Omnicron subvariants more contagious, public urged to stay vigilant
As a result, public health experts are urging Malaysians to remain cautious and adopt preventive measures similar to those practised during the peak of the pandemic, especially among high-risk groups.
Universiti Kebangsaan Malaysia community health specialist Professor Dr Sharifa Ezat Wan Puteh said subvariants such as LP.8.1 and NB.1.8.1 are more transmissible, although they do not appear to cause severe illness compared to earlier variants.
"These subvariants are classified as Variants Under Monitoring (VUM) by the World Health Organisation (WHO).
"If infected, the symptoms are generally mild, such as cough, cold, and low-grade fever, and most people recover within a few days.
"However, we cannot predict when a more severe variant might emerge, so it's important to continue self-monitoring and remain vigilant," she said.
Recently, both Thailand and Singapore have reported a sharp rise in Covid-19 cases.
Thailand recorded 65,880 new cases and three deaths between May 25 and May 30, while Singapore reported an estimated 14,200 cases from April 27 to May 3 —up from 11,100 the previous week — with 133 hospital admissions.
In Malaysia, Melaka reported a more than 20 per cent increase in Covid-19 cases last week, with 93 new cases recorded in Epidemiological Week 23 (June 1–7).
Dr Sharifa Ezat advised the public to wear face masks in crowded places, especially when travelling abroad, and to maintain good personal hygiene.
"High-risk groups such as individuals with comorbidities, the elderly, pregnant women, and children should be especially careful. Even common symptoms like a cough or mild fever can escalate in these groups," she added.
Meanwhile, Universiti Sains Islam Malaysia senior lecturer and public health specialist Dr Mohd Hafiz Jaafar, said increased public awareness has made it easier to detect Covid-19 cases.
"Additionally, recent activities such as school holidays and festive celebrations have contributed to increased movement and interaction.
"However, the overall impact does not appear to require widespread hospitalisation, as most cases involve only symptom management," he said.
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'Obese children may also develop sleep apnoea, a condition where breathing (repeatedly) stops (and starts) while sleeping. This can cause the right side of the heart to enlarge or thicken, increase pressure in the lungs and potentially lead to death during sleep,' he said, adding children also risk developing bow legs due to the stress of supporting their excess weight. LIFELONG OBESITY RISK The 2019 National Health and Morbidity Survey (NHMS) found that 29.8 percent of children aged five to 17 fall into the categories of overweight (15 percent) and obese (14.8 percent). On May 24, Deputy Health Minister Datuk Lukanisman Awang Sauni was quoted by the media as saying that, based on NHMS data, the prevalence of overweight and obesity among children is continuing to rise. 'For children under the age of five, the rate increased from 5.6 percent in 2019 to six percent in 2022. 'For adolescents aged 13 to 17, the prevalence rose from 28.5 percent in 2017 to 30.5 percent in 2022, indicating that one in three children is experiencing overweight or obesity issues,' he said. Pointing to the rising number of overweight and obese children in Malaysia, Dr Muhammad Yazid said if the issue is not controlled, they will add to the nation's overall obesity statistics in adulthood. 'Statistics show that 70 to 80 percent of children aged six to eight who are overweight or obese will remain obese as adults. Out of 10 obese seven-year-olds, only three will achieve a normal weight in adulthood,' he said. Excess weight results from consuming more calories than needed, often due to unhealthy eating and lack of exercise and physical activity, he said, adding that sleeping late or insufficient sleep can also contribute to obesity as tired children tend to feel hungrier during the day. 'When children lack sleep or have poor sleep quality, they eat more the next day due to fatigue. Like adults, they tend to choose sugary, high-calorie and fatty foods to regain energy. 'Even if they know the food is unhealthy, their brain is already wired to crave such food,' he explained. SEDENTARY LIFESTYLE IMPACT While genetics plays a role, Dr Muhammad Yazid noted that environment and habits matter more. He said studies show that if one parent is obese, the child's risk of obesity increases fivefold, and if both parents are obese, the risk goes up 13 times. 'Only a very small number – less than two percent – of obesity cases are due to genetic syndromes. Most cases are due to the environment (they live in) as obese parents tend to eat more and exercise less, and their children follow suit. 'In a study ('MyHeART') that we did, we assessed the fitness levels of teens aged 13, 15 and 17. Fewer than 10 percent were genuinely fit and less than 30 percent engaged in useful physical activities daily. 'Our calorie intake far outweighs calorie burn due to our sedentary lifestyle. Food is easily accessible… just order and it's delivered to your door,' he said, adding that another study has shown that Malaysian teenagers are generally not physically active. He also pointed out a lack of awareness about the importance of Physical and Health Education (PJK) classes in schools. 'PJK is often sidelined, seen as unimportant and frequently sacrificed for other academic activities. But that short session is the only chance some students have to exercise and sweat, which is vital for their health. 'After school, many kids just spend time on their gadgets and (online) games, staying indoors instead of going to the park or playing football or cycling. When we talk about this issue, (parents) will raise concerns about safety, unpredictable weather and other things. 'This is where local authorities and the government must play a role by providing safe and well-maintained recreational areas where local communities can exercise and participate in physical activities, thus fostering a healthier lifestyle,' he said. While the medical challenges of obesity are daunting, treatment options are available — though not without their own limitations. METFORMIN Rejecting claims that childhood obesity in Malaysia is only an urban issue caused by busy parents, financial status and access to food, Dr Muhammad Yazid said the situation has changed. 'In the United States, many obese persons come from low-income groups because healthy, nutritious and high-quality food is expensive. In contrast, in China, it's the wealthy who tend to be obese due to access to a wide variety of food. 'In Malaysia today, those with money can afford to eat a lot, while those without money eat whatever is available, regardless of whether it's healthy, high in sugar, salt or otherwise,' he said. Regarding appropriate weight-loss medications for children, Dr Muhammad Yazid said currently, no drug has been specifically approved for those under 12. He said metformin, a medicine to treat type 2 diabetes, has many side effects when given to children under 10, such as stomach ache, flatulence and discharge of oily stool. 'We can't give school kids this medicine as they may have an 'accident' in school and be teased by their friends,' he said. Dr Muhammad Yazid added that while metformin is 'not popular for children under 12, we will consider it in certain cases'. 'Metformin is used for type 2 diabetes and can be given to children aged 10 and above who show signs of insulin resistance or prediabetes. The aim is to reverse their health issues before they develop full-blown diabetes.' This medication is usually taken for up to a year for weight loss, but some patients may need to take it for more than a year to prevent extreme weight gain and their insulin resistance from worsening, he said, adding scientific data has shown that the use of metformin can reverse prediabetes in 50 to 70 percent of cases. LIRAGLUTIDE, BARIATRIC SURGERY Referring to a study conducted and co-authored by him together with several of the world's leading medical experts, titled 'Liraglutide for Children 6 to Less Than 12 Years of Age with Obesity – A Randomised Trial' ( ), Dr Muhammad Yazid said their research involved the use of liraglutide – an injectable medication suitable for obese children aged six to under 12, to help reduce their appetite. The study, published in 'The New England Journal of Medicine' in September 2024, found that treatment with liraglutide for 56 weeks, combined with lifestyle interventions, resulted in a significantly greater reduction in BMI compared to placebo combined with lifestyle interventions. 'Liraglutide tends to be more effective in children and youth than adults, with fewer side effects compared to other medications. We only prescribe it after all other weight loss efforts fail,' he said, adding that liraglutide costs about RM1,900 per month, making it unaffordable for many families. As for bariatric surgery, he said it is seen as a last resort for extremely obese children at risk of developing NCDs. However, it is not recommended for children who have not reached puberty due to potential disruption to growth. 'Currently, bariatric surgery is not performed on children unless under very specific conditions, usually in cases of extreme obesity where obesity-related diseases have started to develop. It can be done for adolescents who have stopped growing and entered adulthood,' he said. Bariatric surgery is performed to reduce the size of the stomach, making the patient feel full quickly even with small meals. However, it also reduces nutrient absorption, which can lead to nutritional deficiencies if not properly managed. 'Post-surgery, patients must continue to consult doctors and dietitians to ensure they get the right supplements. For instance, a lack of vitamin D can lead to osteoporosis, while vitamin K deficiency can cause bleeding and bruising. In the US, (there was a case of ) a patient (who) became blind after undergoing bariatric surgery due to a lack of vitamin A,' he said. RAMPANT SALE OF JUNK FOOD Beyond hospitals and clinics, the everyday environments children are exposed to – especially at school – also play a critical role in shaping their eating habits and long-term health. Sharing their concerns over the increasingly rampant sale of sugary drinks, snacks and fast food, including outside school gates, several parents interviewed by Bernama described the situation as a 'threat' to their children's health. Siti Balkis, 42, a government employee, said almost every day her children, particularly the two younger ones who are in primary school, would buy ice cream, snacks or 'jelly balls' (colourful jelly candies) after school as the street vendors are just a few steps away from the school gate. 'Every time after school, they want to buy something. It's hard to stop them because the stuff is right there in front of them. Children are easily influenced, especially by the bright and attractive packaging. 'Sometimes, we as parents don't even know what our children are eating because many different types of snacks are available in the market these days,' said the mother of four. Father of two Muhammad Saufi, 39, meanwhile, said the presence of vendors selling food high in sugar, salt and other additives outside school premises calls for stricter action from the authorities. 'The types of food being sold also need to be monitored because most of them are unhealthy. Kids may love the taste of these snacks, but they can have serious health effects,' he said, suggesting that schools work together with Parent-Teacher Associations and local councils to more closely monitor the sale of food outside school gates and promote healthier alternatives at affordable prices. As Malaysia grapples with the long-term consequences of childhood obesity, experts stressed that treatment alone is not enough. Early prevention, public awareness and stronger enforcement of regulations are crucial to breaking the cycle before it burdens the nation further. From sugar-laden drinks sold outside school gates to inherited risks compounded by sedentary routines, this issue demands urgent, multi-pronged actions – not just to manage weight but to safeguard the future health and productivity of the nation's younger generation. Tomorrow: Behind every overweight child is a hidden struggle – not just with their health but with their confidence, emotions and sense of self. In Part Three, we uncover the silent mental toll of childhood obesity. (This story was produced under the 'Communicating Noncommunicable Diseases' Media Fellowship by Probe Media Foundation Inc [PMFI], Reporting ASEAN [RA] and World Health Organization [WHO]. The views and opinions expressed in this piece are not necessarily those of PMFI, RA and WHO.)
