Despite massive Covid-19 vaccination campaign, experts say new standard could stay in Malaysia for years

Experts have predicted that 2022 will not look like the pre-pandemic era. – Photo of Malaysian Mail

KUALA LUMPUR (August 23): As Malaysia and the world fight to vaccinate their way to herd immunity and restoring normalcy, infectious disease and epidemiology experts say society should prepare for life with Covid-19 at least in the medium term.

Malaysia has accelerated the national Covid-19 vaccination program to vaccinate the entire adult population by October, but experts have warned that this alone will not be enough to herald the end of the global pandemic, given the current circumstances.

They see existing safeguards such as regular disinfection, face masks, and physical distancing remain for the foreseeable future, along with possible additions such as frequent testing and vaccine boosters even after getting the so-called. “Collective immunity”.

Although they agreed that Malaysia is on track to achieve herd immunity by the end of 2021 with the current vaccination rate, experts predicted that 2022 will not yet resemble the pre-pandemic period. because Covid-19 and its variants have still not been eradicated.

“The problem with collective immunity and Covid-19 is that over time many new [variants]have been detected and current vaccines are not 100% effective in preventing transmission.

“The main benefit of the vaccination program will probably be to significantly reduce the risk of hospitalization and death,” said Dr Sanjay Rampal, professor of epidemiology and specialist in public health medicine at Universiti Malaya. Malaysian courier.

This view was supported by recent data from the Department of Health, which showed that more than one in five new cases of Covid-19 involved people with a history of vaccination.

As such, immunopathology specialist Professor Sibrandes Poppema said the prevailing view within the health community was that Covid-19 could become endemic, with outbreaks and epidemics occurring around the world.

When asked if that means Covid-19 could turn out to be like the flu, Poppema, who is also president of Sunway University, said he would eventually become one.

“However, in the first few years, there would still be many people with insufficient immunity and therefore larger epidemics than those typically seen with influenza can be expected.

“Over time, Covid-19 could also become like the other two endemic coronaviruses and be part of the annual mix of viral colds,” he explained.

With breakthrough infections still a distinct possibility, Dr Sanjay said it was unrealistic to expect Covid-19 to be eliminated until there is both a low global incidence rate which is accompanied by effective and widespread vaccination.

However, Professor Dr Yahya Mat Arip, a virologist at Universiti Sains Malaysia (USM), stressed that this does not diminish the importance of vaccination, saying that the success of such programs is necessary to minimize the risk of mutations in Covid-19 through new infections.

Each new infection has given SARS-CoV-2, the coronavirus that causes Covid-19, an opportunity to mutate into a new variant, which Dr Yahya said vaccination could reduce even if it couldn’t eliminate.

Minimizing the risk of new variants was also important to ensure that vaccines currently available and under development would continue to be effective against the coronavirus, he said.

“Eventually the genome would stabilize and there would be a dominant variant,” he explained.

Over time, Covid-19 could become an endemic disease much like mumps, measles and hepatitis which, while not completely eradicated, could be effectively contained through vaccination.

“As a virologist, I firmly believe that we can achieve herd immunity, but we must remember that we cannot prevent infections and that the virus will always be present in our world. But, we can reduce drastically, if not completely, prevent the effect of infection which is disease, ”he said.

Living with Covid-19

According to Professor Poh Chit Laa, director of the Virus and Vaccine Research Center at Sunway University, Malaysia and other countries must prepare for sporadic and severe outbreaks of Covid-19 even after this end of this pandemic, and compared it to the flu.

Although not typical in Malaysia, influenza historically causes between three and five million cases per year, of which an average of 300,000 to 650,000 are fatal.

“Governments believe that as long as their countries achieve 80% herd immunity, they should be treated like the flu with a few hundred thousand infections and a few thousand deaths per year,” she said.

Other changes observed, said Poh and other experts, include how countries have already started aligning their policies to treat Covid-19 as endemic.

Experts said preparations were already underway for possible doses of the booster vaccine, as well as semi-regular vaccination for high-risk groups such as the immunocompromised.

Poh said the additional doses would be particularly critical for countries that rely heavily on tourism for their income, noting that inbound tourists pose an increased risk of importing a new variant of Covid-19.

Policy changes

Going forward, Dr Sanjay said future regulations should build on the experience gained over those two years to ensure compliance with preventive standard operating procedures.

He said these should be developed based on scientific evidence and focused on community empowerment, noting that repeated government interventions so far have led to “pandemic fatigue”.

“Authoritative, top-down management of the pandemic will not gain the necessary long-term community buy-in; the emphasis on policing, law enforcement and unreasonably high penalties rather than compassionate health promotion approaches reinforces this disconnect with the community, ”he said.

For Dr Yahya, it was also vital that health authorities continue to strengthen measures to manage the pandemic even after the country vaccinated 80% of the total population, which was the target of “herd immunity”.

Contact tracing, testing and quarantine systems should not be abandoned as this would leave the country exposed to new waves of infection or new variants, he explained.

Dr Yahya said continuous surveillance for new cases should also be done to establish adequate epidemiological data.

“These epidemiological data are beneficial in terms of the prevalence of the disease, so that early intervention is possible before the situation gets out of hand,” he said.

Poppema cautioned against complacency once collective immunity is achieved, saying the consequences of this fact could already be seen in countries that were ahead of Malaysia in the vaccination race.

“Once we have achieved collective immunity, we have to remain cautious, but as we have seen in Europe, human nature forces us to revert to our previous behavior fairly quickly. This is especially true for young people, ”he warned.

He added that the continued sequencing of new cases should also be a priority to keep track and follow the developments of new variants.

Additionally, Dr Yahya suggested that, if financially feasible, a study to monitor levels of protective antibodies among the vaccinated population should be conducted as it would offer vital information for achieving herd immunity.

“Despite all these things, we might still have a the tarik season to a mamak in 2022, ”he joked. – Malaysian mail