Thursday, August 5, 2021

Time to do away with bunker mentality, experts say on lockdowns

They say Malaysia needs a new approach in its war against Covid-19.

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Experts are urging the government to do away with the “bunker mentality” of enforcing lockdowns to curb the rising numbers of Covid-19 infections which reached a daily high of over 13,000 last week despite the strict movement controls imposed since June.

Azrul Mohd Khalib, chief executive of think tank Galen Centre for Health and Social Policy, said lockdowns and restrictions create an artificial environment and a false sense of security.

“We have to learn to manage and live with this disease,” he told MalaysiaNow.

“That is why it is important for as many people to get registered and vaccinated as soon as possible.”

The current lockdown, dubbed MCO 3.0, was enforced on June 1.

The announcement came days after health director-general Dr Noor Hisham Abdullah warned Malaysians to “brace for the worst” amid an exponential trend indicated by the country’s Covid-19 graph. At that point, daily cases were at a high of about 8,200.

“We have to learn to manage and live with this disease.”

It also came amid an ongoing debate over the need to maintain a balance between lives and livelihoods, as businesses deemed non-essential are shut down each time a lockdown is declared.

Azrul said the government could not continue to rely on the same approach taken during the first MCO last year as the outbreak had long since made its way into the community.

“An epidemic of this level of infectivity means that a high level of adherence to SOPs and good hygiene practices will likely have a more effective impact than lockdowns, which yield temporary and unsustainable results,” he said, adding that total restrictions on movements should be a last resort.

‘Inferior intervention’

Dr Sanjay Rampal, an epidemiologist at Universiti Malaya, agreed that the effectiveness of lockdowns had decreased over the past year.

Speaking to MalaysiaNow, he added that lockdowns have a temporary effect and come at a high cost.

He said lockdowns, which he called an “inferior intervention”, could only reduce community transmissions if the entire country is under lockdown for four to eight weeks.

“However, it has a very high psychological, social, and economic cost,” he said.

Even with the arrival of the Delta strain in the country, Sanjay said lockdowns are not necessarily an effective measure if certain sectors are still allowed to operate.

“It has a very high psychological, social, and economic cost.”

“The Delta strain is more easily transmitted, but the severity of the disease does not appear to worsen,” he said.

“The latest lockdown has not been as effective, partly due to the decreased intensity which allowed more movement by the working population to lessen its financial and economic impact.”

He, too, said the results of the restrictions are likely to be temporary, with cases increasing once they are lifted.

‘Many failures’

But Malaysia has not been alone in its struggle to find a solution to the rise in number of Covid-19 infections.

While some countries have managed to bring their numbers under control, others are still fighting a seemingly never-ending surge of cases.

In Italy, the first European country to be hit by the global pandemic, clinical biochemist Dr Salvatore Chirumbulo spoke of a similar failure of lockdowns.

Italy’s strictest lockdown was enforced from March 8 to May 31 last year, after which the government came up with a warning map which categorised areas according to colours much like Malaysia’s red, yellow and green zones.

But Chirumbulo, from the University of Verona, said cases and deaths continued in the country despite lockdown measures.

“Population density is one of the factors that should be considered for any lockdown policy.”

“The many failures were due to lockdown in houses, hospices, hospitals, workplaces, leading to the incubation of infected people and rising infection contacts. Home therapy protocols were shallow and clumsy,” he said, adding that data was also uncertain and communication non-transparent.

On the latest lockdown in Malaysia, he said it is difficult to hamper viral spreading due to the high population density in many areas.

“Population density is one of the factors that should be considered for any lockdown policy,” he said, adding that age distribution, crowding, urbanisation density, rural areas, communication frequency among citizens and the reliability of healthcare structures must also be taken into account.

He said a better alternative would be to reduce hospitalisations by improving home therapy within the first three days of symptoms.

‘Intended to be temporary’

Closer to home, the New Zealand health ministry attributed its success in containing the spread of Covid-19 to its use of an alert system.

“In March last year, less than a month after the first case was confirmed in the country, an alert level system was devised with four different levels, and the country went into Alert Level Four lockdown,” a spokesman for the country’s health authority told MalaysiaNow when contacted.

“Lockdowns are not intended to reduce the number of people infected and eliminate the disease.”

Alert Level Four requires everyone apart from essential workers to remain at home. Only essential services such as supermarkets and petrol stations are allowed to operate, with standard infection prevention control measures in place.

After three weeks at Alert Level Four, the country progressed to Alert Level Three.

However, the ministry said other measures were equally important including vaccination, isolation and quarantine, contact tracing and basic hygiene messages urging people to stay at home.

Azrul agreed that countries such as New Zealand and South Korea have a better understanding of the epidemiological situation which allowed them to target their lockdowns.

“South Korea, for example, has a very high level of SOP compliance and an aggressive strategy of testing for new cases.

“They understand that lockdowns are intended to be temporary and to keep their health systems from being overwhelmed.

“Lockdowns are not intended to reduce the number of people infected and eliminate the disease,” he said.

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