KUALA LUMPUR, July 20 – Minimizing social interactions is the key step individuals should take to avoid infection with Covid-19, in addition to getting vaccinated, improving ventilation and maintaining physical fitness, said Dr Amar-Singh HSS.
The senior consultant pediatrician has advised the public to strictly follow the home safety bubbles – keeping contact only with members of their household – adhering to all Covid-19 standard operating procedures (SOPs) and enacting new ones standards.
He pointed out that there are currently no “safe” numbers for people to come together, amid a burgeoning epidemic despite more than six weeks of nationwide lockdown.
“Keep a strong home security bubble,” Dr Amar said at a recent virtual conference titled “Covid: The Current Situation in Malaysia and the Response of Churches,” hosted by the Methodist Church of Malaysia.
“If you see your neighbors when you jog by the side of the road, you don’t stop to talk. I still see neighbors talking to each other every day. I am worried about them because it is a very risky thing to do.
“Don’t interact with anyone. You want to talk to your neighbor, you make a video call to him and talk to him.
“You want to buy food, you should buy from stores that give you the option to buy from outside if possible. Try not to enter a store, you can scan the QR code from outside. All restaurants should consider moving services outside or offering takeout at the front door. “
He also called for a workplace safety bubble for those who commute to their workstations.
“People who work together have to be honest. I call it a bubble of confidence. You should tell everyone you work with as soon as you come in contact with who is positive or if you are infected. If you’re not feeling well, you shouldn’t come to work.
On top of that, Dr Amar advised the public not to have lunch with co-workers as unmasking in a group indoors would increase the risk of being exposed to the coronavirus. He also suggested not removing face coverings in the workplace, including places like toilets, due to poor ventilation.
Dr Amar said the COVID-19 cases reported daily by the Department of Health (MOH) do not reflect the actual scenario, as the number of new infections depends on the number of tests for Covid-19.
“The reported numbers depend on the tests, which unfortunately are not shared with the public,” Dr Amar said.
The Department of Health is sharing cumulative Covid-19 tests conducted across the country to date, instead of releasing daily test numbers. State or district test data is also not available.
“Don’t focus on clusters, focus on community spread, which is the biggest part of the pandemic,” Dr Amar said.
Malaysia reached its first 100,000 cases of Covid-19 in 334 days on December 24 since the virus struck the country. But the next 100,000 reported cases took a month. The fifth 100,000 cases were accumulated in just 22 days, while the sixth and seventh 100,000 cases took 14 and 17 days, respectively.
“So right now we’re increasing by 100,000, every 15 to 16, maybe sometimes 17 days, and recognize that means our pandemic is moving at a very rapid rate right now in our country.”
Dr Amar also highlighted the high positivity rate of the Covid-19 test in Malaysia last month, ranging from 6.64% to 7.68%, indicating more undetected cases in the community (it has since passed at 8 to 9%). He mentioned that the Movement Control Order (MCO) has only been successful in reducing coronavirus cases for a short time.
“Our pandemic is growing, not diminishing. So MCO interrupted it for a very short time and now it is starting again, mainly because it is spreading in the community in an uncontrolled manner.
Dr Amar pointed out that death rates in Malaysia from Covid-19 are increasing, including death rates in non-Covid-19 patients. He said full use of intensive care unit (ICU) beds has resulted in an insufficient number of beds for new critical patients and patients with other illnesses, resulting in the deaths of patients such as accident victims. severe, heart patients and cancer patients.
“Our intensive care beds are very full. We have now reassigned the general beds to be used for ventilation of people, which is not ideal. Some of our patients ventilated in intensive care are dependent. They have been there for a few months, some ”.
“This therefore prevents all intensive care units from being used by people who contract a new disease from Covdi-19. So once that happens, the death rates will go up. “
Dr Amar said mortality among non-Covid-19 patients during the outbreak should be reported, especially those who cannot get an intensive care bed.
Dr Amar also noted that intensive care care requires trained healthcare staff and mortality will increase with insufficient staff to care for ventilated patients. He claimed there were stage four and stage five Covid-19 patients with serious illness still awaiting admission to hospitals across the country; be ventilated in emergency departments.
“If all of my colleagues across the country could speak up, maybe the horror of what they are facing could actually galvanize the public to be more careful about our situation,” he said.
“The first 500 deaths from Covid-19 took us about a year. But right now, we’re taking seven days to get 500 deaths. Five hundred people die from Covid-19 every seven days, and our death rate has increased. “
“Before, 0.4% of people who got sick died. It is now 1.3%. So that’s a big difference. We are losing almost three times as many people as at the start of the pandemic. “
Maximum use of intensive care has also prompted doctors to sort patients based on their chances of survival, Dr Amar added.
“So it’s very painful for doctors and we don’t like it. But you have to decide who you want to save. Most doctors will likely save those who can do better than those they think have high mortality. “
Dr Amar also mentioned that the 1.3 percent case fatality rate varies depending on the age of the patients. “If you are older, you are more likely to die. If you are younger, you are less likely to die. Additionally, some who leave the ICU also die later – our rough estimate is that 10 percent of those who leave the ICU die. In addition, we have no idea of collateral deaths.
From May 1 to July 14, Malaysia reported a total of 531 dead Covid-19 cases. This represents 10.6% of the total deaths from Covid-19 recorded during the same period.
Dr Amar said there is no data that can identify the status of those people who died from Covid-19 before they can seek medical treatment. He said it could be those who did not know they tested positive and then died at home, or those who tested positive and were asked to stay home before get a place in overwhelmed quarantine centers. Death cases could also be people with Covid-19 who developed serious illness in a shorter period of time.
“We don’t know any of this data; it is not available to us. But losing 10 percent of our deaths from brought deaths suggests to us that the system has failed in all areas and is no longer responding to what is happening. “
Dr Amar also noted that the ‘long Covid’ is another issue that should be addressed in the outbreak. Although Malaysia does not have complete data on long-standing Covid patients, Dr Amar said data from the Ministry of Health showed that 60% of ventilated Covid-19 patients who were discharged from the ICU suffered from ‘lingering effects of coronavirus infection.
According to Dr Amar, as of the end of June, nearly 72% of the small sample of Covid-19 cases with variants identified of concern in Malaysia were the Delta strain originating in India and could be the dominant cause of the latest wave of L ‘ Malaysia epidemic.
“Our problem is that there are very few genomic tests in our country compared to other countries in our region.”
In addition to this, Dr Amar also praised the acceleration of vaccination against Covid-19 in the country, as he called for even faster vaccination rates.
“We don’t expect vaccines to stop all infections. We want the vaccine to prevent serious infection or hospitalization. “
July 18, a total of 41.9% of the adult population in Malaysia received the first dose of Covid-19 vaccine, of which 19.4% were fully vaccinated.
However, Dr Amar noted that the vaccination program should be accelerated in parallel in all states as the Delta strain can easily increase Covid-19 infections in other states as they begin to ease movement restrictions. .
“Of course there are people who don’t believe Covid-19 is a problem. I wish they could come into the Covid-19 ward and work there for a week. I think they will be transformed.