EVEN as the third wave of Covid-19 continues in Malaysia, the burden of the disease here is still lower than in many other countries. Malaysia ranks 114 globally based on incidence density.
We may be in the midst of a pandemic characterised by major waves of outbreaks that wax and wane, but the current burden is still manageable.
The implementation of the conditional movement control order appears to have averted any concern of high widespread community transmission, hence our standard operating procedures should be re-calibrated to make them more sustainable in terms of benefit and cost.
An important characteristic of our outbreaks is that the transmission has been driven by a few large clusters instead of high widespread community transmission. These large clusters may be due to a more virulent strain of the virus or multiple generations of propagation before detection.
It may be time to think out of the box rather than getting boxed in with existing terminologies, and look at calibrating the intensity of our public health interventions based on maximising benefit-to-harm ratios.
Following are a few insights to various prevention activities.
There appears to be no need for inter-district travel restrictions. Travel restrictions should be based on larger geographical areas for easier implementation and lesser disruption, for example the creation of four regions in Peninsular Malaysia and one each for Sabah and Sarawak. When the need arises, travel between regions may be restricted.
Work from home is a useful recommendation, but it should not be made compulsory unless there is high widespread community transmission. There are many barriers to working from home. Effective policies require an evolution of work culture and a conducive home environment. Organisations may have to invest in their workers to prepare them to be more productive when working from home.
Though there is a low likelihood of a super spreader event, social gatherings should be limited to half the capacity of an enclosed area regardless of the occasion.
National exams such as SPM and STPM should not be further delayed. In the current schedule, students in Form 5 and Form 6 have already had to endure a few extra months of learning and the stress associated with this.
The quarantine period should be reduced for a more sustainable approach to weather this pandemic. The United States Centres for Disease Control and Prevention (CDC) now recommends shortening the quarantine period for those without symptoms to either 10 days without the need for testing, or seven days with a negative test result on Day 7.
PROF DR SANJAY RAMPAL
Professor of Epidemiology and Public Health Medicine Specialist
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