A 2,500 sq ft wall mural on Kuala Lumpur Klinik Kesihatan (KKKL) was launched in October 2020 as an homage to frontliners and top government officials leading Malaysia’s fight against the Covid-19 pandemic.
The two-part aerosol and wall paint artwork by Abdulrashade and Yaul Acap—respectively titled “Rasa” and “We Are Strong Together“—depicted then-Health director-general Dr Noor Hisham Abdullah, then-Prime Minister Muhyiddin Yassin, a masked female nurse with large eyes, as well as an elderly woman, a food delivery worker, and a mother looking tenderly at her child.
The giant mural was commissioned by the National Art Gallery and the Ministry of Health (MOH). But after the Madani government came into power, Malaysia’s Covid memorial of sorts to health care workers has disappeared—the wall was whitewashed.
Yaul Acap (real name: Dhiyaul Mohamad Ashraf Dawari), who painted the mural of Dr Noor Hisham and Muhyiddin, wrote that the mural couldn’t have been removed for aesthetic purposes because its colours were still vibrant when he saw it in October 2023.
“Before this artwork was erased, I was already aware about the act, so I’m not that shocked. But I really want to know why it was erased. I heard it had to do with political issues,” said Yaul Acap, in response to a person who posted in January 2024 about the disappearance of the entire two-part Covid-19 artwork.
“I had hoped that after the pandemic was over, the drawing would serve as an historical work, not political. But after three years, it was politicised,” he added. “So I started to think, do political powers have the ability to erase history? If yes, then is the history of Malaysia that we have been reading all this while 100 per cent true and accurate? Discuss.”
(The MOH did not respond to CodeBlue’s requests for comment on when and why the KKKL mural was removed.)
When I ask Dr Noor Hisham how he feels about the elimination of the Covid-19 mural, he says, “Over the years, the new government will negate whatever the previous government has done, regardless of party, or the new health minister will not continue the work of the previous health minister.”
We are at the second APIC-ADVA Asia Pacific Summit on Infectious Diseases and Immunisation in Singapore. Dr Noor Hisham, who retired in April 2023, joins current and former Health DGs from Singapore, New Zealand, and the Philippines in a panel discussion on lessons from the Covid-19 pandemic.
Curiously, Dr Noor Hisham doesn’t boast to the regional conference about how Malaysia had among the world’s fastest Covid-19 vaccination rates in 2021 that was even reported by Australian media. Instead, he mostly talks about outbreaks and lockdowns in 2020, the early phase of the pandemic before the brutal Delta wave hit Malaysia’s health care system like a tsunami.
“To say no to politicians is not easy, but you use facts, science, and data to say no to politicians. The challenge during the pandemic wasn’t only a health crisis, but a political crisis. Handling politicians is the greatest challenge as the DG of Health,” Dr Noor Hisham tells the conference in closing remarks, sparking laughter from the audience of mostly medical practitioners.
After the panel discussion, we sit down together and DG Hisham (as he was fondly known when he was Health director-general for a decade from 2013 to 2023) talks to me for about an hour about his reflections on Malaysia’s Covid response, five years on.
Dr Noor Hisham remembers the various politicians who attacked him during the Covid-19 pandemic or who pushed for things that he feels exacerbated the public health crisis.
He names them, one after another, like in Taylor Swift’s “Look What You Made Me Do”—the lead single off of reputation, a glorious revenge-fantasy album in response to her haters: I got a list of names, and yours is in red, underlined.
Teresa Kok.
Hannah Yeoh.
Lim Kit Siang.
Gobind Singh Deo.
Fahmi Fadzil.
Tiong King Sing.
These are mostly MPs from Pakatan Harapan (PH) that was in power, under Prime Minister Dr Mahathir Mohamad, when the first Covid-19 case was diagnosed in Malaysia in January 2020. The PH administration was replaced by the Perikatan Nasional (PN) coalition government under PM Muhyiddin a few months later in March, following the Sheraton Move.
Except for Lim (who retired from politics and did not run in the 15th general election) and Kok who remains a backbencher MP representing Seputeh, the rest are now ministers in Prime Minister Anwar Ibrahim’s administration. Tiong is from Gabungan Parti Sarawak (GPS).
“The Opposition became the government, the government became the Opposition. You are still the same—attack left, right, and centre. That’s the challenge—handling politicians from both sides,” says Dr Noor Hisham.
“They want to discredit the government of the day. It’s not me—nothing personal—but they want to discredit me and attack the government of the day. The government of the day used me to defend against the Opposition.”
The Opposition became the government, the government became the Opposition. You are still the same—attack left, right, and centre.
The former Health DG cites an argument by politicians over the concept of R0 (pronounced R-naught)—a mathematical term that indicates how contagious an infectious disease is. For example, a disease with an R0 of 18 means that an infected person will transmit it to an average of 18 other people.
“The Opposition questioned, ‘why use R0?’ I said, ‘the whole world is using R0.’ They said, ‘R0 is not accurate.’ So if you don’t use R0, what do you use? ‘K dispersion.’ Then I turned around and said, ‘can you explain to me what is K dispersion?’ They couldn’t explain.”
I can’t remember what on earth K dispersion is either.
“That shows that they just want to bring you down however they can. That’s the issue,” says Dr Noor Hisham.
Left: Health director-general Dr Noor Hisham Abdullah holds a press conference on Covid-19. Photo posted by Majlis Keselamatan Negara’s Facebook page on February 28, 2021. Right: Zero locally transmitted Covid-19 cases were reported in Malaysia on July 8, 2020. Photo from Kementerian Kesihatan Malaysia’s Facebook page.
The former Health DG says “we did well” early in the pandemic, pointing out that “zero” Covid-19 cases were reported on some days—until the Sabah state election on September 26, 2020, that saw politicians and party workers from the peninsula and Sarawak flooding the state during the campaign.
“They insisted—human rights—both sides. Teresa Kok brought this issue up, Hannah Yeoh also brought this issue up: ‘Election is a human right.’ The government of the day, same thing, also wanted to have. We said, ‘better not to have’, but they insisted because cases zero already. So what do you do?
“Obviously I said, ‘okay, if you want to have it, that’s fine. But you have to comply to SOPs.’ We didn’t have a vaccine or therapeutics, so we only had public health measures. But if you defy all the public health measures, you still congregate in crowded areas and confined spaces, you don’t put on your mask, obviously infection will spread.”
In just 10 days, Covid-19 spread from Sabah to all other states following the election. The MOH did not mandate a 14-day quarantine for people returning to the peninsula from Sabah, choosing instead to release people from home quarantine once results from their RT-PCR test at airports turned out negative.
“I feel very demoralised by them because you’re doing the right thing, but you’re being attacked just for political reasons. Very demoralising. You can’t satisfy both parties, but what we did—we followed science, facts, and data,” says Dr Noor Hisham.
A water cannon truck and Federal Reserve Unit (FRU) officers block more than 100 MPs from going to Parliament on August 2, 2021. Photos posted by Batu Kawan MP Kasthuri Patto’s X account @PattoKasthuri on August 2, 2021.
Dr Noor Hisham cites his controversial advice to suspend the final day of a special Dewan Rakyat meeting on August 2, 2021, triggering a march by more than 100 Opposition MPs to Parliament. Riot police prevented the legislators—who demanded Muhyiddin’s resignation as prime minister—from entering Parliament.
“I understand that the government of the day wanted the closure of Parliament so that there’s no confidence vote. I understand. But Parliament was not closed down because of that—but because there was an infection,” he says.
The former Health DG points out that 11 highly infectious Covid-19 cases were detected in the Parliament building with a cycle threshold (Ct) value of less than 15 after the special Dewan Rakyat meeting convened on July 26. (A low Ct value corresponds to a high viral load.)
The 11 Covid cases in the Parliament outbreak emerged on July 29. Dr Noor Hisham remembers the exact day—nearly four years later.
They want to discredit the government of the day. It’s not me—nothing personal—but they want to discredit me and attack the government of the day. The government of the day used me to defend against the Opposition.
“On Thursday, we swabbed everyone and it’s positive—Ct value less than 15, reported by IMR (Institute for Medical Research). What do you do? Close or not to close? A lot of people said, ‘don’t close, let the no-confidence vote take place first.’ But we made the decision and advised Parliament to close based on the evidence—because it’s a closed section,” says Dr Noor Hisham.
“Within two weeks, I was attacked left, right, and centre. Lim Kit Siang attacked me. Then Gobind Singh Deo said I faked the IMR report. Fahmi came on TV and said, ‘what hero are you talking about? This hero is playing politics.’ The government of the day did not support me. Not a word from them. Doesn’t matter; we closed Parliament.”
Dr Noor Hisham was summoned to a Public Accounts Committee (PAC) hearing on August 2 during the closure of Parliament. He duly complied, wearing a face mask and shield at the meeting.
“They questioned me. So I explained again. I was under a lot of pressure, as if I was doing the wrong thing.”
DAP’s mouthpiece The Rocket published an article on August 4, 2021, with the headline: “Health DG’s objectivity called into question”, including a graphic titled, “Is the Health DG acting on behalf of science or on behalf of Perikatan Nasional?”
But the former Health DG was vindicated after two weeks. A total of 102 people were infected because of the Parliament outbreak; these Covid-19 cases included the death of a political secretary to a deputy minister from Sabah.
“So in hindsight, we were right,” says Dr Noor Hisham.
“If we had not closed Parliament, I dare not think what will happen if more people—parliamentarians, most of them are 50 and above—get infected and many succumb. Who will be blamed? I will be blamed, if I had not closed Parliament.”
Dr Noor Hisham also remembers an “attack” from Tiong, then the prime minister’s special envoy to China, who accused him in Parliament in November 2020 of being scared of dying (“takut mati”). Tiong later apologised.
“I heard about it. I prepared myself. Then when the question came in during the PC (press conference), I answered it.”
I was under a lot of pressure, as if I was doing the wrong thing.
I ask Dr Noor Hisham if, upon reflection, he made wrong decisions in the pandemic response or if there was something he would have done differently.
“In hindsight, I only wish that I had full political support from both sides. The Ministry of Health would function at the optimum rather than for us to prepare to answer the questions and doubts created by the Opposition at that point of time.”
It’s mystifying why Dr Noor Hisham still seems aggrieved by the political attacks against him five years ago, considering that he got his way most of the time—putting the country under varying Movement Control Orders (MCO) for nearly two whole years.
For all of the perceived abuse he received from politicians, legislators on both sides of the divide supported brutal lockdowns against the people, even as a seemingly indefinite containment strategy produced diminishing returns and increased harms.
Politicians only cared when they were personally affected by being prevented from attending Parliament—not to fight back against one of the world’s “top doctors” by questioning his public health response, but to bring down a backdoor government.
Dr Noor Hisham was also adored nationally not as a mere DG, but as the General leading Malaysia’s war against Covid-19. It wouldn’t be a stretch to say that Tan Sri Hisham was the second most powerful person in the country during the pandemic after the prime minister.
But some hurts run deep, perhaps. Another Taylor Swift lyric comes to mind—from “Bad Blood”:
Did you think we’d be fine?
Still got scars on my back from your knife
So, don’t think it’s in the past
These kind of wounds, they last, and they last
Malaysia had no government for about two weeks in early 2020, after the Sheraton Move that saw Dr Mahathir resigning as prime minister on February 24, 2020. Muhyiddin was sworn in as his successor on March 1, 2020; his Cabinet was sworn in on March 10, 2020.
Dr Noor Hisham reveals that civil servants across ministries came together to make decisions in the Covid-19 response during that interim period without a government.
“Although there was no minister or politician, we spoke to the army, PAT (Chief of Armed Forces), the Ministry of Foreign Affairs—all the civil servants from the respective ministries,” he says.
“MITI (Ministry of Investment, Trade and Industry), for example, talked to the business community. Then we talked to Wisma Putra, we talked to the ambassadors. We engaged with China through Wisma Putra, as well as with all ministries. And also the police and army—they need to be informed on what to do and what not to do. Like, for example, we’re talking about lockdown, how to lock down, which area. All the implementation is not us—it’s them.”
When I ask if other ministries questioned the science behind lockdowns to curb an airborne respiratory infection, Dr Noor Hisham says, “Science is science. So MOH advised accordingly, based on the science.”
Left: Armed soldiers walk past barbed wire during a Recovery Movement Control Order imposed on the country. Right: An armed soldier and a police officer manning a roadblock during the Covid-19 lockdown. Photos posted by Majlis Keselamatan Negara’s Facebook page on July 27, 2020.
Malaysia’s Covid shutdowns were extremely long and harsh. A village in Tawau, Sabah, was put under an Enhanced Movement Control Order (EMCO) for nearly one month in April 2021, until residents successfully protested against another planned two-week extension of the four-week lockdown. Malaysians across the country flew white flags outside their homes in a desperate call for food and aid. I point out that some people were driven to starvation.
“The thing is—at that point of time, you don’t have a vaccine, you don’t have a therapeutic. So you need to strike that balance between life and livelihood. At that point in time, once you’re infected, that means it’s as good as dead,” Dr Noor Hisham replies.
“Every day, we had 500 dead bodies in the hospital, 400 to 500, in each hospital. Even the morgue in HKL (Kuala Lumpur Hospital) was congested. In [Tengku Ampuan Rahimah] Klang Hospital, at that point of time, bodies were on the ground, beds; there was no proper place. We had to loan a container to put the bodies. One container can fit 45 bodies. HKL had five containers; and you had to turnover in 24 hours.”
He says China’s lockdowns were worse than Malaysia’s. I point out that China could deliver food to their people.
“This is where we need to rehearse in terms of food distribution. Just like how floods happen every year, you have to prepare in terms of your reserve food for the people,” says Dr Noor Hisham. “It’s a whole-of-government and whole-of-society approach. Everybody has to play a role.”
The former Health DG reiterates that the point of lockdowns was to “buy time.”
“The lockdown was not permanent. We all believed that it was only a temporary measure. So our intention of the lockdown was to wear off the infectivity period. If the infectivity period is two weeks, if you can lock down two weeks, then we can actually control the infection.
“Many times, when we look into the spike, the projection—we put in AI, all accurate—infection was projected to increase in the next three to four weeks. But it did not happen. Why? Because action is being taken and then we blunt the rise of the cases.”
If movement restrictions were only meant to be temporary, why did Malaysia procure Covid-19 vaccines late? Malaysia signed our first agreement with Pfizer-BioNTech for its mRNA vaccine, also the country’s first Covid-19 vaccine deal, in November 2020.
Singapore, in comparison, signed its first deal for Covid-19 vaccines as early as June 2020—this was for Moderna’s mRNA vaccine. The island republic signed two more purchase agreements in August 2020 for the Sinovac and Pfizer vaccines.
Despite regulators in the United Kingdom, the United States, the European Union (EU), Singapore, and the World Health Organization’s (WHO) Covax Facility approving the Pfizer vaccine in December 2020, Malaysia’s National Pharmaceutical Regulatory Agency (NPRA) only gave conditional approval two months later in January 2021.
Singapore received Pfizer vaccines in December 2020, two months before Malaysia rolled out Covid-19 shots in February 2021.
“During the pandemic, we did not know which vaccine was more effective. Long-term data was not available. But we had no time. We can’t wait until we get the data. So we need to procure whatever vaccine we have first,” Dr Noor Hisham tells me now.
In hindsight, I only wish that I had full political support from both sides.
He struck a very different tone some five years ago, when he told the public that the MOH needed to wait for official clinical trial data. Despite Pfizer-BioNTech issuing press statements on November 9, 2020 and November 18, 2020 about the interim and final analysis of the effectiveness of their Covid-19 vaccine from a Phase Three trial (final results showed 95 per cent vaccine efficacy), Dr Noor Hisham expressed reservations multiple times about approving the shot.
In December 2020, he even told the media that he wanted to wait for three months’ use of the Pfizer vaccine in the UK that had authorised it for emergency use. “In Malaysia, we will not make any exceptions to use the vaccine for emergencies. This is to ensure the safety of all,” Dr Noor Hisham was quoted as saying.
When I point out his reluctance with the Pfizer vaccine then, Dr Noor Hisham says, “Not Pfizer—AstraZeneca, because of the issue of clots.”
He adds that he was the second person in Malaysia to be vaccinated with Pfizer, after the prime minister.
“We realised that after six months, the waning of antibodies with the Chinese [Sinovac] vaccine was faster as compared to Pfizer and Moderna. So we did a study—if you give a booster with the Moderna or Pfizer vaccine, then the antibodies last longer.”
Dr Noor Hisham—who was appointed last year as adviser to the Sarawak state government for health autonomy under the Malaysia Agreement 1963 (MA63)—is a senior consultant surgeon in breast and endocrine surgery. I ask if he had any challenges leading Malaysia’s Covid-19 response, given that he doesn’t have a background in public health or infectious disease.
He highlights key officials in other countries who were also surgeons managing the pandemic, such as Dr Mike Ryan (trauma surgeon), executive director of the WHO’s Health Emergencies Programme and Prof Dr Kenneth Mak (surgeon in hepatobiliary and pancreatic surgery), Singapore’s Health director-general.
“Surgeons make fast decisions; we don’t sit on it. If you sit on it, the infection will continue to spread. You have to make decisions, rightly or wrongly,” says Dr Noor Hisham.
“For example, the closure of Parliament—I had to make that decision, rightly or wrongly. If data shows that there’s positive cases, obviously it’s right. But if I closed Parliament without the data, I’m already a sitting duck. The next government that comes in, the first thing they’ll do is kick me out of office. But they did not because they know I’m right.”
DG cannot say, ‘I don’t know; yes also can, no also can.’ Then no decision will be made. All the ministries, police, and army are all waiting for your decision.
I tell Dr Noor Hisham that a surgeon cuts out tumours, but a virus can’t be killed that way. He replies that surgery isn’t about “cutting out everything”, but about deciding whether to operate in the first place.
“A good surgeon knows when not to operate. A junior surgeon operates on everything, but a senior surgeon knows when not to do it.”
Surgeons tend to think in black and white, but public health is a grey area. Covid-19 was a novel pathogen; public health measures in Malaysia and around the world frequently changed—in dizzying confusion—as scientists learned more about the virus.
“Yes it’s grey, we understand, but you still need to make decisions,” says Dr Noor Hisham. “I understand the grey area in terms of the incubation period—it’s all grey area—but you need to make a decision, yes or no.
“DG cannot say, ‘I don’t know; yes also can, no also can.’ Then no decision will be made. All the ministries, police, and army are all waiting for your decision.”
Under the Madani government, the Dewan Rakyat passed the Prevention and Control of Infectious Diseases 2024 amendment bill last October—legislating wide and arbitrary powers for the Health director-general to literally issue “any directions in any manner” to individuals or groups for managing infectious disease outbreaks. Contravening the DG’s directions is a criminal offence.
So, despite the way politicians slammed the closure of Parliament as a “black spot” on the country’s legislative history, these same MPs went on to codify powers for the office of the Health director-general that will enable this person to legally repeat Dr Noor Hisham’s actions in 2021.
The 2024 amendment Act also authorises the use of “force” (read: arrest) and tracking devices to enforce isolation (read: detention) or surveillance, for an indeterminate period (read: indefinite), of individuals suspected of being infected (read: arbitrary).
“I don’t think anyone—be it in the past, present, or future—ever expected that there would come a day when Malaysian Members of Parliament are prevented from going to Parliament,” DAP veteran Lim Kit Siang said on August 2, 2021.
Three years later, MPs voted to whitewash the “black spot” on Malaysia’s democracy—just like the wall of KKKL that once documented the now-forgotten battle by government leaders, frontliners, and ordinary citizens against Covid-19.
Dr Noor Hisham is the anti-hero of this story—vilified for doing the right thing because of the pandemic paradox, in which public health success was achieved when something (catastrophic) didn’t happen as a result of actions taken to prevent that outcome that nobody could see. Because nothing happened.
CodeBlue editor-in-chief Boo Su-Lyn spoke with Dr Noor Hisham at the sidelines of the 2nd APIC-ADVA Asia Pacific Summit on Infectious Diseases and Immunisation on February 11, 2025, in Singapore. This article is part of a special CodeBlue series marking the fifth anniversary of the World Health Organization declaring Covid-19 as a global pandemic on March 11, 2020.
