What is ivermectin and why Malaysia is in no rush to approve it for COVID-19 treatment - CNA

KUALA LUMPUR: The drug ivermectin, which has all along been used for veterinary treatment of parasites, has come under the spotlight after calls for it to be included as part of Malaysia’s list of treatments for COVID-19.

The focus on the drug came after news reports in April 2020, citing how researchers at Australia's Monash University had experimented with the drug and found that a single dose could stop the COVID-19 virus from growing in cell culture within 48 hours. 

Malaysia's health ministry announced on Jun 5 that ivermectin trials have been initiated. These trials will be done by the ministry and Institute for Clinical Research (ICR) at 12 ministry hospitals. 

The trial was approved by the ministry’s Medical Research and Ethics Committee on May 25 and the first patient was enrolled at the end of May. The ministry expects the trial to be concluded by September.

Meanwhile, calls for ivermectin to be approved for COVID-19 use have continued to grow.

In early June, a senior citizen even lodged a police report in Johor state, accusing the health ministry's director-general Noor Hisham Abdullah of committing a crime by refusing to adopt ivermectin as a treatment for COVID-19 patients.  

A loose coalition of medical and consumer groups, calling itself the Malaysian Alliance for Effective Covid Control (MAECC) has also issued a statement urging the government to include ivermectin in its list of drugs used to treat the coronavirus.

In an online press conference on Jun 21, the coalition called for the government to fast-track the use of ivermectin, highlighting that the drug has been in use over the last four decades, with more than 3.7 billion doses prescribed. 

The attention on ivermectin is not only happening in Malaysia. In Indonesia, pharmacies are reportedly running out of the drug, following viral social media posts touting its potential as a coronavirus treatment.

READ: Desperate Malaysians fly white flags as a call for help to survive COVID-19 lockdown

Here's what you need to know about ivermectin, and why the Malaysian health authorities are adopting a considered approach:

WHAT HAS IVERMECTIN BEEN USED FOR?

Dr Vellayan Subramaniam, a long-serving veterinarian and former deputy director of Malaysia's national zoo, explained that ivermectin was first discovered in the 1970s. It became more commonly used from the early 1980s.

“This was first used for food livestock, and later, it was extended to equines, then companion animals.

“Later we extended ivermectin to exotic animals and pets, except tortoises and turtles for which the drug is toxic. Some dog breeds are also susceptible to ivermectin intoxication,” he said.

A bottle of generic Ivermectin as an injectable solution, about to be used by Dr Vellayan for parasite control on a rabbit. (Photo: Dr Vellayan Subramaniam) 

The veterinarian explained that it was common for drugs to be repurposed, even across species from animal to human and vice-versa.

“This is what you call off-label use. We already use ivermectin to treat parasite infections in humans like lymphatic filariasis, caused by worm infection. 

“We also use it to treat ectoparasites, meaning parasites that live on your body surface by applying ivermectin as a topical solution.”

Hence, he said that it was not impossible for laboratory researchers to discover ivermectin as a potential treatment for the current pandemic.

READ: 'Quite impossible' for COVID-19 vaccine recipient to be injected with empty syringe, says Selangor health department

WHAT IS THE WHO SAYING?

The World Health Organization (WHO) and other leading regulatory agencies such as the United States Food and Drug Administration and European Medicines Agency have cautioned that there is insufficient evidence on ivermectin's efficacy in treating COVID-19.

FILE PHOTO: A logo is pictured outside a building of the World Health Organization (WHO) during an executive board meeting on update on the coronavirus disease (COVID-19) outbreak, in Geneva, Switzerland, April 6, 2021. REUTERS/Denis Balibouse

In March this year, WHO stated that current evidence on the use of ivermectin for COVID-19 patients was inconclusive. Pending further data, it recommended that the drug only be used within clinical trials.

WHO explained that due to the increased international attention on the drug as a potential treatment, a guideline development group of experts from multiple specialties was formed. The group reviewed pooled data from several randomised controlled trials.

“They determined that the evidence on whether ivermectin reduces mortality, need for mechanical ventilation, need for hospital admission and time to clinical improvement in COVID-19 patients is of ‘very low certainty’,” the WHO stated, explaining this was due to the small sample sizes and methodology limitations of available trial data.

WHAT IS THE MALAYSIAN HEALTH MINISTRY'S POSITION?

The health ministry is in the midst of studying ivermectin’s use for COVID-19 treatment.

In an interview with Bernama on Jul 10, Dr Noor Hisham explained that the ministry was studying the drug’s effectiveness and its side effects for COVID-19 patients in Category Three (those with lung infections) to Category Five (critical with multiple organ complications).

Malaysia health director-general Noor Hisham Abdullah. (File photo: Bernama)

On Jul 11, the ministry posted on its Facebook page that ivermectin is only allowed to be used on an off-label basis, with close supervision by certified doctors.

“Until now, clinical studies’ results are insufficient to prove that ivermectin can treat or prevent COVID-19, only vaccines have been proven to prevent COVID-19,” the ministry stated.

The ministry also listed some side effects from the drug’s usage, including skin rash which might necessitate hospitalisation, nausea, vomiting, stomach distress and diarrhea, swelling, sudden low blood pressure and liver damage, as well as seizures and disorientation.

IVERMECTIN AN "IMPORTANT, USEFUL OPTION": MEDICINE ASSOCIATION

In the meantime, the proponents of ivermectin are saying that the trial process should be expedited.

Dr Vijaendreh Subramaniam, who is the president of the Malaysian Association of Advancement of Functional & Interdisciplinary Medicine (MAAFIM) said that waiting for the completion of the trial in September might be too late given the urgency of the crisis. MAAFIM is a participating body in the MAECC group.  

In a Facebook post, Malaysia 's health director-general Dr Noor Hisham Abdullah urged Malaysians to comply with health protocols as there are concerns that the ICU hospital beds in the country may not be enough to cope with the number of patients. (Photo: Facebook/Noor Hisham Abdullah) 

When interviewed by CNA, Dr Vijaendreh noted that Malaysia’s COVID-19 crisis was becoming worse by the day. 

“I think it is a situation that needs urgent addressing,” Dr VIjaendreh said, adding that ivermectin was already being used in some countries to treat the pandemic. 

“The Czech and Slovak republics have seen very good responses, while India, at the height of its massive crisis, also used the drug to contain the disease too,” he noted.

Dr Vijaendreh opined that Malaysia is currently at the same stage of the COVID-19 crisis where India was at two months ago.

READ: Indians turn to black market, unproven drugs as COVID-19 surges

“But we must be very clear, ivermectin is not a magic bullet. It doesn't mean that if we use ivermectin, all our COVID-19 problems go away,” Dr Vijaendreh said.

“But it is emerging as an important, useful option to be included in our treatment arsenal, especially in the early stages and as a prophylactic (to prevent disease),” Dr Vijaendreh explained. 

On MAECC’s part, he said, the coalition would continue to engage the ministry to have ivermectin implemented earlier.

Residents register for coronavirus testing at a private hospital in Sunway, on the outskirts of Kuala Lumpur, Malaysia on Oct 7, 2020. (Photo: AP/Vincent Thian)

“We had a meeting with the ministry a few days ago on this issue, and we’ll continue to engage them, but the matter is in the ministry’s hands.

“But we will share information and data as it emerges, and hopefully they’ll be persuaded to use this approach to try and contain the pandemic as soon as possible,” Dr Vijaendreh said. 

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2021-07-14 22:07:26Z
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Malaysian family infected with Covid-19 Delta variant despite staying at home since April - The Straits Times

KUALA LUMPUR - Madam Noriah Bakar and her family have largely been in self-imposed isolation at home since April this year.

Despite this, the 36-year-old, said her husband and two sons tested positive for the Delta variant of the coronavirus last week, as Malaysia struggled to contain a resurgence in Covid-19 infections in the country.

A record high of 11,618 new cases were reported on Wednesday (July 14), bringing the cumulative total so far to 867,567. On Tuesday, the country reported 11,079 new cases, the first time daily infections surpassed the five-figure mark.

"We're dumbfounded because since mid-April, my husband has only been out once to collect work documents, and I only left the house twice about three weeks ago for my vaccination appointment and to buy bread," the homemaker from Subang Jaya, in the state of Selangor, told The Straits Times.

"We rely heavily on online services for groceries despite it costing a lot of money, so we can't think of what we did wrong," she added.

Malaysia's health chief Noor Hisham Abdullah warned on Tuesday that the number of new cases could increase over the next two weeks as the highly infectious Delta variant, which can be easily transmitted by air, has been detected in almost every state.

First identified in India, the Delta variant is 55 per cent more transmissible than the Alpha variant, which originated in Britain and was itself around 50 per cent more transmissible than the first variant detected in Wuhan, China, according to the World Health Organisation.

Medical experts noted that the Delta variant has an R0 (R-naught) value or the average number of new infections generated by each case of five to eight while the original Wuhan one had an R0 value of 2.2 to three.

"It is likely that B.1.617.2 (Delta) will displace other variants as what has happened in other parts of the world, and that is a cause for great concern," Professor Awang Bulgiba Awang Mahmud, the government's Covid-19 Epidemiological Analysis and Strategies Task Force chairman, told The Straits Times.

Apart from the emergence of newer strains, Dr Bulgiba said a combination of widespread community transmission, airborne spread due to poor ventilation and poor adherence to health protocols due to pandemic fatigue were among the reasons for the surge in cases around the country.

Malaysia has thus far recorded 273 cumulative cases categorised as variants of concern, of which 67 were Delta variant infections.

Covid-19 screening in the meantime has jumped by more than 30 per cent. Between July 6 and July 12, a total of 825,373 tests were conducted, 200,728 more than between June 29 and July 5.

Epidemiologist and biostatistician Kamarul Imran Musa, who is an associate professor at Universiti Sains Malaysia, told ST: "More tests lead to more cases, more transmissions lead to more cases. So to be more certain, we can look at the positivity rate. Unfortunately, since the last week or so, the positivity rate seems to be on the increasing trend which indicates increasing transmission."

Some states, such as Selangor, have recorded a positivity rate exceeding 10 per cent for seven consecutive days.

In an effort to curb the spread of the disease, several states and localities are now under an enhanced movement control order in which residents are not allowed to leave their homes except to buy essential items and attend to medical matters, including vaccinations.

"The only real long-term preventive strategy is vaccination," said Dr Bulgiba.

He said the Pfizer-BioNTech/Comirnaty and AstraZeneca vaccines work against the Delta and Beta variants after two doses, while a single dose does not offer optimal protection.

Medical experts have suggested ways for the government to ramp up vaccinations, including by cutting the interval between doses for the AstraZeneca vaccine to four weeks instead of nine. Another measure would be having a mix of doses for the Covid-19 vaccine.

"I would strongly suggest that the vaccination rate be stepped up especially in high-risk areas to make sure that all eligible and vulnerable persons are vaccinated as quickly as possible. Selangor's vaccination rate is being massively ramped up but its two-dose coverage still lags behind Sarawak's," Dr Bulgiba said.

"One cannot deny that Sarawak is doing a pretty decent job of vaccinating its people despite the massive logistical challenges it faces," he added.

Based on the Special Committee for Ensuring Access to Covid-19 Vaccine Supply's website, a total of 50.2 per cent of the state's population have received their first jab, while Selangor's stood at 24.1 per cent.

Malaysia’s record cases explained

New Covid-19 infections in Malaysia charted a record high for the second day running on Wednesday, hitting 11,618 cases despite a nationwide lockdown since June 1. 

Most of these were reported in its most populous state Selangor, with 5,051 cases and capital Kuala Lumpur which saw 1,749 cases. Neighbouring Negeri Sembilan registered 1,537 infections.

Ramped-up testing, and the highly contagious Delta variant are factors that have driven the recent spike in numbers.

Health Director-General Noor Hisham Abdullah has said that the emergence of the Delta variant as the dominant variant in the country, along with increased testing in lockdown areas, contributed to the record cases.

The Delta variant can spread faster via airborne transmission and has an infectivity rate of five to eight. This means that if the variant infects 100 people, they can pass the virus on to 800 more people in a very short period of time.

“We projected that the number of cases from July 3 will increase. It has been a week, and we anticipate that it will go up for a week or two, before we see cases stabilise,” Tan Sri Dr Noor Hisham said at a news conference on Tuesday. 

“One of the reasons is because of the Delta variant. It is airborne and so the transmission is faster.”

About 70 per cent of daily cases are from the Klang Valley - Malaysia’s most populated and industrialised area covering the capital and most of Selangor - and Negeri Sembilan. 

Large parts of these areas are under the tightest level of lockdown, with its residents subject to intensified testing efforts. The authorities have also stepped up screening on thousands of factory and construction workers here.

According to the Health Ministry, from July 6 to 12, a total of 825,373 Covid-19 tests were carried out, compared with the previous week where only 624,645 tests were conducted. 

Experts told The Straits Times last week that lockdown measures must be complemented with contact tracing, speedier vaccinations and better data on the spread of new variants. Previous lockdowns also contained too many exemptions allowing industry to operate, they said, causing workplace transmissions to soar.

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2021-07-14 11:39:03Z
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Thailand considering limits on AstraZeneca COVID-19 vaccine exports - CNA

BANGKOK: Thailand is considering imposing limits on exports of locally manufactured AstraZeneca COVID-19 vaccines to fight its own crisis, an official said on Wednesday (Jul 14), a move likely to impact neighbours and stir concerns of vaccine protectionism.

Any attempt to regulate exports could further slow vaccine rollout to Malaysia, Vietnam and Indonesia, which are also battling spikes in infections and supply disruptions caused by earlier export curbs imposed by India.

The move also marks a fresh setback to AstraZeneca, which had initial delays in regional production and delivery and hoped to put it back on track from this month and meet its supply commitments to the region.

Nakorn Premsri, a key member of the National Vaccine Committee, told reporters when asked about a plan to place a quota on vaccine exports that the committee had "agreed in principle" on such a draft order.

"Right now, the order has not been issued yet," Nakorn said, adding that various agencies will need to review it and consider its impacts.

He did not address at what levels export quotas might be set.

READ: Thailand approves self-tests, self-isolation as COVID-19 cases climb

AstraZeneca Thailand said in late June that its partner Siam Bioscience, owned by King Maha Vajiralongkorn, will produce 180 million doses this year, just over a third for Thailand and two thirds for elsewhere in Southeast Asia.

"Right now we will talk with the vaccine manufacturer so they can deliver the vaccine to Thailand in a suitable manner that matches the outbreak situation in the country," Nakorn told reporters.

Representatives for AstraZeneca did not immediately respond to a Reuters request to comment on Nakorn's statements.

AstraZeneca delivered 6 million doses, as promised, to Thailand in June when the country's mass vaccine rollout started. A Thai official last month said a similar volume would be delivered in July, short of the previously announced 10 million monthly doses.

READ: People jabbed with Sinovac COVID-19 vaccine to get AstraZeneca as second dose: Thailand health ministry

READ: Thailand defends COVID-19 vaccine 'mix-and-match' after WHO warning

Thailand has been producing the AstraZeneca vaccine since June and is slated to export it to several other countries in Southeast Asia, as well as Taiwan. The Philippines and Malaysia are among countries that have experienced delivery delays.

The country is suffering its worst coronavirus outbreak yet, with hundreds of deaths in recent weeks and more than 8,000 new cases reported on many days this month - and only about 5per cent of its more than 66 million population fully vaccinated.

Thailand's government has so far used the AstraZeneca's viral vector vaccine and Sinovac inactivated virus vaccine.

The government is also revising its vaccine acquisition plan and announced on Wednesday it will more than double the targeted number of doses to 120 million, among those viral vector and mRNA types. It did not mention inactivated virus vaccines.

It had earlier said it would order 28 million more doses of the Sinovac vaccine, but it this week announced a plan to administer AstraZeneca shots as a second dose to those of the Chinese vaccine, to better protect against variants of concern.

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2021-07-14 12:27:15Z
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Malaysia sees record 11618 new Covid-19 cases for second straight day - The Straits Times

KUALA LUMPUR (REUTERS) - Malaysia reported 11,618 new coronavirus cases on Wednesday (July 14), a second straight day of record case numbers.

Total cases hit 867,567, the Health Ministry said on Twitter.

One of the reasons for the rise is the emergence of the Delta variant, said health director-general Noor Hisham Abdullah on Tuesday.

"We were informed that the Delta variant is now the dominant variant," he told a news conference.

The number of infections is projected to further increase in the next two weeks before stabilising, he added.

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2021-07-14 07:53:21Z
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Concern grows over Indonesia's regions as Delta COVID-19 variant ravages Java - CNA

JAKARTA: Concerns are mounting in Indonesia over the ability of its regions to cope with a spike in coronavirus cases, according to its health minister, as the highly transmissible Delta variant spreads quickly across the world's largest archipelago.

Indonesia is struggling to slow the pace of COVID-19 transmission, with its biggest daily increase in coronavirus infections with 54,517 cases on Wednesday (Jul 14), taking the total tally to just over 2.67 million cases.

The data from the country’s COVID-19 taskforce also showed 991 new deaths, bringing the total number to 69,210. Indonesia has the highest number of coronavirus cases and deaths from COVID-19 in Southeast Asia. 

The Delta variant first identified in India has been found in 11 areas outside of the densely populated Java island, health minister Budi Gunadi Sadikin said.

Cases and bed occupancy rates have risen in parts of Sumatra, Papua and Kalimantan, or Indonesian Borneo, and far-flung regions like West Papua were especially concerning, he told parliament this week.

"We must monitor this tightly, because if there's something happening there, their health capacities are below Jakarta or Java," Budi said.

READ: COVID-19: Southeast Asia sees spike in new cases, deaths as region struggles to contain Delta variant

READ: What might have caused the huge spike in Indonesia's COVID-19 cases post-Idul Fitri holiday

In East Nusa Tenggara, infections have more than doubled in the last three days, while in Lampung on Sumatra, bed occupancy on Monday had reached 86 per cent, East Kalimantan at 85 per cent, and West Papua at 79 per cent.

Ismen Mukhtar, an epidemiologist in Lampung, said Indonesia's regions were extremely vulnerable.

"Health facilities are urgently needed because they save lives," he said.

"But what's more important is limiting transmission."

Java hospitals have been deluged in recent weeks, with many people struggling to get treatment. Most of the 550 people who have died in isolation since June were on Java, according to independent data initiative group Lapor COVID-19.

As health experts warn Indonesia could be the next India, the government has scrambled to boost capacity and secure sufficient oxygen supply.

Senior minister Luhut Binsar Pandjaitan, who spearheads the emergency response, on Wednesday said oxygen supplies were well managed, with more than 1,500 oxygen generators expected to arrive from Singapore and China.

More than 2,000 newly graduated doctors and 20,000 nurses would soon be deployed to hospitals, he added.

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Commentary: Vietnam's attitude towards Chinese vaccines is very telling - CNA

SINGAPORE: Two similar events and yet a world apart when it comes to popular sentiment.

On Jul 7, Vietnam marked the delivery of 97,000 doses of the Pfizer vaccine to the country. The delivery ceremony was graced by the country’s Vice Minister of Health and the US Chargé d’affaires. The modest amount is the first batch of 31 million doses that the Vietnamese government has ordered from Pfizer-BioNTech, an American-German tie-up.

Just two weeks earlier, a similar ceremony was held to mark the arrival of 500,000 Sinopharm doses donated by China. Vietnam’s Health Minister and Chinese Ambassador to Vietnam were present.

On balance, there is a semblance of parity in the appropriate levels of protocol and political significance accorded by the Vietnamese government to both events.

Yet, public reactions on both mainstream and social media suggest overwhelmingly negative attitudes towards Chinese vaccines in contrast to their enthusiastic embrace of Western vaccines.

READ: Vietnam receives 2 million COVID-19 vaccine doses as it tackles worst outbreak

This is reflective of the zeitgeist in Vietnam. In general, the populace, in particular younger Vietnamese, is favourably disposed to the United States at a time when bilateral relations are on the uptrend. By contrast, popular attitudes towards Vietnam’s northern neighbour are less salubrious, in part due to the brewing South China Sea disputes.

An examination of reader comments in the country’s most popular newspapers – the mainstream tuoitre.vn and the digital vnexpress.net – bears this out.

In two vn.express and tuoitre.vn articles similarly titled “Vietnam approves Sinopharm COVID-19 vaccine” on Jun 4, very few comments expressed favour for the Sinopharm vaccine. An overwhelming majority said that they would rather wait and pay extra to get their top choices – the Pfizer and US-made Moderna vaccines.

There is also a considerable acceptance of Astra Zeneca, Russian Sputnik and future made-in-Vietnam vaccines. Quality measured in terms of efficacy and safety is cited as the main reason for expressed preferences.

READ: Commentary: Inaccurate public understanding of COVID-19 vaccine efficacy has implications for vaccination rates

DSITRUST AND ANTI-CHINA ATTITUDES

Many readers rejected the Sinopharm vaccine outright, due to visceral anti-China attitudes or an entrenched distrust of made-in-China products.

A health official sprays disinfectant on the first batch of AstraZeneca-Oxford COVID-19 vaccine shipment after its arrival at the Tan Son Nhat airport in Ho Chi Minh city, Vietnam on Feb 24, 2021. (Photo: AFP/Phu Nguyen)

Only a minority gave considered and informed reasons, such as reports of Chinese vaccines’ lack of clinical trial data, their lower effectiveness compared to the Pfizer and Moderna vaccines, and COVID-19 resurgence in countries that have inoculated with Chinese vaccines such as Bahrain, the Seychelles, Uruguay and Chile.

While expressing their hesitancy towards Chinese vaccines, many Vietnamese support their government’s announcement to give the Sinopharm jabs to only China-related elements, namely Vietnamese people living in border areas with China or engaging in trade and service with China, and Chinese nationals in Vietnam.

According to the Chinese Embassy in Hanoi, this plan was a bilateral consensus to enable the Sinopharm donation to Vietnam.

Yet, in an odd twist of events, the Chinese Embassy in Hanoi on Jun 24 expressed concern that the Vietnamese government had “broken its promise to give priority to Chinese nationals” by planning to distribute the Sinopharm vaccines to its nine northern provinces severely affected by the recent surge.

READ: Commentary: How COVID-19 vaccines are being weaponised as countries jostle for influence

The embassy added that the Chinese nationals should be vaccinated ahead of the other groups, in line with China’s “Spring Sprout” programme which seeks to get its citizens abroad to be inoculated. It is estimated that there are over 500,000 Chinese nationals in Vietnam.

On Jun 25, the Chinese Embassy announced that Vietnam agreed to withdraw its earlier distribution plan after the Chinese complaint. These developments were not publicised on Vietnam’s domestic media and were only reported in the Viet-language programmes of foreign outlets such as the British Broadcasting Corporation (BBC), Radio Free Asia (RFA), Voice of America (VOA) as well as the Global Times.

The public expression of discontent by the Chinese Embassy when it could have been done through quiet diplomacy has only worsened the Vietnamese public’s already low perceptions of China and its vaccine outreach.

They do not see the Sinopharm donation as an act of Chinese generosity but a self-interested move that serves Beijing’s political agenda towards its own nationals overseas while taking advantage of Vietnam’s vaccination logistics.

It also demonstrates the clumsy projection of Chinese soft power overseas despite its leader Xi Jinping’s recent directive to present a “credible, loveable and respectable China” image.

READ: Commentary: Some soul-searching needed in China’s fresh push to make friends and influence people

WARM RECEPTION TOWARDS WESTERN VACCINES

In contrast, the US Embassy’s Facebook post about the Pfizer delivery on Jul 7 garnered more than 1,500 positive reactions within 12 hours (and counting). Most online visitors expressed their thanks in the comments, eliding the fact that the delivery is part of a commercial contract.

A man and his children, all wearing protective masks, ride a bicycle on a street during the coronavirus disease (COVID-19) outbreak, in Hanoi, Vietnam on Jul 27, 2020. (Photo: Reuters/Kham) 

Positive reactions to vnexpress.net and tuoitre.vn news articles are also observed. No negative comment was registered, except for some concerns expressed over the storage of the Pfizer vaccines.

There was also a great deal of interest in securing access to the jabs and giving them to high-priority groups and localities. In a related development, a donation of 2 million doses of Moderna vaccines will be arriving in Vietnam shortly, as the Biden Administration scales up its vaccine outreach worldwide.

Prevalent negative public perceptions about Chinese vaccines versus their warm receptivity towards Western ones, together with a genuine concern about the effectiveness of vaccines, partly explain the Vietnamese government’s reluctance to buy Chinese vaccines, except for limited numbers to be used in emergency situations amid the supply crunch.

READ: Commentary: Has China’s vaccine diplomacy worked in unexpected areas?

This is despite the fact that the country is urgently ramping up its vaccination drive amid the latest and most serious wave of COVID-19 infections. Only 3.8 per cent of the 96 million people in Vietnam have been inoculated.

This is the second lowest rate in ASEAN, putting Vietnam just ahead of Myanmar, which continues to grapple with the political crisis resulting from the February coup d’etat.

Ultimately, Vietnam’s determination to keep Chinese vaccines at arm’s length is geopolitical. As noted by some observers, Vietnam will try its best to avoid being beholden to China’s vaccine supplies so as to keep its spine and act in its own interest on the South China Sea disputes – the biggest problem in Vietnam-China bilateral ties.

However, the Chinese brand – be it COVID-19 vaccines, trust between putative Communist comrades or consumer confidence – has a mountain to climb in its immediate southern neighbour.

Hoang Thi Ha is Fellow and Lead Researcher (Political-Security) at the ASEAN Studies Centre of ISEAS – Yusof Ishak Institute. This commentary was first published in ISEAS – Yusof Ishak Institute's Fulcrum.

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2021-07-13 22:07:00Z
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More than 11000 new COVID-19 cases in Malaysia, third record in less than a week - CNA

KUALA LUMPUR: Malaysia reported a record 11,079 new COVID-19 cases on Tuesday (Jul 13), a sharp increase from already high infection levels in the past week.  

This is also the first time that daily COVID-19 cases have hit five figures.

Only 27 of the new infections were imported, with the rest classified as local cases. 

More than half of the new cases were once again from the Klang Valley area, with 5,263 in Selangor and 1,521 in Kuala Lumpur. 

There were 1,033 new infections in neighbouring state Negeri Sembilan while Sarawak and Johor registered 472 and 406 respectively. 

The health ministry also announced 125 more fatalities, aged 27 to 86, taking the national death toll to 6,385. 

Sixteen of the victims were classified as "brought in dead" as they did not die in hospital. 

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A soldier wearing personal protective equipment disinfects an area under enhanced lockdown in Kuala Lumpur, Malaysia on Jun 29, 2021. (Photo: Reuters/Lim Huey Teng)

A total of 972 patients are in the intensive care unit, yet another record. Of these, 456 require respiratory support. 

The number of critically ill patients has been at record levels for more than a week, with the health ministry repeatedly stating that hospitals, frontline personnel and morgues were overwhelmed. 

Twenty-three more clusters were also identified, taking the total number of active clusters in the country to 870. Thirteen of the new clusters stem from workplaces while 10 are in the community. 

The health ministry said the increase in cases was partly attributed to the spread of the Delta variant.

Members of the public are encouraged to adopt double-masking especially in high risk areas as "airborne" transmission can occur, it added.  

Malaysia entered its third nationwide lockdown on Jun 1, shortly after it breached the 9,000 mark for new cases for the first time on May 29.

Numbers reached record levels again on Jul 9 and Jul 10, with more than 9,100 cases on each day.

Health ministry data showed that more than 3.6 million people have so far completed the full COVID-19 vaccination regimen. 

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A nurse administers a COVID-19 vaccination to a durian fruit vendor at his house in rural Sabab Bernam, central Selangor, Malaysia on Jul 13, 2021. (Photo: AP/Vincent Thian)

This is still short of the country's target to inoculate 80 per cent of its population, or 26.7 million out of the total 33 million people in the country.

Health director-general Noor Hisham Abdullah on Tuesday said vaccination was the solution to the COVID-19 pandemic. 

A fully administered vaccination has been proven to decrease the likelihood of death or hospitalisation, he added. 

Dr Noor Hisham said 2,779 health ministry employees tested positive for COVID-19 after they were fully vaccinated. However, a majority of them were asymptomatic or had mild symptoms. 

None of the affected individuals was critically ill and those who had mild symptoms could be quarantined at home, thus reducing the number of patients in hospital, he said. 

As of Tuesday, Malaysia has reported a total of 855,949 COVID-19 cases, of which 96,236 are currently active or infectious. 

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2021-07-13 13:52:30Z
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