Abdul Halim Abdul Jalil*

KPJ Ampang Puteri Specialist Hospital, Selangor, Malaysia

*Corresponding Author: Abdul Halim Abdul Jalil, Consultant Pediatrician, KPJ Ampang Puteri Specialist Hospital, Selangor, Malaysia and Formerly Professor and HOD of Pediatrics, Lincoln University College, Malaysia.

Received: August 31, 2021 ; Published: September 01, 2021

Citation: Abdul Halim Abdul Jalil. “COVID 19 Pandemic - A Reflection”. Acta Scientific Paediatrics 4.10 (2021): 01-02.

As of August 2021, The World Health Organisation (WHO) has reported 210 million Covid 19 cases and 4.5 million deaths. It has been 20 months since the pandemic started. Different countries respond differently enabling us to analyse and pinpoint strategic factors that can be successfully used to mitigate or contain the pandemic.

Standard Operating Procedures (SOPs) adopted include face mask, hand washing, social distancing and sanitation. Lockdowns have been implemented. Contact tracing has been carried out and cases diagnosed are quarantined. Schools have been closed. Ports of entry have been closed. Covid 19 vaccines were made available since beginning of 2021.

In spite of all these measures surges of cases were reported even in those countries with a very high rate of vaccination e..g Israel [1]. In many parts of the world the health care systems are overwhelmed with insufficient intensive care beds to cater for those in Category 4 and 5. The effects of prolonged lockdowns have resulted in closure of enterprises. Many have lost their jobs. These have led to an economic crisis. Schools and academic institutions have been closed since the beginning of 2020. Agricultural food production has been affected. Increasing demand for foodstuffs has led to increase in prices. There has been increasing reports of emotional trauma, domestic violence and suicides, practically everyone has been touched and forced to accommodate to the crisis.

Why have all these measures failed to contain or mitigate the pandemic? Factors include poor implementation of the SOPs leading to the emergence of new clusters, inadequate contact tracing, testing and delay in getting data for action to isolate diagnosed cases. Those vaccinated are reported to have breakthrough infections and can still transmit the virus.

The Covid 19 pandemic is now more than 20 months duration and shows no sign of abating. Lockdown is effective if carried out with meticulous attention to detail (as in the Chinese model). Protracted lockdowns carry with it disastrous effects on the economy. The way forward seems to be to adapt to the situation or to live with covid 19. The Singapore pandemic response is one of the most successful programs and merits a closer look. Although the infection rate is high the mortality rate is one pf the lowest. Admittedly, their socioeconomic condition, the communication strategy with the populace and the efficient use of healthcare resources contribute to their success. The response may not necessarily be appropriate for some countries. Singapore however is an example of a country that has emphasised “living with Covid 19”, assuming that the next person may be an asymptomatic carrier. Lockdown is to be avoided not only because of the damaging effects on the economy but also because of its very negative effects on mental health. Various media outlets are used to improve public awareness and to remind the public to observe masking, social distancing, online learning and meetings. In addition contact tracing and adherence to quarantine utilising efficient technological systems such as Trace Together and Safe Entry are used to detect people within close range and duration of an encounter with an infected person. There are legal implications for individuals who defy the health precautions (Singapore Ministry of Health, 2020b).

As of August 2021, some five billion doses of Covid 19 vaccines have been administered (WHO). Vaccines are not perfect. Currently, the short term safety profile of Covid 19 vaccine appears acceptable, but additional studies and long term surveillance are needed to further define the safety profile [2]. But relying on vaccination alone may not be appropriate with new data showing breakthrough infections and reports of adverse reactions [3,4].

With frightening numbers of severe Covid 19 cases overwhelming the healthcare facilities, the focus should be on treatment options to complement vaccinations. Regrettably, this is rarely mentioned in the mass media. Around 80% of Covid 19 patients are self limiting, 14% require admission and 6% require intensive care. The immune system can be enhanced by Vit D, Vit C and Zinc and keeping a healthy lifestyle [5,6]. Medications such as Ivermectin [7], hydroxychloroquine have been used by clinicians worldwide and can be used early once diagnosis is made. Treatment protocol should be made available to physicians who can monitor patients closely and arrange for immediate hospitalisation if patients deteriorate into category 4 and 5.

The world needs the best of leading scientists and frontline physicians to navigate us through this pandemic. A strong leadership which is open to new ideas from subordinates, from other experts in the country and flexible enough to change in accordance to the changing situation is needed. Authorities should engage with other experts within the country and worldwide to find the best solution based on sound science. “Sound science should be effectively communicated to policy makers and should constitute the prime foundation in decision making amid this pandemic. Implementing policies without a clear scientific basis could lead to catastrophic consequences, particularly in light of attempts to reopen the economy in many countries” [8].

Bibliography

1. Meredith Wadman. “A grim warning from Israel: Vaccination blunts, but does not defeat Delta”. Science Insider 6 (2021): 55.
2. Andrzejczak-Grządko and Z Czudy M Donderska. “Side effects after COVID-19 vaccinations among residents of Poland”. European Review for Medical and Pharmacological Sciences 12 (2021): 4418-4444.
3. Adam K Wheatley., et al. “Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies”. Nature Microbiology 5 (2020): 1185-1191.
4. Qianhui Wu., et al. “Evaluation of safety profile of Covid 19 A rapid review”. BMC Medicine (2021).
5. Alez Vasquez. “Textbook of Clinical Nutrition and Functional Medicine, Inflammation mastery 4^th Edition” (2016).
6. Hotchkiss RS and Opal SM. “Activating Immunity to Fight a FoeA New Path”. The New England Journal of Medicine 392 (2020): 1270-1271.
7. Pierre Kory., et al. “Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19”. American Journal of Therapeutics 3 (2021): e299-e318.
8. R Zhang., et al. “Identifying airborne transmission as the dominant route for the spread of COVID-19”. Proceedings of the National Academy of Sciences - NCBI (2020).

Copyright: © 2021 Abdul Halim Abdul Jalil. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.