Prioritise Mitigation As Zero Covid-19 Cases Unrealistic: Experts

By CodeBlue | 26 April 2021

The Health and Sciences Covid-19 Advisory Group of Experts (EAG) moots highly targeted MCOs with comprehensive digital find, test, trace, isolation, and support (FTTIS) elements.

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KUALA LUMPUR, April 26 — A group of medical experts has urged the government to focus on mitigation measures to prevent a fourth Covid-19 wave in Malaysia, amid a surge of infections.

The country has reported more than 2,000 daily new Covid-19 cases in the past 11 consecutive days.

“After more than one year of living with Covid-19, the government should prioritise mitigating the spread of the virus as it is no longer realistic to try and get infection rates down to zero,” the Health and Sciences Covid-19 Advisory Group of Experts (EAG), which met Prime Minister Muhyiddin Yassin last April 21, said in a statement yesterday.

Mitigation means no longer using containment measures like the Movement Control Order (MCO), but to ensure that the health care system is not under pressure and to protect people from developing severe disease or dying from Covid-19.

CodeBlue reported that the intensive care units (ICU) for Covid-19 patients in both Sibu Hospital and Sarawak General Hospital have reached full capacity. Sibu Hospital, particularly, has been overwhelmed and forced to step down critical Covid-19 patients with poor prognosis from intensive care.

According to EAG, Covid-19 mitigation measures should focus on targeted MCOs with comprehensive digital find, test, trace, isolation, and support (FTTIS) elements. 

“Highly targeted MCO will minimise economic disruption, on top of reducing the spread of Covid-19, balancing the wellbeing of both lives and livelihoods.”

EAG also emphasised that state and district health authorities must be empowered to work with external experts, determine clear and transparent thresholds based on the population density, number of cases, geo-characteristics of the area, and precise communication to the public.

Besides that, EAG also suggested the government to conduct prompt and comprehensive surveillance through mass targeted testing using antigen rapid test kits (RTK-Ag) with quick test results.

“Current testing guidelines which still require fulfilling persons-under-investigation (PUI) and close contact criteria, may result in undetected sporadic cases in the community.”

EAG noted that technological advancements can be utilised for predictive risk modelling and assessment to identify Covid-19 hotspots and risk areas before an outbreak occurs.

EAG cited the wide population testing initiative carried out in Slovakia using RTK-Ag kits and other mitigation measures, which were able to decrease Covid-19 prevalence by up to 70 per cent in the country. 

Besides that, EAG also proposed to strengthen risk communication by providing clear explanations on the science behind Covid-19 measures to enhance the understanding of the public on matters such as the rationale behind the standard operating procedures (SOP).

EAG said that this will boost the trust of the public and ensure better compliance of SOP for a longer duration. 

“For example, the general public should have a better understanding of the risks of indoor dining and socialising in a confined space compared to visiting an outdoor Ramadan bazaar which abides by strict SOPs.”

EAG also highlighted the need to boost the Covid-19 vaccine rollout while combating vaccine hesitancy among the public.

“‘Pop-up vaccine registration and information centres can be established in high traffic public areas, such as Ramadan bazaars, shopping malls and office buildings, in collaboration with non-government organisations,” said the group of medical experts.

“Additionally, national community engagement programmes for encouraging vaccine registration and combatting hesitancy among vulnerable and marginalised populations such as the elderly, Orang Asli, migrants, and the digitally illiterate must be urgently expanded.”

EAG, chaired by former Health director-general Dr Abu Bakar Suleiman, is an advisory group comprising representatives from the Academy of Medicine of Malaysia (Dr Rosmawati Mohamed), the Malaysian Medical Association (Dr Mary Cardosa), the Malaysian Public Health Physicians Association (Dr Fadzilah Kamaludin), and the Association of Private Hospitals of Malaysia (Dr Kuljit Singh), as well as infectious disease physician Dr Christopher Lee.

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