Testing still Malaysia’s weakest link, says Dr Jemilah

 

Efficient testing will become the most important factor once Malaysia has finished with vaccination and goes into containment, says Dr Jemilah Mahmood.

PETALING JAYA: The test, trace, isolate and support strategy is Malaysia’s weakest link in its pandemic management strategy, Dr Jemilah Mahmood has said.

The special adviser to former prime minister Muhyiddin Yassin on public health said a national testing strategy would be needed to stave off small outbreaks as states begin to reopen their economies.

She told CodeBlue that testing was a key measure to contain the virus as the country begins to prioritise mitigation over containment, reversing tack only in specific localities when needed to prevent small outbreaks.

“I want to say, first of all, that Covid-19 is not over. What is happening very clearly is that we will have waves of outbreaks, but hopefully, the waves are small and very manageable, and patients don’t feel very ill as more people are vaccinated and our health system can cope.

Dr Jemilah Mahmood.

“But it doesn’t mean that we should forget about testing. In fact, once the numbers come down and things are calmer, this is when our find, test, trace, isolate, support (FTTIS) becomes very important. This will allow us to go into containment again, which means we want a minimal number of outbreaks,” she said.

While testing has increased nationwide with over 21.8 million tests administered to date, the country’s positivity rate remained in double-digits at 13.2% yesterday, pointing to under-testing and undetected cases in the community.

In fact, the national test positivity rate has remained above 10% since July 21, well above the maximum benchmark of 5% set by the World Health Organization to assess whether testing volume is sufficient.

Citing Singapore’s TraceTogether system as an example, Dr Jemilah said Malaysia’s tracing process must be more automated so close contacts can be swiftly identified and alerted.

“They have something called TraceTogether, but you also have a token that you put together with your phone in your pocket, so that when you cross each other, if you’re a close contact, the token will ping to your phone. That way, you don’t miss any of the contacts, and you have an automated tracing approach.

“We need to use much more artificial intelligence and machine learning to be able to build models and predict. It’s all available. There are experts in the country already doing it.

“Most importantly, the health ministry must not try to do everything on its own. You must bring in external expertise to help look at the data more broadly, look at new ways of tracing, new ways of isolation, and then be very transparent with the public on the information as well,” Dr Jemilah said.

In addition, she said a more holistic approach must be taken to ensure patients and close contacts are isolated and that involves state representatives, village committees, enforcement officers and civil society organisations.

“The other very important thing is support. How do you make sure you support the person who is being isolated? Do they have enough psycho-social support? If that person is a breadwinner, how will the family receive their provisions and food? This is where the community comes in.

“So, for effective pandemic management, I would say the medical part is only one aspect. But the biggest, and very important part of it, is community participation,” said Dr Jemilah. - FMT