Masking up in schools: Why are some Malaysians debating about it
Singapore's stance, however, is that it might sanction targeted masking.
By Min Hari
As a new COVID-19 subvariant rears its head, Ilyani Shari finds herself thinking about how she will get her school-going son to mask up again.
"He's autistic. So, it's not easy to reason with him," the mother of three says. "But at the same time, I'm worried about him contracting the virus from school."
Ilyani's situation is not unique, of course. All over the country, parents are considering whether or not to make their kids don face masks again, following an uptick in COVID-19 infections due to the Arcturus subvariant.
Arcturus, also known as XBB.1.16, was first detected in Malaysia in March. And now, with daily COVID infection numbers coming in at about 1,000 a day, the country's Health Ministry is mulling if masks should become mandatory in schools once again.
The Malaysian Medical Association (MMA), however, believes such a move is unnecessary and believes it is more important for students to wash or sanitise their hands.
Yet, unsurprisingly, not everyone agrees. And a heated debate has played out on social media, with public health expert Dr Jemilah Mahmood, for one, labelling MMA's statement as "wrong" and "dangerous".
Essentially, the issue at the heart of it is Arcturus. While there is not enough evidence that it is more dangerous, it could be 1.2 times more infectious than the last major sub-variant, Kraken.
Clean hands and airborne threats
"The SARS-CoV-2 virus continues to mutate and evade antibodies resulting from infection or vaccination. As such, the rise in the number of cases is to be expected, particularly as mask-wearing is less common now," said epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud, who is also the government's COVID-19 Epidemiological Analysis and Strategies Task Force chairperson.
"If infections continue to stay mild and do not result in serious illness, then it will not cause hospitalisations to rise. However, the true picture is difficult to ascertain as tracking of infections has dwindled even as more people are getting infected or re-infected," he adds.
Health Ministry data shows that cases rose 0.6 per cent to 9,780, while hospitalisations increased by 9.2 per cent to 3,381 in the 14 days leading to 29 April.
Deaths caused by COVID-19, meanwhile, have also risen by 25 per cent, with public hospitals reporting current occupancy rates of 70.3 per cent, compared with 50 per cent on 22 April.
To better protect oneself, thus, Prof Awang says wearing face masks is the best option, especially in crowded indoor environments, as hand hygiene alone can't deal with an airborne disease like COVID-19.
"Masking is as important for children as it is for adults. We do need to remind children not to touch their eyes, nose or mouth, but more importantly, we need to teach them the correct way to mask up. As I said, COVID-19 is an airborne disease, so masking up with a good-fitting, high-quality mask is the best way to protect against infection," he said.
The role of vaccines
Importantly, Prof Awang noted that it is no longer possible to expect vaccines to protect against symptomatic infections as antibody levels tend to wane over time.
"(Furthermore) the current boosters being used in Malaysia appear to be monovalent, which is not as good as bivalent boosters," he said, citing a study by the New England Journal of Medicine.
For the record, bivalent COVID-19 vaccines — i.e. vaccines that work by addressing two different versions of the coronavirus, and which research has found to be more effective than monovalent vaccines — had been originally scheduled to arrive in the country earlier this year.
However, delivery seems to have been delayed, although the Health Ministry has recently stated that they were waiting for the Attorney-General’s Chambers (AGC) approval for the country’s procurement of the bivalent vaccine.
Hence, the epidemiologist's view that masking be made a priority.
"For the future, however, we really should be thinking of pan-coronavirus vaccines (vaccines that aim to address a cross-section of coronavirus strains), intra-nasal vaccines and vaccines which are specifically designed to induce cellular immunity," he adds.
A problem of enforcement
Dr M. Murallitharan, medical director of the National Cancer Society, meanwhile, believes masking up again will be challenging, especially given how society currently views COVID-19.
This is why targeted education and enforcement are needed to ensure the public, including students, have their face masks on in close quarters, for example.
"The problem and the challenge with masking up is there is very little social compliance and poor ability to enforce it. (So) keeping up the consistent messaging and driving consistent behaviour in hygienic practices is crucial," he said.
To be clear, the Arcturus subvariant has been detected in more than 20 other countries, including Singapore, India, Nepal, the United States, Australia and the United Kingdom. And a number of these are also weighing reintroducing previously commonplace restrictions.
Malaysia's southern neighbour Singapore in April experienced an increase in flu cases on top of a new COVID-19 wave.
Hence, the republic's health ministry's stance that it might sanction targeted masking, particularly in schools where multiple students fall ill with respiratory symptoms.
Datin Noor Azimah Abdul Rahim, the chairperson of educational group Parent Action Group for Education (PAGE) Malaysia, believes that responses to the Arcturus threat should not be a zero-sum game. Rather, masking and hand hygiene should go hand in hand.
"(Masking again) may need getting used to. It has now become a norm (not to don masks) and students must not let their guard down. And not just teachers, but students, too, should remind each other to take the necessary precautions," she said.
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