The COVID-19 research team of the University of Macau (UM) has analysed the latest situation of epidemic prevention in Macao, stressing that the relaxation of anti-epidemic regulations is a necessary step to help the local community return to normality. Macao, like other cities, was impacted by the first wave of the Omicron variant. The resulting major changes have put a strain on the whole community and the healthcare system. While trying to adapt to the new normal, residents could be puzzled as to what to do when they and their families are threatened with getting infected with COVID-19. In such circumstances, the research team hopes that everyone stays calm and works together to combat the epidemic.

According to the UM research team, adhering to the zero-COVID policy for three years, Macao has been successfully protected against the most virulent original COVID-19 strain and its Delta variant, and has gained the time needed to prepare for the inevitable impact that comes after the relaxation of anti-epidemic regulations. During this period of transition, Macao’s epidemic prevention guidelines are continuously optimised according to the development of the national epidemic prevention policy. What is also important is for all the sectors of the local community to have a good understanding of the virus, good personal hygiene practices, vaccine supply, treatment experience, healthcare resources, medicine and related anti-infection product reserves, and distribution of epidemic prevention kits, and effective plans to countermeasure the challenges, which have collectively prepared Macao for the new progress of the epidemic.

Before the peak in COVID-19 infections, the number of cases will certainly surge and a significant increase in the number of recorded cases and hospital occupancy rates would be expected. However, according to the experiences of the vast majority of people infected with the Omicron variant, post-infection discomforts such as fever, pain, and cough can be treated effectively with the right medications, and patients usually recover within five to seven days. In fact, there have been cases of recovery of infected patients in Macao, with the earliest infected groups gradually recovering and returning to work. During home isolation, infected individuals should take appropriate personal precautions, maintain good home hygiene, and avoid unprotected contact with family members as much as possible. People who are infected should stay at home and avoid meal gatherings until they have fully recovered. They should also wear appropriate masks when going out, adhere to point-to-point travel, and avoid using public transport as much as possible. It is believed that increasing cases of recovery will help alleviate the overwhelming concerns about the infection and build confidence in handling the new situations among the general public.

Meanwhile, the data also shows that people with underlying medical conditions, the elderly, and those who have not been vaccinated are more likely to develop more severe symptoms such as shortness of breath, palpitations, and chest pain after being infected with the Omicron variant. The increase in the number of COVID-19 cases has indeed placed a heavy burden on the healthcare system. In this regard, the SAR government has established outpatient clinics for COVID-19 patients in the community setting to triage cases with mild symptoms who need to seek medical advice, thus reserving emergency and inpatient services for patients with more acute illnesses.

For this reason, the UM research team reckons that it is very important for the residents to make good use of the community outpatient clinics. At the same time, the government should step up the efforts to promote the use of the clinics and, depending on the changing needs, increase the service capacity and the number of clinics accordingly. The symptom-based triage measures and the appointment workflow should be continuously reviewed and optimised. Moreover, the public-private partnership with private healthcare facilities and the community pharmacy network should be further leveraged to make it easier for people with mild symptoms to seek medical treatment and obtain medicines.

Drawing on the experience of Singapore in its latest outbreak, the UM research team noted that: (1) The virus is constantly mutating, and the latest variant in Singapore is Omicron XBB.1. However, this wave of the epidemic was shorter than those caused by other strains, as the number of cases reached its peak more quickly and then declined more sharply; (2) The number of hospitalised patients increased significantly, but they were mainly people aged 70 or above; (3) Although people who are vaccinated and/or have a previous infection may not necessarily be immune to XBB.1, people with a previous Omicron infection were less likely to test positive in this wave than those without a history of infection; (4) Hybrid immunity (immunity provided by a combination of infection and vaccination) is more effective in reducing the number of hospitalised patients and deaths per capita. In addition, many countries like Australia are now facing the fourth wave of Omicron cases, which means that reinfection is possible and that the risk of reinfection with a new COVID-19 variant cannot be ruled out.

According to the UM research team, it is possible that COVID-19 infection will continue to affect people’s lives in the future although the impact is expected to gradually weaken. To maintain the normal operation of the city, it is necessary to continuously improve effective cross-sector measures, especially the care and triage services for the elderly in the high-risk group. The possibility of reinfection for people with an infection history is lower, and hybrid immunity offers more effective protection. In conclusion, the public should continuously maintain good preventive measures, utilise medical resources wisely, and, especially for the elderly, get vaccinated according to the guidelines for better protection even if they have already been infected. At the same time, wearing a mask properly and practising personal hygiene remain essential means to slow the spread of the virus and flatten the sharp increase of cases.