Omicron -- Calm Before Storm ?

After more than half a year the world battling with Delta variant of the Covid-19 and with nations one by one upping the population vaccination rate, the world probably thinking seeing the light of the tunnel already.  Unfortunately, just last month, a piece of news created another shock to the world -- a new variant Omicron was discovered in an infected person on 11th November 2021 in Botswana and 14th November in South Africa.  WHO on 26th November 2021 named this B.1.1.529 variant as Omicron and classified it as a Variant of Concern.  While scientists and researchers still gathering data on this variant in particular how much transmissible and severe relative to the Delta variant, Omicron infected person as of now in general either is asymptomatic or with mild symptoms in a fully vaccinated person.  This has led some experts starting to declare this might be the variant that could end the pandemic.  Are these experts correct ?  If so, why WHO was fast to declare it as Variant of Concern compared to the duration in the past with Alpha, Beta, Gamma and Delta variant.

Presently, the followings are found about the Omicron variant :-

1. Omicron has found to have 50 mutations with 32 in the S gene as compared to between 9 and 13 in the Delta variant.  Higher number of mutations does not necessary translates to be more dangerous but rather it is easier to adapt to the human species by generating another variant.  However, note that it also doesn't mean it will not mutate into another more deadly variant too.

2. There were higher reports of immunity evasion in the Omicron than Delta, meaning it is better at evading the immunity provided by the vaccine than the Delta variant.  In fact,  many of those mutations involve the actual spike protein, which is critical part of the virus that allows it to enter the cells of the human body and make them sick.

3. Omicron can reinfect people who previously being infected and survived by the earlier variant of the SARS-CoV-2 virus.  Meaning, this is threatening the naturalized immunity of those previously infected.

4. Scientists at University of Hong Kong reported that Omicron variant multiples about 70 times faster inside the human respiratory tract tissue than the Delta variant.  This study yet to be peer reviewed as of now.

5. UK health officials estimated that within a household, the risk of spreading Omicron variant to another member is three time higher than the Delta variant.

6. As of now 19th Dec 2021, according to WHO, Omicron has been detected in 89 countries with Covid-19 cases involving this variant doubling every 1.5 to 3 days with community transmission and not just infections acquired abroad.

So, is this Omicron be the one that could end the pandemic ?  Whoever that expert suggested afraid have absolutely no data on hand to substantiate given that the world is still collecting data and research on this variant.  This is just a hope, a wish that the SARS-CoV-2 virus behaves like the influenza A/H1N1 virus in the 1918 Spanish flu pandemic that eventually mutates to the common flu virus we are having today.  However, in life science nothing is absolute until scientifically proven.  SARS-CoV-2 and Influenza A are 2 different classes of virus, they could have similar and common characteristics but don't expect they both behave exactly the same.  It is very disappointing and an irresponsible act to see a doctor who have years of experiences in infectious diseases and yet committed such a mistake.  That suggestion, that thought, that statement definitely have influenced certain people mindset towards the Omicron variant.  No need to look far, just see the daily facebook comment section of the ST page (those usual suspects at the usual place) one can easily find day in day out these people just spamming the thoughts that it is of no serious, "endemic" already no fear, Singapore should even open up more for the economy.  These are exactly the Selective Joe which was mentioned in Covid-19, The Long And Winding Road ! -- Part II.  These people with their selective mindsets are not going to help end the pandemic but just prolong it.

Since WHO classified as Variant of Concern on 26th November 2021, data from research were coming in biasing towards the negative aspect instead.  On top of that, vaccine makers like Pfizer and Moderna were fast into developing specific vaccine for Omicron despite claim that a fully vaccinated people with the mRNA together with booster shot still able to prevent severity and death.

So far majority of the reported Omicron infection were on fully vaccinated and even people with booster shot failed to escape from being infected.  The study from Imperial College London dated 17th Dec 2021 revealed that (Omicron largely evades immunity from past infection or two vaccine doses).  UK also reported first death, first confirmed death globally from Omicron on 13th Dec 2021 (refer here).  In UK latest study dated 17th Dec 2021, it was found that there is no evidence that Omicron variant is less severe than Delta (refer here).

In US, Cornell University also suffered a massive Omicron outbreak reporting 903 cases among students from 7 to 13 Dec 2021 with majority of the cases in a fully vaccinated individual.  In fact, nearly 97% of the students in the university are fully vaccinated.  That definitely not a piece of positive news for Omicron variant (refer here).

Other European nations were not spared with Omicron infection too.  Holland went from partial lockdown in 28th November 2021 when Omicron was first announced to the world to a full lockdown from 19th Dec 2021 till 14th Jan 2022.  In the east side of the globe though Omicron infection is still not as massive as the west, countries are tightening their borders and preparing for the worse.

The reaction of vaccine makers toward Omicron also doesn't provide much positive sentiment.  It's almost a hard fact now that the mRNA vaccine which is the highest efficacy among all the vaccines fares worse to the Omicron variant than to the Delta variant.  2 doses protection is almost render to be useless in infection prevention (just look at the Cornell University outbreak).  Vaccine makers are pushing for booster shot and even preparing to roll out an Omicron specific vaccine.  Pfizer CEO already admitted that 4th Covid vaccine doses may be needed sooner than expected due to Omicron (refer here).  Even with booster shot (the 3rd doses), it's still not a guarantee there won't be breakthrough in immunity.  The first local person to be infected with Omicron is a staff working at the Changi Airport who is fully vaccinated with booster shot and yet breakthrough occurred.  This really raised the concern that was highlighted in the previous post of vaccine becoming a double-edged sword, is it becoming a reality now ?

The vaccine becoming a double-edged sword was first raised in Herd Immunity Through Vaccination ? (dated 5th Jun 2021), way way before Omicron variant and just at the massive global outbreak of the Delta variant.  There were already breakthrough cases among the vaccinated with the Delta variant.  The rationale of vaccine becomes a double-edged sword is that the vaccine on one hand is able to prevent severity and death but on the other hand increases the platform and raise the probability of further mutation to either a more contagious or deadly variant.  While there isn't direct evidence Omicron is indeed mutated from a vaccinated person, there isn't direct evidence to conclude it is not too.  One thing is global vaccination rate is definitely higher as of now compared to the time when Delta was first emerged.  In fact, there isn't direct evidence Delta wasn't mutated from vaccinated person too.  For Alpha, Beta and Gamma, that could rule out as then vaccine wasn't available.  However, with the Omicron variant having the ability to evade immunity protection from vaccine, this raise the possibility it is mutated from a vaccinated person.  The basic of life science, living things react to changes for survival.  The virus could be reacting to the antibodies produced by the vaccine that it manages to mutate into another variant to overcome it.  Some might raise the fact that South Africa vaccination is less than 30% thus for that to happen chances are not high.  Chances are not high doesn't mean absolutely no chance or not possible !

There will be people going to deny the vaccine is a double-edged sword despite having no concrete scientific evidence to prove it is not as this is against their narrative.  

The first group shall be the vaccine makers.  For what reason, that is quite obvious and we don't even need to dig into detail about it.

The second group is none other than the government of each of the nations.  They are the one pushing strong and hard on vaccination and even rolled out discrimination measures against the unvaccinated.  Hardly, we see politicians being outright honest to admit mistake.  In fact, the more tyrannical one will just label that as false information or fake news despite not able to prove scientifically it is impossible.

The last group is none other than doctors, experts, specialists and scientists.  Unless they have no greed in title, status, financial power and getting recognition with national awards or a true hard fact throws in front of them, they will just toe the line of the politicians and maintain silence.  Even with a possibility, they don't even dare to raise an alarm.

Some might hard to apprehend why despite fully vaccinated and booster shot still can be infected.  Explaining the scientific way might still unable to understand.  Let put it in a more layman perspective.  Take the example of police and thief as an analogue to the vaccine and the virus.  The thief is the virus.  Each of the many disguises the thief put on to prevent being caught is the variants that were mutated.  The system to catch the thief is the vaccine.  Police is the antibodies that will hunt down the thief.  Police can't hunt the thief down without knowing how he looks like and that is the job of the vaccine.  The vaccine is responsible to research and find out the look of the thief and his many disguises.  With that information, copies of those are handed to the police so that they can hunt him down.  Immunity escape and breakthrough cases represent the thief has managed to disguise into a new look that wasn't inside the database of the police resulting in failure to hunt him down.  Booster shot is just like increasing the number of police say from 100 to 500 to track the thief down.  However, despite the increase in number of police, they still holding the same old database of the thief as before.  This is like riding on the fact that now have more police to raise the probability of hunting the thief down but not acquiring another new disguise of the thief.  As times go by as long as the thief still remain at large, the number of police tracking him down will reduce over times as they are being redeployed to other crimes.  This explains why the effectiveness of the vaccine wanes over times.  Unless the technology in the vaccine is advanced enough to the point that it is able to formulate all the possible disguises of the thief else it will never able to totally prevent infection and transmission. We have heard vaccine makers are developing a specific vaccine for Omicron, this is like adding a new disguise information of the thief to the police so that they can be more accurate in hunting him down.

For those who think they are fully vaccinated and with booster shot, infected with Omicron only resulting in mild symptoms might not be a big deal, they forget that they could be the one that the Omicron will mutate into another worse variant.

If you think vaccine as a double-edged sword is bad enough, there is still an even worse news -- double infection.  Again, this issue was raised in Herd Immunity Through Vaccination ? dated 5th Jun 2021.  Then the question was "what if multiple variants among the 4 (Alpha, Beta, Gamma and Delta) enter the body?"  Those with medical background might say it is rare occurrence.  It might be rare but doesn't mean will not happen.  In fact in early 2021, there was indeed a Belgian elderly died from double infection (refer here).  Now referring to this piece of article, Omicron variant may have picked up a piece of common-cold virus dated 4th Dec 2021.  While the finding didn't present any concrete evidence Omicron was mutated from a double infection, this raise the concern of possibility.  A rare occurrence in scientific perspective is not impossible.  Rare simply means conditions are not all aligned to become a norm.  

According to WHO, prior to Omicron, the Delta variant is responsible for 99% of the Covid-19 cases globally.  Scientists and experts are taking about Omicron going to replace Delta as the new dominant variant and with the state of Omicron infection globally now, it is just a matter of time when that will happen.  To overcome 99% of the infections, there bound to be overlap between the 2 variants.  In so, double infection with Delta and Omicron is not something impossible.  In fact, Moderna chief vaccine maker officer, Dr Paul Burton already sounded this possibility on 14th Dec 2021 (refer here).  The outcome of this double infection might produce another more deadly variant which the vaccine can becomes totally useless in prevent severity and death.

The world is going to vaccinate the children against Covid-19 and with no surprise Singapore Government already gave the green light for those between 5 to 11.  Came across a parent being interview regarding children taking the vaccine, said parent mentioned believe in science so intending to let the children get vaccinated.  This brings a very interesting insight and no am not going to discuss whether should children get vaccinated or not but another aspect.

Believe in science is one thing, understanding science is another.  Should one believe in science but not understand it, science will become a double-edged sword.  Understanding science will allow one to know when to step on the brake and when to full throttle ahead so as not to fallen into the double-edged sword scenario.  Just believe in science and go full throttle ahead is never a wise thing to do.  Now, for that parent who said to believe in science, the natural immune system in our body itself is a science.  It is something that scientists still have lot of unknown about.  If you believe in science, do you believe in the natural immune system that exists in our body for few thousands years already or the vaccine that is still yet to be fully tested for long term side effects ?  Parent should understand science and make the right decision for their children regarding vaccination and not purely based on believing in science or trust in the government.

Nobody in this world can claim to understand science fully as there is still lot of unknown in science to mankind.  Similarly, for infectious diseases experts or doctors despite many decades of experiences in virus modeling, infectious diseases treatment and research still cannot be said to fully understand virus.  However, that should not be an excuse in not understanding science.

If it said how the world ended up with Omicron and not ended the pandemic earlier is due to failure to understand science as one of the reason should be of no surprise.  We already have politicians that demonstrated that.  Gave them the data, they interpreted it like an economist instead of scientist when the pandemic itself is a science.  A brainy human being with economy degree and MBA from prestige university totally defeated by the brainless virus when trying to make the virus followed the narrative.  Doctor, the one who supposed to lead the world out of the pandemic, the one who supposed to understand science more in depth than most people can fail too.  Why ?

A doctor turned politician surrendered his rights to understand science

A doctor endorsed vaccination discrimination gave up his rights to understand science

A doctor placed title, status, financial power, awards ahead of everything never understand science

A doctor treating human life as digit and statistics doesn't deserve to understand science

A doctor who doesn't understand science is nothing but a quack doctor

Many are looking to the next mutation to end the pandemic after the Delta variant.  They are not wrong but will it be this Omicron variant or the next one ?  The general belief is a variant which is less contagious and is this the only way ?  On the contrary, the next mutation to a more deadly variant would be a better candidate to really end the pandemic.  Why ?  As deadly as it is meaning vaccine is totally useless to prevent severity and death.  It is then people will start to be more aggressive in testing, quarantine and isolating to break the chain of transmission.  In addition, deadly variant means it will kill the host before it could transmit to another which further help to break the chain of transmission.    

If vaccine is not a double-edged sword for the Omicron, the next mutation will surely be given that the global vaccination rate will be even higher with children coming in couple with  those booster shots.

Added 27th Dec 2021

came across report saying South Africa is giving up contract tracing on Omicron infection as it believed almost the whole population has been infected.  To many on the surface this might be implying South Africa is rising the white flag but should anyone observes comments and views from inside South Africa will be a totally different story.  Omicron was first discovered in South Africa and spread rapidly to rest of the world with the west side of the globe falling one by one like a domino.  However, most forget one fact about South Africa.

South Africa till today is only having about 25% of its population fully vaccinated.  Alarmly, it has over 70% of its population being infected by the SARS-CoV-2 virus and its variants.  That is to say, at least 90% of the population has that immunity to the virus inside their body either due to the vaccine or the naturalized one from previous infection.  Death and hospitalization rate for South Africa still remain low unlike those in the west of the globe seeing recording breaking cases and threatening the healthcare system.  Another interesting fact is South Africans practically not wearing mask, doing social distancing and so forth of those pandemic restriction.  In fact, majority of the population also not bothering to get vaccinating despite the push from the government.

Now, look at Israel, the government is pushing for 4th dose despite having like slightly over 90% of the population being vaccinated.  Like the west of the globe nations, Israel is getting massive hit by Omicron too.  With over 90% of the population fully vaccinated, mask wearing and social distancing restriction still on to cope with Omicron, it is a total contrast to South Africa.  Israel, a nation who like many others including Singapore is trying to vaccinate the population out of the pandemic while South Africa is a nation that majority of  the population is having the naturalized immunity instead of from the vaccine, are performing totally differently at the moment.

Should South Africa ends the pandemic before any other countries, this will be a tight slap and wake up call to the rest of the world who try to vaccinate the population out of the pandemic.  This of course is not a piece of good news for the vaccine makers and even political leaders who all along keep pushing for vaccine mandate.  Question is will any scientists, researchers and experts willing to do a thorough investigation into it, South Africa vs Israel and not afraid to publish the truth ?   Should that be the truth, any political leaders dare to admit their mistake in pushing restlessly for the vaccine when it does really serve the purpose ?  For sure, Singapore political leaders will not admit the mistake as they never have the courage to admit own mistakes, in the past, present and future.

Omicron, the variant to end the pandemic ?  Probably not going to happen to those nations who just trying to vaccinate the population out of it.

Singapore Covid-19

柏杨写了一本丑陋的中国人，Covid-19却写了一篇丑陋的新加坡人

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

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

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

This installment shall continued with the groups after The Government and The Doctor that helped steering Singapore Covid-19 pandemic situation into "the long and winding road" path.

The Journalists

Singapore's journalism is a monopolize business, with one and only one newspaper publishing company (referring to both offline and online press) it can't help but to say there isn't much alternative views from journalists.  In fact in 2021, Singapore's ranking in World Press Freedom has dropped to an all time low of 160 out of 180.  No prize will be rewarded if the ranking shall continue to drop in the future.  With globally fighting against fake news, rationally the nation press should and would be the most reliable source of information for anyone to turn to.  Coupling with the low World Press Freedom ranking, one no need a rocket science brain will know how easily it can be manipulated to serve one's propaganda.  Failing to provide unbiased, objective but instead lopsided views, opinions, reports and analysis will have quite a substantial impact on the path in which Singapore Covid-19 has chosen in the pandemic.  Ask anyone on the street about the nation press, the words or phrases "biased", "lopsided" and "government controlled" would be the most common answers you can get.   

Since the start of the pandemic last year till present, rarely found a coverage, views, opinions and reports that were not in line with the Government's narrative.  Even at times doubts and uncertainty arose, they failed to exercise their rights as a journalists to raise the issue.  

"Do not wear mask if one is not sick" and "it is not worse than SARS" were the 2 prominent examples in the early phase of the pandemic last year.  With little known of the virus, the Government and experts view on the above were largely published without questioning.  Now, both of those were totally wrong.  The early warning sign (seriousness of the virus) from China's Government action of locking down Wuhan city and Hubei province also failed to prompt them to raise the concern was the Government's action not proactive enough at that time.

When the Government adopted the mRNA vaccine in the nation vaccination programme, from then on reports, news and opinions from vaccine were mostly lopsided in favor of the mRNA vaccine.  Publishing news on both the mRNA and non mRNA vaccines were nothing but following a designated template.  For the mRNA vaccine, positive news were fast and prompt to put it up so as the negative news on the non mRNA.  As for the negative and positive news on the mRNA and non mRNA vaccines respectively, it will be either slowed or totally ignored.

Personal opinions from the journalist were rarely opposite of the Government's narrative.  Take the case of vaccination in the time when the Government was pushing to get more people vaccinated.  A lighting quick opinion of why not make the vaccine compulsory was put up.  With the fact that the vaccine still not largely tested of any possible long term side effects, even scientists couldn't even put their neck down the chopping board to claim a negative ascertain, this type of message contributes nothing constructive as a whole.   

When the Government kept on flip flopping on its measures, the journalists at best were to look up the so-called experts that only serve to defense the actions but were never question was there something wrong in the decision making.  Average Joe on the street can even tell something wrong with the decision and yet they couldn't ?

Even as of present when daily infected number hitting more than 3000 cases with death being reported almost everyday despite having a population rate of more than 80% vaccinated (one of the highest in the world at the moment), healthcare system feeling the stress and yet all they could do is just to initiate a support campaign for the overworked healthcare workers.  With clear cut evidence that the system has led to the status of the healthcare system, they surrender their rights to question the Government.    

Given the benefit of doubts there are still journalists who posses the right work ethic, this pandemic definitely brings out the black sheep in the industry.  These selective few (in particular health correspondents) with obvious not being objective and unbiased are none other than politically poisoned -- past, present, future.  These impacts if said don't help Singapore Covid-19 situation moving into the "long and winding road" path is unbelievable.

握笔如持剑，文字极尖锐
挥之讨公正，出于圣心也
生怀邪念者，执意助政治

The Influencers

This group of people usually characterized by their status (very commonly self-proclaimed success), wealth (mostly well off), education background (mostly highly educated from well known university) and their circle of network.  They could be politician, direct connect of politician, businessman, professional or even celebrity.  They are at best ride on their social influences to propagate the Government's propaganda or rebut any negatives of the Government.  Smartly and skilfully crafted message with selective data and information dug out from the internet was used to support the fact is the norm for them.  With the vast social network they have, these messages can be relaid by their followers from one to another through social media in the shortest possible of times and thus achieving their objective.  

Take the case of the vaccine.  With the government adopted the mRNA vaccine, they were quick to dig out data comparing the effectiveness and efficacy between the mRNA and the non mRNA vaccine.  They however, omitted the fact that the trial population (gender, age group, background of the person, etc) were not the same and there is no common basis to make a conclusive comparison.  When the mRNA vaccine was found to be ineffective in preventing infection, they quickly changed the focus to still able to prevent severity.  In fact, at that point of time the non mRNA vaccine was the most administrated globally and hardly any concrete data to demonstrate those can't prevent severity.  When data showed that the effectiveness of the mRNA vaccine waned till 40% after 6 months, vaccine maker pushing for booster shot and those non mRNA vaccine was in not such a good position anymore, they found no way to hot sell the story anymore.

Prior to the delta variant hitting Singapore, citizens urged the government to shut the border to high risk nation in particular India when it was being hit by the variant massively, the government deflected to Singapore cannot shut all borders forever.  These influencers again quick to the block echoing the government's view.  They could even brilliantly explained how closing borders could affect the economy when the fact was Singapore just need to shut the border to the high risk nations.  Moreover, with their education background and work experiences, they are all capable of contributing solutions to close the border to high risk nations without completely hurting the economy.  Economy is not controlled by a binary switch which can only be opened or closed.  There are ways, policies and measures to cautiously open and close without to the extreme.  Neither any of these influencers bother to contribute any solutions when they clearly know that.

When the pandemic situation in Singapore took a turn to the wrong side, they will just dig out statistic of those countries that did even poorly than Singapore to justify the Government is still doing a good job.  For countries (or places) that fare better than Singapore (China, Hong Kong, Taiwan, New Zealand, Australia, etc), those statistic will never appear in their book.

When the mediocre doctor and expert started to labeled unvaccinated elderly being selfish and hostage to the population, these influencers were at their act again.  This time a celebrity just single out these elderly without even bother to find out the true reason for them not taking the vaccine.  Some could be due to underlying medical conditions which disallow them to do so, some were adverse of the side effects and awaiting for a safer vaccine, which you can't fault them.  Perhaps, a small faction is truly what they've described.  However, that doesn't warrant these influencers to 一竹竿打翻一船人.  Now, with daily death of infected elderly regardless of vaccination status lately,  can you still claim these unvaxx elderly being selfish and as a hostage to others ?

With globally recommending booster shot for those vulnerable, am waiting for these influencers to surface to hot sell the idea again.  However, they forget that booster shot just increase the quantity of the antibodies and not improving the quality of the vaccine.  Few months later unless the virus has lose its contagiousness, the booster shot effect again will wane off and another booster shot will be called for.

These influencers more often being caught start counting the chicken before they are being hatched.  For them, the philosophical of psychology "when thou manipulate the psychology of others to achieve thine objective, they will get back to thee eventually" will apply.  That's the law of nature !

The Selective Joe

The Selective Joe are mostly the average people on the street.  They can be easily spotted at the Facebook comment section of The Strait Times page and online forums.  Sometime, they will also appear in the Strait Times forum section.  Their understanding, reasoning, analyzing and logic always fall only to the level of what they want to believe in.  They refuse to move beyond that as it will totally contradict their belief.

Take the case of the effectiveness and efficacy of the mRNA vaccine.  When concrete data suggested that the vaccine can't totally prevent infection and transmission, despite knowing the effect wane to as low as 40% after 6 months, they will just dig out data and charts to show the death rate is still lower with the vaccine to convince doubters about the usefulness of the vaccine.  Their level of analyzing and logic will just stop there.  They refuse to think beyond that with more of the population being infected and seeking medical attention, the healthcare system can become overload and indirectly causing more fatality.  A typical trademark for this group is they will just use simple and short sentence like "go read up" to silent the doubters.  Do they themselves really fully understand the subject is largely questionable.

To the topics that the nation must open up the borders and not closed for economic reason, they just aligned their belief perfectly with the government.  They could talk in such arrogance way to those suggesting temporary lockdown to contain the infection that these people don't really understand the economic impact of such an action.  They could even bring out quotes from those influencers to support their claim without even bother to understand are those correct rationally.  In actual fact, afraid, they are the one themselves who don't really understand.  Opening and closing of an economy is not a binary switch which you can either open or close only.  Policies, measures, methods or strategies can be tailored to either biased toward more economic benefits or prioritize citizens' life instead and at the same time keep the economy running.  Just look at Hong Kong, having the same open economy model as Singapore, they are able to control the domestic cases very well and still get the economy running.

When others criticized or complained about the flip flopping, start-stop measures of the government, they will jump into the defence of the government with this type of trademark -- "as if you can do a better job".  However, they forget nothing is perfect, even government can make mistake.  If the people in the government doesn't have the solution doesn't mean no other people or other group can't have.  Won't be surprised they are the actual one without any solutions.

When the government and experts started to zero in on the unvaccinated including discriminating measures in the name of protecting them, they will join in in support of it without even bother to question is that the correct way.  Again their typical trademark of short and simple sentence -- "it is to protect the unvaccinated".

When the government decided on the "endemic" route and despite the start-stop measures we've observed lately, these people will jump in to urge the government to have that iron fist in them to carry on and not flip flopping.  They will never question are those actions really the correct one.  Should those are the wrong one keep pushing ahead will do more damage instead.   

These people very often repeat or quote from the government or the influencers to justify they are standing in the correct side but forever never question is that the correct one.  They are the one that keep supporting and cheering on the government to carry on in the "long and winding road" path regretfully.

The Final Thoughts

The nation now is experiencing daily death of elderly regardless of vaccination status.  Though majority of them have underlying medical conditions which in a way lead to the death but that shouldn't use as an excuse.  If the pandemic was controlled appropriately not to the extend of getting more 3000 cases daily, these elderly might still have some more years to live by.  These elderly are not just any tom, dick and harry.  They are the one born in the 30s and 40s that worked hard, put their trust and faith in LKY and his peers to build up the nation to what it is today.  If you asked them has the LKY led system ever fail them, they might have a few complains here and there due to the sometimes hash policies by LKY but they can still proudly tell you the answer is ZERO.  Now, coming from the same political party, this is the first and also the last time (for those who have passed away) that the system fails them.  Those born in the 50s to 70s should know as these elderly are their parents who everyday went to work before sunrise and only came home after sunset.  They rarely have a day rest or times to spend with their children and now it is the actions of these people that fail them.  They worked their blood and sweat out in their younger days so that the future generation can have a better life but just to see :-

The million-dollar ministers who can afford to pay up in full cash a condominium for their children while ordinary people have to service a 30-years mortgage fail them with the system

The expert who own a clinic of his own labeled them selfish if they refused to be vaccinated

The foreign expert who since day 1 yet to give some good advices singled out them as being hostage to others if they refused to be vaccinated

The doctor in the medical school who feel like in cloud nine when students greet him as professor suggesting refusing to pay for the treatment cost should they are unvaccinated

The doctors that choose to be mediocre only know how to show data in defence of the government's action but never grow the backbone to speak up even if the healthcare system is inching toward breaking point

The politically poisoned journalist totally surrender the rights to question the system that fail them

The self proclaimed successful influencers did nothing constructive but just start counting the chicken before they are hatched

The selective joe who live in comfort like a pseudo rich only know how to point finger at them as if they are the sole cause of the present situation

The discriminating measures in the name of protecting them were put on them should they chose not to be vaccinated

The death of these elderly, do these people have any 恻隐之心 to feel sorry and responsible for it or the life of these elderly is just a statistic ?

The nation has the choice to either walk the "long and straight path" or  the "long and winding road" in this Covid-19 pandemic after containing the foreign worker dormitory outbreak last year.  The over-confident, incompetent and mistakenly taking the vaccine as the light to end it guided the nation into the "long and winding road" instead.  

The "long and straight path" is not something impossible or difficult to achieve, all it needs is patience and cautions at every little steps.  Managed and contained the domestic cases well to the extend the people could live with just a little restriction like mask wearing only to enable the domestic economy running.  With the domestic economy as a cushion, the nation can then take a small step to open up the economy, wait for stabilization then open up a bit more.  This is to ensure that if the timing for that small little step is wrong, swift actions should be able to prevent another uncontrollable outbreak.  Don't even need to resort to discriminating measures at all.  The "long and winding road" on the contrary did more damage as the flip-flop, start-stop measures only made the people confuse, made the businesses difficult to plan ahead to survive.

Courage is needed to make the correct choice.  This is not just ordinary courage but the 大勇 in 儒学之勇.  With this, one is not afraid to admit the mistakes instead of making excuse for it.  With this, one is not afraid to backtrack if something goes wrong instead of keep bulldozing ahead hoping it will turn out right eventually.  We have quite a few of the 1st generation leaders having it, we still can find a few in the 2nd generation of the leaders.  Come the 3rd generation of leaders, after searching high and low, regrettably we can't find any.  This proves that 大勇 cannot be inherited.  Now, for the 4th generation of leaders, you jolly well spend those times in more productive things than trying to find it on them.  大勇 they don't have, 小勇 they have plenty and that explained why instead of admitting to the mistakes, they just blame everything under the sun except themselves for it.

Be it the "long and winding road" or the "long and straight path", given times, the whole pandemic will eventually come to a stop, seeing the light at the end of the tunnel but the underlying shall be different.  In the "long and straight path", we overcome the virus with our actions and determinations.  As for the "long and winding road", the virus runs its full course until its 3 stages (entry, genome replication, exit) cannot prolong any more when it has infected most of the population, run out of hosts to carry on as the naturalized immunity gained from the population forming the barrier.  This is exactly what happened in the 1918 Spanish Flu pandemic.  The medically trained doctors should know but do they dare to single out  so as to risk jeopardize the chance of getting a national award for toeing the line with the government ?

Do think twice at the end of the pandemic when the government trying to claim credit for it.  Is it their actions that lead to it or is it the brainless virus that defeats the one with the brain that has a degree in economy and MBA from prestige university ?  

柏杨写了一本丑陋的中国人，Covid-19却写了一篇丑陋的新加坡人

The above was written in Covid-19, An Opportunity To .............., dated 15th Apr 2020.  

The initial underestimate and self praised of being well prepared for the pandemic

The oversight of the foreign workers' dormitory outbreak instead used hindsight as an excuse for it

The data oriented to the extend of lacking the instinct to be proactive in slowing to close border to high risk nations

The over-confident on the vaccine in believing in herd immunity but ended the vaccine effect can only last 6 months and herd immunity is an impossible

Gave them the data but interpret like an economists when the pandemic is clearly a science

The self-belief of "endemic" but ended up with all the flip flopping and start-stop measures

When things go against them, put the blame on the unvaccinated  instead

Discriminating measures just to pile up pressure on the population to get vaccinated to achieve their target but in reality vaccinated can't stop the transmission

Continue the discriminating measures further when things don't go along with their narrative

Mediocre experts that since day 1 yet to put up some good advices for the pandemic and yet believe they are not wrong

Doctors and healthcare workers inching toward healthcare system breaking point don't even have the backbone to question the system but instead blame the population for it

Journalists give up their rights and chose the path to be politically poisoned

The nonconstructive influencers only know how to add support to the government even if it is moving towards the wrong direction

The blinded selective joe just refuse to fault the government and instead blame everything under the sun

With all these people, how is it not true the above statement on 丑陋的新加坡人.

the Wong, the Ong, the Gan, the Lee, the Chan, the Yong

the Fisher, the Leong, the Mak, the Cook, the Lye, the Ooi

the Salma, the Fernandez

the Ho, the Em Lee

the Jerome, the Akmal, the Meng Tat, the 秋燕, the Lisa, the Lilian, the Kwok Weng, the Maydeline, and so forth

History will never forget and forgive these 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

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

Covid-19, The Light At The End Of The Tunnel ?

With countries one by one slowly opening up after vaccinated majority of their population despite the Covid-19 pandemic still ongoing, in particular with the B1617, Delta variant, is the ligth at the end of the tunnel for Covid-19 ?

Singapore is one of those countries that starting to opening up after vaccinated majority of the population.  As of 21st Aug 2021, according to MOH statistic, 78% of the population has completed the full regimen of vaccination.  This makes Singapore embarking on the so-called endmeic route with Covid-19 when its decided to raise the white flag against the zero Covid-19 policy.  Endemic ???

Endemic

It was told that the nation shall treat Covid-19 as an endemic just like the common flu.  Is there an endemic with common flu ?  One of the common flu strain that circluting around the population causing people infected with flu during the flu season is the Influenza A/H1N1 strain, the exact strain of the 1918 Spanish Flu pandemic.  If looking at past history after the 1918 Spanish Flu pandemic, the 1977 Russian Flu and the 2009 Swine Flu were both pandemic that involved exactly the same strain as the Spanish Flu, Influenza A/H1N1.  If widens the scope a bit, instead of Influenza A/H1N1, focus on the Influenza A (one of the 4 types, A, B, C, D) as the other 3 types are known to be less severe.  After the 1918 Spanish Flu, there were the Asian Flu, A/H2N2 in 1957, the Hong Kong Flu, A/H3N2 in 1968, the Russian Flu, A/H1N1 in 1977 and Swine Flu, A/H1N1 in 2009.  A total of 4 notable pandemics involving the Influzena A virus in the past 100 years.  Moreover, we cannot guarantee going forward, the world won't be hit by another Influenza A pandemic as there is in theory a possible 198 combinations for this virus to mutate into but scientists thus far only managed to identify 131 subtypes.  So, is Influenza A virus still an endemic ?

The same is for Covid-19, the same family class of coronavirus as the 2003 SARS and 2012 MERS.  None of the coronavirus since 2003 SARS has been totally eradicated and within a 2 decades time frame, the world has been hit with the same family class of coronavirus 3 times.  So, is it really an endemic ?  Probably, the closet is co-living with the virus and be prepared for potential future pandemic with the same family class of coronavirus again.  Endemic, the word is nice to the ear to say it but scientifically afraid is incorrect !  So when political leaders, doctors, journalists or whoever tell you "endemic with Covid-19", better think twice !

Narrative

The narrative for Covid-19 has changed several times since the breakout last year, in particular after we have the vaccine.  

1. Vaccine Function

There was so much promise and optimism about the vaccine when it was first developed as political leaders, doctors, experts, specialists and scientists believed this is the one to end the pandemic.

 

Above were 2 screenshots from US CDC and Singapore Gov.sg message on the vaccine when the vaccine was first rolled out.  The keyword is "Protect You (Yourself), your family (loved ones)".  Whoever read that message will definitely interpret as the vaccine is able to prevent severity, infection and transmission.   Unfortunately, now the scenario is apart from prevention of severity, reducting death rate, the vaccine fails to prevent infection and transmission.  Around the world, fully vaccinated person still get infected and still able to transmit to others including family, loved ones, coworker and the community.  The only truth still remain intact is prevention of severity and reduction in death rate (as of now).

2. Vaccine Effectiveness / Efficacy

When the vaccine was first developed, vaccine makers talked about effectiveness.  The mRNA technology vaccine was trial with an effectiveness of around 95% while the conventional inactivated vaccine was between the 75% to 80%.  As the Delta variant striked few months ago with fully vaccinated person can also get infected and transmit to others (Israel, UK, US, Singapore and other parts of the world all happening), the narrative changed to efficacy instead as it is still able to prevent severity (as of now).  The studies from Israel and UK (refer The Number Game Of Covid-19 dated 25th July 2021) and many others more all came to a conclusion that the vaccine effectiveness faded to almost just 40% against the Delta variant after 6 months.  Now, booster shot is being called upon for those immunity has been waned due to time lapse.  Booster shot is just to increase the quantity of the antibodies against the virus but not the quality of the vaccine against the virus.  Hence, after certain time periods, we will be back to sqaure one about the waning of vaccine effectivness.  The initial promise of the vaccine was never met thus narrative changes.

3. Herd Immunity Through Vaccination

To get herd immunity, the population must be vaccinated.  That the initial notion to end the pandemic.  As such, countries were campaigning to get their population vaccinated as much as possible.  Israel, UK and US were few of those countries with at least 50% of its population fully vaccinated and decided to ease restriction and opened up.  However, that kind of vaccination rate still unable to provide the needed herd immunity against the Delta variant.  The herd immunity is derived from the mathematical formula (1 - 1/R0) whereby R0 represents how many others are infected by one.  The Delta variant according to UK study found to have R0 between 6 to 8.  This will translate into a herd immunity requirement of at least 84% against the Delta variant.  The population must have at least 84% being vaccinated or gained the naturalized immunity after recovered from earlier Covid-19 infection.  With that, countries for the past few months were aggressively getting their population to be vaccinated in hoping to reach the high herd immunity rate.   However, lately, experts and scientists were slowly one by one coming out to claim the impossible to achieve herd immunity in particular against the Delta variant.  The followings are some of those reports :-

-- Has the Delta variant of SARS-CoV-2 made herd immunity impossible ? 

-- The word may never reach herd immunity against Covid-19

-- Scientists now say herd immunity impossible against Covid-19 due to Delta variant

-- Here's why herd immunity from Covid is 'mythical' with the delta variant

Just days ago, even Singapore government through the multi-task force against Covid-19 admitted to that, Singapore won't reach COVID herd immunity: Lawrence Wong.  This is not something new to me as in the post The Many Questions About Covid-19 Vaccine dated 14th May 2021 already questioned about herd immunity through vaccine.  

Another aspect is herd immunity is calculated from a mathematical formula, a theoretical model.  Theoretical model will have lot of assumptions being made so that the formula could model to the situation.  The formula only has 1 variable, R0, suggesting there are lot of real life conditions not being factored in.  Vaccine effectiveness which wane over period of times, rapid mutation rate of virus and fixation of population couldn't be vaccinated due to age inegiblity or underlying health conditions, etc are definitely some of the conditions didn't factor into the formula.  Another doubt is whether the formula is assuming the ideal case that vaccinated person will not get infected and transmit the virus to others.  This however is untrue in real life.  The situation doesn't improve when decision makers fail to analyze comprehensively those practical impacts before makeing the decision on herd immunity.  Again, narrative changes.

4. Vaccine Side Effects (Short and Long Term)

Minus the general known side effects from any vaccination like fever, sore or pain at injection site, chills, headache and fatigue found during the trial phase, others more severe effects were not known until the mass population was vaccinated.  These severe side effects include blood clots, anaphylaxis, myocarditis and pericarditis.  Though it is found to be rare, there are still quite a number of vaccinated person suffer either injury or die from it globally.  Lately, EU is looking into new possible side-effects of skin rash and kidney disorders (refer here).  Apart from that, US CDC also recently looking into potential side effects that could affect female (refer here).  While there isn't any conclusion from the above two recent investigations, there is still a big unknown of the potential long term side effects of the Covid-19 vaccine.  Vaccine makers, scientists, experts or even politicians unforuntately don't have a time machine for them to leap forward 10 to 20 years into the future to affirm it.  What they claim now is purely based on the data as of now.  Can you just use present data to extrapolate into the future ?  From the initial of the vaccine is very safe to discovering of rare side effects in which people has been injuried or died from it to investigating into new side effects and a big unknown of potential one into the future, the narrative defintiely has changed.  Nevermind the statement globally used "benefits outweigh the risks" as scientifically how is it allow to compare a countable number to a big question mark ?  

5. Infection

There is no question last year every countries treated every single infection very seriously to the extend of locking down the nation to contain it.  However, as vaccine rolled out, except for selective few countries who still strongly believe in zero Covid-19 policy, the rest are slowly changing their reaction toward infection.  Riding on the fact that the vaccine still able to prevent severity and reduce death rate (as of now), the narrative has slowly changed.  Now is even though vaccinated personal can still be infected and transmit the virus to others, as long as said person displays mild symptoms could just rest at home like the normal illness to recover.  In addition, government even intending to not reporting in-depth detail or totally not reporting daily infected cases.  The pandemic defintiely is not over and with experts and scientists warn of potentially more contagious variant could be mutated going forward, such action put it bluntly is like throwing those vaccinated person under the bus -- get vaccinated, be mentally prepared to get inflected since the vaccine can prevent severity and reduce death rate.  Now, who in the right frame of mind would want to be vaccinated, yet still get infected and not to mention transmit to others ?

6. Vaccination Is Not Mandatory

All the vaccines are approved by WHO under the EUA (Emergency Use Authorization) scheme and as such this couldn't be made mandatory.  Should it become mandatory, if anything happens from the vaccine, vaccine makers and the government of the nation will be held accountable for it.  However, since vaccine makers are being exempted of any legal liabilities by almost all the countries, the responsbility will have to be solely put on the government.  The statement "vaccination is voluntary" still stand globally as of now but the underlying narrative definitely has changed to something totally different.  Some countries are making it compulsory for those employed in selective sectors to be vaccinated (healthcare, peoeple in high risk sector, civil servants, etc).  Policy makers are putting restrictions on the unvaccinated shutting them out certain activities (indoor dininig-in, access to shopping mall, air-conditional public transport, indoor facilities, etc) in the name of giving the vaccinated benefits and to protect the unvaccinated.  Some even associated employment with vaccination status.  Regardless of vaccinated or not, the person still can get infected and transmit to others, so how on earth scientifically it is to protect the unvaccinated.  It is very easy to comestic one's true intention by words but not the psychological aspect of it.  Such actions do nothing constructive except dividing the society, discriminating the unvvaccinated and at the same time putting pressure (either through the restrictions or levrage on the power of media in particular journalism or manipulating the vaccinated as a psychological prawn) on those to get vaccinated in order to achieve their own propaganda.  This is exactly descibed by the famous Chinese quote "司马昭之心路人皆知“.   These psychological prawns are not the average joes, carefully screening through it, these Leow, Ho, Koh, Em Lee, Meng Tat, Chieh, Gerald, Jeremy, Vincent, Salma, Adrian and the list goes on are all well educated being atttended or attending established university such as Oxford, Oxford Brookes, Yale, NUS, NTU, Johns Hokpins University Carey Business School, Longy School of Music of Bard College, etc.  Perhaps due to their educational background and social network influence they are the best candidate as a psychological prawn.  Ironically, the more educated you are fail to avert being used as a psychological prawn.  Nevertheless the philosophical of psychology is "when thou manipulate the psychology of others to achieve thine objective, they will get back to thee eventually".  This is how notorious the narrative has changed thus far.

What's Ahead ?

If you believe the narrative that vaccination is the way to end the pandemic by turning it into an "endemic", you probably can say we are seeing the light at the end of the tunnel.  However, is that really so ?  This is the narrative what human being want to see but not what the virus wants.  The pandemic definitely not over as there are still countries in other part of the world lagging in behind in term of vaccination.  A world not working in synchronization can't move forward much.  Moreover, there is still lot of concerns and worries and any complacency, the world will be back to square one.

Vaccine can prevent severity and reduce death rate (as of now) but it can't 100% prevent infection and transmission to others.  For every symptomatic infection occurs in a vaccinated person meaning there is a breakthrough of the virus.  To achieve breakthrough, the virus must have reacted to the antibodies produced by the immune system.  For a virus to react, the only way is through mutation into another variant (the basic of life science, living things react to changes to seek survival).  As mutation is a random process meaning the virus won't mutate in a systematic way (A will become B, B will become C and so on), there won't guarantee the mutated variant will not be more contagious or even deadly than the original.  As more and more of the population vaccinated, this will increase the platform for more breakthrough and at the same time increase the odd of mutating into either a more contagious or deadlier variant.  As such, the vaccine will eventually become a double-edged sword, something that was mentioned in previous posts.  This will change the whole narrative again.

There are still some variants apart from Delta, Alpha, Beta and Gamma exist within the population.  The Delta Plus (upgrade version of Delta), Lambda (first detected in Peru last year), B1621 (discovered in Colombia this year and yet to have a Geek letter assigned to it) are among those in which WHO still considered them as "Variant of Interest" but starting to get some attentions.  In particular the Lambda as early study found that it is more vaccine resilience than the Delta variant.  The B1612, accounting for about 88% of the infection in Peru could be (or already) spreading to other South America nations.   Taiwan already reported one of its citizen being infected with it.  This variant also responsible for the death of several vaccinated people in a Belgium nursing home.  Should any of those fail to contain and allow to spread globally, the consequence could be even worse than Delta.  This is especially so when the direction now is vaccainted people with mild symptoms shall just treat it like normal flu staying at home to recover from it.  Infected with any of those, slow to response, to detect and contain will just reset the whole pandemic again.  The world already have precedence with what happen in Israel, UK, US, Taiwan and now ongoing New Zealand.  For Israel, UK and US, the trio riding on more than 50% of the population were vaccinated starting to ease measures and get hit by Delta variant with sharp rise of daily cases.  Taiwan and New Zealand on the other hand were in a state of mask off among the population before being hit by the Delta variant.  When the Delta variant strikes, sharp rise in daily cases too.  That could be the same for Lambda or even worse.

The long-covid syndrome for those infected.  The consequence of that unfortunately still under study and is an unknown.  Who will get it, who will not, will vaccinated people get it also ?  It's still an unknown.  This is on top of the still largely unknown long term side effects from the vaccine, in particular the mRNA vaccine.

In previous post (The Number Game Of Covid-19 dated 25th Jul 2021) it was mentioned the world needs GOOD Doctor to step forward to take control of the pandemic.  Unfortunately till now, yet to see one, not just Singapore (very likely will not see one giving the status quo now) but globally.  Where are they ?  Still self indulging in money counting, collecting awards, immersing in the title, the appointment and the frame, over confident of own ability or the worst case still trap inside own think box.  Being trapped inside own think box is not something rare.  It happens to everyone especially so frequent in politicians and veterans.  Still remember last year when the pandemic first broke out, view from experts were "not worse than SARS", "healthy no need to wear mask" and "transmission is not aerosol".  All these were because based on their past encounters with SARS and MERS resulting in them percepting Covid-19 virus as the same.  In SARS, mask wearing was not mandatory and none of the countries entered lockdown, shut border to contain it.  SARS wasn't able to aerosol either.  However, all these turned out to be false for Covid-19.  Another example is the mutation of variants.  To them, virus mutates all the time is a norm.  However, to layman like us, within such a short period of time we have Alpha, Beta, Gamma and Delta being mutated and their contagiousness is not lesser than the original strain is something different than SARS and MERS.  As long as these doctors, experts, specialists or even scientists still trap in their own think box, they will not have the instinct to act differently, the world will be going round and round with the pandemic.

One thing that can be concluded so far is the virus is impossible to be eradicated.  In fact in medical history so far only 2 infectious diseases (smallpox and rinderpest) have succeeded.  As such, the priority for this coronvirus is to find a way to reduce the mutation rate.  Vaccine should be one and not the only tools to do that.  Putting all hope and bet on the vaccine to do the job might not be the wise choice.  If it fails, what's next ?

Thus, with vaccine (need to stress not a cure) that can only prevent severity (at the moment) but not 100% prevent infection, really can see the light at the end of the tunnel for this pandemic ?  Alternatively, are we going to have more narrative changes going forward when situation changes ?  The later case which Singapore terms it as "The Art of Prata Flipping" is a specialized skills for the government of the day in case you are not awared of it.

 

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