KUALA LUMPUR, Feb 8 ― As Malaysia’s daily Covid-19 caseload continues to skyrocket, triggered by the Omicron variant, and with the Johor state election in sight, some Malaysians have started to fret over the possibility of another national lockdown despite the government’s assurances otherwise.

Yesterday, Health Minister Khairy Jamaluddin said the healthcare system was ready for the Omicron wave, and coupled with the relatively high number of booster doses administered, it was safe for the Johor state election to proceed, but in accordance with strict standard operating procedures (SOPs).

Malay Mail sought the opinion of several health experts, all of whom shared the same concern: that the non-compliance of SOPs by both politicians and the public could trigger an even bigger wave of Covid-19 infections than anticipated.

Attitudes and behaviour

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Galen Centre for Health and Social Policy CEO Azrul Mohd Khalib said that the recent state polls in Melaka and Sarawak indicated that Malaysia can conduct elections without a spike in cases of those requiring hospitalisation.

He, however, emphasised that despite the warnings, all election campaigns involve some form of physical gathering, where in all likelihood, SOPs will be selectively observed or ignored altogether.

“Politicians will want to be seen shaking hands, speaking without masks and glad-handing supporters. It is still retail politics; going house to house, ceramah sessions and pondok panas.

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“I would repeat the same thing that most of us have been emphasising: keep a distance, consistently wear face masks, use hand sanitisers, avoid closed and crowded spaces,” he told Malay Mail.

As for Malaysia Medical Gazette managing editor Dr Khoo Yoong Khean, he felt that the Johor state election could potentially be a cluster source or a superspreader event as there are opportunities for greater social interaction — from campaigning to voting day itself.

“During the election, likely a high number of elderly folks will be out as well to cast their vote, and as part of the high-risk population, they will be exposed to the risk of infection.

“We also must remember our children's vaccination has only just begun so their risk will also be increased with adults around them being exposed to Covid-19 as there are many intergenerational interactions in our community,” he said to Malay Mail.

Dr Khoo added that a high vaccination rate in Johor — ideally 80 per cent of the state population — would help mitigate some risks, but not all.

“With a high hospitalisation rate in the state, even a small cluster can overload local hospitals. So healthcare institutions must be ready for any spike in cases.

“This includes a quick response in contact tracing to break transmission chains and preparing for a surge in clinics and hospitals,” he said.

At the time of writing, a check on the Health Ministry’s CovidNow website showed that Johor’s vaccination rate for those with at least two doses of a Covid-19 vaccine currently stands at 80.8 per cent.

Not if but when

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah told Malay Mail that Malaysia will definitely see a surge in the number of Covid-19 cases after the Johor state election.

But he added that there might not be many serious cases as the majority of people have already completed their vaccination, and received a booster shot.

“Definitely, after the election, we are going to see a surge in numbers, but the severity and all might not be that bad seeing that everybody has gotten at least two doses and the booster dose. But then again, we still let our guard down.  

“I think what the Election Commission and Health Ministry should do is, as far as possible, encourage ceramah via social media and try not to have any contact — people attending ceramah, people shaking hands and being in large groups.

Dr Raj added that in situations where physical distancing and contact are unavoidable, then only allowing those who have been boosted to attend political events should be the way forward.

“There has to be very strict SOPs and not allow physical contact. And if there is any (occasion where) physical contact is unavoidable, they should only allow people who have already gotten the booster dose.

“The main thing is to not allow those who have not been vaccinated to attend all these political ceramah,” he said.

As for recommendations on how to reduce the threat of a bigger Covid-19 wave after the state election ends, Azrul said that the recommendations and SOPs are the same as they have always been and the problem is whether people — the public and politicians alike — will listen, understand and behave in a safe manner.

“Keeping a distance, wearing face masks, using hand sanitisers, avoiding closed and crowded spaces. Experience tells us that no amount of policing or enforcement is going to work unless people are proactive and supportive of these measures,” he said.

A firm hand

Dr Khoo said that authorities will need to set out clear guidelines for campaigning and also for the process of vote casting.

He also stressed that these guidelines must be non-negotiable, with severe punishments to follow if they are breached.

“These guidelines must be non-negotiable. Anyone, regardless of which parties, must adhere to these guidelines.

“Should anyone be caught breaking them, there must be appropriate penalties, even as far as barring them from running as a candidate, if we want them to take this seriously.

“Far too often we have seen in past elections some politicians breaking SOPs without any real punishment or remorse,” he said.

He added that campaigning should be conducted with as little crowd as possible.

“If there are political speeches or ceramah, attendance needs to be limited to ensure safe physical distancing and perhaps mandatory RTK testing before attending or giving speeches,” he said.

Dr Khoo suggested that a staggered voting system could help to control the crowd to reduce the possibility of the deadly virus spreading.

“I am not sure if legally it is possible but one suggestion is to break the voting day into two days, instead of one day, so crowd management will be more manageable,” he said.

Malaysia’s daily Covid-19 cases reached another milestone yesterday, after the Health Ministry recorded 11,034 new infections over a 24-hour period.

Johor registered 1,582 cases yesterday, making it the state with the highest number of infections after Selangor.

Khairy said the Health Ministry has sent several SOP recommendations to the National Security Council (NSC) for its consideration.

He offered his assurance that the Omicron variant is not the dominant variant in the community like the more deadly Delta variant and if Malaysians were to follow the SOPs and practise good hygiene, they can avoid another wave of infections despite a mass event like an election.

The Johor state election was triggered two weeks ago after caretaker Mentri Besar Datuk Seri Hasni Mohammad from Umno sought the dissolution of the state assembly despite still holding a one-seat majority, following the death of Datuk Osman Sapian who was the Bersatu assemblyman for Kempas.

The Election Commission is scheduled to meet tomorrow to decide the nomination and polling dates for Johor.