Battle against Covid-19 work in progress

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A nurse administering the vaccine to a senior citizen at Batu Kawa Health Clinic.

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First of a three-part series

FOR well over a year now the world has been held to ransom by an unrelenting virus that has already claimed millions of lives, taken medical facilities to the brink, wrecked economies and destroyed livelihoods. And it is still causing untold damage.

Vaccines are now available to check its spread but, almost as if it does not wish to be outdone, the virus keeps mutating, sending governments all over the world scrambling for sustainable answers.

In hindsight, it may well be that many countries were a trifle slow in reacting to the threat posed by the Covid-19 pandemic. An ominous warning was given by the World Health Organisation (WHO).

“Be fast, have no regrets. The greatest error is not to move and speed trumps perfection when it comes to dealing with an outbreak such as a coronavirus,” advised WHO epidemiologist Dr Michael Joseph Ryan.

Truth be told countries that did not hesitate to implement drastic measures in curbing the virus have had some measure of success in controlling its spread.

The virus was first detected in 2019 when cases of pneumonia of an unknown cause struck Wuhan City, Hubei Province in China.

On Jan 30 last year, WHO Director-General Dr Tedros Adhanom Ghebreyesus declared the coronavirus outbreak a public health emergency of international concern (PHEIC) after 98 cases were reported in 18 countries outside China.

On March 11, the outbreak was classified as a pandemic after 118,000 cases had been reported in 114 countries, with the loss of 4,291 lives.

In Malaysia, the first three cases of Covid-19 were detected on Jan 25 in Chinese nationals from Wuhan who entered Johor Bahru from neighbouring Singapore.

Though the Ministry of Health (MOH) was initially able to curb the virus from spreading further, the virus ultimately found its way in.

It emerged, all cylinders firing, during a mass religious gathering at the Sri Petaling mosque from Feb 27 to Mar 1. The event which was attended by 16,000 people triggered a Covid-19 outbreak in the country with the Tabligh Cluster being subsequently declared.

Soon after Sarawak recorded its first three Covid-19 cases in Kuching district on March 13 last year.

The State Disaster Management Committee (SDMC) then said that two of the cases were linked to the Tabligh Cluster, while the third involved a family member of the second case.

The virus continued to spread and Sarawak went on to register the first Covid-19 fatality in the country.

It claimed the life of a 60-year-old pastor from the Emmanuel Baptist Church in Kuching on March 17.

As of Aug 23 this year, the state has recorded a total of 99,838 Covid-19 cases and 501 fatalities.

But the Sarawak Government has been swift in its response, setting up the Covid-19 Quarantine and Low-Risk Treatment Centre (PKRC) in each district statewide.

It has also been helping with the provision of financial support and food aid to its citizens.

With the implementation of the full lockdown in the nation back in March 2020, Chief Minister Datuk Patinggi Abang Johari Tun Openg unveiled the Sarawakku Sayang Assistance Package (BKSS).

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On top of that, Members of Parliament and state assemblymen have been reaching out to people in need in their respective constituencies.

Non-governmental organisations have also stepped forward to help out.

Multiple groups of people have been reaching out to the needy through the White Flag campaign.

One of the NGOs that has been actively helping people and handing out donations is Hope Place.

Its founder Kelvin Wan stated that there are a lot of kind-hearted people who would like to contribute but do not dare to deliver the items personally to places such as the hospital.

“Hence, we collect the items and contributions from the public to be distributed to hospitals and the frontliners.

“The contributions do not stop there. We also give aid to those in need such as families with Covid-19 positive members, residents who are put under enhanced movement control order (EMCO), and also those who lost their homes due to fires,” he explained.

He said that thus far, Hope Place has been able to distribute aid to the people thanks to the caring attitude of people in Kuching.

“If we did not have any contributors, we would have closed down by now. This is because, to date, we have a total of 200 families under our care but that does not mean we would not help those who are not under our wings.

“The four main criteria that we look for in those who apply for our aid are those who are disabled, abandoned elderly, single parents with children who are still in school and those with a total income of below RM500,” he added.

But despite the gallant efforts of all concerned the going has been tough on everybody as the virus, given the many emerging variants, is showing no signs of abating.

The federal government, like its counterparts elsewhere in the world, announced a vaccination roll-out to stem the tide of infection among the people.

The inoculation drive began on Feb 24 with former prime minister Tan Sri Muhyiddin Yassin becoming the first person in Malaysia to receive a Covid-19 vaccine shot followed by about 500,000 frontliners nationwide involving healthcare workers, welfare officers, security staff and elected representatives.

“The National Covid-19 Immunisation Programme (PICK) will be carried out in three phases with the first involving a total of 500,000 medical and non-medical frontliners which will be completed in April, while the second phase involving 9.4 million people will be catered to the elderly, high-risk groups and people with disabilities from April to August.

“Meanwhile, the third phase and final phase will be for citizens aged 18 and above, covering more than 13.7 million people from May to February next year,” he said then.

According to PICK Coordinating Minister Khairy Jamaluddin, as reported on March 9 this year, the country has secured 32 million doses of the Pfizer-BioNTech vaccine; 12 million doses of the AstraZeneca vaccine; and 12 million doses of the Sinovac vaccine.

In addition, Malaysia has also ordered a total of 3.5 million CanSino vaccines and will start administering the single-dose vaccine soon.

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“The vaccine (CanSino) will come in stages and thus far, we have received 200,000 doses on Aug 20. The arrival of the CanSino vaccine will facilitate vaccine administration in areas with poor access,” said MOH director-general Tan Sri Dr Noor Hisham Abdullah in his Twitter account.

The vaccination roll-out has been a major factor in curbing Covid-19 transmission and in Sarawak as of Aug 16, the state had given the first dose of the vaccine to 1,822,036 individuals and 1,664,749 people their second dose.

This shows that the state has administered the first dose to 89.2 percent of the adult population while 81.5 percent of them are fully vaccinated.

The accelerated vaccination roll-out in Sarawak contributed to achieving herd immunity (80 percent of the population) by August.

“Sarawak is very fortunate as we have worked closely with the Federal government. We did offer to buy (vaccines), but the Federal government insisted on the national obligation saying that ‘you don’t need to buy, we will give it to you’.

“At the moment, we are very fortunate because we have enough vaccines for our people,” said the SDMC adviser Datuk Seri Dr Sim Kui Hian.

Dr Sim Kui Hian (left) speaks to nurses at the Batu Kawa Health Clinic.

With the vaccination roll-out ongoing throughout the nation, Sarawak has established a total of 121 vaccination centres (PPVs) statewide and is targeting to administer 50,000 doses per day.

According to Dr Loong Cai Yin who is one of the front-line team members at Stadium Perpaduan PPV, the vaccination roll-out has been intense at the PPV.

“We also have to work on weekends and public holidays to make sure that people are getting their vaccines,” she said.

Dr Loong, who is a dentist, was deployed to the PPV in mid-June due to the situation there being critical and extra help being needed.

“I was assigned to the data team to ensure that there are no hiccups from the recipients’ registration until discharge. As our team consists of doctors and dentists, I am glad to have a great leader to lead me hence, I managed to adapt to the whole new workstation quickly,” she added.

She said daily, the PPV vaccinates up to 4,000 people.

But the work is not a bed of roses as often they would receive complaints due to the congestion and long queue.

“However, the team managed to tackle the problem and immediately made changes as we realised the importance of clients keeping to their appointment times.

“Hence, people who come a few hours before would be denied and asked to come back again on his/her specific time given.

“The journey has not been easy but with great teamwork from different backgrounds, it was made possible,” she explained.

Dr Loong also talked about the challenges when faced with recipients not turning up for their second dose.

“My colleague and I in the ops room are in charge of calling clients who are late for appointments or who fail to attend their appointment.

“Some have unavoidable reasons such as being put under EMCO while some were unreachable or refused to take their second dose.

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“In these circumstances, we would not open the vial until there are six recipients gathered at the registration,” she said, explaining that there are six doses per vial of Pfizer vaccine, thus making it necessary to wait so that the vaccine would not go to waste.

“However, we do feel bad letting the recipients wait for the others before we open the vial. So, in this case, we would contact those who missed their vaccine appointment days before to come to make up with the number.

“At times like this, the waiting for the latecomers would result in stretching our shift till late, which is 10 or 10.30pm,” she said.

Dr Loong Cai Yin and her team at Stadium Perpaduan PPV.

As to how she handles the constant change of vaccine guidelines, she stated that staff in the PPV need to be updated at all times on the guidelines.

“This is because there is still much ongoing research regarding the Covid-19 and the vaccine itself.

“For example, according to the past research, the Covid survivors are only eligible for the vaccine after three months post-Covid but the latest guidelines state that they can get it by two weeks.

“The same goes for vaccines for pregnant women and breastfeeding mothers. They used to only give Pfizer to these groups but now both Pfizer and Sinovac can be given to them.”

On another note, she said that the Stadium Perpaduan PPV would be closed permanently on Aug 26.

“Hence, we have been rolling out only second doses for the past three weeks to clear everyone’s second doses.”

“I’m glad to have had the opportunity to learn how the whole vaccination programme is being carried out,” she added.

However, despite the ongoing vaccination roll-out, Dr Sim, meantime, felt that several public health intervention measures still need to be implemented to contain the spread.

“Being fully vaccinated does mean immunity. As we will need to live with the virus, even after vaccination, we still need public health interventions.

“This includes the Covid-19 standard operating procedures (SOPs) which need to adapt to the current situation as the virus keeps mutating,” he added.

On July 8, the first positive case of the more transmissible Delta variant was detected in Sarawak.

Since then, there has been a sharp increase in Delta variant cases in the state.

“The Delta variant detection rate is approximately 90 percent in Kuching division alone,” said Professor Dr David Perera, director of the Institute of Health and Community Medicine (IHCM) Universiti Malaysia Sarawak (Unimas).

He disclosed that as of Aug 10, they had sequenced 338 samples received throughout Sarawak, of which 73 per cent was linked to the Delta variant.

“This is a sharp increase compared to the 50 percent detection rate reported on Aug 3. Besides, 90 percent of the cases from the Kuching division sequenced in this testing round were linked to the Delta variant. This suggests a widespread high prevalence of the Delta variant in the Kuching division community,” he stated.

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