patients in intensive care units (ICUs). Patients under Category 4 require oxygen assistance while those under Category 5 need to be ventilated.
- In comparison, 24 were Pfizer recipients while seven had taken the AstraZeneca vaccine.
- When the immunity afforded by vaccines starts to wane, it also raises the real possibility of an increase in the transmission of the disease, which means the possibility of a new wave occurring is no longer remote.
- In recent days we have seen the latest wave of Covid-19 cases hitting Europe with a vengeance.
- Some countries have responded by imposing partial lockdowns and placing more restrictions on unvaccinated people.
- Germany, which has declared a state of emergency, shattered a new record on Nov 18, reporting more than 65,000 new cases. Some German health officials are warning that the true number of cases could be two or three times as many.
- In the neighbouring Netherlands, more than 20,000 new cases were reported on Nov 17,a new record for the third day in a row, and on the same day in France, where a fifth wave of the pandemic is underway, the number of new cases topped 20,000, a level not reached since Aug 25, Reuters reported.
- So it’s not paranoia when the authorities in Malaysia here is warning about the emergence of a new wave, and the best thing we as responsible citizens of the country should do is to heed the advice to religiously continue observing the SOPs and especially going for a booster shot when your appointment to do so is given on your MySejahtera app.
- This is the only way to forestall the emergence of a new wave.
- It is indeed very assuring when on Nov 21, Khairy announced the Health Ministry will introduce a heightened alert system to detect early signs of an increase in Covid-19 cases in the country.
- Through the system, the MOH proposed that some sectors be tightened if there was an increase in cases, but it would not be a “total lockdown”.
- “I will announce the matter, including details of the situation on how this system will be applied. Maybe in a week or two. If we can, we want to avoid lockdown because lockdown not only disrupts the economy, but has other effects on family well-being and mental health.”
- Khairy said so far, the level of MOH’s health system was still under control, but there were early signs of an increase in cases. He reminded the public not to be too complacent when the states transitioned to Phase Four of the National Recovery Plan (NRP).
- “We are very worried because we have seen the early signs (of rise in cases). However, it has not reached the level of paralysing the health system, but the signs are very clear,” he added.
- He went on to say his concern was the increase in serious cases requiring hospitalisation, especially critical cases in categories four and five.
- Citing the situation in Negri Sembilan as an example, he said the number of hospital admissions doubled in a month. From Oct 25, only 35 patients needed oxygen assistance statewide, but yesterday (Nov 20), the figure increased to 70.
- “If this trend continues, we will have to provide beds for critical treatment such as in the intensive care unit (ICU), and need oxygen supply to treat patients,” he added.
- On the booster dose, Khairy once again called on the public who had received an appointment for the booster dose to get the jab, and not to choose the type of vaccine given by MOH, as the Ministry would conduct an investigation if there were any serious side effects among recipients.
- Last week Austria became the first European country to make Covid vaccination a legal requirement, with the law due to take effect in February.
- Politicians in neighbouring Germany are debating similar measures as intensive care units there fill up and case numbers hit fresh records.
