DR Awang Bulgiba, chairman of the Science, Technology and Innovation Ministry's Covid-19 Epidemiological Analysis and Strategies Task Force, recently commented on the persistently high Covid-19 death count despite a ramped-up vaccine rollout in the Klang Valley and drop in daily hospital admissions.
Without more disaggregated daily data, we can't tell if the slowing trend of infections in the Klang Valley may have been compensated by increasing death counts in the less-vaccinated states now grappling with the Delta variant.
When hospital and intensive care facilities are overwhelmed, some mild-to-moderate cases who are advised to self-monitor at home may deteriorate quite rapidly before they can be admitted for treatment.
However, the increase in BID (brought in dead) cases, comprising 20%-30% of daily Covid-19 deaths, among foreigners suggests that migrant status is an important factor.
On Aug 13, the Health Ministry reported 318 Covid-19 deaths, of which 93 were BID.
Dr Chong Chee Kheong, deputy director-general of Health who also heads the Greater Klang Valley Task Force, noted that "some 80% of the BID cases involved those who either never had access to screening for Covid-19 or never came forward to be tested. A large number of the BID cases are non-Malaysians."
Dr Chong didn't say it explicitly, but we can safely guess that most of the untested foreign BID cases were undocumented migrants.
Malaysia, sadly, is reaping the consequences of decades of corrupt mismanagement of the "supply chain" for foreign labour, namely a persistently large pool of undocumented migrant workers often living in congested workplaces and dormitories, who have strong incentives to avoid contact with government agencies. Already fearful of detection, arrest and deportation in pre-pandemic times, their anxieties and insecurities are exacerbated by the policy reversals of the National Security Council (NSC) and its contradictory messaging over an offer of temporary amnesty to facilitate Covid-19 testing, contact tracing, isolation and treatment, and vaccination.
This problem with undocumented migrants, which persists despite repeated rounds of amnesties, will prolong our catastrophic experience with Covid-19 (and future pandemics as well).
The NSC should stop penalising undocumented migrants and their employers for the duration of the pandemic. The government should build upon the strong interest of most employers to keep their workers uninfected (to avoid a business or production shutdown or lockdown of workers' dormitories). Instead of penalising them for employing undocumented migrants, they should be incentivised to get their employees vaccinated as soon as possible (penalties instead for employing non-vaccinated workers?).
Khairy Jamaluddin, the newly appointed Health Minister, is justly proud of our institutional capacity for ramped-up vaccination (kudos for his leadership of a well-organised effort). The major bottleneck was supply of vaccines.
The likelihood of further variants and endemic Covid-19 emphasise the importance of local capacity for manufacturing vaccines and other pandemic essentials as part of Malaysia's pandemic preparedness.
Pharmaniaga's RM3mil investment in the CoronaVac vaccine is a first step towards a much-needed mature capability that can be repurposed in a pandemic outbreak. Putrajaya has received repeated offers from Cuba for collaborative research and product development. Joint-venture offers from Russia and China as well can position Malaysia as a regional platform for the manufacturing and distribution of vaccines and essential medicines for South-East Asia.
The BRICS countries (Brazil, Russia, India, China, and South Africa) in particular (plus Cuba and Iran) collectively have the R&D, financing, and manufacturing capabilities for supplying much of the developing world with affordably priced essential medicines and vaccines (and less extortionate terms for technology transfers to venture partners).
Malaysia should also explore this collaborative platform for developing indigenous capacities for vaccines and pharmaceuticals manufacture.
CHAN CHEE KHOON, Sc.D (Epidemiology)
Citizens' Health Initiative
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