Date: 7 October 2021, Thursday
Venue: Facebook Live @Penanginstitute
About the Talk
Malaysia’s Covid-19 vaccination rate has been impressive, and generates hope that the pandemic will fade away. As Malaysia transition to the endemic phase, the struggle of living with the pandemic remains. The panel of experts in this webinar discussed about living with the endemic, what to expect in the near future, and what the policy areas are where Malaysia can better prepare itself for future pandemics.
About the Speakers
Azrul Mohd Khalib, CEO of Galen Centre for Health & Social Policy
With a background in genetics and public health policy, Azrul has worked as a development and programme policy specialist for more than 20 years. He has extensive experience working on strategic health system issues related to access to healthcare, sexual reproductive health, HIV and AIDS, gender-based violence, and humanitarian assistance.
Azrul is currently the Founder & Chief Executive Officer of the Galen Centre for Health and Social Policy, an independent public policy research and advocacy organisation based in Kuala Lumpur, Malaysia. His previous positions have been with the Institute for Democracy and Economic Affairs (IDEAS); the International Planned Parenthood Federation (IPPF); representing the Joint United Nations Programme on HIV/AIDS (UNAIDS) under the United Nations Development Programme (UNDP) and the International Committee of the Red Cross (ICRC). Azrul has also worked with the United Nations Children’s Fund (UNICEF) and Malaysian AIDS Council. He is co-founder of the CodeBlue health news website. Azrul is also a board member of the Center to Combat Corruption & Cronyism (C4 Center). He is a writer, has been a columnist with two Malaysian media outlets and is a co-presenter with BFM 89.9’s Health & Living programme where he discusses health policy.
Dato’ Dr Amar-Singh HSS, Former Head of Paediatric Department of Hospital Raja Permaisuri Bainun, Ipoh
Dato’ Dr Amar-Singh HSS, Cert Theology (Aust, Hons), MBBS (Mal), MRCP (UK), FRCP (Glasg), MSc Community Paediatrics (Ldn, distinction), is a Consultant Paediatrician. He served in the civil service for more than 35 years and was formerly the Head of the Paediatric Department at Ipoh Hospital and the Head of the Clinical Research Centre at Perak. He is the advisor for the National Early Childhood Intervention Council (NECIC) and the National Family Support Group for Children & People with Special Needs. He has a long-standing interest in children in the community, disabilities, family self-help groups, NGOs, child abuse, adolescent counselling, and disadvantaged & marginalised children (especially the Orang Asli/Indigenous People). He assisted the Ministry of Health in revising child health services and introduced several national programmes for children. With his wife, he also offers spiritual direction and counselling. He is an active child advocate and is the recipient of the “Outstanding Asian Paediatrician Award” 2012 and “SENIA Advocacy Award” 2016. He is also an Honorary Senior Fellow at the Galen Centre for Health and Social Policy.
Moderator: Dr Choong Pui Yee, Senior Analyst, Penang Institute
3.00 pm: Welcoming and Introduction
3.05 pm: Presentation by Dato’ Dr Amar Singh on the challenges of achieving herd immunity, the threat of virus mutation, and how we can live with the virus.
3.35pm: Presentation by Azrul Mohd Khalid on the strengths and weaknesses of our health system/policies and what the areas are that need to be improved for future pandemics.
4.05 pm: Q and A
Key Takeaways from the Webinar
There will be no Herd Immunity
- Covid-19 changes rapidly and herd immunity is not possible at all.
- To have a better grasp of the situation of Covid-19 situation in Malaysia, it is more accurate to track state and district data and to focus on new hospital admissions.
- Another important metric that need to be monitor is the long Covid – the long term persistent damage such as fatigues, shortness of breath, brain fog, sleep disorders, fevers, gastrointestinal symptoms, anxiety and depression which affects 10% to 30% of Covid patients.
- Delta is a lot more infectious than other Covid-19 strains. An average of 76% of Covid deaths in Malaysia are from the Delta strain.
- 1 in 3 people will likely to get a breakthrough infection but vaccinated individuals will clear the infection faster, suffer from milder disease and they are less contagious.
- mRNA vaccines work well for hospitalization and severe cases. Existing data suggests that Sinovac may wane in efficacy over time.
- There is no clear evidence for routine booster as yet especially for the mRNA vaccines. But there may be a need for a booster shot for Sinovac takers.
Covid-19 Endemic and the Possible Future Scenarios
- Endemic means that even in the presence of vaccines, disease will always be present in the community. It refers to the situation when disease is controlled at or below an acceptable level such as when the healthcare system is able to cope.
- It is extremely difficult to predict what will happen in the future as it depends on many factors such as the degree of immunity from natural infection, duration of vaccine protection, breakthrough infections and transmissibility, social contact and vaccine hesitancy, new variants, the acceptable burden of disease and healthcare capacity, and new therapeutic options.
- The most likely scenario is that we will have a cyclic epidemic situation on top of an endemic rate.
- A pediatric crisis is to be expected in Malaysia in the next six to nine months. There will be a lot of children who are going to get infected by the delta strain.
- New effective coronavirus therapy may change our future.
- New vaccine resistance is to be expected because there is no global vaccine equity.
On the Public Policy Front
- There have been strong leadership from the Health Ministry in leading the efforts of procuring vaccines. There have also been clear and coherent public health messaging which leads to Malaysia’s high compliance rate to SOPs. Malaysia also has strong public health expertise, experienced, well-prepared and dedicated healthcare professionals in terms of disease preparedness and resilience.
- But complacency was a concern and raids conducted on foreign migrant communities do not bode well in managing the pandemic. In addition, the double standards of fines imposed on politicians, celebrities and personalities in contrast to the ordinary citizens have also been criticized by the public.
- Malaysia needs to increase funding for the healthcare to face the endemic.
- The healthcare system also needs to be adaptable, flexible and have the necessary people to provide support for a population that is going to face the Covid-19 endemic.
- The reality is that covid-19 is a dress rehearsal of the next pandemic.
Living with the Virus
- As we need to live with the virus, masks are here to stay. Offices and schools in particular need to fix the ventilation and to get their staffs to do regular testing.
- Offices could create covid-19 safety bubbles to keep employees safe.
- It is also suggested to not eat lunch together, to reduce non-essential social activities, to test oneself before traveling, and to get vaccinated.