Reflection a year since Covid-19 – will it End?
In addressing COVID issues today, apart from looking ahead, we need to look at our rear-view mirror. Malaysians forget easily and need to be reminded repeatedly that we are where we are today due to our government folly. COVID outbreak first started due to a concentration lapse involving the government agencies in managing COVID as the politician battle for power in Feb 2020 (Sheraton Move).
Despite the painful experience of 4 months of MCO that crippled the economy, and we returned to some degree of normalization, the peninsular politicians assaulted the Sabah government to grab power and, in the process brought the disease back to the peninsular states. KKM refusal to enforce quarantine for travellers between the two areas before and after the election is the primary reason why KKM resources are strained today and our economy crippling, and people are burdened again.
In short, irresponsible politicians started, contributed, and their actions continue our misery. KKM leadership's lack of foresight and their politically motivated actions continue to contribute to our problems today. KKM strategies are not working. It is time that outside support and control must be put in place. We can no longer leave the disease management solely to KKM top guns. To move out of this doldrums, concerted efforts at all levels must be taken immediately.
Where are we today? By KKM's own admission, the staff is drained, hospitals are full, the disease is in the community, thousands of contacts are not traceable, C19 testing ability and capability are limited. It is time to change the way we fight the disease and work in cooperation with states, local authorities and other agencies.
At this stage, we believe the proposal to de-clutter the hospitals by moving out Stage 1 and 2 patients to isolation centers are being done. Restricting movements are in place to cut down transmission. However, KKM has yet to engage states and local authorities in supporting them in creating community-level quarantine centers, roping in GP’s to support case management.
Despite being helpless, KKM still wants to maintain centralized control. This is no longer KKM battle. It's everyone's battle and all available resources must be used at this stage. If we fail to act now, then the next step will be the painful full-fledge MCO for months or we live in harmony with the virus for a few more years and hope for the best while the vaccination plan being rolled out.
With high disease prevalence, limited testing logistics, KKM needs to work in cooperation with local authorities and the state governments. Every suitable facilities and resource be utilized to create community isolation/holding centers for all primary contacts for a period of 8-10 days. Local GP’s must be given the responsibility to do patient monitoring for signs and symptoms and based on specific guidelines, those with specific symptoms are tested and referred to hospitals. KKM should continue to focus on building up internal capacity and capabilities in managing stage 3-5 COVID cases in house.
While primary contacts are kept in community isolation centers, secondary and tertiary contact should do self-isolation at home. Movements are kept restricted and monitored using technology (google location etc). Employers must ensure that their workers are in home isolation.
Singapore monitored the home monitoring compliance where they ask their contacts to provide a live video stream of their location when called using publicly available applications. The local GP’s monitor cases remotely by using calls to assess their condition. Their locations are monitored live using Google location sharing.
With everyone's cooperation and public engagement, this strategy will work. The attitude towards managing COVID must change. This change must involve everyone. A high-level committee of professionals with diverse backgrounds (including non-medicals) must be formed and empowered with complete oversight over strategy. This committee must have complete authority in guiding KKM and other agencies in combating diseases.