Sunday, October 10, 2021

Covid-19, The Long And Winding Road ! -- Part I

Anybody who knew The Beatles should not be a stranger to the song "The Long and Winding Road".  Singapore Covid-19 situation since the start of the pandemic in January 2020 till now couldn't be best described by this song. 

"The Long and Winding Road" is not referred to the scenic pleasant of the sight of a road stretching up into the hills in the remote Highlands surroundings of lochs and distant mountains (something that inspirred Paul McCartney that eventually came out with that title for the song) but rather the underlying angush at the direction of his personal life as well as a nostaigic look back at the Beatles' history.  Needless to say, the phrase, "The Long and Winding Road" being used to describe Singapore Covid-19 situation is definitely not on the optimistic perspective.

Won't be surprised should majority strongly felt that it was the Covid-19 virus that led to the long and winding road status.  Unfortunately, that perception is totally wrong.  The virus does not have a brain like a human being and it behaves in a very systematic way in 3 stages -- entry, genome replication and exit.  Put it in a more laymen term, the virus can only move among the 3 phases of transmission, mutation and infection.  The one that actually lead us to the long and winding road status is none other than the human beings that manage the pandemic.  There can't be only 1 way to manage a pandemic but different ways of handling will lead us to different scenario.  It just boils down to 1) a long and winding road with lot of uncertainities and no sight of the ending point or 2) walking cautiously along a long and straight road whereby the ending point could be seen.  Singapore's Covid-19 situation like it or not landed in the long and winding road option and how do we ended up there ?


Crisis management is the prime factor that leads the nation in to the "long and winding road" status.  Crisis management is not just refer to the Government that manage the pandemic, it traverses all the way down to the individual of the nation though majority of the responsibility lies on the top level.  


The Government

Situation started to take the turn in May 2021 when the nation was first reported of delta variant infection.  Changi Airport and Tan Tock Seng Hospital were the 2 dfstinct clusters.  Even schools were not spared of when in 2020 not a single infection happened in school.  That was due to the Government was so data oriented that they lacked the instinct to act proactively.  Citizens urged the Government to shut the border early to high risk nations in particular India when the delta variant hit them massively in April.  Instead the deflection was Singapore cannot afford to close border totally.  An opportunity was lost in May 2020 that could end up differently if the Government was aggressive and decisive enough to do another lockdown (refer A Solution To Contain The Current Wave Of Covid-19 Infection in Singapore, dated 19th May 2021).  

The ad hoc ring fencing, ramping up vaccination rate in strong belief of the vaccine and the so-called herd immunity were instead implemented without even having a second doubt on the herd immunity theory (refer Herd Immunity Through Vaccination ?, dated 5th Jun 2021).  That decision led to the July local community outbreak from the KTV and Jurong Fishery Port clusters and that further extending into the heartlands when several of the hawker centers and wet markets were forced to close down for weeks due to infection, impacting people livelihood and daily life.

As if the situation was not bad enough and ignoring those warning signals that suggest more appropriate actions should be taken to contain the virus, the focus was weighed heavily on vaccination.  The vaccination programme even extended to those in the age group from 12 to 18 despite the safety data on hand only restricted to the outcome of the clinical trial.  Slowly, serious side effect like heart inflammation appearred on the younger age group after taking the vaccine globally.  Though it is said to be rare occurrence but if given more time to investigate on and acted cautiously even the rare occurrence could be avoided.   

The target was 80% of the population being fully vaccinated, raise the white flag to zero Covid and embark on the so-called "endemic" route in order to open up the economy.  At the same time, Israel (one of the highest vaccinated population at that time) started to take hit with the delta variant even with data showing the effectiveness of the mRNA vaccine fell to a low of just 40% after 6 months agains the delta variant.  Practically, can't prevent infection and tranmission.  The vaccine fails to perfom to what initially thought it could do except still able to prevent severity.  This is when the Government (globally) so stucked in the vaccine number game (refer The Number Game Of Covid-19, dated 25th Jul 2021) that they failed to realize vaccine is not a cure, just part of the system to overcome the pandemic.  Itself can't do all the work.  Ability to prevent severity alone still not good enough.  Like a mad bull charging recklessly in one direction, the belief of vaccination, "endemic" and "herd immunity" to open up the economy to the extend that discrimminating measures were being used against those unvaccinated unfortunately led to another turn to the worse.

Vaccination target met (KPI achieved for political career advancement), sing the song of "endemic" (reall endemic ?), still believe in vaccine and "herd immunity", brushed aside situation in Israel, layout expectation of daily 100 to 200 cases after opening up the economy as a norm, deciding to reveal less detail of daily infected cases, self praise healthcare system is the only country that yet to to experience overload (China, Hong Kong, Taiwan and New Zealand all have exprienced 0 cases for consecutive months in 2020, how on earth that is being considered as not overload of healthcare system ?) without even bother to doubts is that going to work while an average joe could raise doubts and concerns (refer Covid-19, The Light At The End Of The Tunnel ?, dated 23rd Aug 2021).  

Foreign experts citing the impossibility of achieving herd immunity against the delta variant and since then, the Government also admitted the impossibility despite having more than 80% of the population being vaccinated.  A tight slap in the face when they were so strongly in belief of it prior to that.   Now, never even heard of them mentioning the phrase "herd immunity" again.  If that event was not bad enough, the next bomb shell dropped with the outbreak of the bus interchange clusters islandwide.  Daily infected cases exceeded the expectation of 100 to 200, even unlinked cases rose to a never before 3 digits level.  Deny no transmission happened in public transportation, is that so or the tracing technology has hit its limitation ?  Ditched away with reporting daily unlinked cases when number is mountaining up, lot of backlog needed to clear to finally link them all up.  Deprived the people the right to have a transparent and detail information of what's actually happening on the ground.  Don't they realize such vital information would serve as an alert and warning to the people so that they could restrict themselves and indirectly helped to break the virus transmission.  Slowly, clusters here and there popping up one by one.  

When daily infected cases exceeded expected value, immediately shifts the expected value to a higher one and the process repeats until now the so-called expected cases is 10,000.  Heathcare system overload is measured by the number of ICU beds available but largely forgetting that healthcare workers are not robot, they can't work 24 hours non-stop, shortage of manpower will eventually cripple the healthcare system.  Daily cases continued to climb and eventually the shortage of manpower issue surfaced.  Their solution was asking vaccinated people who were infected with no or mild symptoms to do home recovery.  That implementation met with anguish and confusion from the people as instructions were uncleared and things were not at all properly organized.  Haven't they learned the lesson last year in the early phase of the pandemic when communication created unnecessary confusion ? (refer Covid-19, An Opportunity To ....... , dated 15th Apr 2020)  Not only that, all those start-stop and flip flopping measures did more damages in particular to the businesses than the lockdown period last year.

"Sooner or later everyone witll meet the virus"

"Many S'poreans will catch Covid-19 sooner or later, don't be too fearful".

By now, the nation should be very familiar with the above 2 sentences.  Definitely not an encouraging sentence but resemblance the situation of 曹操与鸡肋.  Entered into a situation whereby no clear chances of victory or realized the mistakes but to save face in admitting failure, we resign to the fate of being infected eventually.  

While trying to give reasons on how the nation pandemic situation ended with sharp rises of infection and fatality lately when the population is having one of the highest vaccination rate in the world (as of now 83% fully vaccinated), the response was "no time to explain" and "the virus didn't follow our script".  This type of unacceptable and disappointed response, how to build confident in the people ?  As mentioned the virus behaves in a systematic way, learning their way, get ahead of them and cut off their transmission should be the way to contain the pandemic and not focing them to change to your way.  Gave them the data, they interpret it like an economists when the pandemic is clearly a science.  That how the nation ended in such a state now.

A newly anncouned restriction of banning unvaccinated personal to dine-in in hawker centers, coffee shops and entry to malls and attractions in the name of protecting the vulnerable.  Now look at the following from CNA's report (refer here)


The above is the guideline from MOH, it clearly stated unvaccinated person between age 12 to 49 being infected will be allow to recover at home by default as the severity of illness in them is assessed to be low.  Noticed the highlighted word "unvaccinated person".  If they are deemed not vulnerable then why put in the ban restriction for them ?  Isn't that contradiction ?  This type of contradiction isn't first.  It just showed there isn't a comprehensive strategy in the first place to manage the pandemic.  All along either "monkey see monkey do" copying what other countries are doing or just plain ad hoc all the way.  A real comprehensive strategy or plan will not have contradictions at all.

Some food for thoughts.  For those who happened to have lived their life when LKY was still the PM should know that if he decided to trade-off the pandemic with the economy in sacrifying 100 to 200 daily cases, he would have put in all the measures to ensure that number won't get out of control no matter what.  This is in total contrast of what current crisis management is doing.  When you expecting an upper limit, shouldn't you make sure that upper limit will not be breached ?  That the basic of crisis management.  The current bunch of crisis management team are the one who have lived their life when LKY was the PM.  Respecting, admiring and inspiring with the ways he do thing, they decided to join the same political party and pursue a political career.  When in turn for them to take the lead, they fail to reproduce what they have learned from LKY.  Ironical isn't so ?

How not so they are the one responsible for steering the nation into the "long and winding road" path ? 


The Doctor

Have been observing and waiting for the GOOD DOCTOR to step up to guide the nation out of the pandemic.  Thought all along probably due to they still trap in their own think box (refer The Number Game Of Covid-19, dated 25th Jul 2021).  If that so, outcome might not be bad as when the hard data eventually presented to them, they should be able to walk out of their own think box and make the appropriate advices and recommendations.  However, if that is not so, situation would be very bad as they shall be the next group after the crisis management to help to steer the nation into the "long and winding road" path.

良医以人命为本庸医以利益为优

A good doctor not only possess excellent skills but always put people life as priority.  A mediocre doctor will harbor status, frame, power, monetary and political thoughts or prioritize over people life.  Recapping the key events that these doctor did since the start of the pandemic last year.

1. Advised of not wearing mask if said person was not sick and in the end mask wearing has became mandatory globally.

2. Said the virus is not as deadly and worse than 2003 SARS (both belong to the same family class of the virus) when they knew very little about the virus then.  Global infected number and death for SARS were 8,096 and 774 respectivity affecting around 30 countries, no lockdown was been implemented by any of the infected nations.  As of now, global infected cases and death of Covid-19 are 219M and 4.55M respectivity and almost every nations in this world are infected with the virus.  Lockdown, border restrictions and strict individual measures are still ongoing.  Fatality rate they might be correct (SARS 9.56% vs Covid-19 2.08%) but overall Covid-19 is definitely worse than SARS.  Not to mention you never know when the next threatening variant will be mutated.  Moreover, there wasn't any vaccine during SARS and now in Covid-19 with the vaccine, infection is not slowing down.

3. Covid-19 virus is not aerosol, that was the claimed last year when the world still have lot to find out about the virus but now it is scentific proven transmission can be aerosol.  Any different ?  Of course there is, should this fact was taken seriously last year, meausres taken would be different in prevention and perhaps reduce the possibility of so many variants (Variants of Concern) through mutation.

4. Strong belief in the vaccine and now still is despite already proven effectivenss in prevent infection wanes to just 40% after 6 months while efficacy also fell from the initial 95% to 80%+.  Prevent death is one thing but fail to prevent massive infection and overload the health care system won't help either.  Any different ?  Yes, advise centered around the vaccine and advise with the vaccine as part of the system will have different outcome in controlling the pandemic.

5. It is no longer a kept secret that the mRNA vaccine possess serious short-term side effects in particular heart inflammation among the younger individual.  Globally, there is also substantial figure of death related to the vaccine but here is ZERO.  Logical and rational ?  When the mRNA vaccine just completed its clincial trial test on the 12-18 age group, other nations like UK paused for more data to conclude the safety of the vaccine to this age group before approving, here just with that limited data from the clincial trial, went ahead to approve it.  Even when some doctors raised the concern, the ascending tone of using limited data at that time to debunk was done.  The warning advise of not carrying out strenuous exercise for a week after vaccination was emphasized after a 16 year old suffered cardic arrest due to weightlifhting after vaccination.  Now the warning period has extended to 2 weeks, why, when the population has already more than 80% being fully vaccinated ?

6. The mRNA vaccine was developed and approved to use under the EUA condition in less than a year.  Compared to the traditionally a decade or more duration to ensure safety and no serious long term side effects.  With the limited data on hand and definitely doesn't have the technology of a time machine to leap forward 10 years to see of any serious long term side effects, the message was just so authoriative but scientifically inappropriate to claim the vaccine is very safe to be used.  A life is a life, a life is not a guinea pig !

7. No evidence of transmission in public transport.  Some experiement was conducted to give that conclusion ?  If so, how was the experiment being conducted and which virus was being used in the experiment ?  Present that findings to assure the public indeed no transmission in public transport.  Medical doctor being scientifically trained must have conclusive scientific data to back any claims and not just try to ride out with words.  It is no wonder netizens are sarcastically saying Covid-19 virus doesn't have an ezlink card so can't cause infection in public transport. 

8. Coincidence was the word being used to explain death due to underlying medical conditions from Covid-19 virus or vaccine.  Is this what a medically and scientifically trained doctor should subscribe to ?

9. Fully subscribed into the narrative of herd immunity via vaccination when herd immunity is worked out from a mathematical model with only just 1 variable.  Isn't that too theoretical rather than practical without even bother to utilitize that scientific thinking ?  Now, foreign experts one by one has came forward to dismiss the possibility of the herd immunity concept, what's their stand now ?  Just plain following others to dismiss it when before that was so ascertain about it.  (refer Covid-19, The Light At The End Of The Tunnel ?, dated 23rd Aug 2021) 

10. Endemic is another concept they subscribed into it, endemic like common flu.  Being a doctor and in particular specialize in infectious diseases couldn't be ignornant about the chronicles of pandemic since the 1918 Spanish Flu.  Including the Spanish Flu, within a duration of 100 years, the world has experienced 4 pandemic involving the Influenza virus.  Just less than 2 decades, the world again experienced 3 pandemic involving the Coronavirus.  How is it an endemic when all these have happened ? (refer Covid-19, The Light At The End Of The Tunnel ?, dated 23rd Aug 2021)  

11. 马后炮 or put it politely 事后孔明 is at best for them. With their in-depth knowledge and experience on virus, they should be able to analyze the situation better than anyone but how many times have their analysis turn out to be true ?  It was only things have already happened then they will voice it out "it is expected".

12. With things don't go as expected lately, the view of "might be better to get infected to gain that naturalized immunity" was raised (just like mentioned before in Covid-19, The Light At The End Of The Tunnel ?, dated 23rd Aug 2021, throwing those vaccinated person under the bus -- get vaccinated, be mentally prepared to get infected.).  Get infected with Covid-19 isn't same as get infected with common flu.  Recovered Covid-19 patient has a possibility of suffering long-covid syndrome.  Till now, there isn't concrete data to know who will get it, who will not get it.  To make it worse, the list of long-covid symptoms increases over time as scientists are still researching on it.  With that in mind, how is it appropriate for people to just get infected to gain naturalized immunity on one hand but face the risk of suffering the long-covid syndrome on the other hand.

Are these doctors willing to put their neck on the chopping board to assure there won't be another more threatening variant being mutated going forward ?

From an unbiased perceptive since this is an archive, would want to document down the real good things they have done for this pandemic.  Give them the benefit of doubts, should have some but unfortunately, with my capacity couldn't find it.  Should any readers found it, kindly inform so that could be documented.

Regardless of whether expert or specialist in infectious diseases, a professor in a medical school, a consultant to the medical school, an advisor to WHO, director to a center, doctor in a hospital, appointment holder in a ministry or just plain doctor,


Had save numerous lives before does not automatically qualify as being a good doctor

Had taught numeous medical students does not automatically qualify as being a good doctor

Had published numerous research papers does not automatically qualify as being a good doctor

Had gained numerous recognition does not automatically qualify as being a good doctor

Being high up in the hierarchy does not automatically qualify as being a good doctor

Gave all the incorrect advices definitely is not a good doctor

Used ascending tone to claim credit in saving lives definitely is not a good doctor

Unable to accommodate peers' alternate views definitely is not a good doctor

Aghast at peers for no valid reasons definitely is not a good doctor

Labelled others selfish for not vaccinated definitely is not a good doctor

Denounced unvaccinated as being hostage to majority definitely is not a good doctor

Did not even bother to find out exact reason for people not vaccinating definitely is not a good doctor

Political doctor definitely is not a good doctor


寻良医有如大海捞针,庸医随手一抓一大把

How is it not possible these group of people not in a way responsible for steering the nation into the "long and winding road" path for this pandemic ?


To be continued on next few groups of people................


Singapore Covid-19


打油诗

主将无能垮三军
左士缺策只砸钱
右士辱人自被辱
左象无计只会泣
右象理人理出祸
左马略识色不分
右马讲据终慢拍
小卒仗权乱闹事
大敌当前夸本领
火烧眉头方才悟
城门紧闭称闭窗
高傲自大多借口
知错不认真懦夫


主动是它的名字
领导者最佳战友
为何小红点缺乏
是否无勇气拥有
是否缺远见拥有
是否不知怎拥有
还是不想去拥有

No comments:

Post a Comment