Is TEMCO or CMCO more effective?

PETALING JAYA: A targeted enhanced movement control order (MCO) aimed at specific areas with a high number of Covid-19 cases is more effective than a general conditional MCO nationwide that will affect the economy and the livelihood of the people, say medical experts.

Malaysian Medical Association president Prof Datuk Dr Subramaniam Muniandy said if cases were not widespread, a blanket conditional MCO was not required.

Differing views: (From left) While Prof Subramaniam and Jomo believe a blanket conditional MCO is not required in the country, Dr Zainal believes it is working to a certain extent and Dr Jemilah stresses that it is needed to limit people’s movements.Differing views: (From left) While Prof Subramaniam and Jomo believe a blanket conditional MCO is not required in the country, Dr Zainal believes it is working to a certain extent and Dr Jemilah stresses that it is needed to limit people’s movements.

“We feel that the states and areas which have a significantly low number of cases or have no new cases reported should not be placed under conditional MCO.

“We are concerned about the impact of the conditional MCO on students, ” he said.

Prof Subramaniam pointed out that the government’s targeted approach of imposing an enhanced MCO or the targeted enhanced MCO together with targeted testing, quarantine, isolation of cases and contact tracing in affected areas had proven to be effective in containing the spread of Covid-19.

As such, he said it should be continued as the strategy to address any spike in cases that were localised to a specific area.

He, however, emphasised the importance of maintaining strict discipline in observing the standard operating procedure (SOP) as the virus was expected to be around for the next one to two years or until a vaccine was readily available.

“If public compliance with the SOP is high, there will be no need to impose restrictions and cases will be kept low.

“But public compliance has been inconsistent as can be seen in the hundreds of cases reported daily of people flouting the conditional MCO and SOP. Hence, strict consistent enforcement is needed.

“The government should also increase efforts to educate the public on Covid-19 transmission. This is an area we feel is lacking, ” he said, adding that the government should engage the public sector as well in the fight against the virus.

On Sunday, Khazanah Research Institute (KRI) research adviser Jomo Kwame Sundaram, during the “Budget 2021: Moving Towards Recovery” online forum organised by International Islamic University Malaysia, had questioned whether the country’s MCO was the best option to control the pandemic.

Jomo had noted that other nations such as Japan, South Korea, Taiwan, Vietnam, Laos, India and China had managed to continue fighting the virus without imposing movement restrictions or lockdowns.

Prof Subramaniam noted that Taiwan was indeed a country to learn from as the country had been “quick to respond from the onset” of the virus, while South Korea and Japan had consistently improved and adjusted their safety measures despite a spike in cases.

In his view, the government should consider lifting the conditional MCO in states and areas with a significantly lower number of cases, adding that maintaining strict compliance with the SOP along with regular enforcement would be key to keeping cases low.

The Academy of Professors Malaysia (APM), in an opinion piece, had also said that the current restrictions in place were too strict, adding that prolonging it could lead to “economic, social and health hardship”.

Instead, APM proposed that localities with more than 40 new daily cases should be placed under an enhanced MCO but the rest of the country should return to the recovery MCO phase, adding that detection of localised outbreaks should also continue.

The organisation also emphasised that focused protection using a targeted approach for those in the vulnerable groups was more appropriate while allowing the less vulnerable – young and healthy adults above the age of 12 – to go back to work and school, while people with comorbidity and the elderly need to remain at home.

Last Tuesday, the Academy of Medicine of Malaysia (AMM) had also urged the government to lift the conditional MCO and to adopt a “middle path”.

“There are other ways to contain and mitigate the spread of Covid-19 without enforcing a blanket conditional MCO. AMM urges the government to pursue these other strategies and revert to the recovery MCO.

“We must adopt the World Health Organization’s recommended ‘middle path’ and learn to coexist with the virus while minimising suffering and deaths without stopping and restarting the economy and public life. If Malaysia is to beat Covid-19, we must first learn to live with it, ” AMM said.

It reiterated that a targeted enhanced MCO for areas with high infection rates was less disruptive to the economy and public life.

On Nov 7, Senior Minister Datuk Seri Ismail Sabri Yaakob had announced that all the states in the country would be placed under the conditional MCO for four weeks from Nov 9 to Dec 6, except for Perlis, Pahang and Kelantan.

The government on numerous occasions have also stressed that its decisions have been based on balancing the economy and public health.

‘Conditional MCO works’

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar said the act of balancing between opening up the economy and restricting the movement of people often resulted in confusing SOP.

However, he believed that the conditional MCO had worked to a certain extent, noting that it had helped to bring cases down before.

He said that was vital as the Greater Klang Valley area, including Seremban in Negri Sembilan, was the country’s “engine of socio-economic machineries” with more than six million active and productive Malaysians as well as large foreign worker communities located here.

He added that the government should look into improving the risk communication strategy, especially in terms of the content and the channel of communication.

Meanwhile, Tan Sri Dr Jemilah Mahmood, who is the Special Public Health adviser to Prime Minister Tan Sri Muhyiddin Yassin, clarified that the Health Ministry’s stance in imposing the conditional MCO was to limit social activities as well as to limit people’s movement as much as possible.

Dr Jemilah said this was because data had shown that the spread of the virus happened when people were moving around.

She stressed that economic activities had been allowed to go on as usual where factories and shops remained open.

“We know that the economy is hurting and whatever measures taken so far took into consideration the need to balance the economy and public health, ” she said.

She pointed out that globally the activities that had been targeted to prevent the spread of the virus were cafes, restaurants and indoor activities.

However, she acknowledged that when certain social activities were curbed, some businesses would be affected.

“To find the balance is not easy. But if everyone complies with the SOP, we will not have to have any form of MCO.

“The problem is because non-compliance is still present, ” she said.

In George Town, Association of Private Hospitals of Malaysia president Datuk Dr Kuljit Singh said the current conditional MCO with targeted enhanced MCO in hot zones was working.

He opined that it was the only way to contain the spread of the virus until the country got access to vaccines.

“The Health Ministry already has the experience in controlling diseases very well when we did not understand Covid-19 yet, ” he said.

Penang Health Committee chairman Dr Norlela Ariffin said the current implementation of conditional MCO was sufficient.

“I think the conditional MCO that we are experiencing now is not a hassle, although there are certain restrictions. We can still lead normal lives and go on about our daily activities, ” she said.

She urged the public to always be alert and practise the new norm so that they would not be infected.

“For me, the government now is trying to balance between controlling the pandemic and keeping the economy active at the same time, ” she said.

In Alor Setar, her counterpart, Dr Mohd Hayati Othman, said what the government was doing currently was being done in other parts of the world.

He said even developed countries such as Italy and Britain were going to the extreme of enforcing total lockdowns.

“In Malaysia, most businesses can still continue with certain SOP. For now, that is the norm until we can get vaccines, ” he said.

Dr Kuljit said a total lockdown like the last time was probably not a good thing.

He said there should be a mechanism for enforcing the enhanced MCO in critical areas.

“The government must be very strict when implementing the targeted enhanced MCO and must make sure no one from these areas goes to other places, ” he added.

Dr Kuljit said the people must be cooperative too as the effort would not be a success if the public did not cooperate.

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