Covid-19: In the face of rising cases, Malaysian health experts say better compliance and enforcement much needed

Health workers in protective suits are seen conducting Covid-19 testing in Kuala Lumpur. — Picture by Firdaus Latif
Health workers in protective suits are seen conducting Covid-19 testing in Kuala Lumpur. — Picture by Firdaus Latif

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KUALA LUMPUR, Oct 3 ― Public non-compliance, lax attitudes, fewer reminders and ignorance are some of the reasons Malaysia is seeing a rise in Covid-19 cases, say health experts polled by Malay Mail.

Despite the virus being initially concentrated in states like Sabah and Kedah, new clusters are emerging in other states like Selangor and Kuala Lumpur as a result of individuals returning from Sabah or elsewhere.

The last time Malaysia had cases in the single digit was on September 6. Since then, cases have been in the high double or triple digit range, giving credence to the fact that Malaysia is now experiencing a second wave of Covid-19 infections.

The Ministry of Health (MOH) only made it compulsory for all returnees from Sabah to be tested for Covid-19 at the airport from October 10.

Then there are Defence Minister Datuk Seri Ismail Sabri Yaakob’s briefings and statements which show high numbers of arrests daily for breaking recovery movement control order (RMCO) rules.

“It’s as if they have forgotten that the virus is still out there and can threaten their lives,”said Dr N. Ganabaskaran, former president of Malaysia Medical Association (MMA).

“I see old people hugging each other, others holding hands, fist bumping and so on. All this should stop. Even elbow knocks shouldn’t be done as you can still contract the virus from the touch.

“MOH is doing a great job in handling the outbreak but I feel the people need to be reminded on a daily basis on television and radio that the virus is still out there and is dangerous if you do not comply to the new norms,” he added.

Dr Ganabaskaran said that he noticed standard operating procedures (SOPs) at many eateries are poor. Many patrons are entering these places from various entrances instead of a stipulated single entryway so that they can be temperature checked and their details taken down for contact tracing.

He urged the government to be stricter with their regulations and also to reveal the type of punishment meted out.

“Let it be public knowledge for example, if a restaurant has too many patrons and no SOPs in place the authorities can possibly force them into closure.

Former MMA president Dr N. Ganabaskaran urged the government to be stricter with their regulations and also to reveal the type of punishment meted out. — Picture courtesy of Malaysian Medical Association
Former MMA president Dr N. Ganabaskaran urged the government to be stricter with their regulations and also to reveal the type of punishment meted out. — Picture courtesy of Malaysian Medical Association

“We must remember that the vaccine is still a long way away and even when it’s there, we may only get 20 per cent for ourselves. Which is not a lot if there are many cases,” he added.

Putrajaya called for a movement control order (MCO) to be imposed in March and subsequently called for another four MCOs till May 3. Then a conditional MCO (CMCO) was put in place from May 4 till June 9. After that followed a recovery MCO (RMCO) which will last till the end of the year.

During the RMCO, a wave of reopenings were allowed without significant ill effect. People went to movies, dined at restaurants and started working from offices again.

MOH reduced their daily briefings to thrice a week, as did the defence minister’s press conferences.

Dr Ganabaskaran said maybe MOH should start having daily briefings again so the public can start becoming more vigilant.

“Let the people see them on TV or radio... even if it's for five minutes... as a reminder that this matter is serious since many seem to be taking it easy right now,” he added.

New MMA president Professor Datuk Dr M. Subramaniam told Malay Mail the next two weeks could be crucial to prevent cases from rising. He too agreed with his predecessor that public compliance has been poor since restrictions were lifted.

“MMA fully supports the Health director-general’s call for the people to avoid unnecessary trips to public places to help reduce the risk of infections spreading.  

“We also urge more companies to encourage more staff to work from home where possible and be stricter about SOPs at the workplace. We all need to do our part,” Dr Subramaniam added.

“It must also be noted as well that the RO or R-naught as a whole in Malaysia is now at 1.25. MOH had stated that the critical value of RO in the country is 1.6. In Selangor the RO is currently at 1.95 compared to September 15 when it was at 0.80,” he explained, referring to the rate of infection.

“This is how fast cases can spike. It has already surpassed the critical level in Selangor and if the RO continues to rise further to more alarming levels, the government may have no option but to enforce an MCO until we flatten the curve again,” he said, adding that the RO was at 3.55 before the MCO was enforced on March 18.

These sentiments were echoed by Dr Helmy Haja Mydin, a respiratory specialist from Pantai Hospital Kuala Lumpur.

Dr Helmy said compliance as well as the messaging to the public should be across the board.

“We have sufficient restrictions and regulations in place but the key variable is implementation across the board.

“There should be no difference between individuals when it comes to complying with SOPs. The messaging also has to be consistent across government ministries.

“A lackadaisical approach by some is what got us into this new wave in the first place,” said Dr Helmy.

According to Dr Khor Swee Kheng, who is part of support group Malaysian Health Coalition, MOH is doing a great job in containing the virus.

He, however, feels there should be no political interference in the fight to combat the pandemic and also felt that the public's approach to safety has been left wanting of late.

“It is crucial that MOH receives political support and is completely free from inappropriate political interference. This must happen for the entire duration of the pandemic, not just the first few months,” Dr Khor added.

“Public compliance to the SOPs has generally been good, although there are no accurate ways to measure compliance on a 24/7 basis.

“But public compliance alone is not adequate, and must be accompanied by consistent and equal enforcement, more coherent inter-ministry decision-making and other public health measures.”

Malaysia hit its highest number of cases yesterday at 287 after months of double or single digit infections.

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