MOH Malaysia lists six criteria for lifting MCO and help develop a ‘soft landing’ exit strategy

The Ministry of Health Malaysia (MOH) has listed six criteria to lift the MCO and help achieve a ‘soft landing’ for the nation amidst the Covid-19 crisis:

1. Strict border control: “If we open our borders then people will start coming in and there’s a big possibility they may have the virus.”
2. Single-digit number of cases: Only when cases start to fall in the single-digit can the government seriously consider lifting the MCO
3. Having a good health system and improving testing standards: Look carefully at e.g. (a) testing capability of labs (b) if we have enough wards and intensive care units. Raise the detection standards from say 48 hours to 24 hours or less.
4. Capability to look after high-risk groups — the handicapped, elderly, and those with co-morbidity illnesses, including patients receiving hospital treatment like chemotherapy
5. (5) Adherence to new social norms: “Putrajaya needs to study this and instil in Malaysians’ minds that following social distancing, washing hands frequently and avoiding crowding around each other is the way to go moving forward.”
6. (6) Community cooperation in infected areas: Identify infected areas and get their communities to work with MOH and the relevant authorities to make sure the virus doesn’t spread again.

Read here (The Malay Mail, April 21, 2020)

Characteristics of health care personnel with Covid-19: A US CDC profile from Feb 12 to Apr 9, 2020

What is added by this report? ‘Of 9,282 US Covid-19 cases reported among HCP, median age was 42 years, and 73% were female, reflecting these distributions among the HCP workforce. HCP patients reported contact with COVID-19 patients in health care, household, and community settings. Most HCP patients were not hospitalised; however, severe outcomes, including death, were reported among all age groups.

What are the implications for public health practice? ‘It is critical to ensure the health and safety of HCP, both at work and in the community. Improving surveillance through routine reporting of occupation and industry not only benefits HCP, but all workers during the COVID-19 pandemic.’

Read here (US CDC, April 17, 2020)

WHO's new strategy update outlines six factors for countries as they consider lifting restrictions

1. First, that transmission is controlled; 
2. Second, that health system capacities are in place to detect, test, isolate and treat every case and trace every contact;  
3. Third, that outbreak risks are minimised in special settings like health facilities and nursing homes; 
4. Fourth, that preventive measures are in place in workplaces, schools and other **places where it’s essential for people to go; 
5. Fifth, that importation risks can be managed; and 
6. Sixth, that communities are fully educated, engaged and empowered to adjust to the “new norm”

Read here (WHO, April 16, 2020)

‘Kerala model is nothing but focus on education and welfare’

This opinion piece covers (1) what Kerala did right in fighting coronavirus? (2) Kerala model: Left, right and centre (3) Kerala sticks to WHO guidelines & executes them efficiently (4) No time for political one-upmanship

Read here (The Quint, April 15, 2020)

Infectious Diseases Society of America (IDSA) issues guidelines on the treatment and management of patients with COVID-19

The IDSA have issued 7 recommendations on the treatment and management of COVID-19 patients. These are part of their aim to “develop evidence-based rapid guidelines intended to support patients, clinicians and other health-care professionals in their decisions about treatment and management of [these] patients.”

They recognise the limitations imposed by “the understandable urgency in producing, synthesising and disseminating data during the current pandemic”. In the rush to publish, there has been (1) circumvention of usual research steps (2) limited peer-review process and (3) increased potential for publication bias (in the interest of showing promising data and in the race to achieve recognition).

The recommendations are based on “evidence from the best available clinical studies with patient-important endpoints”. They also discuss trade-offs between “highly uncertain benefits” and “known putative harms”. They cover treatments involving drugs like azithromycin, hydroxychloroquine, lopinavir-ritonavir, corticosteroids and tocilizumab.

Read here (IDSA, March 11, 2020)

Pandemic rules and the law: Shad Saleem Faruqi

‘Those in positions of authority must also remain cognisant of the rule of law dimension. Power is not inherent. It must be derived from the law and its exercise must remain within the four corners of the enabling legislation.

‘From the rule-of-law point of view, an executive order, policy, directive, instruction or scheme does not amount to ‘law’ (and thereby require obedience) simply because of expediency, workability or reasonableness. It must be anchored in and derived from legislation or subsidiary legislation.‘

Read here (The Star, March 26, 2020)