LETTERS: Proponents of endemicity need to specify quantitatively the parameters that constitute endemicity so that it is very clear to all what it means.
The first parameter is quite easy to specify: the capacity of the public healthcare system based on bed utilisation rate in intensive care unit (ICU) wards.
This is necessary because endemicity must be associated with infections that will not paralyse the healthcare system.
Hence, a warning system should be developed to let all especially frontliners know whether at any point in time the healthcare system can cope with the number of daily infections.
For instance, the use of colour coding where green denotes bed utilisation rate in ICUs of below 50 per cent, orange denotes a utilisation rate of 50 to 80 per cent and yellow is a rate of between 80 and 100 per cent, and finally red, above 100 per cent.
As long as this rate is in green or orange, the situation is endemic because the hospital can cope with rising infections.
The first sign of danger is yellow when the rate is 80 to 100 per cent, which means private hospitals need to be roped in to increase the capacity of the healthcare system before it gets overwhelmed.
Once the bed utilisation rate is 100 per cent, then the army would have to be roped in to set up more field hospitals. With the capacity of the healthcare system being taken care of, endemicity is sustainable.
Next is the death numbers. Proponents say, we can really move very fast towards endemicity in as short a time as possible by removing all restrictions, and opening all borders.
But they do admit this will lead to a surge of infections so high that the healthcare system cannot cope, and people will die for lack of oxygen supplementation because there is no room for them at hospitals.
It is, thus, the human cost because all lives matter, preventing the proponents of endemicity from implementing this superfast approach.
But what does all lives matter means when we know that Covid-19 will cause some deaths?
What are the death numbers that we can live with during endemicity? One way to arrive at a proxy number is to compare it with other endemic viruses like the common cold.
From the average figures of deaths a day/week/month/year caused by the common cold in the past 10 years, we can then use this average proxy figure to denote the number of deaths that's consistent with endemicity.
Finally, specifying quantitatively the parameter on daily cases "when the virus is circulating among us without being the threat like now". This is very difficult to determine.
In the past, when the daily infection figures were consistently in the three digits, this was considered as threatening enough to merit a Movement Control Order.
The last time we had a three-digit daily infection was in September 2020 after the Sabah state election.
So, what this means is the daily infection number consistent with endemicity is a moving number like a moving average, depending on the surge of each wave.
For now that number could be below 5,000 cases a day because before we experienced the current 5-digit surge, the daily infection numbers were hovering below that for quite a long time, accompanied by the feeling that things were quite normal as if we were already in an endemic phase.
JAMARI MOHTAR
Editor of Let's Talk!
Kuala Lumpur
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times