Covid-19: Signs of a fourth wave upon us

PETALING JAYA: Malaysians must do all they can to prevent another spike of Covid-19 cases, as health experts believe that a fourth wave is imminent with a lapse in standard operating procedure compliance.

This comes amid a statement from the Science, Technology and Innovation Ministry that the vaccine supply to Malaysia is slow-paced, and with Ramadan bazaars being allowed to operate.

For a few days now, the number of new infections has also been higher than recoveries.

Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said that real-time data and field observations are providing signals of an impending fourth wave.

She said the major contributing factor to the rising cases right now was people’s behaviour.

“These include tendencies to get together – workplace and family gatherings, kenduri functions and having closed interactions during meals without face masks on.

“With these underlying issues in society, the possibility of a new strain would fuel even more cases, ” she said.

Dr Malina said she believed that the drastic increase of new cases would potentially lead to similar outcomes seen in the third wave in terms of intensive care unit (ICU) treatments and mortality rates.

There are several Covid-19 variants in the country right now including the Nigerian variant (B.1.525), British variant (B.1.1.7) and the South African variant (B.1.351).

Universiti Malaya expert virologist Prof Dr Sazaly Abu Bakar foresees a fourth wave if interstate travel is allowed.

“The last two waves were all related to interstate travel – the second one was when people came back from Sabah and the third was when the government allowed interstate travel again, ” he said.

Dr Sazaly added that the current rise in cases was due to interstate travel as well as mass gatherings.

“Interstate travel is actually still taking place right now because the government has to make sure the economic lifeline is still going, so people are travelling for work.

“The clusters seen now are also related to workplaces.

“I believe gatherings in confined spaces as well as mass gatherings involving more than 25 people are happening, ” he said.

The World Health Organisation (WHO) has warned of a critical point in the pandemic as several countries including the United States, Canada, India, Brazil, South Korea and Britain brace for a resurgence of cases.

A Covid-19 infectivity rate forecast shared by Health director-general Tan Sri Dr Noor Hisham Abdullah on Twitter showed that the infectivity rates would reduce from an Rt of 1.2 to 0.8 if there was compliance to the SOP, in which daily figures would fall below 1,000 cases by the end of May.However, the forecast showed that if there was non-compliance to the SOP, the infectivity rates would increase from an Rt of 0.8 to 1.2, and cases would rise to more than 2,000 per day by mid-May.

While R-naught or R0 is the rate a person infected with a disease may spread it to one other person assuming no one has immunity, “Rt” is a similar but real-time metric taking into account current control measures and the proportion of the population with immunity.

An Rt of less than one means that an outbreak is subsiding while an Rt above one means that the virus is spreading, with each contagious person infecting more than one other person.

In his tweet, Dr Noor Hisham said that the Rt nationwide stood at 1.09 as at April 13. The highest Rt now is in Terengganu at 1.34, followed by Putrajaya (1.29), Sabah (1.21) and Sarawak (1.18).

Public health specialist Asst Prof Dr Mohammad Farhan Rusli from International Islamic University of Malaysia also agreed that a fourth wave would hit the country soon.

He said that the only way the country would be able to weather it would depend solely on the speed of the vaccination drive.

“The vaccines will now prevent us from progressing to a severe Covid-19 outbreak, thus reducing the impact on our healthcare facilities.

“It is likely that we may have to live with Covid-19 for a long time, so the vaccination rate must be stepped up, ” he said.

Dr Mohammad Farhan, who is also on the Selangor Covid-19 Task Force Committee, said the vaccines were no longer a matter of prioritisation, but a matter of “speed and volume”.

Currently, he noted that the government faces multiple issues such as resistance from the public, time, vaccine allocations, and the general anxiety of the population in accepting certain vaccines.

“It is imperative that states be allowed to directly purchase vaccines and be the middlemen to private hospitals and general practitioners who wish to procure different vaccines for different patients’ needs, ” he said.

A total of 632,668 individuals have received the first dose of their vaccine under the National Covid-19 Immunisation Programme as at April 13.

Meanwhile, 417,470 individuals have received their second dose, thus completing their inoculation, bringing the total number of Covid-19 doses administered in the country to 1,050,138.

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