Tuesday, 26 October 2021

Let's get back to the old normal : Part II (Wearing masks now is still an oxymoron.)

In my previous post, I basically said that wearing masks post vaccination is "living in fear". Some people responded by comparing wearing masks with safety belts in cars, applying sunscreen in the sun and wearing cycling helmets while cycling. I still stand by my statement; that wearing masks 24/7 post vaccination is not necessary and that most people still wear them out of fear. 

Safety precaution is all about "proportionate response". The key word is "proportionate". "Sense of proportion". Look it up in the dictionary.

In Malaysia, on average, there are 7 deaths from road accidents daily. That is more than 2,500 deaths per year from road accidents. Do we ban cars? No. Because the benefit of cars and vehicular transportation far outweigh its potential danger. We set reasonable speed limits and safety precaution like safety belts. But here is the thing. You only have to wear safety belts ONLY when you are using/riding a car. If you do not like wearing safety belts, you can choose not to ride a car. You can ride a motor bike or public transport. Wearing safety belts has been proven to greatly save lives in an accident. The probability of survival in an accident is high when you wear safety belt. This is proven. Hence, safety belt is an acceptable "inconvenience" considering the high safety benefit compared against high probability of death when not wearing them.

Similar argument for cycling helmets. Although cycling helmets are designed for cycling athletes who has to cycle at top speed along rough terrain. If you are just cycling slowly for recreation and short distance travel, you do not have to wear them, in my opinion. Even if you fall at slow speed, I do not think you would break your head. You would be able to respond and break your fall. Again, it goes back to risks and benefit. Cost benefit analysis. Proportionate response. Snail pace cycling habit versus athletic speed. 

As for sunscreen. Only white people need to wear them. Dark skinned people living in the tropics generally do not need them. Again, proportionate response. Nobody is forcing anyone to wear sunscreen when out in the sun. You decide based on your own circumstances and your own risk appetite. Your own cost benefit analysis and risk appetite.

However, mandating everyone to wear mask 24/7, especially post vaccination is a policy borne out of fear. In the beginning, when we do not have global data, wearing masks make sense. In the absence of complete data, we err on the side of caution. But now we do have global data. The virus only affects about 1% of the population. Even then, out of that 1%, not all will die. Most will have low to mild symptoms. Most will survive. Even those who die, mostly they die from secondary complication.

This is what I mean by proportionate response. Mandating masks for 100% of the people for something that only greatly affects less than 1% of the population is insane. Again, risk and benefit. Sense of proportion.  

About 90% of Asians are lactose intolerant. Do we ban milk?  

Less than 1% of the adult population worldwide is gluten intolerant. Do we ban wheat flour? Well, why not? The statistic is the same as the virus. Less than 1% is affected.

Less than 1% is affected by CoVid19 and we mandate masks, but yet we do not ban wheat flour even though also less than 1% is affected by gluten intolerant. About 90% of Asians is lactose intolerance and yet we still let milk and milk products flood the market. Why? 

This is what I mean by proportionate response. When we response out of proportion to the danger, it is almost always, because of fear. People who jump and scream when encountering cockroaches, mice and small bugs. They are responding out of proportion to the actual "dangers" posed by cockroaches, mice and small bugs. They are reacting out of fear.

In my industry (oil, gas & petrochemical), we have a concept called ALARP. It means "as low as reasonably practicable". We eliminate and reduce hazards as low as reasonably practicable. The key word here is "reasonably practicable". What is reasonable? According to cost and benefit standards as agreed with the industry practitioners and regulators.

Everything has to be within reasonable risks, not zero risks. Otherwise you would be disabled, cannot do anything, cannot drive, cannot walk, cannot swim, cannot process chemicals, cannot anything.

It is the same with CoVid19. It cannot be zero CoVid19 cases or zero death.

Do you remember the original objective of the lockdown? It is not to achieve zero death. It is so that the number of cases are within the capacity of the healthcare facilities. This means some people would still fall sick and maybe die, but there are enough hospitals and doctors and nurses and medical equipment and morgues to handle the cases. They are not overwhelmed. 

Well, the number of cases post vaccination suggest this is the case. 

People who come into contact with positive people also do not necessarily need treatment. Nor do they need to be quarantined.

So, what is the proportionate response to post vaccinated world?

Back to normal. 

The old normal.

No more masks. No more contact tracing. Otherwise you are just living in fear.

Salam.


Wednesday, 13 October 2021

Let's get back to the old normal.

Post vaccination mask mandate is an oxymoron.

The question is, does the vaccine works or not? If it works, and we are now treating the disease as endemic, why are we still mandating the wearing of masks?

If the vaccine works, at worst, most infected people will only get a mild fever. Death, if any, will only occur to people with comorbidity, same as with any other pulmonary diseases that are endemic.

Majority of people will be OK when they get the flu, common cold, and other pulmonary related diseases. A tiny few will die, most probably from complication of secondary illnesses. That's what endemic means, at its most basic real life implication.

Based on the statistics of these existing endemic diseases, we do not go around wearing masks in our daily lives. Even when our work colleagues or family members have the sniffles of the nose, we do not react. We do not suddenly order everyone to wear masks. We do not even order them to go home. In fact, in a normal workplace, we give the guy the option whether to take medical leave or continue working with the sniffles, depending on the severity of their sniffles and workload situation; basically, their choice. We do not run away from them like they are carrying the black plague or some zombie virus.

It should be the same with CoVid19 when we say we are treating them as an endemic. That is the real life implication when we say a disease is endemic. We should stop fearing them like we do not fear the flu and the common cold. Even before vaccination, more than 99% of the population are not affected, and I include those that are asymptomatic and/or has only mild fever and do not need breathing assistance.

Post vaccination, the number is higher. In fact, the fatality rate now is very, very low, almost negligible, and certainly are able to be managed by our healthcare infrastructure. In fact, majority of severe symptoms and deaths are now people who are not vaccinated (and the numbers of cases are low and manageable).

I respect the freedom of choice of those who do not want or are not vaccinated for whatever reasons. They have made their choice. They have to live by that choice. They have chosen to live with that risks. I respect that.

We cannot continue to make policy based on those people who, for whatever reasons, are not vaccinated. Now that 90% are vaccinated, we should open the country fully. And I mean fully. 

Interstate travel, no physical distancing, dine in, back to office, recreation & sports, everything. No mask mandates. 

If people want to continue wearing masks, let it be their personal choice, but no mask mandates from the government. Also no vaccine passport for citizens moving within the country. (The only "vaccine passport" that I may agree with is foreign tourists & workers from other countries, but with an expiry limit of implementation, maybe for 1 or 2 years, or until 90% of global population are vaccinated. The point being, it should not be a permanent thing. Also, no need for quarantine.) We have defined herd immunity as 90%. This is an accepted scientific conclusion. If this is true, then we should make policy based on this conclusion.

We should stop fearing CoVid19. Having immunity does not mean you will not get CoVid19. It means if you have it, your survival rate is very, very high. It's the same as chicken pox vaccine. You are vaccinated when you are a baby, but when you are 10 years old, you still get chicken pox. But the most important thing is that, the disease did not cause brain damage to you. Chicken pox become just like the common cold. People do not fear chicken pox anymore, even though, at its worst, you could die or suffer brain damage. (Just google "can you die from chicken pox?".)

It should be the same for CoVId19. 

So, I say, open up everything.

No mask mandate.
No physical distancing.
Come back to the office.
Go to the gyms & parks.
Restart the economy.

No new normal.

Let's get back to the old normal.

Salam.