ONE of the new norms we are getting accustomed to is getting numbers about the Covid-19 situation from our government and media all the time.

We constantly learn about the number on a daily basis of new infections, the recovery rate versus case fatality rate, the percentage of asymptomatic cases, and inevitably, the R-naught (R0), a simple number computed from a complex differential equations based on a designed epidemiological model, yet one so powerful that essentially dictates the government’s decision on whether orders of societal and ways of our livelihoods need to be temporarily halted.

Understandably, with much about the new virus and the disease it causes remains unknown, and with no known effective medical interventions available, common sense requires both the government and the people to rely on non-pharmaceutical means, such as social distancing, and be very cautious in dealing with the situations associated with it.

Hence the government that practices as such will suffer little or no political penalties for being overly cautious, as opposed to those which are seen to be lax or under-cautious, as is the case of the United States.

But there are reasons why we should be careful not to be too obsessed with R0.

Some experts in other countries have reminded the public it is an imprecise estimate that rests on assumptions, such as arbitrarily assigned parameters like transmissibility and contact rate, which are necessary for modelling but not necessarily true.

What it captures is an average index for the entire population in our country, which obscures local dynamics. It is also a lagging indicator, which is an inappropriate reference of current status of the epidemic and can fluctuate when case numbers are low.

But there are other numbers that should concern us more than the totemic R0, as there are inevitable adverse consequences that come with our government’s efforts in breaking the chain of Covid-19 infections.

In the controversial Great Barrington Declaration, prominent experts such as Dr Martin Kulldorff, Dr Sunetra Gupta and Dr Jay Bhattacharya, along with tens of thousands of other medical and public health scientists and medical practitioners, have argued against lockdown policies on the ground that such measures would inflict harm on short- and long-term public health, such as lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings, deteriorating mental health, and affect underprivileged disproportionately.

While health leaders in the world, such as the director-general of the World Health Organisation (WHO), have explicitly criticised the position taken by the declaration, there should be no denying that guidelines published by the WHO and similar bodies have also advised cautious implementation of such measures on ethical grounds before.

It is important to constantly question the outcomes and impacts of the policies, to look for unintended consequences of the policy, to ask if local contextual factors would influence the level of impact, and to be aware of the economic impact of the policy that could be equated to loss of life and longevity.

Precisely what is the real cost associated with public health policy on a bigger picture? We need these numbers to put things in perspective, but where are these numbers to be seen in Malaysia?

What is not controversial is the fact that underprivileged and vulnerable groups are among the most impacted. As our country has just experienced a 17.1% contraction in gross domestic product in the second quarter, performing worse than some of our neighbouring countries, the number of unemployment has increased by 50% between last year and August 2020, recording a rate of 4.7% with approximately 800,000 people out of work.

Unfortunately, 53% of these people have no access to employment protection like the Social Security Organisation. The public learned from the parliamentary session that 30,000 small- and medium-sized enterprises have been forced out of business since the movement-control order (MCO) was implemented from March until September.

In a webinar hosted by ANU Malaysia Institute recently, Dr Muhammed Abdul Khalid, former economic adviser to the government, shared more worrying numbers – 5.6% of our households currently live under absolute poverty, and a further 16.9% are relatively poor.

If each household loses a mere RM700 from their incomes, an additional 800,000 households will fall into poverty.

Some 75% of Malaysians find it difficult to raise RM1,000 cash for immediate emergencies, even if the Employees’ Provident Fund savings are made available, 42% of the contributors have less than RM10,000 in the account to see them through this trying time.

Before Covid-19, the prevalence of stunting among Malaysian children under five was at a staggering 21.8%. In Kelantan, this figure stands at 34%.

Now that Covid-19 has hit, the number is expected to rise.

At the very least, 500,000 children who had been receiving free meals might have now lost their access to nutrition due to school closures. Meanwhile, 37% of the children do not own any device they need for online learning, while 20% of the children do not participate in online learning as a result.

This does not include the millions of migrant workers, documented or not, who have contributed to our productivity.

It is not my position to argue for an alternative policy to MCO and its variants. After all, it is still an effective measure that has proven to be successful in containing the spread of local infections, preventing the overcrowding of hospitals in our country and saving many lives.

However, if it continues to be the prevailing strategy for an extended period, then people deserve to know and understand the threats the policy could have on their livelihoods and wellbeing in the foreseeable future.

But more importantly, we need to protect the underprivileged groups more aggressively. As such, the government needs to start addressing issues that have emerged since the implementation of MCO, particularly those issues faced by the most impacted.

The government needs to release relevant data, information, and evidence to facilitate more inclusive discussions on the policy among the public and the civil society. This is to allow higher transparency and better accountability in the relief and recovery policies, to allow more constructive debates on risks and benefits based on evidence, and to better justify the national budget allocations.

We need more numbers than just the R-naughts and the daily infections.

It’s time for our government to communicate with the public on the threats the Covid-19 policy could have on a broader framework.

Sweeping these issues under the carpet of Covid-19 and R-naughts could very well be a path that turns out to be deadlier than the disease.

We should try all we can to prevent that from happening. – November 16, 2020.

* Chan Yit Fei is a founding member of Agora Society. He is a cellist and educator by profession, and a biotechnologist by training. He writes to learn and to think, and most importantly, to force himself to finish reading books that would otherwise not see much of the light of day.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.