Lauding Selangor for aggressive Covid-19 tests, experts urge other states to follow suit

Health workers collect swab samples to test for Covid-19 at Dewan MBSA Paya Jaras Tengah, Sungai Buloh May 26, 2021. — Picture by Ahmad Zamzahuri
Health workers collect swab samples to test for Covid-19 at Dewan MBSA Paya Jaras Tengah, Sungai Buloh May 26, 2021. — Picture by Ahmad Zamzahuri

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KUALA LUMPUR, May 29 — Selangor’s free mass Covid-19 screenings were a constructive step in combating the pandemic, said health experts who recommended the tactic as a critical accompaniment to other steps such as lockdowns.

Since launching the scheme, Selangor has consistently been the state with the highest number of new Covid-19 cases reportedly daily, but this development has led to views that states without a similar programme were allowing undiagnosed Covid-19 cases to go undetected.

The medical professionals agreed with Selangor Mentri Besar Datuk Seri Amirudin Shari and state Covid-19 task force chairman Datuk Seri Dzulkefly Ahmad that repeatedly enforcing the movement control order (MCO) without supplementary steps such as increased testing, aggressive contact tracing and accelerated vaccination would yield limited and temporary results.

The doctors also concurred that drastic steps such as the MCO should only be to alleviate pressure on the overwhelmed public healthcare system and not be considered a solution to the pandemic.

Yesterday, the Prime Minister’s Office also announced a “total lockdown” of the country from June 1 to 14, during which all non-essential activities will be barred.

“They are intended to buy time for the health system to rest, while ensuring that other measures are built up, such as widespread testing with a short turn-around time and consistent SOPs with fair enforcement,” Dr Khor Swee Kheng, an independent health policies specialist, told Malay Mail

Echoing this was the former president of both the Federation of Private Medical Practitioners Associations Malaysia (FPMPAM) and Malaysian Medical Association (MMA), Dr Milton Lum. 

Dr Lum argued that without measures such as expanded testing, the MCO has limited potential as the government was adamant on allowing most economic activities to continue albeit with restrictions.

“Businesses can function, their capacity may be lowered but still there is movement of people, so a lockdown has to be accompanied by mass testing in those areas where there are a lot of cases.

“If we just have a lockdown and hope that it will go away, it is not going to happen. The approach taken by the Selangor government is the correct approach,” he told Malay Mail

Virtually no traffic is seen in Kuala Lumpur during the movement control order 3.0, May 11, 2021. — Picture by Ahmad Zamzahuri
Virtually no traffic is seen in Kuala Lumpur during the movement control order 3.0, May 11, 2021. — Picture by Ahmad Zamzahuri

According to Malaysia Medical Gazette managing editor Dr Khoo Yoong Khean, lockdowns without added public health measures were a “short-term solution to a long-term problem”. 

Dr Khoo added that unless increased testing and similar steps were adopted, each new peak of the Covid-19 infection curve would surpass the last as Covid-19 was now entrenched in the local community.

This view is supported by Malaysia’s current record for new Covid-19 infections that hit 8,290 yesterday. The previous peak in January was 5,728. 

“Lockdowns are the easiest to implement but take the hardest toll on the community. 

“So yes, I think doing mass testing, though it will spike our numbers up, is important to know the real extent of the outbreak. Only then can we implement proper countermeasures and policies,” he told Malay Mail

On May 8, the Selangor state government kicked off its free mass-screening exercise for all state dwellers to detect what Amirudin coined ‘silent carriers’ within the state, under the Selangor Public Health Action Plan. 

This led to Selangor contributing the highest number of new Covid-19 cases within Malaysia, and since May 9, a day after the mass testing started, the state has registered 31,505 new cases as of May 26. 

Amid rumours of the federal government imposing a nationwide lockdown earlier this month, Amirudin and Dzulkefly advised Putrajaya against doing so without simultaneously increasing testing and accelerating vaccination 

Then, after Selangor and KL were placed under the MCO on May 6 and May 7 respectively, rumours began to swirl that Selangor, with its soaring infection numbers, was being considered to be placed under a stricter, full-blown MCO with only essential services allowed to operate.

However, as Covid-19 case numbers continued to soar, Prime Minister Tan Sri Muhyiddin Yassin announced a nationwide MCO from May 12 to June 7, effectively removing the overlapping enforcement dates between states. 

Since the latest MCO, dubbed by many as MCO 3.0, daily Covid-19 numbers have repeatedly reached new heights.

On May 1, Malaysia had a total of 411,594 Covid-19 cases. As of yesterday, that number now stands at 549,514 or over a third higher.

Also, there have already been 1,046 deaths in the month to date, almost as many as all the losses of January, February, March and April combined.

A health worker conducts a Covid-19 swab test at Dewan PU7 in Puchong Utama May 22, 2021. ― Picture by Yusof Mat Isa
A health worker conducts a Covid-19 swab test at Dewan PU7 in Puchong Utama May 22, 2021. ― Picture by Yusof Mat Isa

Leading by example

Seeing the results of Selangor’s mass testing, the medical experts said this showed that other states must also take responsibility and ownership of their situation instead of waiting for cues from the federal government. 

Dr Lum said Selangor’s aggressive approach in weeding out “silent carriers” was commendable and should be emulated, instead of only relying on the baseline positivity rate of 5 per cent of tests conducted.

While he acknowledged that it would not be easy for larger states like Pahang and Sarawak, he stressed that any effort in this direction would be beneficial.

“You might not be able to do it in the entire state for some, but certainly they have to test in those areas where there is a high number of cases. 

“So yes, the other states should follow in Selangor’s footsteps,” he said. 

Dr Khoo concurred and said mass testing was critical in limiting the number of new infections, which would also reduce the risks of new variants developing.

What about vaccines?

As with many other global pandemics, the light at the end of the tunnel starts with the rollout of vaccines, but the medical experts expressed misgivings with the rate of Malaysia’s Covid-19 vaccination that has fallen behind schedule. 

Dr Lum said the National Covid-19 Immunisation Programme (PICK) was progressing far too slowly and must be urgently expedited.

“The vaccination numbers have to run ahead of the numbers of positive Covid-19 cases, but now the situation is it’s running behind,” he said. 

The low rate of inoculations has started calls for concentrated vaccination drives in areas with higher risk of infection, but Dr Khoo said this might end up overcomplicating things. 

He said the PICK was already convoluted with parallel programmes, such as the previously spun off AstraZeneca opt-in vaccination scheme.

Dr Khoo said adding too many initiatives could lead to a lack of focus.

“For critical areas, I think our tried and tested measures like testing, contact tracing, and isolation can help,” he said. 

Dr Lum was for the idea of targeting vaccines in areas of higher risk, however, and disagreed with suggestions that these could lead to perceptions of inequality.

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