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January 2022 Vol 2 No 8

Your Editor, Jamari Mohtar, feels that since he has given a review of 2021, it is now time for him to write on what 2022 portends …

  • We have seen how cautious optimism ebbed and flowed during much of 2021 with regard to the prospect that Covid-19 would be eradicated.
  • The picture would not be that different in the early days of 2022 judging by the fast-paced events on the Covid front with regards to the spread of the Omicron variant.
  • A little over six weeks since the Omicron variant was first reported to the World Health Organization (WHO) in South Africa on November 24, it has spread rapidly across the globe, in what the Director General of WHO, Dr Tedros Adhanom Ghebreyesus described as a ‘tsunami of cases’ that is overwhelming health systems.
  • This was the stark warning against complacency from the head honcho of the WHO. “Just like previous variants, Omicron is hospitalizing people and it is killing people,” added Dr Tedros at a press conference on January 6.
  • And the pandemic is far from over. The week ending January 2 saw the highest number of cases reported since the pandemic’s start, according to the WHO, and new record Covid-19 infections are being reported by countries from Argentina to Israel each day.
  • Here are the stark facts of how rapidly the Omicron has struck:
    • In the last week of 2021, 1 in 15 people in England had Covid-19, rising to 1 in 10 in London, according to the Office of National Statistics, with Prime Minister Boris Johnson calling it the “fastest growth in Covid cases that we have ever known”;
     
    • The number of people in London hospitals with Covid-19 almost quadrupled in a month, from 1,100 in early December to 4,000 in early January, the BBC reported, and 200 military personnel were deployed to help London hospitals hit by staff shortages;
     
    • Australia, total confirmed Covid-19 infections have passed one million with more than half of these occurring last week, according to Reuters; and
     
    • Hong Kong is reimposing some of its strictest virus curbs since the pandemic began, putting fresh strain on the financial hub’s economy as kindergartens and primary schools will close again, while air passengers from “high-risk” countries are set to be banned from transiting through Hong Kong International Airport.
  • South Africa announced on December 30 it had passed its peak of Omicron infections, without seeing a major spike in deaths.
  • Preliminary studies showed there was a reduced risk of hospitalization from the variant compared with Delta, along with a reduced risk of severity in both younger and older people.
    • But uncertainties remain. The true picture on what Omicron is all about can only be gleaned from more researches and studies in the coming weeks and months.
    • Thus, it’s too premature to say Omicron is less severe or mild than the Delta variant, hence Dr Tedros’ warning against categorizing the variant as ‘mild’.
    • The symptoms for Omicron also appear to be different from previous Covid-19 variants. While the main Covid-19 symptoms are still said to be cough, high temperature and loss of smell and taste, Omicron accounted for half of all cold-like illnesses in the UK, the ZOE Covid study reported in December.
    • The top five symptoms reported in London on the ZOE app for those testing positive for Covid-19 were runny nose, headache, fatigue, sneezing and sore throat.
    • Studies on animals suggest Omicron infects the upper airways more than the lungs, which could explain the different symptoms. But this has implications for children, reports Nature, who tend to be more affected by upper respiratory tract infections due to smaller nasal passages.
    • Meanwhile health experts have cast doubt on reports of a possible Covid-19 mutation combining elements of both the Delta and Omicron variants. 
    • While the evidence on “Deltacron” remains scarce, French virologists warn that the emergence of such hybrid strains is a distinct possibility.
    • The controversy started in Cyprus, currently roiled by Europe’s highest Covid-19 rate of infection, where a local team of scientists claimed last week to have discovered the new variant. 
    • Led by Leondios Kostrikis, a professor of biological sciences at the University of Cyprus, the scientists said the new strain presented Omicron-like genetic signatures within the Delta genomes – hence the name “Deltacron”. 
    • The findings have been sent to GISAID, an international database that monitors and shares official data on Covid-19, giving other scientists access to the genetic details of “Deltacron”. 
    • Initial reactions have been sceptical at best, with prominent experts suggesting the apparent new strain looks more like a “scariant” – an unconfirmed strain causing a global scare – than a variant. 
    • On the economic front, the global economy is in the midst of a robust but uneven rebound from the pandemic, with demand growth outrunning supply growth and inflation rising quickly almost everywhere.
    • A report from S&P Global Ratings said while the spread of the virus has not been brought fully under control, its economic impact has clearly weakened. 
    • For a given level of infections, measures restricting mobility have eased. This reflects governments having a higher degree of tolerance overall for Covid-19 infections, as well as being able to more precisely target and curtail certain types of activities, for example skewing measures against unvaccinated parts of the population. 
    • Moreover, for a given level of mobility restrictions, the impact on consumption has declined. Households have redirected their spending power away from activities that are “locked down” (food and entertainment) and towards those where spending is still possible (durable goods). 
    • While the offset is not one-to-one, the reduction in consumption in mid-2021 was much lower and flatter than in 2020, and this looks to be the trend, moving forward to 2022. 
    • Over coming weeks, S&P Global Ratings expect additional evidence and testing will show the extent of the danger Omicron poses to enable it to make a more informed assessment of the risks to credit. 
    • It expects the markets to take a precautionary stance and governments to put in place short-term containment measures. 
    • The macro focus of the recovery has shifted to inflation. Earlier it was thought there would be a modest and temporary rise in inflation in early 2021 as economies re-opened. 
    • However, events turned out differently. Price pressures have persisted and broadened more than expected. And the debate is now whether inflation is transitory and will gradually ease, or whether it is persistent and requires an earlier-than-planned policy response. 
    • Inflation pressures from oil and supply chains – which have been driving inflation dynamics in many countries – shows initial signs of easing. This gives some weight to the transitory view. 
    • On this basis, global GDP growth is forecasted to be 5.7% in 2021 and 4.2% in 2022 before declining closer to a trend of around 3.5% in 2023-2024.
    • Before we even question the necessity of a fourth booster jab, the pertinent question to ask first is whether Covid vaccines work against the Omicron variant?
    • A vaccine is defined as a biological preparation that provides active acquired immunity to a particular infectious disease, which typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins.
    • The agent for the first generation vaccines that we have now was made from weakened or killed forms of the microbe, its toxins or the surface proteins of the earliest strains of Covid-19 because the Delta and Omicron strains hadn’t made their appearance yet.
    • The Delta and Omicron variants appeared long after the vaccines were approved and distributed for use. Hence, from day one, the effectiveness of these vaccines started to wane because we are dealing with the new strains.
    • However, the fact that the earlier strains from which the vaccines were made from have almost completely disappeared from the scene showed the vaccines’ full effectiveness against the previous strains.
    • So what we need now are second generation vaccines that take into account the Delta and Omicron strains in their make-up, and this can be done by either introducing a completely new vaccine or by tweaking the current vaccines to take into account the mutations that had caused the emergence of the two latest strains.
    • But having said this, since the two latest strains are also part and parcel of the Covid-19 virus family, the first generation vaccines are also successful in preventing infections for otherwise the majority of those who had been vaccinated – whether with one, two or three (booster) doses – would all have been infected.
    • Moreover, if the Covid-19 vaccines do not completely prevent infection, data have shown they still have a higher immunity against severe illness and hospitalization, i.e. you may be infected but if you are fully vaccinated, the chances of developing into a severe illness or being hospitalised are very low.
    • Worldwide evidences have shown it is the unvaccinated that forms the majority of deaths in many countries.
    • In Singapore for instance, unvaccinated individuals accounted for 70% of the republic’s Covid-19 deaths last year – 555 out of 802 Covid-19 deaths.
    • Speaking in Parliament on Jan 10, Singapore Health Minister Ong Ye Kung said most of the vaccinated individuals who died from Covid-19 had received non-mRNA vaccines.
    • He went on to reveal the crude incidence rates of deaths among the vaccinated based on type of vaccination are 11 deaths per 100,000 for those vaccinated with Sinovac, 7.8 per 100,000 for Sinopharm, 6.2 per 100,000 for Pfizer-BioNTech, and 1 per 100,000 for Moderna.
    • “Be mindful we are calculating this based on quite a small sample of 247 deaths … These rates are only indicative since they do not account for other factors which can affect mortality such as the age and timing of vaccination,” added Ong.
    • In a Nov 22 White House press briefing, Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), said unvaccinated people are about six times more likely to test positive than vaccinated people, nine times more likely to be hospitalized, and 14 times more likely to die from Covid-related complications.
    • At the time Dr Walensky made the statement, the Delta variant was the dominant strain. But how have things changed in the US now that Omicron has taken over?
    • It’s still early in the Omicron surge in the US. Still, most hospitals there are stretched beyond capacity, according to Dr Faheem Younus, vice president/chief quality officer/chief of Infectious Diseases at the University of Maryland Upper Chesapeake Health.
    • Some – including his hospital system – are now operating under crisis mode, as more than 75% of all hospitalized Covid-positive patients in the University of Maryland Medical System’s 12 hospitals are unvaccinated.
    • “A majority of the remaining 25% have received only 1 or 2 shots,” said Younus, adding that this wave is “dramatically worse” than Delta.
    • This has prompted President Joe Biden on Jan 4 to characterise the surge in Delta and Omicron as “a pandemic of the unvaccinated” during a meeting on Covid-19.
    • “You know, be concerned about Omicron, but don’t be alarmed,” said Biden. “But if you’re unvaccinated, you have some reasons to be alarmed. Many of you will – you know, you’ll experience severe illness, in many cases, if you get Covid-19 if you’re not vaccinated … some will die, needlessly die.”
    • Malaysia should release data on the number of Covid-19 deaths among the unvaccinated so as to open the eyes of those who stubbornly refuse to vaccinate and their supporters so that they will then realise not only on the danger of their death lurking around but also the deaths of peoples they may infect.
    • In France, on January 5, President Emmanuel Macron probably out of frustration and deep disgust at the five million people still unvaccinated, said he wants to annoy France’s unvaccinated ‘to the bitter end’, as the country reported another daily record with more than 271,000 Covid-19 infections. The Omicron variant continues to drive a fifth wave of the virus in France.
    • “The unvaccinated, I really want to piss them off. And so we will continue to do so, to the bitter end. That’s the strategy,” Macron said.
    • Insinuating the unvaccinated, he added: “When my freedom comes to threaten that of other people, I become irresponsible. An irresponsible person is no longer a citizen.”
    • Meanwhile a study from Imperial College London suggests the best protection comes from three Covid-19 vaccine shots, which is why countries have rolled out booster dose programmes.
    • Compared to the Delta variant, scientists found Omicron to evade the immune response from either previous infection or vaccination much more easily.
    • In December, they estimated vaccine effectiveness against symptomatic Omicron infection of between 0% and 20% after two doses of the AstraZeneca and Pfizer vaccine, and between 55% and 80% after a booster dose.
    • The UK Health Security Agency’s chief medical adviser, Dr Susan Hopkins, told the Guardian: “I think what we’re seeing is that if you’ve had two doses more than three months ago, then it’s not going to prevent you from getting symptomatic disease.”
    • But it’s not sustainable to administer boosters every three to six months, said Patrick Vallance, Britain’s chief scientific adviser. The long-term view would be to settle into a “more routine type of vaccine programme”.
    • So instead of fourth booster dose, just ensure that 90% of the adult population in Malaysia have a third booster jab, and continue to ensure patiently through carrots or sticks that majority of the unvaccinated in Malaysia have their first dose.
    • Ditto with those having their first primary dose, encourage 100% of them to have their second dose in order to be fully vaccinated.
    • Instead of a fourth dose, make it more routine with an annual dose, even if Omicron has been brought under control in case a new variant after Omicron emerges.
    • Since Malaysia started to introduce the third dose last October, then the annual dose should start from this October onwards, beginning with those who have completed their third dose last October.
    For more on the spread of the Omicron variant, the unvaccinated and the economic outlook for 2022:
    • Since 2020 Covid-19 has affected almost all countries and more than 50 million people around the world. It has governments operating in a context of radical uncertainty, and faced with difficult trade-offs given the health, economic and social challenges it raises.
    • And it doesn’t help matters that the start of the pandemic coincided with an on-going surge in nationalism and declining support for multilateralism that was championed by the Trump administration, resulting in each country managing the pandemic crisis in a manner that is parochial and oblivious of what is going on in another country.
    • The irony of it all is the anti-vax movement without the support of government infrastructure or multilateral mechanism has managed to forge unity all over the world among its adherents and recruiting more people to its fold, thus thwarting the efforts to eradicate the virus.
    • I was reminded of a pattern in early 2021, which in a way is a reflection of a Chinese wall phenomenon when each country manages its own pandemic crisis either by being oblivious or taking only a cursory interest to what is happening in other countries.
    • That pattern I was referring to was, while Europe was in the gripped of a third wave during early 2021, the Covid situation in Malaysia and many parts of Asia was relatively stable.
    • Then as Europe was “recuperating” from the third wave in May, it was India’s turn to be gripped with the dramatic third wave of the Delta variant.
    • In August just as India was recovering from the Delta variant, it was Malaysia’s turn to be hit by the Delta variant, causing five-digit daily infection figures.
    • Will this pattern be repeated this year with regards to the Omicron variant, which is hitting hard Europe now?
    • Hence, it is very good the Health Ministry under the very able leadership of Khairy Jamaluddin is busied with ensuring the spread of the Omicron variant does not spiral out of control.
    • Perhaps he should request from his Saudi Arabian counterpart in the spirit of international collaboration that those devious travel agencies that do not ensure their umrah pilgrims, mutawwif (pilgrim guides) and officials had been fully vaccinated should be banned from the umrah and hefty fines imposed on them, as being fully vaccinated is a condition required by both countries for umrah.
    • Also, those at the point of departure at the Saudi airport that were tested positive should not be allowed to return home, as they needed to be quarantined in Saudi Arabia, and allowed to go home only when they were tested negative after the required quarantine period.
    • This is the standard operating procedure everywhere so that the Omicron virus is not easily transported from one place to another.
    • The term Chinese wall, which I used earlier, is used in the business world as a praiseworthy concept as it describes a virtual barrier intended to block the exchange of information between departments if it might result in business activities that are ethically or legally questionable.
    • But in managing a pandemic crisis of an epic proportion like Covid-19, this wall must be demolished in the interest of saving humankind.
    • Another example of this Chinese wall that needs to be demolished is when South Africa and Botswana were in for a rude shock when almost all countries over the world banned the entry of people originating from these two countries after they had in all transparency reported the emergence of Omicron.
    • Yes, the ban is needed to prevent the spread of Omicron but what about the economic fallout that these countries would face from the ban?
    • This will only encourage countries in future not to report on the emergence of new strain because there was no incentive to do so, in fact only “punishment” will ensue.
    • What needs to be done in this case is for international cooperation and multilateral platform for a fund to be created to assist such country while the ban is implemented to alleviate the economic fallout.
    • Take it as if the country is being hit by 10-Richter scale earthquake or a tsunami where normally in the spirit of blessings and mercy for all, aids came pouring in from all over the world.
    • These aids could also take the form of sending in experts and sophisticated genome sequencing facilities there to understand better and quickly the new variant that is putting human lives at stake.
    • Another area of collaboration is vaccine equity across the globe, which is championed by the World Health Organization (WHO).
    • It targets for 70% of the world’s population to be fully vaccinated by July, which is aimed at helping to end the acute phase of the pandemic.
    • Based on the current rate of vaccine rollout, 109 countries will miss the WHO’s target for 70% of the world’s population to be fully vaccinated by July.
    • WHO Chief, Dr Tedros Adhanom Ghebreyesus has warned vaccine inequity across the globe risks prolonging the pandemic.
    • “Booster after booster in a small number of countries will not end a pandemic while billions remain completely unprotected,” he said.
    • He has a point there because if world leaders have a care less attitude to the relatively huge unvaccinated people outside their country, it will be these outside people that may spread the virus into their country once they are ready to open up their borders.
    • Thus, from sharing health data to solving global supply chain issues, Covid-19 has reiterated the importance of international cooperation and increasing support for multilateralism. Even at the local level, action and inaction can affect global health.
    • This is what the whole of world approach is all about – different in magnitude but similar in concept as the whole of government or the whole of society approach.
    Read more on the third covid wave in Europe, international collaboration and multilateralism, the concept of Chinese wall and the travel ban on South Africa:

    Umrah pilgrims, umrah pilgrims … what telah happened …

    • It is very disturbing to hear that 14% (12) of returning umrah pilgrims were not only tested positive for the Omnicron variant but that they were not vaccinated at all.
    • How on earth could they perform the umrah when both Malaysia and Saudi Arabia require umrah-goers to be fully vaccinated?
    • Now the blame game has started from the travel operators right up to the government agency responsible for ensuring that pilgrims are fully vaccinated.
    • But really the first party to be blamed is the 12 pilgrims themselves. Why are they so obstinate in not getting the full vaccination before they even contemplated to go for the umrah?
    • They have the gall to beat the system when they know what they are doing is against the law, and the irony of it all is being devious in doing so when the objective of the umrah is to purify their soul.
    • The full weight of the law should be upon them in that once they have recovered from the Omicron infection – if they ever recover – an intense interrogation of these wrongdoers should be pursued on how they manage to beat the system.
    • Are they in league with a syndicate that falsify vaccine certificate? Are their travel agents complicit in facilitating their umrah? Are they under the influence of the anti-vaxxers who egged them on to beat the system? Are there government agency official or a Saudi element abetting all this wrongdoing?
    • These are all serious issues in the context of the rapid spread of the Omicron variant globally which in the words of the head of the World Health Organization, is ‘tsunami of cases’ that is overwhelming health systems.
    • To date, Malaysia has 245 confirmed cases of the Omicron variant in the country, and according to Defence Minister Datuk Seri Hishammuddin Hussein, the plan for the transition to the endemic phase early this year has to be postponed “after considering the impact of the floods and (infections caused by) returnees from abroad, with special focus on umrah pilgrims”.
    • “All states are now in Phase Four (of the National Recovery Plan) and my initial plan was to announce the transition (to endemic phase) early this year,” added Hishammuddin.

    A little over six weeks since the Omicron variant was first reported to the World Health Organization (WHO) in South Africa on November 24, it has spread rapidly across the globe, in what the Director General of WHO, Dr Tedros Adhanom Ghebreyesus described as a ‘tsunami of cases’ that is overwhelming health systems.

    “Just like previous variants, Omicron is hospitalizing people and it is killing people,” added Dr Tedros at a press conference on January 6.

    And the pandemic is far from over. The week ending January 2 saw the highest number of cases reported since the pandemic’s start, according to the WHO, and new record Covid-19 infections being reported by countries from Argentina to Israel each day.

    Here are some stark facts of how rapidly the Omicron has struck:

    – In the last week of 2021, 1 in 15 people in England had Covid-19, rising to 1 in 10 in London, according to the Office of National Statistics, with Prime Minister Boris Johnson calling it the “fastest growth in Covid cases that we have ever known”;

    – The number of people in London hospitals with Covid-19 almost quadrupled in a month, from 1,100 in early December to 4,000 in early January, the BBC reported, and 200 military personnel were deployed to help London hospitals hit by staff shortages; and

    – In Australia, total confirmed Covid-19 infections have passed one million – with more than half of these occurring last week, according to Reuters.

    Preliminary studies showed there was a reduced risk of hospitalization from the variant compared with Delta, along with a reduced risk of severity in both younger and older people.

    But uncertainties remain. The true picture on what Omicron is all about can only be gleaned from more researches and studies in the coming weeks and months.

    Thus, it’s too premature to say Omicron is less severe or mild than the Delta variant, hence Dr Tedros’ warning against categorizing the variant as ‘mild’.

    Since 2020 Covid-19 has affected almost all countries and more than 50 million people around the world. It has governments operating in a context of radical uncertainty, and faced with difficult trade-offs given the health, economic and social challenges it raises.

    And it doesn’t help matters that the start of the pandemic coincided with an on-going surge in nationalism and declining support for multilateralism that was championed by the Trump administration, resulting in each country managing the pandemic crisis in a manner that is parochial and oblivious of what is going on in another country.

    The irony of it all is the anti-vax movement without the support of government infrastructure or multilateral mechanism has managed to forge unity all over the world among its adherents and recruiting more people to its fold, thus thwarting the efforts to eradicate the virus.

    This in a way is a reflection of a Chinese wall phenomenon when each country manages its own pandemic crisis either by being oblivious or taking only a cursory interest to what is happening in other countries.

    A Chinese wall is a term used in the business world as a praiseworthy concept as it describes a virtual barrier intended to block the exchange of information between departments if it might result in business activities that are ethically or legally questionable.

    But in managing a pandemic crisis of an epic proportion like Covid-19, this wall must be demolished in the interest of saving humankind.

    An example of this Chinese wall that needs to be demolished is when South Africa and Botswana were in for a rude shock when almost all countries over the world banned the entry of people originating from these two countries after they had in all transparency reported the emergence of Omicron.

    Yes, the ban is needed to prevent the spread of Omicron but what about the economic fallout that these countries would face from the ban?

    This will only encourage countries in future not to report on the emergence of new strain because there was no incentive to do so, in fact only “punishment” will ensue.

    What needs to be done in this case is for international cooperation and multilateral platform for a fund to be created to assist such country while the ban is implemented to alleviate the economic fallout.

    Take it as if the country is being hit by 10-Richter scale earthquake or a tsunami where normally in the spirit of blessings and mercy for all, aids came pouring in from all over the world.

    These aids could also take the form of sending in experts and sophisticated genome sequencing facilities there to understand better and quickly the new variant that is putting human lives at stake.

    Another area of collaboration where the Chinese wall needs to be demolished is vaccine equity across the globe, which is championed by the World Health Organization.

    It targets for 70% of the world’s population to be fully vaccinated by July, which is aimed at helping to end the acute phase of the pandemic.

    Based on the current rate of vaccine rollout, 109 countries will miss the WHO’s target for 70% of the world’s population to be fully vaccinated by July.

    WHO Chief, Dr Tedros has warned vaccine inequity across the globe risks prolonging the pandemic. “Booster after booster in a small number of countries will not end a pandemic while billions remain completely unprotected.” 

    He has a point there because if world leaders have a care less attitude to the relatively huge unvaccinated people outside their country, it will be these outside people that may spread the virus into their country once they are ready to open up their borders.

    Although a study from Imperial College London suggests the best protection comes from three Covid-19 vaccine shots, which is why countries have rolled out booster dose programmes, but it’s not sustainable to administer boosters every three to six months.

    So instead of fourth booster dose, just ensure that 90% of the adult population in Malaysia have a third booster jab, and continue to ensure patiently through carrots or sticks that the majority of the unvaccinated in Malaysia have their first dose.

    Ditto with those having their first primary dose, encourage 100% of them to have their second dose in order to be fully vaccinated.

    Also, instead of a fourth dose, make it more routine with an annual dose, even if Omicron has been brought under control in case a new variant after Omicron emerges.

    Since Malaysia started to introduce the third dose last October, then the annual dose should start from this October onwards, beginning with those who have completed their third dose last October.

    Worldwide evidences have shown it is the unvaccinated that forms the majority of deaths in many countries.

    In Singapore for instance, unvaccinated individuals accounted for 70% of the republic’s Covid-19 deaths last year – 555 out of 802 Covid-19 deaths.

    According to Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention, the unvaccinated people are about six times more likely to test positive than vaccinated people, nine times more likely to be hospitalized, and 14 times more likely to die from Covid-related complications.

    This has prompted President Joe Biden on Jan 4 to characterise the surge in Delta and Omicron as “a pandemic of the unvaccinated” during a meeting on Covid-19.

    Malaysia should release data on the number of Covid-19 deaths among the unvaccinated so as to open the eyes of those who stubbornly refuse to vaccinate and their supporters so that they will then realise not only on the danger of their death lurking around but also the deaths of peoples they may infect.

    Thus, from sharing health data to solving global supply chain issues, Covid-19 has reiterated the importance of international cooperation and increasing support for multilateralism. Even at the local level, action and inaction can affect global health.

    This is what the whole of world approach is all about – different in magnitude but similar in concept as the whole of government or the whole of society approach.

    Regards,

    Jamari Mohtar,

    Editor, Let’s Talk!

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