Covid-19, the catch-22 numbers game

For a long time now, we have been a people caught up with numbers. Since the Covid-19 pandemic hit Malaysian shores early last year, we have watched the figures go up and down, lately more the former direction than the latter.

When countries across the world began rolling out their inoculation programmes, though, our focus on numbers changed. It contracted, becoming smaller and smaller until finally narrowing down on one or two specific brands of Covid-19 vaccine seen as the problem child in the family of jabs deployed in the global push towards immunisation.

AstraZeneca and Johnson & Johnson appear to be the black sheep, particularly AstraZeneca since Johnson & Johnson is not currently part of our vaccine portfolio, voluntary or otherwise. We seize on every piece of news we find on people developing blood clots after receiving a dose of either vaccine and wonder, what if that happens to me?

Thrombosis is no laughing matter, of course. And to develop such a condition after being administered a substance meant to protect you against illness and death is a great irony, especially if you were young and in otherwise good health, with your entire life ahead of you barring any unforeseen tragedies.

In Norway, the second European country after Denmark to drop the AstraZeneca jab from its programme, 135,000 doses of the vaccine had been adminstered as of mid-March. Of these, eight relatively young and healthy recipients developed severe thrombosis, four of whom died.

In Denmark, which booted AstraZeneca from its vaccination programme in mid-April, more than 140,000 people were given the jab. Two cases of thrombosis were reported, one of which was fatal. Health authorities there cited “suspected rare but serious side effects” although they did agree with the assessment of the European Medicines Agency (EMA) that the benefits of the jab outweigh the risks.

The EMA, along with the World Health Organization, have repeatedly said that the benefits of being vaccinated with AstraZeneca outweigh the risks, including of getting infected with Covid-19. While acknowledging the potential development of blood clots, the EMA said this should be listed as a “very rare” side effect.

Just this month, though, Ontario in Canada also moved to suspend administration of AstraZeneca, saying the decision was made “out of an abundance of caution”. Throughout the entire country, at least 12 cases of blood clots were confirmed at the time out of more than two million doses administered doses, proving fatal in the cases of three women.

Such numbers stick in our brains, perhaps even triggering bouts of anxiety. Death is a serious matter, and even the possibility of death is unpleasant enough for most of us to avoid the thought of it if we can help it. We watch our diets and we try to exercise; we take our vitamins every day and if we’re diagnosed with an illness, we do everything in our power to ensure recovery.

The people who died of blood clots after receiving their jabs were all real people, with real families and friends who found themselves mourning a loss when they should have been celebrating a step forward in the fight against Covid-19. No one is dismissing their cases or saying that they don’t matter.

But as long as we’re taking numbers into consideration, let’s be fair and include other numbers as well. For example, 44 – the most Covid-related deaths our country has recorded to date in a single day. Or the total death toll, which passed 1,900 yesterday. Or the total number of confirmed cases in Malaysia, which is not so much inching as it is bounding its way towards 500,000.

Not too far away in India, daily deaths sometimes outnumber our daily cases. On May 12, the country’s official death toll topped 250,000 – more than half Malaysia’s total number of infections so far. Observers and health experts believe that even this massive figure is only the tip of the iceberg and that thousands of other deaths go unreported every day.

In Malaysia, we look at the data available on AstraZeneca and we worry. Many of the deaths linked to blood clots developed after administration of the jab were young people, healthy people, who should have had years more ahead. As it is, vaccine hesitancy is riding high – Khairy Jamaluddin, the minister in charge of the country’s immunisation programme, recently revealed that 8,000 people had cancelled their vaccination appointments after the government announced that AstraZeneca would be included in the portfolio of jabs. Most of them re-registered once the jab was made optional.

No one wants people to die of thrombosis, especially not those in the prime of their life.

But don’t forget that the number of young people contracting Covid-19 in the country is also on the rise. Health director-general Dr Noor Hisham Abdullah said in his first press conference in months on May 8 that Covid-19 variants have been identified as one of the factors behind the increase in number of infections among young people. He also spoke of worsening symptoms, and of growing admissions to the ICU.

The longer we wait, the higher the chances that we will end up catching Covid-19 from some source or another. In tandem with this will rise the odds of passing it on to friends or family members, despite our best efforts to follow health SOPs.

If we worry about Covid-related numbers, we should do so holistically. It does no one any good to latch on to one particular set of figures and to agonise over it in isolation without taking into consideration the larger context.

Sometimes, we cling on to the idea of a perfect solution to the problems in life, a solution with zero fallout. Unfortunately, most if not all of the time, there is no such thing. Covid-19 is a catch-22 situation. There is no perfect vaccine – even Pfizer, the model child in the vaccine family, does not provide 100% protection against the virus. But there is no way to guarantee that we will never be infected unless we hole up at home and cut off all interaction with the outside world for the foreseeable future.

In the end, each of us will have to make a decision. At its core, Covid-19 is a game of numbers, and there’s nothing for it but for us to pick ours and roll with them.