Seeking truth from facts in Covid-19

Prior success does not mean much as far as combating the Covid-19 virus is concerned. Over the past week, Malaysia has seen a record- high number of new cases. The headlines are definitely worrying, but we are certainly not alone.

The rest of the world too is grappling with an upsurge in new cases, an ominous sign even before the northern hemisphere heads into colder winter months. This rising second- third wave is reported in countries that had previously managed to contain the spread via lockdowns and stringent restrictive movement measures as well as those that were largely spared the initial outbreak.

It is a stark reminder that we cannot afford to be complacent about the still- present risks. No one is immune. Not even the president of the US, who, together with his wife and several close aides, was confirmed positive for the virus. But it is also very important that we must not panic and overreact.

It is possible that the world may never eradicate Covid-19, even with vaccines, not unlike the flu. No vaccine will be 100% effective and the virus may continue to mutate and persist. Nevertheless, continued progress in medical science will surely make it less fatal, like it did with the human immunodeficiency virus (HIV) that causes AIDS.

The fact of the matter is, Covid- 19 may turn out to be yet another disease that we will just have to learn to live with. It is the new normal — and as clichéd as they sound, these words are not to be taken lightly. And if that is the case, all decisions made in regard to the viral outbreak need to consider real world practicalities as opposed to being purely ideological.

We may have to revert to some of the previous restrictions such as 50% seating capacity for eateries and lowering the number limits for gatherings in mosques, churches, weddings, funerals and so on.

Enforcement must be strengthened to ensure strict compliance with the standard operating procedures ( SOPs) — for instance, mandatory wearing of masks and physical distancing in public places, temperature screening and check- in at malls. There may even be a need to implement enhanced targeted and localised movement controls.

But few countries — if any — will revert to the stringent nationwide lockdowns such as those imposed at the outset of the pandemic. There are very good reasons this must be the case.

The intent of the initial stringent lockdowns was to buy time, to allow countries and healthcare systems to be better prepared. We did that. But such lockdowns are unsustainable. The cost is too high, and is it not just the economic fallout.

Often lost among the headlines is the collateral damage. This includes lives that are, or will be, lost because of the postponement of routine medical care — such as going for cancer screening, where early diagnosis is critical for chances of recovery — and help for treatable and preventable diseases such as dengue and malaria as well as elective surgeries.

Delaying the recovery of economies and jobs will lead to loss of livelihoods. The pandemic is hitting the poorest the hardest. Poverty has cascading consequences such as domestic abuse and malnutrition that could result in a long- term health impact, even starvation and lives lost when people can no longer afford to seek medical treatment. Education, the most important bridge to income equality, gets bumped down in the priority list.

There is another important statistic against widespread lockdown — the death toll. The fatality rate varies from country to country, depending on a host of factors such as the extent of testing and tracing, cultural norms, demographics and quality of healthcare services.

Around the world, however, the number of daily deaths relative to new cases has been on a steady decline from the peak in April and May (see chart). The fatality rate will change throughout the duration of the pandemic — though we believe it will continue to drop. Why?

Experience and knowledge. Our under