It’s not as bad as it seems: Flattening Covid-19 fear with facts

Is getting Covid-19 as scary as it seems? Read on to find out.

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By Ling Hui

SARAWAKIANS, it’s time to take a step back to look at the big picture, and not dwell too much on the Covid-19 daily caseloads anymore.

Ever since the pandemic struck in March, 2020, all citizens including Sarawakians have unconsciously grown a new habit of checking the number of new Covid-19 cases, deaths, and clusters of the day every evening.


With number forecast outlets like Sports Toto, Magnum 4D and Cash Sweep closed these days, daily Covid-19 numbers have somehow replaced the announcements of jackpot results.

When figures are low, we say a prayer so that the trend will continue downwards the next day; when figures are alarmingly high, we also pray that there will be an improvement in the coming days.

About a month ago, Sarawak’s daily caseloads shot up to over a thousand and has never dropped back down to triple-digits since Aug 18. Two weeks ago on Sept 9, Sarawak saw its first 3,747 cases and one week later on Sept 12, the case number breached the 5,000-mark and registered 5,291 cases in one day.

As of Sept 19, 5,291 cases remained the highest ever recorded in Sarawak. The situation is definitely not ideal with reports of large numbers of infections every day, but daily case numbers are not the only data available on the virus.

 

Sarawak’s 99 per cent: Category 1 and 2 cases 

Since Aug 12, the State Disaster Management Committee (SDMC) began including the breakdown of Covid-19 patients in Categories 1 to 5, with the sole aim of informing the public that although the daily infection rates are high and ‘scary’, almost all of them are in the mild and non-severe categories.

Not once, in the past month, has the percentage of Category 1 and 2 patients with none or mild symptoms fallen below 99 per cent of the total caseload numbers.

In comparison, the number of Category 3, 4 and 5 cases, which are more severe with lung infections and needing oxygen or ventilators, mostly took, at most, 0.49 per cent of the total number of cases. In the period of 39 days from Aug 12 to Sept 19, Sarawak counted 31 Category 3, 45 Category 4, and 96 Category 5 patients out of the total of 96,401 cases.

Graph showing almost 100 per cent of patients in Category 1 and 2, out of the total number of Covid-19 cases daily from Aug 12 to Sept 19, 2021. Compiled and drawn by DayakDaily.
Distribution of Covid-19 patients in Category 3, 4 and 5 from Aug 12 to Sept 19, 2021. Graph compiled and drawn by DayakDaily.

Thus, it is safe to say that the overall severity of individuals who contracted Covid-19 in Sarawak has been fairly low, despite the distressing case numbers of late. With lower severity, the chances of recovery are subsequently higher as well.

Among the positive cases, individuals who are assessed at the Covid-19 Assessment Centre (CAC) to be sufficiently fit and have the ideal home conditions for self-quarantine are being sent back home. Without even the need for admission to hospitals, these patients could monitor their health by themselves and only need update their status through the MySejahtera app.

Some quarantine cases do not even take up to 14 days before the patients are declared healthy, released from isolation, and back to their usual daily lives.

 

Its really not as scary as it seems

“I thought I would be in grave danger, but it is okay after all,” said John Ilus, who was once a Covid-19 Category 1 patient.

The story began on Aug 16 when one of John’s staff members said he was not feeling well, so John advised him to get swabbed quickly. Thereafter, the staff tested positive for Covid-19.

John then instructed the rest of his employees who came into contact with the first employee to get their tests done, including himself. John’s test was completed at one of the test centres in Tapah, where he was later verified to be infected on Aug 22.

As soon as he heard the news, John was devastated by the fear of the unknown. He was then called up to visit the CAC in Serian on Aug 23. There, he was diagnosed as a Category 1 patient and sent back for a home quarantine following assessment and approval by specialists.

“That was how it started. The only thing I had was ‘positive’, but no symptoms at all to tell that I have Covid-19. From the beginning until the end,” he told DayakDaily through a phone interview.

Throughout his 14-day isolation period from Aug 24 to Sept 6, John was requested to do self-monitoring every day and update his conditions such as blood oxygen level and blood pressure in the MySejahtera app. He had his own set of equipment at home for those measurements, so there were no qualms with performing it himself. Besides constantly updating his status, he was also required to be easily contactable, mainly for emergency purposes.

Equipment used by John for self-monitoring during his home quarantine. Seen in picture are a blood pressure monitor (top and right), oximeter (left), and digital thermometer (bottom).

Being isolated from the outside world and trapped with the virus that got him there in the first place, it was no surprise that John felt down, stressed out, and sometimes depressed. Not to mention the unavoidable angst faced, for the first time, with a threat that cannot be seen with the naked eye.

“I was very down in the beginning. I would have questions floating in my head: Why me? Why am I the unlucky one?

“But after that, it was okay. I got better, because of support from friends and family. Many of my doctor friends called me to ask about my condition including (Dato Sri) Dr Sim (Kui Hian), and one Dr Kiu even asked me to send daily reports of my condition to him.

“Two YBs checked in on me too. (Datuk Amar) Douglas (Uggah Embas) also called to tell me not to worry. Then, I started to realise that it’s really not that serious,” said John, who is also Bukit Semuja assemblyman.

Finally feeling more spirited toward the end of his quarantine, he said he was surprised to find some of his friends who also tested positive for the virus from the same office to be released earlier than him. It was one of his sources of motivation too, convinced that being positive with Covid-19 was really not as serious as he thought.

John, who is now back to his normal daily routine, wished to thank all friends and family who had sent their regards and support through messages and calls during his quarantine. He was also grateful that none of his family members were infected through him.

Self-monitoring that John had to do every day of his 14-day quarantine to keep doctors up to date on his condition.

So, that was the side of the story of an asymptomatic Covid-19 patient. Category 1’s that took up about 80 per cent of the daily case count would, no doubt, have gone through similar experiences where they ‘felt fine’ but their Covid-19 results said otherwise.

This phenomenon would not have been so common like today, if not for the availability of vaccines.

 

Recap of Sarawak’s vaccination journey

As of Sept 19, Sarawak has successfully administered a total of 3,772,085 doses of vaccines, to 1,949,521 individuals with their first doses, and another 1,822,564 with their full doses, according to the daily update by Special Committee on Ensuring Access to Covid-19 Vaccine Supply (JKJAV). Percentage wise, 64.7 per cent of the total Sarawak population or 89.2 per cent of total adult population has been fully vaccinated.

The total cumulative vaccine doses administered in each State in Malaysia as of Sept 19, 2021.

Looking back, it was in early June when the Sarawak government really picked up the pace of vaccination as the State was finally provided with enough vaccines. In the first week of June, the number of total vaccines administered was between 8,000 to 15,000 doses per day, from the previous record of only a few thousand or even hundreds daily.

It took about one week for the mass vaccination centres (PPVs) such as Stadium Perpaduan and Borneo Convention Centre Kuching (BCCK) to adjust their facilities, manpower, and other resources to the sudden increase of vaccination load each day.

Starting June 12, the rate of vaccine administration escalated to at least 40,000 doses a day. The highest vaccination record that Sarawak had achieved was on July 12 when the total doses administered hit 87,239 doses, with 55,772 second doses and 31,467 first doses. At that point in time, a larger portion of the eligible Sarawak population had already received their first doses, so most of the doses given away in the following weeks were to those who had already been partially vaccinated.

Between the end of July and August, the immunisation rate then slowly went down as the vaccine supply exceeded the number of recipients stepping up for jabs. After Sarawak reached 81.5 per cent full vaccination on its adult population on Aug 17, the State government started opening up PPVs and allowing health clinics to accept walk-in Covid-19 vaccinations. While vaccines sit waiting in syringes, the authorities were out looking for ‘leftover’ adults to be vaccinated.

Covid-19 vaccination rate in Sarawak as of Sept 19, 2021. Taken from CovidNow official website.

Sarawak, that managed to reach 80 per cent herd immunity in less than two months’ time, was ahead of schedule. It came in second, after Labuan, to have achieved this milestone before other states in Malaysia under the National Covid-19 Immunisation Program (Pick).

Now, after all that hustle, was it worth it?

 

Did the Covid-19 shots work?

You and I may not feel it, but the vaccines are doing their jobs. Other than preventing a person from contracting Covid-19 easily, the vaccines mainly serve to keep the person from getting seriously ill if he or she does get the virus. That explains the small number of Category 3, 4, 5 cases and a lot more Category 1 and 2 cases as the Delta variant continues to spread in the State.

Quietly, the coronavirus has since seen Sarawak’s mass vaccination for adults shifting its focus to those who are still unvaccinated, especially adolescents and children under 18-years-old who were previously not eligible for vaccination due to medical concerns.

It soon became the ‘pandemic of the unvaccinated’ when the eight-year-olds, one-year-olds, and even babies started to test positive for Covid-19 in August.

Though not the most pleasant way to find out the efficacy of vaccines, this shows that there exist certain obstacles or obstructions for the virus to attack those who already have immunity against it.

“Covid-19 vaccines are effective,” read a report by Centers for Disease Control and Prevention (CDC) on the benefits of getting vaccinated. Even when it comes to the notorious Delta variant, vaccines are proven to be efficacious in reducing one’s risk of being infected, on top of avoiding hospitalisation and death. Echoing this, the World Health Organization (WHO) in a statement dated April 30, said “vaccines are a very powerful tool in our fight against Covid-19”.

Though vaccines work differently in different bodies, doubting the efficacy of vaccines is like ‘betting against the house’. It is like reading about a driver, who had his seatbelt on, dying in a car crash, and people questioning the function of seatbelts. Seatbelts, or in this context vaccines, are only preventive tools to lower the risk of infection, if not the chance of death and severe symptoms, especially when Covid-19 is here to stay.

 

See the bigger picture: More vaccination, less death

Talking about reducing the chance of death from Covid-19, it is evident that Sarawak has been recording one of the lowest death rates in Malaysia, thanks to its high vaccination rate.

According to CovidNow statistics, Sarawak reported 3.6 deaths per 100,000 people as of Sept 19, while Penang and Johor topped the list with 17.9 and 12.5 deaths per 100,000 people, respectively. That is four to five times more than that in Sarawak. Simply saying, if there is an average of five deaths in Sarawak each day, Penang would have at least 25 and Johor 20 on the same day.

Relatively, in terms of ventilator use for Category 5 patients who are at the highest risk of mortality, Sarawak recorded 37.3 per cent utilisation while Penang had used up to 68.3 per cent and Johor 54.3 per cent. This was despite the fact that Sarawak registered the highest rate of new cases, with up to 17.4 cases per 1,000 people, as compared to Penang, Johor and other states.

It can be concluded that Sarawak also has less Covid-19 patients on the brink of death as compared to most of the other states, but specifically only Penang and Johor in this context.

The reason to explain this is Sarawak’s 10 to 20 per cent higher vaccination rate than the two states. Penang, as of Sept 19, managed to fully vaccinate 57.4 per cent of its total population and 74.5 per cent of total adult population. Johor, on the other hand, has administered full doses to 49.9 per cent of its total population or 69.5 per cent of the total adult population. They are still a few steps behind.

Comparison between Sarawak, Penang, and Johor in terms of deaths per 100k people, cases per 1k people, and ventilator utilisation percentage. Taken from CovidNow official website.

Comparison between Sarawak, Penang, and Johor in terms of Covid-19 deaths, patients ventilated, and in the ICU. Statistics courtesy of the CovidNow official website.

 

Current Covid-19 death scenario in Sarawak

Back to Sarawak itself, one who happens to notice the recent increase in Covid-19 fatalities in the State could always argue otherwise; that the numbers of deaths have not been low lately. Yes, the mortality rate in Sarawak has, in the past two weeks, shot up to double digits and there is no sign of a downward trend yet.

It was on Sept 5 that the State saw more than 10 deaths. Following that, it was an average of eight to nine fatalities each day in a period of seven days. The highest record as of Sept 21 was on Sept 19 when there were 20 deaths in a single day.

But, here’s a theory. Assuming that Covid-19 deaths are linearly related to the daily caseloads, the number of deaths are then calculated per 1,000 daily cases. While the case numbers have evidently increased, the chances of discovering more fatalities will subsequently rise. The probability has just gotten higher.

From the proposed calculation, deaths per 1,000 daily cases in Sarawak have been rather consistent in the past four weeks between Aug 23 and Sept 19. Thus, it is fair to say that there has not been any drastic changes in deaths, despite how things look.

On Sept 20, SDMC chairman Datuk Amar Douglas Uggah Embas said the 20 deaths on Sept 19 were inclusive of a backlog cases of which the earliest one was backdated to Sept 6, which was about two weeks before that. He emphasised that the deaths reported in SDMC reports was not recorded within a single day.

The backdated reports of Covid-19 fatalities occurred because the authorities needed time to perform a post-mortem on the deceased who were suspected to have died of Covid-19 to determine the actual cause of death.

On this note, SDMC advisor Dato Sri Dr Sim Kui Hian, also on Sept 19, pointed out that the Ministry of Health (KKM) and the Sarawak State Health Department (JKNS) should make public the mortality review and post-mortem reports, to reveal whether the recent Covid-19 victims contracted the virus before or after they passed.

Table showing the deaths per 1,000 daily caseloads from Aug 23 to Sept 19, 2021. Compiled and drawn by DayakDaily.

Unfounded fear of Covid-19, even after the discovery of vaccines and in this post-vaccination era, can be hard to eliminate in a short period of time. But it is time to separate the facts from fear.

Life needs to go on as Sarawak and the rest of the nation transition into the endemic phase.

It’s time. It’s time to take a step back from Covid-19 anxiety and start living with it. With the availability of vaccines and measures in place to curb its spread, Sarawakians will need to endure and do all they can to ensure that their lives can go on with a semblance of normalcy. — DayakDaily