This too shall pass

A PETITION with over 350,000 signatures has been circulating, calling for a ban on people from China travelling to Malaysia. The intent is to supposedly protect the Malaysian people.

Reading its content and call for action, based on the “unhygienic lifestyle” point, one could be mistaken for thinking that it is more xenophobic and bigoted in nature rather than being based on any scientific basis or good public health strategy. But this didn’t stop more than a quarter of a million Malaysians from adding their names to the petition.

The fact is, despite the Chinese government imposing an unprecedented travel restriction on over 20 million people in three cities, the move to contain the spread of the novel coronavirus outbreak is not likely to succeed. The time for containment within geographical borders (which are not recognised by any virus, bacteria or pathogen) has long passed. It may have been possible months ago but the barnyard doors are wide open now. The virus is already moving rapidly across the globe, thanks to air travel and the holiday season.

Based on a century’s worth of public health experience and epidemiological evidence from previous outbreaks, travel bans have been found to be unable to actually prevent infections. They also divert much needed political attention and resources. Travel bans create a harmful Maginot mentality that conveys a false sense of security, implying that the population would be protected.

Malaysia’s Health Ministry is already being guided by the World Health Organisation’s (WHO) prevention and control strategies regarding this outbreak. WHO’s recent Emergency Committee meeting reviewed current reports and recognised the urgency of the situation but held off on declaring a Public Health Emergency of International Concern, which imposes a legal duty on member states to act. The 2009 H1N1 pandemic, 2014 polio declaration, 2014 Western Africa outbreak of Ebola, Zika virus epidemic in 2015-16, and 2019 Kivu Ebola epidemic were previously declared as such. WHO might still do that for this outbreak.

What we can do now is use what we learnt from previous and ongoing pandemics and epidemics (eg: annual flu, influenza, SARS, MERS) to figure out the best way to control the spread of this virus. In 2002, severe acute respiratory syndrome (SARS) infected more than 8,000 people in 29 countries, including Malaysia. There were 774 deaths. The fatality rate was around 10%. There is no treatment available, but a possible vaccine is on the horizon.

The Middle East Respiratory Syndrome (MERS) emerged from Saudi Arabia in 2012 and is still spreading today. It has been found in 27 countries, including Malaysia. More than 2,500 people have been infected, with around 860 deaths, which leads to a fatality rate of around 35%. There is no treatment available and there is no vaccine.

Despite the higher mortality rate for MERS and an infectious disease epidemiologist’s nightmare scenario of hundreds of thousands of people congregating at the epicentre of a disease, the annual hajj or umrah pilgrimages to Mecca were not stopped. Neither were thousands of Malaysian pilgrims quarantined or stopped from going into the country, despite there being fatalities from MERS infection among Malaysians.

Knowledge and good understanding of public health, virology and epidemiology inform and guide authorities on what, how and the best course of action to manage and contain these epidemics. It isn’t blind faith but informed decision making.

Make no mistake. This is a serious epidemic. We should not downplay it or trivialise concerns. Like all other coronaviruses, this novel one will move around the globe. People will be infected, and there will be deaths. Absolutely.

However, communication and the dissemination of accurate and evidence-driven information and practices will serve us better rather than calling for bans and reacting to messages spread through conspiracy sites and the paranoia of our neighbours and friends.

There is much information out there but some of it is misleading, sensationalised and even deliberately wrong.

Constant vigilance, accurate information, good communication, practice of the recommended precautions and, most importantly, cooperation will be what brings this outbreak under control.

These days, using social media, it is easy for us to second guess the efforts of the Health Ministry or question whether ministry officials are being transparent. We justify it out of concern and fear for ourselves and our families. It is only human to do so. However, take a minute and think about the courage of our women and men who are healthcare professionals on the frontlines of this epidemic. They are doing the necessary and critical work to protect the rest of us. The least we could do is to have their backs and support them as they do the work they are trained for.

A recent report by the Economist Intelligence Unit, using its Global Health Security Index, found that Malaysia ranked higher than Singapore in preparedness for major infectious disease outbreaks. This country’s response framework ranked 18th out of a total of 195 countries.

So this is not blind faith but trust that the women and men of the Health Ministry not only know what they are doing but are also highly skilled at what they do.

We have lived through several pandemics, and from the looks of it, we can and will get through this one too.

AZRUL MOHD KHALIB

Chief executive, Galen Centre for Health & Social Policy