Time To Move On From Lockdown-Like Restrictions And Embrace The Future — Dr Sanjay Rampal & Dr Victor Hoe

Elevating our public health system to the next level will help us be more resilient and manage pandemics more efficiently and effectively.

Now is a very challenging time for all of us, with a need to balance health and the economy. The Klang Valley has been under lockdown-type SOPs for the past 14 weeks, which has led to increased stress and anxiety among the rakyat. Even after 14 weeks of sacrifice, the virus persists, and we have still not realised the containment of the disease. 

Lockdowns of communities, schools, and businesses are not a sustainable long-term intervention. As the World Health Organization (WHO) stated, “Lockdowns are not sustainable solutions because of their significant economic, social & broader health impacts”. It should be used at high intensity for short periods, during which longer-term public health measures are developed and implemented.

The use of lockdowns for long term prevention of Covid-19 is akin to using a sledgehammer to kill a mosquito.

Why Have The Lockdowns Not Produced The Desired Results?

The current lockdown-type SOPs are aimed at community quarantine and movement restriction. Physical business establishments and schools have been closed for long periods during this pandemic.  However, due to the incomplete nature of the lockdown, the disease continues to spread in the community.

Restrictions and SOPs by themselves do not prevent transmission. It is the people complying with SOPs that reduce the daily reported cases. Individual-level SOPs should remain.

The current community quarantine and movement restrictions may be relaxed. The intense movement restrictions (roadblocks) have failed due to a combination of sustained local community transmission of disease, dense urbanised, interconnected metropolitans, and community fatigue. 

We Must Stop And Rethink The Future

Those who must stay at home and those required to continue going to work have both suffered equally during this current wave. Those who work on-site may get infected and bring home the infections to loved ones.

In comparison, those who must stay at home may suffer from loss of income and livelihood. There is an increase in the risk of mental health issues in both groups.

Effective and efficient public health measures are important to control the outbreak. This includes effective case identification, case notification, contact tracing, isolation and quarantine measures, and risk assessment and preventive control measures.

However, the sudden rise in cases and a public health care system without reserve capacity has resulted in sustained Covid-19 transmission in many states. 

It may be more cost-effective for the nation to permanently augment its public health care and hospital services to reduce the need for future lockdowns. We must rethink the public health care system, using technology to our advantage. The current crisis has accelerated the migration to mobile technology. 

Our MySejahtera has evolved since it was introduced more than a year ago. The adoption was slow to start with, likely due to a lack of trust. People were afraid that spatial tracking would reduce individual liberty and lead to a nanny state.

However, after one year, MySejahtera is almost second nature to one’s movement; we never leave home without it. With its latest updates, MySejahtera has integrated part of the public health services like case notification, contact tracing, and monitoring of isolation and quarantine.

This is promising as it increases the likelihood of us living with the disease without having any further large-scale lockdowns. The next step would be the development and adoption of an automated real-time system to identify and quarantine close contacts.  

It is time to move on from the current lockdown type restrictions. Elevating our public health care system to the next level will help us be more resilient and manage the current and future pandemics more efficiently and effectively.

Dr Sanjay Rampal is Professor of Epidemiology and Public Health and Dr Victor Hoe is Professor of Occupational and Public Health at University of Malaya.

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

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