NINETEEN months after Covid-19 first emerged in Wuhan, China, and proceed to plague the world, Malaysia is experiencing its largest wave yet of infections.

The country logged a record 17,045 new cases yesterday. Total cases have crossed the one million mark.   The public is frustrated as repeated and extended lockdowns seem to have failed to mitigate the public health crisis and bring the spread under control.

A majority of scientists around the world as well as the World Health Organization (WHO) are starting to believe that Covid-19 is likely to become endemic.

Malaysians have been fed the false hope that we can win the fight against the Covid-19 with repeated lockdowns. When the failure of the lockdowns became apparent, public admiration for the Health Ministry spokesman took a dive, as did public trust.

The fact is, lockdowns have dire consequences and are only effective within a certain window of time. 

For one, we are inherently social beings who cannot live without interaction with one another. Not being able to do so takes a toll on our emotional and mental health.
 
On top of that, lockdowns disrupt our economic activities and interfere with the modern economic structure which is extremely intricate and volatile. Therefore, a series of lockdowns without proper financial subsidisation policies from the government could lead to depleted coffers and public discontent. 

Even in countries where the government has provided appropriate financial aid, lockdowns are unsustainable due to their detrimental effects on supply chains, mental health and more.

Countries such as the United Kingdom, Germany, the United States, Italy, and Singapore have recently lifted most if not all of the various movement restrictions as the national strategy to contain the coronavirus. These countries are now encouraging the people to return to normalcy with the advice: Learn to live with Covid-19.

The good news is, the national immunisation rate has improved to the point of being commendable.  The recent announcement of Deputy Prime Minister Ismail Sabri and Health Minister Adham Baba that the government will consider relaxing the restrictions for those who are fully vaccinated indicate that the government has shifted its fundamental strategy for handling the pandemic from lockdowns to vaccination.

Yet there has been no change in the official narrative in the risk communication to the public. We are still being fed the same old statistics and SOPs.

On the other hand, we hear nothing of risk assessment from the government, particularly whether the fully and partially vaccinated were among the new Covid-19 cases and if so, how many, beyond the director-general of health Dr Noor Hisham Abdullah’s disclosure that 3,106 (or 1.36%) of fully vaccinated healthcare workers were infected between February 24 and July 14. He went on to reassure the public that vaccines could reduce the severity of the disease and risk of death.

Nor have we received a plausible explanation from the MOH that is backed by data and scientific evidence as to why daily cases and deaths continue rising after vaccinations have dramatically picked up.

Strategies to combat a pandemic typically run into a trilemma of equality, liberty, and mortality.

While lockdowns may be effective as a mitigation measure to reduce virus transmission, they heavily restrict civil liberties and inflict other harms, including causing non-Covid deaths. 

Targeted intervention policies for high-risk groups could reduce the risk of infection but their implementation raises issues of inequality and discrimination. To minimise public disagreement and achieve consensus on the direction of government policies, the public has no choice but to engage in an inconvenient discussion: What would be the acceptable costs to society and individuals as we move from MCO and start to learn to live with Covid-19?

We should also bear in mind that whichever direction or policy we choose, the trilemma dictates that there will never be a perfect solution. Someone will always lose out.

We must be aware that even though the government’s plan for “vaccination passports” could restore some degree of freedom, the freedom will not be restored equally.

For instance, there are people who are not vaccinatede because they are immunocompromised or have health contraindications, people reject vaccination for personal reasons, and people who are too young to receive the shots. What about those who acquired immunisation naturally via infection? Will they still require a vaccine passport? Will they be entitled to a passport? How will the government ensure they will not be treated unequally or discriminated against?

It is useful to learning from the previous pandemics of history. For example, the death rate for tuberculosis in Europe was 100 per 100,000 population per year in the early 20th century, but the disease has been controlled for decades, thanks to medical interventions as well as human evolution.

It may serve as a reference for making exit plans while taking precautionary measures. The government should champion public health education which focuses on holistic approaches consisting of vaccination, new guidance on handling new cases, including the assurance that everyone who needs treatment will get it, personal hygiene practices, and self-isolation.

Vaccination is not the be-all and end-all but but a part of mitigation measure .

Finally, I urge authority to practise transparency in sharing information so that the public can make informed choices after assessing the risks. – July 26, 2021.

* Chong Kok Boon is a member of Agora Society. He is a self-declared Peter Pan who advocates science in forging a more democratic and humane society.