COVID-19 (Korona Virus): In The Context of Disaster Preparedness in Malaysia - by Lt Col Dr Maimunah Omar
COVID-19 (KORONA VIRUS): IN THE CONTEXT OF DISASTER PREPAREDNESS IN MALAYSIA
By Lt Kol Dr Maimunah Omar
THE coronavirus now called Covid-19 has become an epidemic. At the time of writing (16th February 2020), it is recorded that the outbreak of the Virus has now reached 69,000 cases globally and the death toll is 1,671 people. Malaysia itself recorded 22 cases. No deaths have occurred in Malaysia unlike one death in 2003 and 105 deaths during the 1998-1999 Nipah-Virus outbreak. It is known that both SARS-CoV and MERS-CoV can be transmitted person to person- although this is not yet confirmed for Covid -19, it is reasonable to assume that human-to-human transmission is possible and mainly transmitted by large respiratory droplets and direct or indirect contact with infected secretions.
WHAT IS DISASTER PREPAREDNESS?
Disaster preparedness is a continuous and integrated process resulting from a wide range of risk reduction activities and resources rather than from a distinct sectoral activity by itself. It requires the contributions of many different areas - ranging from training and logistics, to health care, recovery, livelihood to institutional development. Disaster preparedness minimizes the hazard’s adverse effects through effective precautionary measures that ensure timely, appropriate and efficient organization and delivery of response and relief action. Preparedness can be divided into two categories which are the government and the individual, or generally according to the respondent or recipient. Actions entailed in the disaster preparedness are planning process, Emergency Operations plans (EOP), exercises, training, equipment, warning, public awareness including the media’s role.
COVID-19 AND RELATION WITH DISASTER PREPAREDNESS
Malaysia’s Action in Curbing Covid-19
The government has taken further steps to tighten measures against the outbreak of the Covid-19. Indeed, Malaysia has been more proactive in its measures now compared to how it handled similar crises in the past. It has installed more thermal scanners at all entry points, isolated Covid-19 cases, placed suspected cases under quarantine up to issuing health alert card for travellers and flight crew returning from China. The government has also taken steps to ensure the country’s readiness to address the coronavirus infection in line with the recommendations by the World Health Organisation (WHO)
Planning and Guidelines
As for healthy and security issues, the Malaysian government follows certain rules and regulations such as Malaysian Strategy for Emerging Diseases (MySED) Workplan (2012-2015), Public Health Emergencies of International Concern or PHEIC event releasing a Guidelines 2019 Novel Coronavirus (2019 nCoV) Management In Malaysia No. 2/2020. MySED II Workplan provides a common framework for action implementation and strengthening under the International Health Regulations (IHR), 2005 in Malaysia and it is developed following extensive consultations with states, technical experts and partners from various levels and organizations by incorporating our previous experience from managing actual events through the all-hazards approach. Malaysia is prepared to face any public health emergency threats currently and in the future. The Guidelines 2019 Novel Coronavirus (2019 nCoV) Management In Malaysia No. 2/2020 is a complete information to guide those who are involved in handling COVID-19 cases including Private Hospital / General Practitioners (GP): Flow Chart For Management of Acute Respiratory Infection When 2019-nCoV Suspected, Government Facilities : Flow Chart For Management of Acute Respiratory Infection When 2019-nCoV Suspected, Screening And Triaging Protocol For Ambulance Transfer For Patient Under Investigation (PUI) 2019-nCoV, Management of Close Contacts of Confirmed Case and many others. There are 31 specific guidelines stated in the Instructions.
In order to ensure all the planning will run smoothly and to safeguard the health and security of the citizens, coordination and collaboration with other agencies are important. As for healthy matters under MySED II, the Ministry of Health Malaysia collaborates with other stakeholders such as National Disaster Management Agency (NADMA), National Security Council (NSC), Department of Veterinary Services, Ministry of Agriculture, Ministry of Foreign Affairs, Royal Malaysian Police, Fire and Rescue Department of Malaysia, Atomic Energy Licensing Board (AELB), Department of Wildlife and National Parks Peninsular Malaysia, Ministry of Water, Land and Natural Resources, Ministry of Transport and Hospital Universities. Each agency has their own SOP and framework for detecting, preparing and responding to public health emergencies. At this state the Health Ministry closely monitors the current virus outbreak from the World Health Organisation (WHO) and ASEAN International Health Regulation (IHR). They also have good coordination with NADMA, Foreign Affairs Ministry on the lock-down situation and also the Immigration Department to tighten the security at our country’s entry points.
Equipment and Immediate Stimulus Package
There is no doubt that proper and adequate tools and equipment are vital to assist the response agencies during the disaster cycle especially at the preparedness stage. In order to curb the spread of this virus, the Ministry allocated RM 227 million for the purchase of medical and non-medical equipment for all health facilities nationwide. During the outbreak of SARS in 2003, a similar package worth RM 7.3 billion was implemented. Currently, entry points to the country are enhanced by increasing the number of thermal scanners as well as laboratories to speed up the investigation and detection of sample results from suspected coronavirus patients, other than machinery and special equipment. In addition to government hospitals, the Ministry of Health will expand the facility to conduct Covid-19 detection tests which include 18 laboratories at the Institute of Medical Research (IMR) and National Public Health Laboratory (MKAK), 4 state public health laboratories and 12 private labs at government hospitals nationwide.
In the event of a disaster, it is important that the public is prepared to provide its own responses. Public preparedness awareness can be considered as actions taken to empower ordinary citizens to help themselves, their families and the people around them. There are many effective ways to increase public preparedness and response-oriented activities such as Public education, public awareness and warning, and the media plays a significant role to transmit warning messages, alerts and give instructions with specific information. With regard to this Covid-19 our government particularly the Ministry of Health is praised for using the social media platform especially through their official Facebook where they keep updating the current information and progress of the disease status from time to time to the public to avoid fake information from spreading to the general public. The Minister also directly announces over live telecast about the current situation globally and locally and also about the actions that have been taken.
ACTIONS THAT SHOULD BE EXPECTED IN THE FUTURE
Despite all the actions and precautions considered and taken by the government, there are a few measures that should be thought through by government for future preparedness. One of them would be training and real exercises through coordination with all relevant agencies to ensure that the handling of the situation is effective. All this while, exercise and training that have been implemented have been merely disaster-related such as flooding, earthquake and other similar issues. Now is the right time for the government to conduct and handle this kind of situation. With two previous experiences on MERS and SARS and now Corona Virus, it is vital for our related agencies to conduct and implement exercise especially regarding this matter.
Review Current Existing Guidelines
One point that the government should look into is to review their local policies and ensure that its current operational procedures are updated and in line with the current situation. Possibly, certain rules and regulations need to be omitted or added to safeguard the nations. For example The Prevention and Control of Infectious Diseases Act 1988 should be revised and relook.
Managing Fake News
Many people follow the news via the social media. The emergence of the social media as a key source of news content has created a new ecosystem for the spreading of misinformation and fake news. Concerning Covid-19, false information was "spreading faster than the virus". Even The WHO has labelled the spread of fake news on the outbreak an ‘infodemic’. It also hits our country, where the spread of fake news creates panic situations and a sense of uneasiness among the netizens. Even though we have Acts and Laws to detect and detain those who spread false information, we should think of ways to reduce its spread in early stage of news broadcast such as the collaboration with the social media networks, establishing an awareness group and many others. Users can up-vote or down-vote comments and links posted by other users. It is worth noting that more active awareness actions and activities could be done at every level of the community.
Whether Covid-19 is a health emergency or an epidemic, all precautions that should be taken by the government have been done, but of course in order to meet the requirement, there are some room and space that need to be improved as a preparation for any uncertain situations or disaster in the future.