Be ready for Delta variant wave

MUCH of the nation’s recent Covid-19 focus has been on the Klang Valley, including Negri Sembilan, and rightly so as the outbreak in these areas continues to rage.

We, however, may not be aware that other states outside the Klang Valley are gradually slipping into a crisis.

If you track ICU bed use by Covid-19 patients for Kedah, Penang and Perak as examples, you can see a steep rise in the past three to four weeks according to Health Ministry data.

Most of the rapid change in the situation is due to the Delta variant of the virus, which is most likely the predominant strain spreading in the nation now.

The Delta variant is highly infectious as it has a very high viral load and infects more persons faster.

In addition, the fully vaccinated rates for many states outside the Klang Valley are lower due to limited vaccine supply.

Data for July 25 shows that completed vaccination rates (two doses) for the states (percentage of the total population) were 11.5% for Kedah, 14.5% for Penang and 14.4% for Perak. With the Delta variant, two-dose protection is important.

We need to act now to prevent the situation in many states from getting worse. We possibly have a narrow three- to four-week window to act. Some suggestions are:

> States must advocate for more vaccine supply and ramp up vaccination to the maximum possible. Leave no vaccine vials in storage.

Avoid using large vaccination centres (PPVs) and instead do drive-by vaccination and use existing infrastructure (maternal and child health clinics, school health teams, GPs, private hospitals). We want to reduce the risk of mega PPVs being a Covid-19 transmission location.

> Reduce all non-critical social interaction to cut community spread of the virus. Avoid social, travel and religious activities.

Avoid the use of vaccination passports at this time for travel, and especially avoid interstate movement.

> Use the PCR (polymerase chain reaction) test only for hospital admissions and expand dramatically RTK-Ag (antigen rapid test) testing for all contacts, whether symptomatic or not.

Enable the public to self-test by making available reliable, cheap, saliva-based RTK-Ag tests at pharmacies and healthcare centres/GP clinics.

The state governments should consider subsidising these tests. Anyone who is RTK-Ag test positive should be isolated and monitored.

> Activate a state-level multi-sectoral disaster team, not unlike the Greater Klang Valley Task Force. Get plans in place, teams activated and resources on standby quickly so when the Delta wave hits, we will be better prepared.

This includes increasing the number of hospital beds, oxygen delivery capacity and electrical power supply.

> The state-level disaster management teams must be empowered to act immediately (ie, decentralise decision-making) and supported by state governments.

Remember that the Federal Government has invested significant resources to support the Klang Valley and may have limited funds for other states. Hence state governments must come together with business leaders to act for their states.

> We need to give a clear message that vaccination alone will not stem the Delta wave; we need to maintain all public health measures – ie masks, ventilation, physical distancing, etc. We need to encourage the public to be vigilant and maintain SOPs even if vaccinated.

> Finally, share data transparently with the public to comprehensively explain that the true situation is crucial.

We cannot say “everything is under control” when we know it is not. Granular, down to district level, data will encourage an all-of-society involvement to reduce the impact of the Delta wave. A concerned public is one that acts.

We have an opportunity to ensure the anguish that residents of the Greater Klang Valley area are experiencing does not spread.

If good, strong regional leadership steps up now, we just may avoid the worst of the crisis that is impending.


Consultant paediatrician

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