IT is important to take into account the Malaysian context, culture and election behaviour when formulating Covid-19 Standard Operating Procedures (SOPs) and guidelines if Malaysia is to face more elections in the near future.
Even though some overseas experts have said that the Covid-19 health risk of casting an in-person ballot with all the precautions is relatively low, but in our setting, the risk of transmission is “tremendous” as we do election and political campaigns differently here, says public health specialist Associate Professor Dr Wan Mohd Zahiruddin Wan Mohammad.
Noting the “success” of the Chini by-election as there was no recorded Covid-19 cluster emerging from it despite the high voter turnout, Dr Wan Mohd Zahiruddin, who is from Universiti Sains Malaysia’s School of Medical Sciences, explains how it was a different story for the Sabah polls due to its scale and wider movement of people during and after the election.
“Even though comprehensive SOPs by the Election Commission (EC) were in place, the authorities might not have been able to enforce them all and people might have not fully complied to them in most places and at most of the times due to the larger areas and number of constituencies in a state election, especially during physical face to face campaigns,” he says.
Another possible factor was timing – the state election was conducted in the midst of Covid-19 clusters in Sabah which perhaps have favoured community spread even more.
“And importantly due to the possible spread by those returnees from Sabah to other states in Malaysia who might have been in contact with the carriers of the virus.
“To have another state or even the possibility of a snap general election to be conducted during this current phase of Covid-19 that we are facing now is worrying and best to be avoided or postponed until the situation is well-controlled and the country is declared in a safe phase,” he says.
Strict enforcement of SOPs
Dr Wan Mohd Zahiruddin emphasises that if an election cannot be postponed, all SOPs must be revisited and strengthened.
The SOPs must also be strictly complied by and adequately enforced to all EC staff, stakeholders, voters and importantly, political leaders and their supporters, says Dr Wan Mohd Zahiruddin.
“People must be convinced and they should perceive less risk so that they are able to turn up at the polling stations with optimum numbers to cast their votes,” he says.
This means the EC will have to to come up with more adaptable measures and directives to reduce the numbers of people interacting with others and the duration of the interactions.
He suggests that the National Security Council (MKN) or Health Ministry establish prompt and clear directives on testing and quarantine procedures related to the election activities for EC staff, voters, politicians and supporters.
“We need to take things step by step based on the existing pandemic situation,” he says, adding that crucially, the people should not be put in an awkward situation of choosing between their health and exercising their right to vote.
Avoid unnecessary risks
Dr Khayriyyah Mohd Hanafiah, a researcher in epidemiology and control of infectious disease, cautions against doing anything that would bring large groups of people together, especially if it is within confined areas and for a lengthy duration.
“We know now that Covid-19 is an over-dispersed pathogen, which means the epidemic isn’t sustained by each person getting infected passing it to another three people, but it is sustained by bouts of super spreader events – where you have large clusters arising from a few infected people,” says Khayriyyah, who is senior lecturer in Medical Microbiology at USM.
She explains that this type of spreading is more likely to happen when you provide opportunities for either large groups of people to come together, but especially when you bring people from different areas because then they will go back to where they came from and possibly spread it to one or more people.
“That then complicates efforts to do contact tracing, ensuring contacts adhere to quarantine until they are confirmed to not have the virus,” she says.
Even if there was not a significant outbreak, we have to think about the frontliners and people who will be tasked with dealing with the aftermath of such events and the burdens we place on them to control any possible outbreaks.
Khayriyyah adds that SOPs are meant to help minimise some necessary risks, but not all SOPs are equally effective at minimising risk, and most of them rely on effective enforcement.
“Scientifically, some of the precautions have more evidence of effectiveness than others – for example, proper mask wearing when you are in the presence of others in a confined area – which becomes inevitable at some point because people need to go to work with others, travel or buy things at shops – is known to significantly reduce transmission. For things like temperature checks,there is less evidence that it actually works because the instrument you use is highly dependent on calibration and how it is used, and also infected people can spread the virus even before showing any symptoms (unlike SARS), and people having fever can bring it down with paracetamol,” she explains.
“And so however many SOPs you can come up with, I would first caution against taking unnecessary risks in creating situations that require strict enforcement of SOPs to begin with.”
A balancing act
As Covid-19 will be with us for several years, it is important that we balance public health with other important rights like voting, education and leisure.
However, physician and health policies specialist Dr Khor Swee Kheng stresses that for us to exercise our voting rights safely, Malaysian politicians must learn to campaign in the new normal, and judging from the Sabah state election, some might still have a long way to go.
While Dr Khor acknowledges that several other countries had safe national elections during Covid-19, like South Korea or Singapore, these were done under highly disciplined conditions.
However, although it is conceptually and practically safe for pandemic elections to take place, Dr Khor believes strongly that Malaysia should wait until we have beaten this new wave of Covid-19 and politicians can campaign in safe ways.
Noting that elections are unavoidable in some situations, Dr Khor nevertheless says that there should be “no unnecessary elections until we can campaign responsibly.”
Pointing out that other countries have built up their abilities to conduct voting without being physically present, such as postal voting or proxy voting, Dr Khor suggests that these alternatives can be explored by the EC to determine feasibility and appropriateness for Malaysia’s context. However, he concedes that laws and regulations will need to be revised for this to happen.