A response to health experts’open letter — Muhyiddin Yassin

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JAN 17 —Thank you for your open letter to me dated 7th, January 2021. Let me  express my appreciation that such an august group of professionals have  provided proposals, ideas and opinions related to the management of the  Covid-19 pandemic in Malaysia. 

As you may be aware, on 15th, December last year, I welcomed five  external health experts, all of whom are signatories to your letter, to share  their views and advice in a meeting with senior ministers and officials from  the government, with participation from the Ministries of Health (MOH),  Finance, Trade and Investments and Bank Negara Malaysia.

Tan Sri Dr Noor Hisham Abdullah, the Director-General of the Ministry of  Health, was able to respond to a number of points raised by the experts  and to confirm that many of the concerns raised and proposals made had  already been or were in the process of being addressed.

With respect to testing approaches, since June 2020, MOH has been  using RTK-Ag as a screening test in the community. At that time, we were  one of the first few countries in the world that had used the RTK-Ag as  screening test. The RTK-Ag test kits were evaluated by the National  Public Health Laboratory (NPHL) and the Institute of Medical Research

(IMR) to ensure compliance with the standards required, and later  approved by the Medical Device Authority (MDA) for wider use in the  community. 

In line with WHO guidelines, the RTK-Ag has been used as a confirmatory  result when prevalence of Covid-19 was noted to be high in certain areas  or populations. RTK-Ag test was used as a confirmatory test in Sabah  since 5th, October 2020. Furthermore, MOH has set up five (5) RTK-Ag  testing centres in Sabah to increase the capacity of the RTK-Ag testing.  Up to 14th, January 2021, a total of 365,740 RTK-Ag tests had been  conducted with positivity rate of 3.75 percent. This action had facilitated  MOH in managing the outbreak in Sabah. We were able to identify the  positive cases early, isolate and treat them and speed up contact tracing  activities to reduce the spread of the disease to the community.

In view of the Covid-19 outbreak among foreign workers, MOH has  worked together with SOCSO to conduct mass testing using the RTK-Ag  test. This enables us to detect positive cases early and isolate them, thus  curbing the spread of infection. Up to 13 January, 146,083 RTK-Ag tests  had been done for foreign workers under the SOCSO screening  programme, with 2.0 percent positivity rate and subsequent isolation. 

The laboratory capacity has been increased to an average of 60,000 tests  per day with the participation of private laboratories under strict monitoring  by MOH, employing both Polymerase Chain Reaction (PCR) and the  RTK-Ag tests. MOH is also researching alternative methods of testing, for  example, saliva testing and other new methods available in the market.

The MOH labs also routinely conduct testing to identify new variants of  Covid-19 strains in Malaysia, thus enabling MOH to further improve its management strategies.

Recently, the MOH has announced that all suitable Category 1 and 2  patients who are not high risk can self-isolate and be monitored at home  after a risk assessment is done to ensure the home environment is  conducive and suitable. 

Decanting patients to private hospitals will also help reduce the pressure  on public hospitals and protect the already heavily burdened healthcare  workers there. For a start, the Minister of Finance, the Director-General of  Health and other senior government officials have held a discussion with  senior management of private hospitals, owned by GLCs, to kick start the  decanting initiative. 

Yesterday, the Director-General of Health held another discussion with  senior management of other private hospitals via video call and attended  by almost 400 participants to start implementing the initiative. I am touched by the prompt support we have received from the private  hospitals.

Thank you for laying out in your letter the importance of an all-of-the society approach. Indeed, we have been pursuing this since the onset of  the pandemic almost a year ago. I agree that we must continue and, where  possible, enhance our efforts to engage with the communities, the  industries, the private sector and other key components of our Malaysian  society. Seeking ways to improve compliance with regulations in force for

the greater good of our people remains the key priority of my  administration, as does continuing efforts to improve prevention. 

As you are aware, with the strategies implemented during the second wave, we were able to flatten the curve and managed to reduce the daily  Covid-19 cases to a single digit for almost three months. However, with  the increased movement of people and poor compliance to the Standard  Operating Procedures (SOP) beginning with the Sabah state election, the  daily cases had increased again, following which a third wave was  declared on 20th September 2020. 

Since then, the cases continued to rise, forcing the government to take  more stringent measures such as the Proclamation of Emergency by the  Yang di-Pertuan Agong under Article 150 of the Federal Constitution,  which took effect from 11th January 2021 until 1st August 2021 to control  the spread of Covid-19. Pursuant to the Proclamation of Emergency, the  Yang di-Pertuan Agong has promulgated the Emergency (Essential  Powers) Ordinance 2021 which allows the government to manage the  pandemic more effectively.

As we continually consider these issues, I would like to welcome  nomination of representatives from the signatories of your letter to meet  with the Minister of Health, my Special Advisor on Public Health and  myself, together with the relevant senior officials. I would be open to listen  to your advice and ideas so that we can all collectively contribute to reduce  the number of infections and subsequent impact on the lives of the rakyat.  I agree to form a Health and Scientific Covid-19 Advisory Group which  will advise the government on matters related to Covid-19 pandemic

management, and I urge you to nominate suitable candidates to be  members of this advisory group.

Let me also address the final point in your letter and assure you that my  administration’s primary focus is on managing the nation’s response to  this pandemic and on mitigating the stark social and economic  consequences. I have called for, and will continue to call for, a collective  endeavour. 

I will continue to put aside politics, focus on working across society to end  this pandemic and shepherding the country through difficult recovery that  must follow. I appreciate your desire to support the government on this  and look forward to engaging with your representatives accordingly. 

*Tan Sri Muhyiddin Yassin is the prime minister of Malaysia

**This is the personal opinion of the writers and does not necessarily represent the views of Malay Mail.

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