Malaysia is now trapped in its third extended Movement Control Order, or EMCO, and is being ruled under emergency decree. The country is nearing a million total cases, with new ones running at a 15,000 daily clip and nearing 150 deaths a day. There is little sign that these metrics will decrease anytime soon. It is clear that the country needs to adopt a new strategy.
Malaysia has always been more susceptible to epidemics, with porous borders and an average population density of 99 people per square kilometre with densities in excess of 2,000 in urban areas. There are only 1.6 hospital beds available per 1,000 people 3.3 functioning ICU hospital beds per 100,000. In contrast Italy, which last year ran out of ICU capacity due to a massive outbreak of severe cases, has 12.5 ICU beds per 100,000.
Malaysia has high incidences of diabetes, hypertension, obesity, heart and respiratory diseases and cancers among the population, making members of the public extremely vulnerable to severe Covid-19 contraction. Another vulnerable demographic is those aged 65 years or above, who comprise 7 percent or 2.23 million people.
These factors have fuelled the potential for a disaster waiting to happen. The government and health authorities took no early preventative measures, or even attempted to educate the public about the dangers of the virus for the vulnerable. Gatherings which could potentially lead to superspreader events like the Sri Petaling Tabligh Jamaad, an international Islamic conference last year, were allowed to go forward even though the risks were well known. The Sri Petaling case became not just an epicenter for domestic cases, but regional ones as well.
Malaysia is now in a state of desperation. Industry and commerce is stalled, people are hoisting make-shift white flags as an SOS for food assistance and police reports have been made against the minister of health Dr Adham Baba, director general of health Dr Noor Hisham Abdullah and the ministry of health for refusing to adopt the drug Ivermectin for high risk patients. Videos criticizing the government handling of the pandemic are being downloaded off social media.
Suffering is worse than the disease
The suffering caused by the lockdown is causing more damage than the disease, bringing anguish and desperation to so many. Experience in other countries is indicating that lockdowns won’t eliminate the virus. As numerous countries have shown, including the Philippines, which has implemented the world’s most stringent lockdowns only to suffer 1.5 million cases, the second-most in Southeast Asia, there will always be another outbreak, followed by another lockdown. The World Health Organization (WHO) has never recommended blanket lockdowns, as they cause too much community suffering.
The National Recovery Plan (NRP) announced by prime minister Muhyiddin Yassin on June 15 specifies that current restrictions will only be eased when national cases fall below 4,000 per day. Covid-19 is not going away for a long time, and this arbitrary figure doesn’t differentiate across the severity of cases. Malaysian statistics indicate that 1.4 percent of active cases are severe, requiring ICU care. Therefore, the load on ICU is the critical metric, not the aggregate number of daily cases. Malaysia’s Covid-19 death rate is currently at 227 per million, one of the lowest per-capita rates in the world.
Malaysia’s primary Covid-19 strategy is mass vaccination although the rollout of public inoculations has been slow and haphazard.
Although nearly 15 percent of the population have been fully vaccinated, many of the vulnerable have not had access to the vaccine yet. The program is totally dependent upon imported vaccines. The once-heralded Malaysian Biotechnology initiative has failed the country in providing a local vaccine source. However, recent date from studies in Israel and the United Kingdom show that breakthrough infection rates in those two countries are 50 and 43 percent respectively. Vaccines cannot eliminate Covid-19. There is already talk of people requiring boosters. The fact that those already vaccinated require to undergo quarantine when travelling, shows governments are aware of this.
Long, extended lockdowns have been the result of vaccine mismanagement. This is leading to an even bigger disaster than Covid-19 itself. More than 30,000 Malaysian companies closed last year, and many more will close during this latest extended lockdown. This has led to the loss of almost a million jobs and the closure of 30 percent of retail shops, leaving more than 300,000 without jobs in the retail sector.
Many families are in crisis, unable to feed themselves. This has led to the white flag movement, where distressed families put out a white flag outside their houses as a pled for assistance. People expressing their anguish on social media. The suicide rate is rising, with 468 recorded by police in the first five months of this year, many in a desperate bid to end their problems. Government assistance during restrictions and lockdowns has been scant there are no medium- to long-term programs to assist those in chronic need, like the unemployed.
The MCO isn’t the solution
It is clear that the MCO strategy to lower case numbers isn’t working. The longer the MCO continues, the greater the hardship to the people, and the greater will be the damage to the economy. GDP fell 0.5 percent in the first quarter of 2021, following a contraction of 3.4 percent in the last quarter of 2020. This latest MCO is expected to severely affect the second and third quarters of this year.
There needs to be an urgent transition from the MCO strategy to treating covid like any other infectious disease, an approach that other countries are beginning to implement. Singapore implemented such a strategy in mid-July. This requires an alternative strategy based upon what has been learned about the virus and various strategies employed by countries around the world, over the past 18 months. This is especially the case, with Malaysia possibly unable to afford any new stimulus packages in the future, according to Fitch Solutions.
Any lockdowns should only be applied to the aged and vulnerable. Statistics indicate that 87 percent of deaths in Malaysia have occurred with those who were identified with comorbidities. The rest of the community should be allowed to continue on with their economic activities. With over 800,000 full recoveries from 950,000 cases, and more than 10 million who have received their first vaccination, there is more immunity within the population than at the beginning of the year. With the absence of MOH modelling, IHME Models indicate that daily deaths will reach a peak in August and begin to decline.
With Covid-19 sure to linger, it is necessary to embark upon preventative programs. This should be related to how best people can build up their own health and personal immunity to disease. It requires an investment in education and community level programs, the most neglected tool against the spread of Covid-19 to date, and should in the medium to long term, minimize the impact of outbreaks.
The medical profession has learned a lot about treatment since the beginning of the pandemic in December 2019. Many remedies have now been the subject of research trials and a number of medicines and treatments show positive results. Covid-19 is curable for most with treatment. Most can be treated at home with mobile medical people, taking great pressure off hospitals.
The government needs to undertake major investment to increase hospital capacity, particularly the number of ICU beds. Arrangements need to be made with the private sector under an emergency plan that can be automatically activated if needed. Infectious disease hospitals, once a colonial fixture, must be re-examined along with state quarantine facilities, or a firm quarantine plan.
The feasibility of infectious disease hospitals, once part of colonial times, need to be re-evaluated, along with state quarantine facilities, and a firm quarantine plan, with procedures.
The fallacy of lockdowns is that they aren’t a complete remedy to infectious outbreaks. The disease still slips through, carried by the careless or unaware. There is no point in forcing people to stay at home, with heavy fines on those who breach restrictions, if factories, where many outbreaks occur, are allowed to operate without adhering to SOPs. Inconsistency is rendering lockdowns ineffective, costing the community dearly.
There is growing evidence that the end results from countries that select the lockdown strategy and those that don’t are similar. The only exception is those that chose the lockdown strategy, suffer steep declines in GDP and put their communities under great financial and emotional duress. They are the lockdown losers.
Originally published in the Asia Sentinel
Murray Hunter’s blog can be accessed here.