Face-to-face with Covid-19

In this photo released by Malaysia's Ministry of Health, health workers put on full protective suits as they prepare for the arrival of evacuated Malaysian from China's Wuhan, the epicenter of the new coronavirus outbreak, at Kuala Lumpur International Airport in Sepang, Malaysia, Wednesday, Feb. 26,2020. U.S. health officials warned Tuesday that the burgeoning coronavirus is certain to spread more widely in the country at some point, even as their counterparts in Europe and Asia scrambled to contain new outbreaks of the illness. (Muzzafar Kasim/Malaysia's Ministry of Health via AP)

Malaysia is preparing to face the possibility of Covid-19 being declared a pandemic. In the meantime, frontliners dealing with the outbreak are soldiering on through long work days to contain the disease here.

LIKE soldiers, they save and protect lives –all through their armour of medical gowns and equipment.

The legion of doctors, nurses, surveillance teams, researchers, contact tracers, clinic workers and hospital staff are our heroes in keeping the Covid-19 outbreak under control here so far.

New cases have been reported. But as of now, there has yet to be any local transmission of the virus.

It’s due to the dedication of the frontliners - from screening passengers at airports to the thorough work of contact tracing - the process of identifying those who have been in contact with infected patients.

“Some haven’t had a day off since January, ” says Selangor Health Department director Datuk Dr Sha’ari Ngadiman.

“They are exhausted but highly motivated. Even though they are working overtime, there are generally no complaints, ” he tells Sunday Star during an interview.

While other states have similar protocols, Selangor handles the bulk of international arrivals from KLIA, KLIA2, Sultan Abdul Aziz Shah Airport in Subang and Port Klang.

To deal with the outbreak, staff have been mobilised from other health facilities to boost the surveillance teams at such entry points.

Screening is done for all travellers especially from affected countries like China, South Korea, Italy, Iran and Japan.

Surveillance teams at the airports work around the clock, with work being split into three shifts.

Detailing the process of how patients are detected, Dr Sha’ari explains that the crucial step of contact tracing, which requires health inspectors and doctors to thoroughly interview the infected person about their movements to track down other possible cases.

“Questions can include which taxi did they take, which restaurant did they go to and so on, ” he says.

From combing through the details in the patient’s account, contact tracers have to diligently identify and locate those who have come into close contact with the patient.

This means, anyone who has engaged with the infected person for at least 15 minutes will have to be identified and tested.

It’s a meticulous task, requiring contact tracers to draw circles around the patient.

In one case, a patient who was found to be positive, had attended three Chinese New Year dinners. For each dinner, contact tracers zoomed into who was dining with her at the same table to be tested.

The biggest number of contacts identified to be tested so far is 125 people in one case.

“So far, our team has managed to locate 100% everyone in such circles. But it hasn’t been easy and you can’t do it in one day. Generally, people have been cooperative.

“Contact tracing will only be done to patients who have been tested positive for Covid-19, ” Dr Sha’ari adds.

He shares that some have voluntarily come forward to be tested even though they have had no contact with an infected person.

“If they don’t fit the criteria, we don’t test them as it is unnecessary, ” Dr Sha’ari says, although he understands people are fearful.

A challenge for contact tracers arises when patients do not remember details, or if they reveal new information later.

“When this happens, contact tracers start a new search. Some patients interviewed by contact tracers remember a lot of details, while others require more effort, ” he shares.

Medical staff dealing with patients have also been careful and adhering to protocol, including changing new gowns every time they deal with a different patient.

Ambulance vans are also decontaminated after ferrying patients under investigation to the hospital.

Dr Sha’ari also reveals that there are times hospital staff also have to go the extra mile when treating patients.

“In one case, a baby was admitted and the family members requested for a specific baby milk powder brand. Other brands had caused the baby to have diarrhoea.

“A medical staff had to go to a shopping mall to find something which was similar to the formula, ” he says.

Hospital staff also helped foreign patients as much as they could, such as by providing them with SIM cards, powerbanks and mobile phone chargers.

“Since they are travellers who have been referred to our hospitals, there were many things they didn’t have with them like toothbrushes.

“We did our best to meet their needs, including requests for Western food, ” he says.

And while frontliners stare Covid-19 in the eyes everyday, it is only human that some of them do worry about being infected themselves, Dr Sha’ari admits.

“Our strength is our staff. We make sure they are properly trained to handle personal protective equipment.

“Staff have to take daily temperature readings and any symptoms have to be reported, ” he says.

There is also hospital counselling services for the frontliners should they need to voice out any concerns and if they need psychological support.

Nobody can say for sure when the Covid-19 outbreak will blow over, but Dr Sha’ari has faith that the current system and manpower in place here is prepared if matters get worse.

“Our frontliners are doing what they can for the people. They are ever ready to work and are doing their best, ” he says.

Highlighting the importance of contact tracing, medical virologist Emeritus Prof Datuk Dr Lam Sai Kit Dr Lam says the process is hoped to interrupt or break the chain of transmission.

But there is still a lot to learn about the virus, especially how it is transmitted.

“Frontliners must know how to identify Covid-19 cases and distinguish them from other respiratory illnesses.

“Since it is not always possible to distinguish clinically one from the other, they must handle all suspicious cases as though they are Covid-19.

“Frontliners like doctors, nurses, attendants, cleaners and other care-givers who come into contact with patients must be trained to handle patients and the areas they may have contaminated, and given protective clothings, goggles, and other gears depending on the levels of contact, ” urges the Academy of Sciences Malaysia senior fellow.

Laboratory personnel who handle infectious samples such as throat and nasal swabs, sputum, blood samples, must practice universal precaution to ensure their safety.

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