Dr Dzulkefly: Poor diagnostic policies among failures in Covid-19 management

PETALING JAYA: Malaysia's Covid-19 caseload crossing the one million mark has exposed the shortcomings of the national healthcare delivery system and the government's failure in managing the pandemic, says former health minister Datuk Seri Dr Dzulkefly Ahmad.

Dzulkefly (PH-Kuala Selangor) took the Perikatan Nasional government to task for failing to contain the spread of Covid-19 after it took Putrajaya in March 2020 from the Pakatan Harapan administration.

He told Parliament on Tuesday (July 26) that the government failed to steer the nation out of the third wave of Covid-19 infections by failing to utilise the capability of external experts.

He added that the government also failed to leverage on technology and artificial intelligence (AI) in testing and contact tracing in order to pre-empt outbreaks and predict future Covid-19 hotspots.

The Selangor Covid-19 Task Force chairperson added that when they had access to epidemiological granular line-listing data, they were able to conduct active case detection in community screening using Acura A1 and big data analytics in Selangor, a hotbed of Covid-19 cases.

However, they were now unable to do so as the Health Ministry had stopped sharing granular data with the task force since late last year, citing patients’ privacy concerns and mismanagement of the raw data.

“The Health Ministry only does targeted testing and contact tracing after a cluster has already emerged.

"At times, a cluster is only declared a month and a half after the index case was detected,” said Dzulkefly.

He also cited a media interview with Brigadier General Dr Mohd Arshil Moideen of the Malaysian Armed Forces Health Service Division, who had said that the lack of unified action and top-down coordination was among the main reasons why the nation has failed to manage the pandemic.

“He had said that what was decided at the federal level was implemented differently at the state level and at each district, the implementation was different from what is being done at the state level.

“This was his professional observation. Besides what he mentioned, the 'whole-of-government' and 'whole-of-society' concept being touted by the Government must not be treated as mere rhetoric but must be applied in its approach,” said Dzulkefly.

He added that these shortcomings by the government had led Malaysia to experience a record number of active cases and infections, with the nation crossing its first million caseload on July 25.

“Contact tracing is very important and cannot be done effectively manually or semi-manually.

“MySejahtera, which scans QR codes, is actually unable to unlock the key of success to automated contact tracing seen in countries like Singapore which uses a Bluetooth-enabled contact tracing device technology, or South Korea and Taiwan.

“These countries have a fast contact tracing system and do not merely put one officer to man the phone at the district health office and contact 200 to 300 people daily (for contact tracing).

Dzulkefly added that poor diagnostic policies are among the main failures in the country’s management of the Covid-19 pandemic.

He said that the government had relied too much on the results of the RT-PCR to confirm Covid-19 infections after patients had taken the faster RTK-Antigen test, which slowed down its response cases.

“In a worsening pandemic, there is no need to take an RT-PCR test after an RTK-Antigen test comes back postive. Even the World Health Organisation (WHO) shares the same view.

“Speed is the name of the game. It is like fighting a war,” he said at the special Parliamentary sitting on Tuesday.

He said he was concerned when the government held up placards showing single-digit infection numbers last year, because he knew it would be the beginning of the downfall if the government only based their victory on numbers alone.

He said health experts such as epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud had warned against relying on the number of infections alone, as the method did not truly reflect the severity of the problem in a certain state.

He said if infection numbers were the only metric, then Selangor would continue to score the greatest number of infections based on population size.

Dr Dzulkefly - who heads the Selangor Covid-19 taskforce - said mass testing with the correct metrics will give the nation a clearer picture on the severity of the Covid-19 problem.

He said the government has recently taken a step in the right direction by not relying on RT-PCR tests, but the action had come too little too late.

Dr Dzulkefly added that he is not too worried about the high number of daily infections in Selangor because of its mass testing exercise, but will be even more concerned if the number of patients brought in dead to hospital continues to rise in the state.

Dr Dzulkelfy also said public health measures should continue to be in place to manage the Covid-19 problem, even as more people are being vaccinated.

“We cannot just put all our hopes in the vaccine because there have been cases of infections in a few countries where its population have been vaccinated.

“It takes vaccination and public health measures for us to really overcome this third wave,” he said.

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