With Covid-19 showing no signs of slowing down, what can Malaysia do? Proactive screening of workers’ dorms, tighter SOPs may help, say public health experts

 

A general view of the Tropicana Golf and Country Resort's dormitory for workers in Petaling Jaya October 11, 2020. — Picture by Ahmad Zamzahuri

KUALA LUMPUR, Nov 5 — Adopting a proactive stance in conducting screenings at workers’ dormitories and fine-tuning the Covid-19 standard operating procedures (SOP) for the public could give the edge that the country needs to contain the outbreak, public health experts said.

With the Ministry of Health (MoH) having identified foreign workers as among high-risk groups, especially those residing and working in Covid-19 red zone areas, giving more attention to these neglected demographics may help, they suggested.

Malaysia Medical Gazette managing editor Dr Khoo Yoong Khean pointed to Malaysia’s southern neighbour, Singapore, which attributed nearly 95 per cent of 57,000 Covid-19 cases to its migrant workers in September.

“Easy reference to look at is Singapore. We know worker dormitories and hostels are overcrowded, so the risk of transmission is very high. They are likely to be many asymptomatic cases as well, so proactive testing needs to be done to stop the spread before complications arise.

“This is not mass testing, but like MoH says, targeted testing based on living conditions as a risk factor,’’ he told Malay Mail.

Malaysia Medical Association president Prof Datuk Dr M. Subramaniam, while suggesting that proactive screening of foreign workers is important, also stressed that the government must ensure that their living conditions improve.

“Foreign workers were among the high-risk groups identified by the Health Ministry. Regular testing of this group is important but more important is their living condition, where physical distancing may be difficult to observe

“Some efforts have been made by employers to address this issue but there needs to be follow up action by the government to check on this. Hostels should similarly be checked,’’ he said.

In May, Health director-general Tan Sri Dr Noor Hisham Abdullah stated that cramped living conditions among migrant workers, sometimes up to 15 to 30 people living in a unit, have made them a target group for compulsory Covid-19 screening and testing.

Deplorable living conditions have also been identified as a factor that exacerbates transmission among migrant workers who often reside in cramped spaces.  

Other concerned parties in the country such as the Malaysian Trades Union Congress (MTUC) have called for employers to provide better living condition for their workers, urging them to heed to the advice of MoH and comply with the amended Workers’ Minimum Standards of Housing and Amenities Act 1990.

However, conducting proactive tests on worker dormitories could be costly to the government and even the workers themselves, said the president of the Medical Practitioners Coalition Association of Malaysia, Dr Raj Kumar Maharajah.

“Proactively testing workers’ dormitories and hostels rather than waiting for Covid-19 cases to emerge from these is ideal, but there is a high cost involved. I'm not sure if we will have the budget for this and if not, will workers have the money for it?’’ he asked.

Fine-tuning and enforcing SOPs

Passengers wait to board a GoKL bus at the Pasar Seni bus station in Kuala Lumpur October 29, 2020. — Picture by Yusof Mat Isa

While public health officials are exhausting every avenue to contain the spread of the diseases, they have been consistent in asking the public to abide by the SOPs set in accordance with global standards as a means of prevention against Covid-19.  

Currently, several parts of the country have been placed under another round of conditional movement control order (CMCO) as Covid-19 cases continued to prevail.

Under the CMCO, inter- and intra-district travel is limited and employees have been ordered to work from home.

However, Dr Subramaniam stated stricter enforcement is needed to ensure that all parties comply with the set SOPs.

“There should be stricter enforcement for all SOPs. MMA has observed that there has been a drop in enforcement as a number of shops and restaurants are taking the SOPs lightly.

“There may be a need for plainclothes enforcement officers to keep business operators on their toes. We have also observed that there is almost no enforcement at offices. If manpower is an issue, managers of companies should appoint staff on rotation to enforce the SOPs at the workplace.

“The government should also get more companies to commit to working from home as many companies are still operating with an almost full workforce during this CMCO,’’ he said.

Dr Subramaniam also urged that the National Security Council relook public transport into CMCO areas, pointing out that people have opted to use rail transport to avoid police roadblocks.

“The NSC will need to rethink or fine-tune its SOPs on inter-district travel in areas under CMCO as people can still crisscross districts via rail.

“On a number of routes, you can drive across districts without being stopped at any roadblock even past 10pm when shops have closed,’’ he said.  

Yesterday, Malaysia recorded four-digit new Covid-19 cases for a second consecutive day, with 1,032 new cases.

There were also eight deaths, seven of which were in Sabah.

Dr Noor Hisham said yesterday his ministry expects the Covid-19 infectivity or R-nought (R0) value to be reduced to 0.5 in the next two or three weeks.

He said the conditional movement control order (CMCO) enforced in several areas in the Klang Valley and Sabah had successfully reduced the value of R0 from 2.2 at the beginning of September to 1.0 currently. - malaymail