Topic: Covid-19 Update from CMAAO countries

11^th December, 2021, Saturday; 9.30am-11am

• Singapore Update: The situation is quite stable. There are about 700 cases today; 98.7% cases are mild; hospitalizations are only 0.2%. Two cases of Omicron have been detected but these are not community cases. The country is opening up to several countries via quarantine-free vaccinated travel lanes. A vaccine certificate and recent ART is required for travellers entering Singapore. A PCR is done at arrival and stay at home till results are available. A self-administered ART is required every day for 7 days of arrival because of omicron; on the 3^rd and 7^th day, supervised ART is done. Two persons with booster doses have tested positive for Omicron. In addition, there are 3 new cases today. Omicron cases in Singapore are fairly young. So far, no community transmission in Singapore. 
• Hong Kong Update: Cases are less but quarantine and restriction rules are still very strict. Persons returning back from high-risk countries are quarantined for 21 days (14 days in designated hotel and 7 days at home). There are five cases; all are imported, no local cases. The immunization rate in older persons aged >70 years is less than 40%. In persons older than 80 years, the immunization rate is only 20%. If community spread occurs, these will be the vulnerable population. Total cases are 12k, while mortality is 212. 
• South Africa Update: In Gauteng, which is the epicenter of Omicron, the daily numbers have stabilized. In the fourth week, the clinical picture still stays the same. Very few admissions at the primary care level. It’s a mild disease and is nowhere close to Delta in terms of severity. There are breakthrough infections. In the last 24 hours, there were 19k cases; 20-25 deaths in the last few days; there were 22k cases the day before yesterday. South Africa has conducted total 20 million tests, out of which 3 million are positive. Total deaths are 90k. The recovery rate is now 92.5%. 29.7% of cases from 75,251 tested are omicron. Positivity rate in the last 24 hours is 24%. There are 4795 hospitalized patients (this number reflects any other reason for hospitalization and incidentally found to have Covid on screening); 398 are in ICU and 148 are on ventilator. The average length of stay in hospital is 2.5 days. Positive tests in the 10-to 14-year age group are increasing, which was not seen earlier. 20% of healthcare workers are infected with omicron. If infection is not severe, then patients are treated at home. One out of 90 patients had fever (40^o), no oxygen requirement, only slight tachycardia (up to 103/105). In delta, tachycardia went up to 120/130. Adults take about five days to recover; children are recovering in 72 hours. Lab testing has increased to 70-80k every day; private sector is testing more than the public sector. PCR can differentiate between omicron and other variants. If S gene drop out, then no genomic sequencing; if no S gene dropout, then genomic sequencing is done for other variants. Majority of persons with breakthrough infections are fully vaccinated with Pfizer vaccine. Some provinces in the country are not reporting any deaths and ICU and hospitals are unoccupied unlike during the delta wave. Omicron is currently the dominant strain. At the hospital level, majority of cases probably are still delta not omicron. We are in the fourth week; we do not see the same intensity.
• India Update: There are 32 Omicron cases, most are from high-risk countries, while 1-2 cases are local transmission in contacts. The situation is under control. The number of daily cases is declining as is mortality and hospitalization. The daily cases are around 7000; mortality 42, recovery rate 98.36%. So far, 123 crore doses of the vaccine have been administered; 85% have received one dose, while 45% have received both doses. There is no decision yet on starting booster dose. The priority is that everybody should get the second dose. Schools have reopened; teachers are required to be fully vaccinated. Test positivity rate is 5.2%. ICMR has developed a new rapid Covid test “RT Lamp”, which gives results in 30 minutes. It has very high sensitivity. Vaccine certificate is mandatory for travel, hotel stay, theaters etc. There is no compulsion to take the vaccine, but the policy of persuasion and reach out is being adopted. None of the omicron cases have required hospitalization. Persons from high-risk countries are required to undergo quarantine at government sponsored places.
• Australia Update: There are 45 omicron cases in Sydney, none of them have been hospitalized. Vaccination with Pfizer vaccine for 5-11-year age group will start from 10^th January. Moderna vaccine has also been authorized for booster. Victoria and New South Wales have more than 95% vaccination.
• Pakistan Update: The situation is quite under control. There are two cases in Karachi with signs and symptoms like Omicron, but it will be confirmed in a week. They were detected in the airport. After contact tracing, 11 are in quarantine. The country is in the fourth wave. From 5000 daily cases, the numbers have come down to 200-400 now. Yesterday it was 395.  Total deaths are 28,800. Yesterday there were only 11 deaths. About 50% have received the first dose, while 30% have been fully vaccinated. The government is encouraging the booster dose for the elderly and healthcare workers, only for those who have taken both doses. The positivity rate in the last 24 hours is 0.7%. Schools, markets have reopened. But people are reluctant to take the vaccine and follow SOPs. There is a very good system of telemedicine via which persons who have tested positive is monitored at home. It has been very effective.
• Bangladesh Update: The situation is under control. There are around 100 cases daily, 20k tests per day out of which 1% are positive, 1-2 deaths. 62% have taken the first dose and 30% have taken both doses. Most people do not follow SOPs. Two travelers from Zimbabwe have tested positive; genome sequencing report is awaited to confirm omicron.

Participants

Member National Medical Associations

Dr Yeh Woei Chong, Singapore, Chair CMAAO 

Dr Ravi Naidu, Malaysia, Immediate Past President CMAAO

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

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 Ashraf Nizami, Pakistan

Dr Qaiser Sajjad, Pakistan 

Dr Md Jamaluddin Chowdhury, Bangladesh 

Invitees

Dr Russell D’Souza, Australia UNESCO Chair in Bioethics

Dr S Sharma, Editor IJCP Group

Moderator

Mr Saurabh Aggarwal