Consider forming a new National Pandemic Preparedness Committee or Malaysia’s own CDC (Centres for Disease Control and Prevention) — Vinod Balasubramaniam

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SEPTEMBER 8 — Malaysia has been living with Covid-19 for close to two years now, and with nearly 70 per cent of its adult population fully vaccinated, the country’s International Trade and Industry as well as Health Ministers have both teased out plans to treat the disease as endemic.

The question that follows is — can it then be thought of in the same way as other endemic diseases such as influenza and malaria?

The answer is no, as Covid-19 is still a relative newcomer in contrast to other influenzas, hence there is still a lack of scientific research to assert whether Covid-19 will also become a seasonal human coronavirus.

It will take some time for us to observe the evolutions and to understand how this virus finally settles down in the human environment. With these logistics, procurement will come into play again, and how long will that take?

It is possible, experts say, that Covid-19 could become a seasonal illness, like the flu. Virologists call this an “endemic” disease — one that is constantly circulating among us.

In the years and decades to come, many people will be exposed to it in childhood and develop some immunity, which would protect them later in life against serious diseases.

A healthcare worker administers a dose of the Pfizer-BioNTech Covid-19 vaccine to a frontliner at the UiTM Private Specialist Centre in Sungai Buloh March 2, 2021. ― Picture by Hari Anggara
A healthcare worker administers a dose of the Pfizer-BioNTech Covid-19 vaccine to a frontliner at the UiTM Private Specialist Centre in Sungai Buloh March 2, 2021. ― Picture by Hari Anggara

However, given how the pandemic has been handled so far, it will likely become endemic, with the virus probably taking a similar route to the four existing “human” coronaviruses that are already in circulation and cause upper respiratory infections.

Amidst this backdrop, there is a stronger need to include a newer generation of virologists, microbiologists and epidemiologists into a National Pandemic Preparedness Council or Committee to better prepare/fight against future pandemics, as Covid-19 will not be the last pandemic faced by humanity.

Equipped with innovative/out-of-the-box thinking, these new generations of scientists can certainly complement the senior ones currently advising the government, especially Ministers.

Looking to the future, the country will need constant surveillance on many up-and-coming zoonotic diseases (the recent spill of the H5N8 virus to human beings is one example), and I believe this committee will complement well with all national agencies like IMR and VRI to fight future pandemics.

The government aims to transition to the endemic phase by October and will see the opening of most sectors, including entertainment, etc.

Understandably, the government can’t simply afford to continue blanket lockdowns, which has shown minimal effects in reducing cases/deaths. This has already caused severe repercussions in terms of economic stability in the country.

At the same time, we can’t afford to overload our already critical healthcare system by simply opening the floodgates and allow 100 per cent of economic sectors to be fully open.

To head off further deaths from the virus, the government should tread this transition carefully while putting restrictions to allow only fully vaccinated individuals to enjoy these economic privileges.

Stricter enforcement should be placed to restrict non-vaccinated individuals to be exposed to a large mass of people. We must remember this is the pandemic of the unvaccinated!

Every time the Covid-19 virus reproduces inside someone, there’s a chance of it mutating and a new variant emerging. Cognisant of this, the government should increase efforts to vaccinate eligible people even if it means using legal avenues for those who still resist vaccination while preparing plans for booster doses.

We will need booster doses at some point since more emerging variants are circulating. As various studies have revealed, the main way to stop variants is through global vaccination. With that in mind, the government should not delay in deciding on the booster dose as it is a key linchpin to the exit strategy from the pandemic.

That said, we must first understand that the vaccines we have currently are not a miracle cure. It was designed to provide immunity against symptoms/disease caused by the virus and the possibility of reducing transmission of the virus from person to person.

At this point in time, it’s still unclear whether vaccines prevent transmission with new variants. There is still inconclusive real-world data to show that current vaccines used in Malaysia (Pfizer, Sinovac and AstraZeneca) can stop the predominant Delta strain.

Apart from that, with the virus now causing sporadic infection in the community both in vaccinated (healthcare workers) and unvaccinated individuals, it is even harder for us to trace and track the infections.

Even though Malaysia’s first-dose vaccination rate is among the highest in South-east Asia, however, distribution of vaccines has been uneven. On one hand, vaccination access and administration have vastly improved, with the opening of mega-vaccination sites in urban areas, as well as using community, health and religious centres and deploying mobile units to rural populations, homebound residents and workers in certain industries, among others.

But on the other hand, some communities in Malaysia are in danger of being side-lined. Since most Covid-19 vaccines require two doses, hard-to-reach communities, like migrants, foreign workers, immigrants and the Orang Asli, will find it more difficult to receive full protection.

Nonetheless, there is also a chance that vaccines might change human behaviours. As more people are vaccinated, there is a possibility that they will increase their interactions without proper SOPs, which changes the herd-immunity equation, as it relies in part on how many people are being exposed to the virus.

In a nutshell, Covid-19 is unlikely to give you lifelong immunity. But even if you are infected again, the second infection will likely be less severe.

We might need booster doses against variants and to provide optimal immunological memory against the disease. If CoV-2 experiences antigenic evolution at rates that are similar to influenza, annual shots for vulnerable populations may well be necessary.

* Dr Vinod Balasubramaniam is a molecular virologist and senior lecturer at the Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia.


* This is the personal opinion of the writer or organisation and does not necessarily represent the views of Malay Mail

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