KUALA LUMPUR, May 28 — A doctor who screens Covid-19 patients said another physician cancelled her facial appointment upon learning that she worked in a hospital because she was considered “high-risk”.
The 33-year-old doctor working at a public hospital — who had been scheduled to receive a hydrocortisone shot for acne before her appointment was cancelled last month — disputed the Ministry of Health’s (MOH) assertion that frontline government health care workers were a high-risk group for Covid-19.
“How do you know among the general population there’s no Covid?” the doctor told CodeBlue on condition of anonymity.
“I would say we are at risk, but we wear PPE (personal protective equipment); they all don’t.”
Paediatricians have slammed the Women, Family and Community Development Ministry’s post-Movement Control Order (MCO) Covid-19 guidelines for taska that proposed isolating frontliners’ children from other children at day care centres, as they were considered “high-risk” of getting infected by their parents. The guidelines also claimed that the safest place for frontliners’ children to receive care was at home. Nurseries normally take in children aged below four.
Health director-general Dr Noor Hisham Abdullah, however, maintained Tuesday that MOH frontliners had a high risk of Covid-19 infection, as he cited guidelines from the United States’ Centers for Disease Control and Prevention (CDC) on child care programmes.
According to CDC guidelines: “If possible, child care classes should include the same group each day, and the same child care providers should remain with the same group each day. If your child care program remains open, consider creating a separate classroom or group for the children of healthcare workers and other first responders. If your program is unable to create a separate classroom, consider serving only the children of healthcare workers and first responders.”
A 35-year-old doctor from an MOH facility — who is part of the Covid-19 sampling team that screens high-risk individuals — pointed out that the tone of the Women, Family and Community Development Ministry standard operating procedures (SOP) for child care centres differed significantly from the US CDC guidelines.
“From the SOP in Malaysia, it is clearly stated we are again a high-risk group, hence we should segregate our children and if possible, not sending them to taska because we might spread the disease to others,” he said, on condition of anonymity.
“In US, the tune is totally different — we realise you need support, we will prioritise the HCW (health care workers) first, and to minimise risk of infection from others, we will give special attention to the HCW kids, because we cannot afford to have HCW working in distress or isolated to take care of their children if the kids are infected from others.”
The government doctor told CodeBlue that he sends his six-year-old daughter to a taska, whose owner is “thankfully, very understanding”.
He also said despite the risk of frontliners’ exposure to positive Covid-19 patients, the likelihood of getting infected is significantly reduced once they don protective gear, and practice safe distancing and hand hygiene.
“By doing so, the risk is definitely as equivalent as us staying at home, not going out!”
The frontliner urged health care workers to issue a strong statement to dispel the narrative of the Women’s Ministry’s taska SOP that they were a high-risk group.
“The nation should unite and give utmost support to the frontliners, including giving priority and special attention to take care of their children, so they can continue serve and fight Covid-19 without fear and with full support, not to discriminate and view the frontliners and their children as Covid-19 carriers and high-risk.”
Anonymous MOH frontline health care worker
Another doctor — who treats Covid-19 patients at an MOH hospital and has two young daughters aged over three and one — said besides following strict SOP like wearing PPE and practicing frequent hand hygiene, trained health care workers also take repeated showers after managing Covid-19 patients or patients-under-investigation.
“Most of us shower again after a shift before going home and take another shower at home before exposing ourselves to our family. We change into the hospital scrubs at work. I even have a separate set of shoes that I change in the car before going back home,” the 37-year-old doctor — who sends her eldest child to preschool — told CodeBlue on condition of anonymity.
She also questioned of all the children with Covid-19 in Malaysia, how many were offspring of health care workers and had been infected by their parents who contracted the disease at work.
MOH reported last May 16 a total of 317 positive Covid-19 cases among children aged 12 and below, comprising just 4.6 per cent of the country’s total 6,872 cases.
“The current SOP by the Women’s Ministry will only increase discrimination against the HCWs, and it almost sounds like our kids are not welcomed.”
Anonymous MOH frontline health care worker
“I am not sure as how the individual child care centres are going to interpret this,” said the government doctor.
“I think the narrative of the SOP needs to be corrected and support should be given to the frontliners so they can continue to serve and fight Covid-19, without the additional stress from discrimination and worrying about their children being treated differently.”
Dr Kevin Ng, chairman of the Malaysian Medical Association’s (MMA) SCHOMOS (a section supporting housemen and medical officers), highlighted a UK paediatric register’s reviews of various studies that found children appeared to be significantly less likely to acquire Covid-19 than adults when exposed to the coronavirus. South Korea, for example, with widespread community testing, only recorded a minority of cases in children at 5 to 6 per cent.
“Whilst we cannot be certain until we have the results of widespread, high-quality sero-surveillance studies, it seems increasingly likely that there are comparatively few children with Covid-19 disease in the community, particularly younger children (<10 years),” Alasdair Munro wrote.
Munro concluded, based on several studies, that children were rarely the index case in a household cluster and studies have yet to show evidence that infected children were any more contagious than infected adults. It was also unclear how likely an infected child was to transmit the infection, compared to an infected adult.
“As HCW frontliners, we are probably the most trained and also the most careful with regards to the safety of our children. We take so many precautions and are hyper-vigilant with regards to bringing the diseases back home,” Dr Ng told CodeBlue, commenting on the Women’s Ministry’s taska SOP.
“There should NOT be any need for this blatant discriminatory action against the families of the heroes on the frontlines.”
Dr Kevin Ng, SCHOMOS chairman
Consultant paediatrician Dr Musa Mohd Nordin cited MOH’s report last April 23 that 325 health care workers had tested positive for Covid-19, but 70 per cent had acquired the coronavirus outside MOH facilities. Only 1.7 per cent were infected in the hospital. MOH also said none of its health care workers had been infected from managing confirmed Covid-19 patients.
“This is NOT much different from the national positive rate of 1.5 per cent,” Dr Musa said.
He cited much higher Covid-19 infection rates among health care workers in other countries, such as the US (19 per cent), the United Kingdom (30 per cent), and Spain (13.6 per cent).
“The CDC and UK discriminatory policy on child care is therefore understandable since 19 to 30 per cent of their HCW is Covid positive. MOH is only 1.7 per cent. Why is MOH blindly following and copy/ paste CDC child care policy? It is most unfortunate that MOH is ignoring its own data and our national Covid context,” Dr Musa told CodeBlue.
“All our kids of frontliners, for example HCW, askar, Bomba etc, now are stigmatised. This is like HIV played all over again!”
