Non-medical experts needed to help fight Covid-19


  • Vital Signs
  • Wednesday, 25 Mar 2020

Let me speak openly and sincerely to you, my fellow Malaysians: we have no time to endlessly describe the problems, so let’s get to the solutions.

We’ll start with the lessons from crisis management.

One, we must simplify responses and mobilise everyone.

Two, everyone must hyper-focus on solutions.

Three, we must have “wartime leaders” who can decide and delegate with trust, without being paralysed by fear or imperfect information.

What we want to achieve from this outbreak is so simple that it should become a nursery rhyme: “reduce total number of cases and spread them over time”, also known as flattening the curve.

This is based on lessons from South Korea, Taiwan and China, which were the countries earliest hit, and therefore, have the most to teach the world.

The lessons from the earliest-hit countries teach us that we must do three things simultaneously: social distancing, mass testing and contact tracing.

Any two without the third simply will not work.

Malaysia is adopting all three right now, and hopefully, it will work.

One, the current movement control order (MCO) will reduce face-to-face interactions to reduce viral transmission.

Two, the Health Ministry (MOH) will increase testing to 16,000 samples per day in April (2020). with free tests for both Malaysians and foreigners.

And three, an army of health inspectors and public health experts are performing contact tracing, although we’re doing this manually while other countries are using artificial intelligence and big data.

Pooling our resources

It’s very possible that this outbreak will worsen before it improves. Therefore, more needs to be done, and much of it is lies outside the purview of MOH.

Now is a time to throw every single resource at the problem. We cannot just rely on the Government; we need every organisation and everyone to help.

The Government must lead and coordinate the private sector, civil societies and citizens.

Malaysia contains a lot of capacity, which we must tap.

Here are some groups that we may soon need:

  • Those with 3D printers using an open-access blueprint repository to print items for intensive care units (ICUs),
  • Engineers designing a new cubicle for doctors to see suspected Covid-19 patients that will reduce the need for doctors to change their Personal Protective Equipment (PPE) every time they see a patient,
  • Material scientists who can help with possible replacement textiles if we run out of PPEs, and
  • Think-tanks and researchers looking at food security and crisis communications.

We can’t just ask for money from Malaysians, we must ask for their ingenuity, brains and contact networks.

Passive donations are great, but active participation is even better.

The Government alone can’t solve this; we citizens must organise ourselves.

An evolving role

The Government’s role must evolve as the outbreak evolves.

Right now, the Government can do four specific things better.

One, inter-ministry announcements and communications must be done with one voice.

A suggestion would be to embed MOH policy or public health experts in other ministries to advise them.

Two, the Government must ruthlessly eliminate any red tape.

This is a wartime situation, and bureaucracy-as-usual must be destroyed if we are to ensure that essential goods and services, and the supply chain and trade that support them, can continue.

Three, the Government must plan for unintended consequences, many of which I’ve discussed before.

As the movement control order (MCO) continues and fewer people go to work, there will be downstream implications to visible areas that impact our lives.

For example, who will continue stocking supermarkets or deliver food?

Finally, and most importantly, the Government must help the poor, the homeless and those who lost their jobs.

No one in Malaysia should ever have to borrow rice from their neighbours – this is a stain on our collective conscience as a society.

But sometimes, we’re fixing the wrong problems

Moving into 'wartime production'

This coronavirus and the recent political transition made a lot of Malaysians feel powerless and helpless.

Many people have approached me asking how to help. We should make use of all their offers, not only because they can help also, but also because it will make them feel more in control.

However, I must add some caution.

Money alone won’t solve the problem, because even with infinite amounts of money, we still have a global shortage of everything.

Malaysia’s manufacturing capacity remains low for these items; therefore, we must find alternative solutions in case we need them.

There are two strategies.

The first is to open purchasing lines into China, the factory for the world.

If the world is going to beat Covid-19, we’ll need Chinese factories to snap back into full production of masks, ventilator circuits and hospital beds.

Malaysia needs help from China, and we must not be shy to accept it.

All things being equal, we can try to create a stockpile for ourselves, but must realise that leaving nothing behind for our neighbours is an equally large problem.

The second is to retool Malaysia for “wartime production”.

There are lessons from World War II here, e.g. when Ford stopped making cars and retooled to make bomber planes.

The Government, the Federation of Malaysian Manufacturers (FMM) and Small & Medium Enterprises Association of Malaysia (SMEAM) must join hands to deliver solutions for retooling factories.

These solutions must consider raw materials, accelerated testing and quality assurance, production capacity and alternative technologies, like 3D printing and the latest industrial designs.

Workforces must be quickly retrained, and maybe healthy citizens can even join the national effort by becoming a factory worker.

Indeed, teachers can be taught contact tracing and biologists can be taught how to operate a medical laboratory.

If refugees can become cooks for Hospital Ampang doctors and ordinary Malaysians from the Tzu Chi Foundation can clean wards at Hospital Sungai Buloh, then the rest of us should be inspired to perform different duties as citizens.

We must find the right problems to fix, then fix them ruthlessly.

Donating money is only one part of the solution, and we need citizens to step up as Malaysia reorganizes for war against this virus.

One of the efforts I'm involved in is the Malaysian Health Coalition.

On March 1 (2020), 23 professional and medical societies in Malaysia decided to unite, so that we can better protect the Rakyat’s health and appropriately support the MOH.

Today, we have 38 member organisations, representing doctors, nurses, pharmacists, dentists, paramedics and allied health professionals, as well as civil societies and individual citizens.

Being new, we’re still organising and establishing ways of working.

However, we have already issued several joint statements that suggest ideas and offer support during this national crisis.

We’ll continue trying our best to protect the Rakyat’s health.

I remain optimistic that Malaysia can beat this virus and minimise suffering.

This requires crisis leadership for a maximum national effort that leaves nothing behind.

We must fight this enemy with everything we have and we must have a no-regrets strategy.

Let’s get to work, Malaysia, together.

Dr Khor Swee Kheng has postgraduate degrees in internal medicine and public health, and has worked in five health sectors across three continents. He is currently reading Public Policy at the University of Oxford. The views expressed here are entirely his own.

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