The Evolving Tawar Cluster — Boo Soon Yew

Four days of not knowing you carry the virus — four days of opportunity for the SARS-CoV-2 to spread to persons unsuspecting or who were unprepared.

It is sometimes perplexing when we try to comprehend and piece together information, what more if it is about a disease that can be right at your doorstep, or even next to you at your hospital bed!

That’s what happened in Penang last 13th Aug 2020 when news broke of a positive Covid-19 case in a private hospital who have since been transferred immediately to the Penang Hospital.

But the commendable way it happened was how the alert was sounded by the Kedah Health Inspector who had alerted hospitals (probably in the northern region) at 7.30pm on 12th Aug. And this was a reaction to the index case 9113, who would prove to be starter point of the Tawar Cluster which has since reached a total of 33 positive cases on 15th Aug after contact tracing was done.

Now back to our Penang case at the private hospital — it must be truly commendable of that establishment to take such proactive step, making the announcement in all languages via their social media. Plus undertaking immediate cleaning up and disinfection of the facilities affected.

And we just read on 16th Aug that they even had their medical team, all 59 of them, undergo home quarantine on top of putting them through the antigen test.

It was case 9129, the sister-in-law of index case 9113 that was warded in Penang for a leg wound infection on 7th Aug, well before case 9113 himself was detected on 11th Aug. Four days of not knowing you carry the virus — four days of opportunity for the SARS-CoV-2 to spread to persons unsuspecting or who were unprepared.

And that was what happened in Kedah, the primary location of this Tawar Cluster. Yet Penang was not spared as on 14th Aug, one day after the private hospital announcement, there was one case from Barat Daya (South West) district reported by the MOH. Many thought this was the same case 9129, a 56-year-old female, but it was not!!

The Barat Daya case was case 9149, a 58-year-old female. Finally it was explained that case 9149 was a visitor to case 9113 when he was in hospital. Question now is which hospital?

We know from chronology, case 9113 attended a funeral wake from 31st July to 1st Aug. He developed symptoms of chest pain and fever on 8th Aug (just 1 day after case 9129 was admitted to the Penang private hospital).. and was duly admitted. He was tested on 9th Aug, result came back positive on 11th Aug and subsequent close contact tracing activated. That’s when the Penang private hospital was also alerted.

However, case 9113 was in fact hospitalised initially in a private hospital in Kedah, who was detected together with case 9114 as they both had symptomatic screening done on them. These two cases were reported as part of only 3 local transmissions on 12th Aug. Case 9114 himself, the police officer, would soon be the index case of the Muda Cluster which currently has 3 positive cases as of 15th Aug.

This would be the very same private hospital in Kedah that would add on six cases to the Tawar Cluster — one patient and five staff.

What a difference these few days can make — from the point of not knowing one has the virus till the moment one knows! High infectivity, which prompted our DG to post the latest news on his Twitter handle at 12.45am on Sunday!

It was tested by our very own IMR (Institute of Medical Research) that the strain that infected some patients from the other Sivagangga Cluster had the D614G mutation, one known for its high infectivity. It would turn out to be a point mutation, a change of 1 nitrogenous base of the DNA which changes sequence of amino acids from Aspartic Acid to Glycine.

One small change, with enough time, creating so much effect and havoc! And things are still evolving as in changing, while you are reading this article.

May we in Malaysia show continued resolve to maintain our masking & social distancing, to do our part in breaking the chain! Plus observing our washing of hands regularly. Let us once again pull through this, together.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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