‘Let’s not be too hasty’

Better safe than sorry: Many people are still opting to use face masks outdoors to minimise the risk of infection in Kuala Lumpur.

PETALING JAYA: There should be a reduction in the number of Covid-19-related admissions and deaths, and contingency plans put into place before Malaysia follows Singapore’s move in loosening the mask mandate, say health experts.

Even as Singapore lifts the compulsory use of masks in public places except on public transport and in healthcare facilities on Aug 29, experts here said Malaysia must first consider the ability of the healthcare system to cope.

Not only must Covid-19 related admissions and deaths be brought down to a manageable level on par with other endemic diseases such as dengue, there must be greater booster shot uptake, they added.

Prof Dr Moy Foong Ming of Universiti Malaya’s Department of Social and Preventive Medicine said any removal of mask mandates while indoors should be evidence-based.

“The Covid-19 situation should be closely monitored with the Health Ministry also putting various contingency plans in place.

“This includes scaling up healthcare capacities and stepping up vaccination operations, or even reinforcing mask mandates when deemed necessary,” she said when contacted.

Prof Moy said removing indoor mask mandates would be suitable once Malaysia successfully transitions to the endemic stage, with a low number of both daily Covid-19 cases and deaths, and as long as related hospital admissions do not burden the healthcare system.

“This should happen once the high-risk groups are fully vaccinated and have received their booster doses. This way, they may not develop severe symptoms when infected,” she added.

On the role of masks in preventing the spread of Covid-19, Prof Moy said prior to the vaccines, ecological studies found that transmission was 7.5 times higher in countries that did not have a mask mandate or require universal mask use.

“Modelling studies also found that masks, even with suboptimal efficacy in both preventing one from catching or spreading the infection, could also substantially decrease the infectivity rate if widely used.

“The efficacy of masks also depends on the filtration of the material and the fit of the design,” she said.

As with Singapore, Prof Moy said mask mandates should be retained in healthcare and public transport facilities, and also poorly ventilated areas.

“When it is no longer mandatory in the future, the decision to wear a mask indoors should be determined by the individual and high-risk groups, where they should weigh the risk and benefits before coming to a decision,” she added.

Universiti Kebangsaan Malaysia public health expert Prof Dr Sharifa Ezat Wan Puteh said the removal of mask mandates indoors is a possibility, but added that booster uptake should first be higher.

“We should at least get the booster uptake to about 70% before we consider removing mask mandates while indoors.

“When we reach that number, we also have to take into consideration the presence of potential new variants,” she said.

As at Aug 24, only 49.6% of the population has received their booster dose, according to the Health Ministry’s CovidNow portal.

Prof Sharifa Ezat said that genomic sequencing should also be done more extensively to identify which variants are currently prevalent in Malaysia, adding that this would paint a more accurate picture of the situation.

She concurred with Prof Moy, saying that contingency plans should also be prepared for when masking was no longer required indoors (barring healthcare or public transport facilities).

“For example, we will need community assessment centres ready, with tracing protocols also being more thoroughly implemented,” she said.

Universiti Putra Malaysia epidemiologist Assoc Prof Dr Malina Osman said it was feasible for indoor mask mandates to be removed within the next two weeks.

“Based on current data, it seems that Malaysia is almost at a similar level with Singapore, with all outbreak management indications such as new and active cases, on a decreasing trend.

“We have also been in the transition phase for close to five months since April, where we observed the easing of standard operating procedures (SOPs).

“Despite compliance with recommended SOPs being occasionally ignored, the outbreak in the country has been manageable and well-controlled,” she said, adding that masking indoors should be retained for high-risk groups with a specific SOP set for them.

“When Malaysia does proceed with no longer requiring masking up indoors, authorities should also be open to reversing the decision if needed,” said Dr Malina.