16^th October, 2021, Saturday; 9.30am-11am

• South Africa Update: Vaccination program is not on track; yesterday 20 million doses were administered, but not all are fully vaccinated. Next month, children vaccination for 12-18 years. There is an apprehension that elections in South Africa may trigger a fourth wave. There are ‘Vooma Vaccination Weekends’, which are weekend vaccination drives to vaccinate as many people as possible. There were 733 new cases and 54 deaths in the last 24 hours. There are a total of 2.9 million cases; 2.8 million have recovered, 22933 are active cases, total deaths are 88,562. The positivity rate from 3rd Oct. to 9th Oct. is 3.3%. Till now 5000 cases are hospitalized – 781 in ICU, 386 are on ventilator. The recovery rate is now 96.2%. Till yesterday, 20 million vaccines have been given. Children aged 12 years and older will be eligible for vaccination from 20 October. They will receive only one dose of Pfizer due to the risk of myocarditis. Twenty six percent have been fully vaccinated; 34% have received the first dose. Schools have reopened.
• Australia Update: 85% population has received the first dose, while around 68% have taken the second dose. Victoria will reach 70% in the next 3 days; cases are still a problem here; 95% population in Canberra has been vaccinated; in New South Wales it is 80%. NSW plans to open up for international travel from 1^st November; no quarantine for fully vaccinated international travelers. Australia has been locked down from March 2020. Vaccination for 12-16 years is very good. Vaccination for 5-11 years is expected to start soon with Pfizer vaccine. Schools are starting from next week. There have been 1400 deaths so far. West Australia will not open till February or March next year.
• Dr Heidi Stensmyren, Sweden, President WMA: Vaccination is increasing but varies considerably in different parts of the world. Some countries have achieved more than 80% vaccination rates and have also started vaccinating children older than 12 years, while other countries are lagging behind. Many vaccines are not accepted by all countries. There is lot of misinformation about vaccines. A rise in infections in children has been seen. A pattern that has been seen is that hospitalized Covid patients are from poor socioeconomic group, while post covid are more from higher socioeconomic group. Fewer people hospitalised in ICU.
• Singapore Update: Yesterday there were 1593 cases; about 98.6% cases are asymptomatic. There are 2000-3000 cases daily. Singapore has one of the highest vaccination rates in the world. The vaccination rate is 85%; the target is 92% of the entire population (8% are children). 60,000 elderlies are unvaccinated. Most of the patients hospitalized are in the older age group; those who require oxygenation are also in the older age group. 48 people are in intensive care right now. Deaths are also predominantly in the older age group. 16500 people are in their homes recovering; most of them are asymptomatic. They are given ART and pulse oximeter; they are telemedicine access. They are asked to come to the hospital if they become symptomatic or their oxygen saturation drops. If ART is positive, they are asked to repeat it three days later. Some dormitory outbreaks have started again. Booster shots have started; half a million people have got the booster dose. After the >60 and >50 age groups, now 30-49 years age group will be eligible to take the booster shot. Singapore has very good contact tracking (test-trace-isolate-quarantine-masking). 200 children below 11 years of age are infected yesterday. There have been no cases of influenza because of masking.
• USA Update: After Pfizer, J&J and Moderna vaccines have been approved for a booster dose. There is a decline in the number of new cases in children for the fifth consecutive week. Children are going back to schools. A study released last week said that just like adults, children are susceptible to infection 3.5 time more in schools where there is no masking. The purpose of vaccination is to provide the immune system with the robust support it needs so that it can clear the infection before it causes further disease. In the US, 7 million have been vaccinated; 96% are 65 years and older, 56.8% of children aged 12 years and older have received at least one dose; booster dose for 65 years and older is approved (13.4%), 18-50 with high risk (5.2%).
• Pakistan Update: The situation in the country is improving. There were 890 cases in the last 24 hours, 24 deaths. There are 27,000 active cases, 28,000 deaths so far. About 15.8% population has been vaccinated. Schools have opened. The third booster dose is available for people who ask for it especially those who are traveling abroad or those whose antibody levels are waning. Positivity rate is 2%. Dengue cases are on the rise, especially in Punjab and Karachi. There are few cases of coinfections (dengue and Covid).
• Japan Update: The country has survived the fifth wave and is preparing for the sixth wave during the winter. There are many RSV and non-Covid viral infections are on the rise. 70% people are fully vaccinated. Some cases of myocarditis have been reported after Moderna vaccine; many are cured.
• Hong Kong Update: Hong Kong is following the policy of zero tolerance and not living with the virus as 30% of elderly population is vaccinated so far; vaccine hesitancy is still prevalent among the elderly. When borders open, this elderly population may be at high risk. Only one community case in the recent two months; death rates are stagnant and there have been no new deaths for a month.
• India Update: At the current vaccination rate, only 35% of the population will be vaccinated by the end of this year. The target is to vaccinate around 60% of the population with both doses by December 2021. To achieve this, the required vaccination rate is around 14 million per day. The actual vaccination rate is around 5 million per day. Yesterday, there were only 3 million vaccinations, which falls short of the daily required vaccination rate by 11 million. Cases in India are declining, including in Kerala. A study of the outbreak in Delhi has shown that achieving herd immunity against delta variant is difficult.

Participants

Member National Medical Associations

Dr Yeh Woei Chong, Singapore, Chair CMAAO

Dr Alvin Yee-Shing Chan, Hong Kong, Treasurer, CMAAO

Dr Heidi Stensmyren, President World Medical Association

Dr Marthanda Pillai, India Member World Medical Council, Advisor CMAAO

Dr Wasiq Qazi, Pakistan, President-elect CMAAO

Dr Angelique Coetzee, South Africa

Dr Akhtar Hussain, South Africa

Dr Marie Uzawa Urabe, Japan

Dr Salma Kundi, Pakistan

Dr Qaiser Sajjad, Pakistan

Dr Ashraf Nizami, Pakistan

Dr Prakash Budhakoty, Nepal

Invitees

Dr Russell D’Souza, Australia UNESCO Chair in Bioethics

Dr Monica Vasudev

Dr Yeo Khoonhui

Dr EC Ng

Prof Arun Jamkar

Dr Patricia La Brooyi

Dr S Sharma, Editor IJCP Group

Moderator

Mr Saurabh Aggarwal