For most of last year Thailand managed to keep the virus at bay but a recent surge of infections, driven by the Delta variant of the virus, has been the deadliest yet.

A sluggish vaccine roll-out has led to huge crowds queuing up day after day in some places for COVID tests and inoculations.

The government already has sweeping powers to enforce measures to tackle the coronavirus and rules for control of the Internet. Authorities have been taking legal action against some people, including some celebrities and social media influencers, who have criticised the pandemic response.

READ: Thai hospitals short of beds as COVID-19 cases soar

These include 19-year-old rapper, Danupa “Milli” Khanatheerakul, who was fined 2,000 baht (US$60) on a charge of “public insult” last week after accusing the government on social media of mishandling the COVID-19 crisis.

Six media associations said in a joint statement the government’s legal actions showed “an intent to crack down on the freedom of expression enjoyed by the media and the public”.

The associations are planning to deliver a letter protesting against the government’s new order on Friday.

The government has said that legal action against “false messages” was not aimed at silencing the media.

It was 7pm but the appointment was 6pm the same day.

The corporate communications executive immediately put down her utensils and rushed over to the vaccine distribution centre, located about 45 minutes from her house.

“I drove like The Fast and The Furious over to the centre, because I heard it closes around 8pm,” she said with a laugh.

Ms Lam has been checking her MySejahtera a few times a day since registration for vaccination opened to the public in late February this year. She had also tried to snatch a slot when the government rolled out the voluntary opt-in for AstraZeneca vaccines in May, but to no avail.

Upon arriving at the vaccination centre, her hands were trembling from the adrenaline rush. She prayed hard that she would be allowed to take her first shot before the centre closed for the day, and she was.

“If I hadn’t rushed over, who knows when I’d be eligible again, maybe next year? Hence I’d rather be late to the appointment, than not even take the chance,” said Ms Lam.

READ: Uneven distribution, bureaucracy hamper Indonesia’s COVID-19 national vaccination efforts

Since Malaysia received its first batch of vaccines back in late February, it’s National COVID-19 Immunisation Programme (NCIP) has been gaining steam. NCIP is divided into a number of phases, beginning with immunising the country’s health and security frontliners.

With a steady stream of supplies, vaccination was ramped up across the country. The programme has been breaking daily records in terms of daily doses being administered.

At the same time, however, the situation for Malaysia’s COVID-19 cases has also taken a turn for the worse, with record high infections and deaths being reported.

Increasing the vaccination capacity is the most effective way for Malaysia to get out of the COVID-19 pandemic crisis, Prime Minister Muhyiddin Yassin said in parliament on Monday (Jul 26).

One hundred per cent of adults may be fully vaccinated by October, he added, ahead of the original target of 80 per cent of adults by the first quarter of 2022.

But is vaccination the silver bullet to end Malaysia’s crisis? Experts cautioned that while vaccines can be a key tool, other control measures must still be enforced.

VACCINATION DRIVE GAINING TRACTION

On Wednesday, Malaysia hit another record high for new COVID-19 cases with 17,405 infections. The country has over 1.07 million cases so far.

The current record for COVID-19 deaths logged in a single day is 207, which happened both on Monday and Tuesday.

Kuala Lumpur and Selangor have been consistently contributing the bulk of cases. As such, the government launched the “Operation Surge Capacity” to accelerate the vaccination drive in the Klang Valley, with a goal of administering at least one dose for people aged 18 and above by Aug 1.

Currently, Malaysia’s national vaccination programme uses Pfizer-BioNTech, AstraZeneca and Sinovac.

The country has also granted conditional approval for emergency use to CanSino, Sinopharm and Janssen, and procured Russian-developed Sputnik V. It will also receive Novavax from the COVAX vaccine sharing programme.

Malaysia has allocated RM5.8 billion (US$1.36 billion) to carry out the immunisation programme, which has procured enough doses to cover 130 per cent of Malaysia’s population.

There are currently 2,313 vaccine distribution centres across the country, including private clinics and ambulatory care. In addition, some states and federal territories have also employed mobile vaccine trucks to speed up inoculation, as what happened back in mid-June when four vaccine tracks administered doses to some 7,000 residents in public housing projects in Kuala Lumpur.

READ: People can record COVID-19 vaccination process, says Khairy following claims of improperly administered doses

The COVID-19 Immunisation Task Force (CITF) has announced that walk-in vaccinations for Selangor and Kuala Lumpur can take place from Aug 1 onwards for those who were left out and have not received any appointment date thus far, including those without identity or travel documents.

Coordinating minister for the national immunisation programme Khairy Jamaluddin also announced on Jul 25 that guidelines for illegal immigrants and refugees to receive their COVID-19 vaccines had been approved, and that non-governmental organisations such as the Red Crescent would be involved in the immunisation exercise for such communities.

According to Mr Khairy, 38.2 per cent of Malaysia’s population, or 12.49 million people, have received at least one dose of vaccine as of Jul 27. From the total, over 5.9 million or 18.1 per cent of population have been fully vaccinated.

For the adult population, 25.2 per cent are fully vaccinated, he added.

Malaysia, which has a population of 32 million, is among the fastest countries to vaccinate its people against COVID-19, said Mr Muhyiddin on Monday.

Public health researcher Lim Chee Han agreed that one would hardly complain about the speed with the current rollout rate, which has been accelerated since early last month following a slow start due to delivery delays.

“In fact, it is faster than the world’s average (13.23 per cent fully vaccinated) and Asia’s average (9.81 per cent),” he said.

On Tuesday, Labuan, the federal territory in East Malaysia, became the first in the country to fully vaccinate 80 per cent of its adult population. It has an adult population of 68,500.

LOW REGISTRATION AND INOCULATION RATE IN SOME STATES 

The vaccination drive is not without challenges.

In some parts of the country, “anti-vax” movement and vaccine hesitancy are a concern.

Dr Lim said that even before COVID-19, anti-vaccination beliefs cut across different socio-economic and education levels and the urban-rural divide.

“So I do not think that vaccine hesitancy presents a clear baseline pattern of distribution, perhaps except slightly more obvious for some religious groups in parts of the north and east coast of Peninsular Malaysia on the claim of vaccines’ halal-ness,” he added, pointing out that the northern state of Kedah used to have the worst child immunisation rates prior to the pandemic.

Vaccine registration in east coast states Kelantan and Terengganu are at 62.5 per cent and 76.7 per cent respectively, while Kedah’s stands at 77.9 per cent, as of Jul 27.

They are lagging behind Selangor and Negeri Sembilan as well as the federal territories of Kuala Lumpur and Putrajaya, where 100 per cent of eligible adults have registered to be vaccinated.

Sabah, meanwhile, has the lowest registration rate among all states. Only 40.5 per cent or 1.12 million people of its eligible adult population registered for the programme.

READ: What is ivermectin and why Malaysia is in no rush to approve it for COVID-19 treatment

Speaking to CNA on Jul 21, Sabah State Minister for Housing and Local Government Masidi Manjun said the low registration was due to the Borneon state’s geography and infrastructure, but the registration number is not the state government’s main concern.

“Due to limited Internet penetration in the rural areas, many people prefer to do manual registration,” he explained.

The state minister added that there is an immunisation task force in every state district, coordinated by the district officer to ensure citizen receive their vaccines.

As for inoculation rate, Selangor and Kuala Lumpur have administered the highest number of first doses, at 2.66 million and 2.079 million respectively. By contrast, Kelantan and Sabah have only administered about 360,000 and 650,000 first shots as of Jul 25.

READ: Malaysia government contract doctors frustrated over lack of job security, benefits as COVID-19 drags on

Mr Masidi told CNA that per ratio to population, Sabah was the lowest recipient of vaccines among the states in Malaysia. The Sabah Health Department’s inoculation capacity could hit 50,000 doses daily, but was doing an average of 12,000 doses to spread out the doses until new supplies were delivered, he said last week.

“We would prefer to do walk-in vaccinations – register and get inoculated, and the state has made available buildings to be turned into vaccination centres. In fact, many can be used immediately,” he said.

Research assistant Sabrina Melisa Aripen was among the Sabahans who were still waiting for an appointment.

She signed up as soon as the vaccination registration function was added to the MySejahtera app, and the wait has been very frustrating. Her parents, who are 82 and 76, as well as her friends with special needs or comorbidities have not received their appointments yet as well.

“But I see young, healthy and able-bodied people who aren’t frontliners sharing that they’ve received their doses, how is this fair?” Ms Sabrina said.

She had assumed that her turn would come quickly when the government said vaccines would be given in phases, since she is in her 40s. But she was still not vaccinated when the government announced that from May onwards, those above 18 would soon receive their appointments.

With questions on the immunisation drive’s efficiency and the selection process went unanswered, Ms Sabrina felt overlooked.

Her predicament might soon be relieved with more vaccines being delivered to Sabah.

Mr Masidi announced on Jul 21 that the state had received a total of 747, 980 doses (including 152,100 delivered previously) and another 308,990 doses were scheduled to arrive the following week.

With the arrival, daily inoculation could be ramped up. State Health Director Rose Nani Mudin said on the same day that Sabah could reach 40,000 daily jabs, from 30,000.

READ: Commentary – What’s behind no-shows in vaccination centres across Malaysia?

VACCINES NOT A SILVER BULLET

For those who have already received both doses of their vaccination, some respite from the varying levels of lockdown might be on the horizon.

Earlier on Jul 24, Mr Muhyiddin said those fully vaccinated might be able to enjoy privileges such as being able to participate in sports and social activities, and even dine-ins, as “breathing space”.

Malaysians have been enduring lockdowns in one form or another since the first movement control order (MCO) was imposed on Mar 18 last year.

READ: Thailand’s COVID-19 national vaccination programme hit by supply shortage, uncertain delivery schedule

The appearance of the Delta variant in Sarawak, with 93 cases detected up until Jul 25, and in other states is also an impetus to vaccinate as many eligible people as possible.

In a virtual media presser, Health Ministry director-general Noor Hisham Abdullah urged Malaysians to get their jabs, stating that those inoculated were much less infectious, and unlikely to get as sick.

Dr Noor Hisham pointed out that although 2,779 healthcare workers had been infected after they were fully vaccinated, most were category one (asymptomatic) or two (light symptoms).

Meanwhile, there were only three patients each in categories three (symptomatic with lung infection) and four (requiring oxygen assistance).

However, vaccination drive is no “silver bullet” for Malaysia’s case numbers, Dr Lim cautioned.

“From a public health and life sciences point of view, the current vaccines we have are not ‘silver bullets’, they cannot eliminate disease transmission, though they are expected to significantly reduce the number of cases and need for hospitalisation,” he explained.

Vaccination’s positive effect had yet to be observed as a large proportion of Malaysia’s populace was unvaccinated, and the number of fully-vaccinated people was still too small to significantly reduce the rising trend of local COVID-19 transmissions in certain areas, he added.

“Though currently the government seems like it’s running out of ideas, and it seems that the vaccination effort is their only effective response to the current predicament, many states will only achieve at least a 50 per cent fully vaccinated population by September,” he said.

And even then, Dr Lim added, a 50 per cent fully-vaccinated population was not a magic number to prevent COVID-19 from spreading. If lockdown measures stayed unchanged, more cases could be expected, especially fatalities, he cautioned.

For public health and health economics researcher Nazihah Muhamad Noor at Khazanah Research Institute, vaccines can be a key tool in ending the pandemic, but with provisos.

“But only if we can vaccinate the vast majority of the global population, not just Malaysia’s, quickly enough,” she observed.

“Global vaccine inequity has left the majority of the world population vulnerable and has allowed the virus to replicate in populations that are still susceptible, contributing to the emergence of new variants that can spread and prolong the pandemic everywhere, even in countries with advanced vaccination programmes,” Ms Nazihah pointed out.

As such, other pandemic controls such as testing, contact tracing, quarantine and masks still needed to be widely practised, she added.

The great Seoul area region remains under Level 4 curbs that include a ban on gatherings of more than two people after 6pm.

It provided more funding to public health and constructed a multi-tiered network of disease control and prevention. The central government also reorganised different agencies within the Chinese Center for Disease Control and Prevention into a cluster to enhance crisis coordination.

Following that outbreak, China continued to enhance its health cooperation with US counterparts, having had positive perceptions of the US public health model at the time and a willingness to adopt US practices.

During a visit by then US health secretary Tommy Thompson in 2003, the United States promised to work with China to develop more robust public health infrastructure in China.

READ: Commentary: China may have a spy problem of its own

CHINA CATCHES UP WITH THE US

But prior to the outbreak of COVID-19, Chinese perceptions on US domestic governance had gradually shifted. While the United States maintains the superiority of its governance approaches, China has increasingly seen itself as on an equal footing to the United States.

When meeting with US Secretary of State Antony Blinken and National Security Adviser Jake Sullivan in Alaska in March, China’s top diplomat Yang Jiechi said: “The United States does not have the qualification to say that it wants to speak to China from a position of strength.”

READ: Commentary: After Alaska, age of selective engagement in US-China relations begins

A driving factor in these shifting Chinese perceptions is its tremendous advances in building an effective domestic health system over the last decade. Through a number of healthcare reforms since 2009, China made substantial progress in improving access to care, at a standard commended by the World Bank.

The mismanagement of COVID-19 in the United States consolidated China’s belief that the US model of public health crisis response is ineffective. As of late July, US cumulative case numbers have exceeded 34 million, over 10 per cent of its population, while China has reported around 100,000 cases in a population of 1.4 billion.

This solidified the Chinese view that the United States has lost its health superiority, leading to its conclusion that institutional strength and Chinese culture were key to overcoming domestic COVID-19.

Yet China’s system still falls behind in some aspects – the United States ranks fourth in the World Index of Healthcare Innovation, while mainland China does not even qualify for assessment.

Regardless, it would seem that cooperation may be contingent on US recognition of China’s progress in domestic health governance by approaching it as an equal partner. Until then, the situation could remain more akin to that of a competition.

But China needs to also put President Xi Jinping’s words into practice and be “eager to learn what lessons we can from the achievements of other cultures, and welcome helpful suggestions and constructive criticism”.

China should continue to identify its own flaws and limits in domestic health governance and gauge other countries, including identifying successes that the United States has had.

Renowned Chinese diseases expert Zhong Nanshan stated that China still has space to improve and much to learn from the practices of the United States and other developed countries. Future pandemic cooperation between the two great powers may rest on rebuilding mutual trust and developing a shared understanding of one another’s best practices.

JAKARTA: Indonesia, which uses the Sinovac vaccine as its main COVID-19 inoculation, is considering providing a booster shot, as a study showed antibodies provided by the two-dose shot fade over time, a senior health ministry official said on Tuesday (Jul 27).

Indonesia, which has become Asia’s COVID-19 epicentre with record infections and deaths this month, relies heavily on the Sinovac vaccine that accounts for more than four-fifths of 173 million doses of vaccine supplies it has received so far.

Concerns about the vaccine’s effectiveness have mounted in recent weeks as hundreds of medical workers, most of whom were fully vaccinated with the Sinovac shot, have died of COVID-19 since June.

A study published this week showed that antibodies triggered by the Sinovac vaccine declined below a key threshold from around six months after a second dose for most recipients, although a third shot had a strong booster effect.

READ: COVID-19 surge starting to ease in Indonesia capital, data shows

While researchers said it was unclear how the decrease in antibodies would affect the shot’s effectiveness, Siti Nadia Tarmizi, a senior health ministry official, told Reuters that the reduced antibody level is still enough to provide protection, based on clinical data from Indonesia.

“Right now, the immunisation advisory board recommends a booster vaccination 12 months after the second dose,” she said, adding that the government is still considering whether the booster shots should be one or two-dose schedule.

She did not say which vaccines would be used as a booster shot, but Kusnandi Rusmil, who heads the clinical trials of the Sinovac vaccine in Indonesia at Padjadjaran University, said any approved COVID-19 vaccine can be used as a booster.

READ: Commentary: Overwhelmed Indonesian hospitals with COVID-19 cases behind high doctor fatalities

He said the clinical trial is set to conclude next month and its data so far has also shown a drop in antibody levels over time, leading him to recommend to the government that medical workers should get a third booster shot.

“Lots of medical workers have died, so they need to be given further immunity,” Kusnandi said.

Indonesia has started giving booster shots produced by Moderna to medical workers this month, as 1,569 healthcare workers have died of COVID-19, including nearly 400 between June and July, according to data from the independent data group Lapor COVID-19.

The World Health Organization said earlier this month that it was not clear whether boosters would be needed to maintain protection, until further data is collected.

But several countries have already begun making plans for a booster campaign, while Pfizer and its partner BioNTech prepare to ask US and European regulators to approve a booster dose.

KUALA LUMPUR: Malaysia reported 207 deaths from COVID-19 for the second consecutive day on Tuesday (Jul 27), with the number of critically ill patients also reaching another high.

Thirty-one of the victims were classified as “brought in dead” to hospital, said health director-general Noor Hisham Abdullah.

The country’s current record for COVID-19 deaths logged in a single day is 207. Its previous record was just last week.

The number of cases in the intensive care unit also hit another new record with 1,023 patients warded. Of these, 524 require respiratory support.

A total of 16,117 new COVID-19 cases were also identified, Malaysia’s second highest daily tally after more than 17,000 infections were reported two days ago.

The Klang Valley comprised more than half of the new cases with 6,616 in Selangor and 2,457 in Kuala Lumpur.

A further 1,000 cases were found in Kedah as well as 907 and 618 in Johor and Penang respectively.

Only 26 of the new cases reported on Tuesday were imported infections.

Dr Noor Hisham said 56.3 per cent of the new cases reported on Tuesday were asymptomatic while 41.6 per cent had mild symptoms.

The remaining cases had lung infections, required oxygen support or were in critical condition.

The majority of the new cases had no vaccination history, he added.

MORE THAN 1,000 ACTIVE CLUSTERS

Dr Noor Hisham also said 42 new COVID-19 clusters have been identified, taking the total number of active clusters in the country to 1,028.

Of the record number of new clusters, 25 involve workplaces while 12 are in the community. The remaining clusters involve two high risk communities, two detention centres and an education establishment.

Despite the imposition of another nationwide lockdown on Jul 1, Malaysia’s COVID-19 situation has worsened in recent weeks with a surge in cases and deaths.

In addition to political skirmishes and citizens being hard-hit by the economic and movement curbs, some contract doctors also staged a walkout on Monday at various hospitals across the country.

These contract government medical officers had earlier issued an ultimatum to the government to address their concerns regarding the contract system, including lack of job security and limited length of service.

As of Tuesday, Malaysia has reported a total of 1,044,071 COVID-19 cases, of which 170,224 are currently active or infectious. The death toll stands at 8,408.