The great game plan to have Covid-19 become endemic (living with the virus) essentially means that the pandemic is not expected to end with the virus disappearing but with it continuing to circulate, always affecting a small portion of the population while the rest gain immunity either through vaccination or recovery from infection. One example of an endemic virus is that which causes chicken pox. Two doses of the chickenpox vaccine are over 90% effective at preventing it. Most people who get the vaccine don’t get chickenpox — and those who do usually get a much milder version of the disease. Having said that, let’s look at the numbers here in Singapore at this time of writing.
Should we be alarmed by the numbers? Well, yes and no. Adopting the endemic game plan means that we allow infection to spread and people to recover from it in a controlled manner. So in a way, we should not be too concerned about the numbers. But a favourable outcome hinges on a few factors. One is the effectiveness of the vaccine.
Fortunately, the vaccine is effective, even against the delta variant. Some people may ask, why are we not completely immune to the virus after vaccination? Why are some fully vaccinated individuals still infected? Why do some of them fall ill? Why a handful even die?
The answer lies in the duplication rate of the delta variant. According to the experts, whether a person presents symptoms after infection depends on his antibody level. If the body is not exposed to the virus after vaccination, the antibody levels will fall over time. It has been likened to a bodybuilder who stops exercising. The muscles built up will shrink. Of course, individual and vaccine-dependent variations will also apply.
When a vaccinated person is exposed to the virus, the body may not have enough antibodies to eliminate it at that point in time. However, the vaccinated individual’s immune system would have been primed to start producing more antibodies. In most people, it takes about 4-5 days. Different strains of the virus produce different levels of viral load (the amount of virus doctors can find in your body) at different speeds. The original Wuhan strain of the virus produces enough viral load to cause symptoms in a week and by that time, the body would have put up adequate defences against the virus. Thus, the vaccine confers complete immunity in 90% of the cases.
The Indian delta strain, however, is able to produce enough viral load to cause symptoms in just 3 days. The vaccinated person’s immune system is just slightly behind “schedule” and therefore, symptomatic infections do arise. For a few unfortunate fully vaccinated individuals, the headstart that the virus has is enough to kill them.
When do we need to worry about the numbers when we decide to adopt the endemic game plan? The numbers say that over 98% of infected individuals do not require hospitalisation. Let’s say that 1% of them do require hospitalisation. If the numbers hit 10,000 a day, that would be 100. Can our hospitals cope? Not being an expert, I can’t tell for sure, but it certainly doesn’t look good at the moment even at <2000 and we certainly won’t wish we would ever get there, but the fact remains that we could easily lose control going the endemic path. Nevertheless, I have no issues with our endemic strategy so far. It works but what level of damage/sacrifice is considered acceptable?
However, even with good control, the numbers could be large. The strategy our government is adopting here is “home recovery”. This is where home recovery comes in. It frees up hospital beds for those who need to be hospitalised – that 1%. I have no issues with this until …
You can read all about it here. To me, managing home recovery this way is just like hitting the ball into our end of the court. The guidelines are given to you. Can’t follow? Your problem. Any additional measures you wish to take and the additional costs involved? You bear. A week ago, I had expressed concerns on my Facebook profile. If we’ve tested positive, wouldn’t we want to isolate ourselves and put our family members in a hotel. Apparently, that’s not allowed as family members would have to be quarantined together with the family member who has been tested positive. Pathetic academics may argue that only flats that are “suitable” for such arrangements need to follow the guidelines. Yao mo gao chor ah? Do our pathetic academics live in ivory towers? How many HDB flats are “suitable” (and how practical is it to follow the guidelines) without putting other family members at risk? Chicken pox party? A doctor friend opined that this is what going endemic is all about – at risk of losing control and overwhelming our healthcare facilities of course.
All data/numbers must be viewed in proper perspective. If 1,000 people died in Iceland, out of a population of about 340,000, that would have a far bigger impact than the same number dying in the United States, with its population of 331 million. This difference in impact is clear when comparing deaths per million people of each country’s population – in this example it would be roughly 3 deaths/million people in the US compared to a staggering 2,941 deaths/million people in Iceland.
Going endemic in place like Singapore is very different from going endemic in places like Canada. Until today, when we have clusters at bus interchanges, the pathetic academics and PLPs are still denying that the lack of social distancing on our public transport is a major weak link as there is still “no evidence” of a cluster developing there. They mock other countries’ achievements and play apologist for the mistakes made locally – so 5毛.
Yes, unless we go into a lockdown (which I do not support), the number of new cases and deaths are going to rise exponentially. I do support this game plan in principle, but you can’t deny that it has been poorly executed. The final outcome will still be good if we can accept the loss and sacrifices. That’s what it’s going to boil down to and not what is nicely described as “resilience”.