No lockdown in a vacuum

Waiting: Police and armed forces personnel ensuring order as people wait to get vaccinated at WTCKL. — AZHAR MAHFOF/The Star

PETALING JAYA: As Malaysia enters a two-week nationwide total lockdown on Tuesday, health experts say the vaccination drive must also be accelerated to reduce Covid-19 cases and give healthcare frontliners much-needed breathing room.

Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said Malaysians must abide by the economic and social restrictions in place for the total lockdown while the vaccination process must be hastened.

“All standard operating procedures (SOP) should be standardised, particularly the duration for quarantine. It should not be three, 10,14 or 21 days; it should be the same for all.

“The vaccination process must also be accelerated to have more people immunised, ” she said.

Dr Malina added that in public health, the best approach would be to identify those who were susceptible to Covid-19, screen them and if they tested negative, vaccinate them.

“Therefore, mass screening followed by vaccination would be the ideal option, ” she said.

On whether two weeks were adequate to flatten the curve, Dr Malina said the period should be reviewed afterwards and from time to time, and assessment of the situation should include the number of patients needing hospitalisation and intensive care unit (ICU) treatment.

The number of deaths, those who are fully immunised as well as the R-naught or infectivity rate must also be considered, said Dr Malina.

“Whether we need a lockdown beyond two weeks will depend on the above indicators, ” she said.

Universiti Malaya virology expert Prof Dr Sazaly Abu Bakar said there was certainly a need to ramp up vaccination, but the SOP must also be followed.

“We have to be careful not to create vaccination centre clusters, ” he stressed.

Random Covid-19 screening would be necessary for those in essential services as they would still be moving around during the lockdown, said Prof Sazaly, adding that to see real impact, the lockdown should be in place for at least three weeks.“Employers must be asked to institute workplace bio-safety measures such as improved air circulation or exchanges, physical barriers or distance issues regarding eating places or pantries where most will not wear masks, ” he said.

For this period, we also need to reduce mortality, he said.

“The government should explore new treatment modalities and speed up approval of clinical research and trials to less than 30 days.”

In Kota Kinabalu, local public health expert Prof Datuk Dr Yusof Ibrahim said Sabah’s decision to join in the two-week national lockdown beginning June 1 was necessary.

“Our cases are increasing. Sabah should lock down to control the spread, ” he said.

“Based on our cases, it has become difficult for contact tracing as the Covid-19 virus (seems) to be everywhere, ” said Prof Yusof, Universiti Malaysia Sabah (UMS) senior public health medicine specialist and head of its Public Health Unit.

He explained that many of those who tested positive could not pinpoint where they picked up the virus.

“If you are not sure where you got the infection, then contact tracing will be very difficult, ” he said.

He also said there was a need to further check migrants through stringent border controls.

Furthermore, people have generally dropped their guard on following the SOP, including the use of masks, he said.

“If you go to the mall, you can see small children without masks, small babies in strollers without masks, and people with the mask covering only the mouth or worse, only the chin, ” he said.

On Friday, Sabah Chief Minister Datuk Seri Hajiji Noor said the state government would soon announce the business and service sectors that would be allowed to operate during the lockdown.

Sabah had previously set its own SOP for various sectors of the economy.

Malaysian Association of Public Health Physicians president Datuk Dr Zainal Ariffin Omar said the Health Ministry must get as many people as possible vaccinated.

Second doses should also be delayed to allow more people to receive at least one dose, he said, adding that the focus should be on localities with the highest cases.

“Increase the find, test, trace, isolate and support (FTTIS) system for the whole country, and the quarantine policy must also be reorganised.

“We also need stricter cross-border travel for district, state and international movement. No permission should be given unless it is very important.

“Greater involvement of experts outside the Health Ministry and the National Security Council (NSC) is needed, and the government should also improve its communication machinery, ” he said.

Dr Zainal Ariffin added that the whole population must be mobilised in order to see the number of cases drop during the two-week lockdown.

When contacted, Health Minister Datuk Seri Dr Adham Baba said the ministry will be focusing on ramping up vaccination as more vaccine supplies are expected to arrive in June and July.

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