In vaccine we trust, provided...

National plan: Securing vaccines for the population is a priority.

The MCO and even the just declared Emergency are only stopgap measures. What we need is a national vaccination plan that covers all bases.

SO a state of Emergency has been declared until Aug 1 to fight the Covid-19 pandemic that has become a deadly threat to the people’s health and the economy.

The King’s proclamation came just a day before we begin another round of movement control order in the federal territories and five states, my Selangor included, and conditional MCO for another six.

Declaring an Emergency may sound ominous and scary, especially to older Malaysians who remember it as a draconian measure used during the communist insurrection and May 13 race riots in 1969 – but this is not the case in 2021.

While the Opposition and others can question whether an Emergency is really necessary or if it’s politically motivated, there is no doubt that Covid-19’s third wave is overwhelming us and other nations.

SARS-CoV-2, the novel coronavirus causing Covid-19, has roared back and, worse, mutated as governments relaxed restrictions and winter arrived.

Infections, hospitalisations and deaths have shot up and now there are three new variants.

The first to emerge are the so-dubbed UK and South African strains which are said to be about 50% more contagious.

On Sunday, Japan’s Health Ministry reported it detected a new variant found in four people who had arrived from Brazil. I believe more strains will be popping up.

Meanwhile, many developed countries have started their vaccination programmes in a desperately expensive bid to create herd immunity by the year-end to checkmate the virus.

Our government is still busy buying more vaccines from various pharma companies with the RM2.05bil allocated for this purpose, according to Science, Technology, and Innovation Minister Khairy Jamaluddin.

On Monday, the Health Ministry announced the signing of a deal to buy another 12.2 million doses from Pfizer and BioNTech, bringing the total number of shots to 25 million. That’s supposed to be enough to cover 39% of the population.

We also procured 12.8 million doses of the Oxford-AstraZeneca vaccine and are negotiating to buy millions more doses of vaccines developed by two China pharmas and one by the Russians.

The first lot of 12.8 million Pfizer-BioNTech doses are slated to arrive late next month. The Oxford-AstraZeneca vaccine is supposed to come in two batches between March and June.

But what is our state of readiness and preparedness for the rollout of a very fragile and costly vaccine?

On Christmas Eve, Khairy said the Covid-19 Vaccine Supply Access Guarantee Committee, chaired jointly by him and Health Minister Datuk Seri Dr Adham Baba, had been working on the National Vaccination Plan.

Khairy also said the plan would be finalised by Jan 7 and presented to the Cabinet today with the aim of starting its implementation in February.

But on Jan 8, Dr Adham said the plan still needed “fine-tuning”. Just how long the tuning will take is anyone’s guess.

If it takes weeks, the February implementation deadline will surely have to be pushed back.

That may be an indication that there are still many factors and issues that must be resolved before the Pfizer-BioNTech two-dose jabs can start.

Khairy does seem confident that the committee has worked out key issues like distributing the vaccine mostly in urban areas since it requires deep freeze storage of between -80ºC and -70ºC.

He said 55 locations had been identified nationwide to store the vials at the additional cost of RM16.6mil for the ultra-cold chain facilities needed for safe transfer and storage. (People in rural areas will have to wait for the hardier Oxford-AstraZeneca vaccine.)

But just how complex and difficult it is to store, distribute and administer the Pfizer-BioNTech vaccine can be seen from the chaotic situation in the United States.

The Guardian newspaper reported that slow approval of the US$8bil (RM32.5bil) funding needed for infrastructure as well as scattered logistics have created a haphazard mess.

What the US also lacked was a “clear, coordinated national plan”, Bruce Y. Lee, professor at the CUNY Graduate School of Public Health and Health Policy in New York, told The Guardian.

“Not enough doses have been produced and distributed. Of the doses that have been distributed, the majority have not been administered. They’re either getting (caught) up in the supply chain... or not getting administered, ” he said.

When it comes to logistics, it is not just adequate freezer capacity that is needed but also vaccine accessories such as syringes, needles and alcohol swabs.

The handling of the Pfizer-BioNTech vaccine also proved to be a herculean task in China, according to Bloomberg, as it required “a complex and costly system of deep-freeze airport warehouses, refrigerated vehicles and inoculation points” across the country.

Not only that, healthcare providers also have to be trained to handle the delicate shots, which must be thawed and used within six hours after being removed from sub-zero storage and reaching room temperature. Otherwise, they go bad and must be discarded.

While we are told there are 55 storage locations in Malaysia, it is not clear if these sites are also where the injections will be administered.

But regardless of whether it is the Pfizer-BioNTech or Oxford-AstraZeneca vaccine, US experts say setting up large, centralised inoculation centres that can rapidly administer the doses would be more efficient than sending people to hospitals, clinics or pharmacies.

So perhaps stadiums and conference halls which are not in use can be a viable option for us.

Khairy has said the vaccinations will not be mandatory and adults above the age of 18 can opt in for shots through the MySejahtera mobile app.

Since the plan is to start with frontline workers followed by people with comorbidities and senior citizens, I hope the app will allow me to sign up my mother who ticks all the boxes as a person in a high-risk group.

She turned 87 on Sunday and has non-communicable diseases like diabetes and should be right up there in the queue.

Then there is the public information and communication factor that Khairy and team must get right.

In November, Prime Minister Tan Sri Muyhiddin Yassin said a study found that 82% of Malaysians were ready to be vaccinated and expressed the hope that the number will eventually reach 100%.

But less than two months later, a Health Ministry survey found only 67% of respondents would take the vaccine as concerns over safety and side effects grew. That’s not a good sign because if not enough people get inoculated, achieving herd immunity will take much longer.

So what is required in the national vaccination plan is a strategy that allays fears about safety and makes it easy and convenient for people to register and get the jabs at little or no cost.

Price could actually be a good motivator. So far the government has indicated the vaccines will be given free but it might encourage kiasu Malaysians to stick out their arms if they are told the vaccines are free for only a limited time.

As for the reimposed MCO and conditional MCO, these are only stopgap measures, needed because, as Muhyiddin said, our healthcare facilities like public hospitals are at breaking point.

So, too, the state of Emergency, which allows the government to use whatever resources deemed necessary, like co-opting private hospitals, to cope with pandemic needs.

The only long-term solution is mass vaccinations to achieve herd immunity.

Will two weeks be enough to flatten the infection curve or will the MCO be extended after Jan 26? If not, will the government, using its emergency powers, impose even tougher measures like curfews?

The answer lies in our collective ability to stay home and be disciplined in following the well-established SOP of mask-wearing, hand-washing and physical distancing.

If we can do that, we might just save Chinese New Year which falls on Feb 12.

The views expressed here are the writer’s own.