Covid-19: Medical experts call on govt to implement a more targeted MCO to prevent fourth wave of infections

‘The government has been urged to implement a more targeted movement control order (MCO) with mass targeted testing to prevent a fourth wave of Covid-19 infections. The Health and Sciences Covid-19 Advisory Group of Experts (EAG) said the government should prioritise mitigating the spread of the virus as it was no longer realistic to try and get infection rates down to zero. 

‘It said all resources must be focused on enhancing the implementation of targeted MCOs. It recommended that all MCO areas must fully employ the digitised find, test, trace, isolation, and support (FTTIS) system, which includes the proposed targeted mass testing strategy. "A highly targeted MCO will minimise economic disruption, on top of reducing the spread of Covid-19, balancing the wellbeing of both lives and livelihoods.

"State and district health authorities must be empowered to work with external experts and determine clear and transparent thresholds for when an area should be placed under MCO. The thresholds should be defined according to population density, number of cases, and geo-characteristics of the area, and communicated clearly to the public," it said in a statement on Sunday (April 25).

‘EAG comprises representatives from the Academy of Medicine of Malaysia, Malaysian Medical Association, Malaysian Public Health Physicians Association, and the Association of Private Hospitals of Malaysia, as well as two distinguished members of the medical fraternity. It is chaired by former director-general of Health and International Medical University chairman Tan Sri Datuk Dr Abu Bakar Suleiman.’

Read here (The Star, Apr 25, 2021)

Ground SOPs in science: The Academy of Medicine of Malaysia

‘The Academy of Medicine of Malaysia is troubled by the introduction of the Prevention and Control of Infectious Diseases (Exemption) Order 2021, which states that Cabinet ministers returning from official overseas visits must only quarantine for 3 days instead of the mandatory 10 days for inbound travellers. The Health Minister clarified that only Cabinet ministers who travel in a ‘bubble itinerary’ will undergo 3-day quarantine. Moreover, this move is intended to open up the economy as the policy will eventually be applicable to foreign dignitaries and business travellers.

‘We, the Academy of Medicine of Malaysia, wholeheartedly oppose the Exemption Order as well as any plans to extend the 3-day quarantine rule to other travellers.

‘We wish to remind the government that all standard operating procedures (SOP) must be grounded in science. The quarantine period for inbound travellers is set at 10 days based on research which shows that the risk of transmission is extremely low (~1%) after 10 days with monitoring and testing in place. The incubation period for Covid-19 is on average 5 to 6 days but can be as long as 14 days. Therefore, three days is insufficient to detect symptoms. There must be an evidence-based, public health explanation for the government’s decision to reduce quarantine days.

‘The effectiveness of so-called ‘travel bubbles’ are also still in question as new variants of Covid-19 with increased transmission capability spread rapidly around the world. There is insufficient data on the mutations to develop robust protocols for safe travel. We understand there is urgency to restart the economy for the benefit of Malaysians and businesses that are struggling, but this can only be done by bringing the pandemic under control first. The government must not open up our borders to ‘bubble’ delegations and risk bringing in new variants that could overwhelm our health system.

‘We call on the government to revoke the Exemption Order and—until there is scientific evidence that suggests differently—enforce a 10-day quarantine for all.’

Read here (AMM press release, Feb 10, 2021)

Health and economy will suffer if MCO lifted too soon

‘Noor Hisham is straight forward about what is required to lift the MCO – six conditions to be fulfilled of which three have already been satisfied. The Academy of Medicine Malaysia concurs with him...

‘Detailed guidelines for a return to the workplace are necessary as well as the readiness of both employers and employees to abide by them. If, for instance, it is a crowded workplace, social distancing of a minimum one metre will be impossible to achieve unless, say only half the workforce or less, goes to work. As many people as possible still need to work from home...

‘Premature lifting of the lockdown can be disastrous. Let us spend some thought and effort into deciding what the new norm is, set clear unambiguous guidelines by professionals with no political doublespeak, announce them, and wait for feedback before implementation.’

Read here (FocusMalaysia, April 28, 2020)