Letter: Our Endemic COVID-19 Strategy must include a Variant Strategy

The Malaysian Health Coalition accepts that variants are inevitable in a multi-year pandemic. We urge responsible and calm reporting from the media and the public, and recommend the government to immediately establish and implement an endemic COVID-19 strategy that includes strategies for the Omicron variant and other possible future variants. 

We recommend the following: 

• Increase genomic surveillance 

Malaysia has performed successful surveillance for viral diseases since the 1960s. With Omicron detected here, we need to adapt, pool and utilize these existing resources to increase genome sequencing. According to GISAID (a global non-profit for genomic data), Malaysia sequenced only 0.26% of all COVID-19 cases in the past 90 days, below the recommended 0.7-2.0% depending on case numbers. Malaysia is under-sequencing compared to other developing countries like Thailand, India and South Africa. Therefore, we must actively build our own genome sequencing capacity through innovative partnerships between the Institute for Medical Research, university research and private laboratories. We must sequence more in targeted clusters and at points of entry to understand the spread of Omicron and detect emerging variants. The detection of variants must be coupled with robust real world data collection and analysis of case numbers, admissions, and disease severity to monitor its impact. We must also invest in R&D to expand the personnel, expertise and infrastructure of our surveillance system. This allows new technologies and tools to be deployed to detect and respond to future variants.

 

• Deploy boosters across Malaysia as quickly as possible with good safety monitoring 

Evidence from clinical trials and real-world data sets proves that boosters are effective against variants. Globally, government policies have increasingly supported boosters. We commend the government’s decision to expand boosters to more and more groups. However, we urge the government to publicize booster data, including all safety data regarding Adverse Events Following Immunization (AEFI), to build public confidence about the need for and safety of boosters. Data transparency on safety and AEFIs will increase booster uptake. We also urge the government to build a sustainable booster strategy, which requires answering the question “Will we need Boosters Round 2, 3 or 4?”. Immunological studies may be needed to build clinical evidence to prove the effects of boosters on variants like Omicron. 

 

• Implement the National Testing Strategy robustly

We welcome the launch of the National Testing Strategy (NTS) on November 26, especially its explicit focus on rapid tests and not over-relying on PCR tests. However, there is no implementation date or implementation plan. Therefore, we urge its immediate and robust implementation, with strong government action to ensure that everyone has equal access to affordable, quality and timely testing. Children under 12 who are currently ineligible for the first two doses of vaccine and children aged 12 to 18 currently ineligible for booster doses should be offered more regular testing, over and above the NTS. The NTS must be evaluated and refined constantly alongside the evolving endemic COVID-19, and integrated into the MOH database for centralized data collection and monitoring.

 

As COVID-19 becomes endemic, new variants are very likely to appear. Malaysia needs a variety of solutions to keep the Rakyat safe, and boosters, genomic surveillance and a well-implemented National Testing Strategy will support public health.

 

BERKHIDMAT UNTUK NEGARA.

Malaysian Health Coalition
Full signature list:  

Organisations  

1. Academy of Medicine Malaysia
2. Association of Malaysian Optometrist
3. Association of Private Hospitals of Malaysia
4. College of Surgeons Academy of Medicine of Malaysia
5. Dermatology Society of Malaysia (PDM)
6. IKRAM Health Malaysia
7. Islamic Medical Association of Malaysia
8. Lung Cancer Network of Malaysia 
9. Malaysian Association for Bronchology and Interventional Pulmonology
10. Malaysian Association of Clinical Biochemists
11. Malaysian Association of Environmental Health
12. Malaysian National Society of Audiologists
13. Malaysian Nurses Association
14. Malaysian Paediatric Association
15. Malaysian Pharmacists Society
16. Malaysian Public Health Physician Association
17. Malaysian Society of Anaesthesiologists
18. Malaysian Society of Clinical Psychology
19. Malaysian Society of Intensive Care
20. Malaysian Thoracic Society
21. Medical Mythbusters Malaysia
22. Medical Practitioners Coalition Association of Malaysia
23. MedTweetMy
24. Obstetrical and Gynaecological Society of Malaysia
25. Public Health Malaysia

 

Individuals

1. Assoc Prof Dr Uma Devi Palanisamy
2. Dato’ Dr Amar Singh-HSS
3. Dr Khor Swee Kheng
4. Prof Dr Asri Said
5. Prof Dr Roslina Abdul Manap
6. Prof Dr Sharifa Ezat Wan Puteh
7. Prof Dr Zaleha Abdullah Mahdy

 

Coordinated by: Dr Sean Thum, Dr Subashan Vadibeler, Mellinnda Xavier

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Ipoh Echo.