Unmasked!

 

A Thing of the Past?

So the mask mandate has been lifted here in Malaysia for everywhere except public transport and medical settings. This is a great step forward... or is it?

Well, we are at some stage going to have to move from a situation where masks are the norm in most settings to one where we use masks if we are ill, we live with vulnerable people or a virus (covid or otherwise) reaches such prevalence that it becomes necessary again to control the spread.

The main issue is that here, despite the government mandate, there is a reluctance to take masks off. This reluctance meant that when we went to the local mall to take Thomas (and Nicola, it turned out) birthday shopping and to go for tea, we ended up wearing masks in the majority of the indoor settings just out of social pressure.

Now, this is not necessarily a bad thing, but neither is it a good thing. We are unlikely to see the very high prevalence of virus that was seen in the UK as the population is more widely vaccinated in this part of the world (over 90% of the eligible population - and I think that I'm underestimating there by a fair way) and that the weather means people don't crowd indoors at key seasonal times either. However, it is likely that there will be a spike in cases, although testing is no longer widespread here and identifying a spike might be more problematic.

The UK picture is interesting - cases are at their lowest level for nearly a year, but that is down from a peak of 180,000 cases per week to around about 4,500 cases per week. A dramatic fall, but from a very high point. For context, Malaysia's cases peaked at around 40,000 per week at their highest level and is now around 2000 per week. Given that we have a population roughly half that of the UK in Malaysia this means that the peak was never as high, but proportionately things have settled at roughly the same level of infections per capita. Maybe this is a sign that we have reached some form of homeostasis?

However the figures still hide a strange truth about the UK and therefore probably about many other countries too - the level of excess death, i.e. deaths above an expected level for the time of year, is running quite a bit higher than we would expect.

This is less good news. Though there may be an explanation attached to, rather than caused by, the pandemic and this is the backlog of treatment and delays in the vastly overstretched NHS. As the NHS was operating well below capacity and many people did not seek routine treatment during the height of the pandemic (it's not over yet) then the health system is coping with its normal load plus this backlog. Given that the NHS didn't have a lot of spare capacity to begin with an increase in pressure will naturally lead to negative outcomes and this could go some way to explain the current situation in the UK.

Covid is still a thing. It hasn't gone away and in many countries around the world it is still cutting a swath though the population, it just isn't being reported any more and governments now have other priorities. The collateral damage of mass lockdowns and travel restrictions is now being balanced against the harms from Covid itself, and given the array of treatments and preventative measures at our disposal along with the natural levels of immunity that are washing around the general population from vaccination and exposure to the virus I guess that we can relax measures a bit. There is a fair amount of evidence to suggest that mass uptake of mask wearing can reduce transmission in indoor spaces, but this only works if the majority of people follow this. Interestingly here in Malaysia most people are still wearing mask in most contexts.

In school there are a minority of students who have taken their masks off. Even outdoor we still have students who are wearing masks, probably due to social pressure and advice from home. This has meant that we have absence rates running at relatively low levels.

However, as a teacher I can teach from the front of the class mask free, we can go to outdoor areas and not have to wear a mask - it's kind of the most sensible and balanced approach. I still wear a mask in crowded indoor areas, not because it is mandated, but because the majority of the people around are more comfortable when masks are being worn and making most people comfortable is not necessarily a bad thing.

So there we are - things are pretty much as normal as we are likely to see any time soon!