Preventing the second wave of Covid-19

Vietnam eased its lockdown restrictions in stages from April 22 after having no new Covid-19 cases for about a week, and is currently back to normal with social distancing guidelines in place. — Bloomberg

We keep seeing news about many countries reopening their economies, only to have a second wave of Covid-19 affect their citizens. How can we minimise this?

This is indeed a huge issue that Malaysia must face now.

The ideal situation would be that there is herd immunity in our population towards the SARS-CoV-2 virus that causes Covid-19.

But in order to achieve herd immunity – which we pointed out had to be as high as 70% in the case of Covid-19 in an earlier column – we are looking at a vaccine.

Unfortunately, a vaccine might not be available until 2021, if at all.

So many viral diseases are still without a vaccine, such as HIV/AIDS, and we just have to live with them while taking the necessary precautions.

So how can we reopen our economy while minimising the impact of a second wave of Covid-19?

That is the trillion dollar question.

Do we have an answer?

If anyone in the world has a definitive answer (i.e. just follow these measures and all will be well), they would probably win the Nobel prize!

The truth is that there are many theories by many scientists.

But you still have to carry out the experiment in the real world and see what happens.

It would be ideal to wait until Covid-19 cases are non-existent or minimal before reopening our economies, like in the cases of New Zealand or Vietnam.

But in reality, this is not possible. There may always be new or current cases, with the number fluctuating from day to day, like what we are seeing in Malaysia.

Then there is the difficult balance between saving lives and saving livelihoods.

Reopen the economy too early and we might fail to save lives.

Reopen the economy too late and we might fail to save livelihoods.

Both are disastrous in their own ways and can cause much damage to our societies.

It can also cause governments their re-elections!

We must have a best practice surely?

Business management consultant company McKinsey published a long report on this.

According to the report, there are several things a government needs to have in order to restart an economy after Covid-19.

It is also important to note that the government has to weigh each region in their country differently and decide on different measures for different periods of time.

In Malaysia, I suppose we can do this by states, or even districts within our states.

The first factor in determining readiness is the number of new cases in a given area.

Regions with high numbers of cases and ongoing infections should be the last to reopen their economies (i.e. red zones that can be placed under an enhanced movement control order).

The number of cases considered high will vary from country to country based on their national average.

In each region, the government will also have to consider if the local healthcare system can take the anticipated rise of cases that might be caused by reopening the economy there.

Luckily, in Malaysia, our regions are not that far from each other and a patient from one area can still travel to another one to be hospitalised.

Of course, the patient might cause new cases in that other area if precautions are not taken.

Any other factors?

Yes, the second factor is the strength of our systems in detection (testing), managing and preventing new cases.

We need to have:

  • Adequate medical facilities, especially intensive care units (ICUs) for ventilators and hospitalisation.
  • A diagnostic test with a fast turnaround time.
  • Processes for isolating known cases and detecting their contacts, including apps for contact tracing.
  • Adequate medical resources such as doctors, nurses and personal protective equipment.
  • Good public education and awareness.
Is Malaysia ready for reopening then? Do we have all these measures in place?

I can’t answer that for all regions. Some states are definitely more affected than others.

Perhaps a state-by-state approach would be best – the government would have the most information and expertise to be the best judge.

Let’s take a look at a country that did reopening very well indeed – Vietnam.

In Vietnam, the reopening of the economy (which happened in late April [2020], well before us) was determined by the low single-digit number of new national cases.

Vietnam is divided into provinces rather than states.

The government of Vietnam then graded each province by their risk level: at high risk, at moderate risk and at low risk.

Each province had different reopening and social distancing grades, depending on this risk evaluation.

The reopening was done in a stepwise approach.

Once there were minimal new national cases in the community, people were allowed to start up essential industries first, followed by other industries.

Then restaurants were allowed to open, as well as barber shops.

This was followed by schools reopening. Then massage parlours, and finally, discos and karaokes.

Now everything is open except for international flights, and even that is in discussion with other countries that have low transmission rates.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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