I welcome Director General of Health, Tan Sri Dr. Noor Hisham’s openness to review the definition of close contact, which he said in response to my earlier statement urging the government to review the definition of close contact.
Earlier, I had urged the government to expand the close contact definition to a wider base, similar to the CDC (in the USA) to “someone who was within six feet (1.8m) of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from two days before illness onset”.
[1] In response, Tan Sri Dr. Noor Hisham claimed that Malaysia’s definition of ‘close contact’ was based on the World Health Organization’s definition. [2] However, based on the WHO website ‘a contact is defined as anyone who had direct contact or was within 1 metre for at least 15 minutes with a person infected with the virus that causes COVID-19, even if the person with the confirmed infection did not have symptoms’. Contacts should remain in self- quarantine during the 14- day monitoring period to limit the possibility of exposing other people to infection should they become ill, similar to the definition of the CDC.
It would be much appreciated if the Ministry of Health can clarify why there are seemingly differing definitions of close contact from WHO. I hope the willingness to do the review can be executed as soon as possible to curb the outbreak that we are facing in the current wave of infections.
To complement the suggested expansion of the definition of close contact, the Health Ministry should also adopt an “anyone who wants to get tested, should be tested” policy – where those who declare themselves to a contact, at any testing facility should be tested immediately without delay. This contrasts with the current system where individuals identified as close contacts will be contacted to come in for a scheduled test, which could be days after patient zero was diagnosed. In that few days, the number of infections would have been multiplied.
I strongly feel there is a need for the Ministry of Health to build up on this as we have been constantly crossing 4 digits and outbreaks have been happening in factories with more than 250 people. MOH should engage these areas immediately when there is an outbreak to prevent further spread of the virus.
[3] On the 26th of November 2020, Top Glove Malaysia detected an outbreak, and out of the 1,884 cases that was recorded nationwide on that day, 1,067 cases came from Top Glove’s facility in Klang, Selangor. How did it spread so fast to so many people in a short time if close contact tracing AND constant testing were done in the factory itself? The cases should not have surged so high that it led to the Teratai cluster which accounted for more than half of the 2,188 nations cases if contact tracing and close contact tracing was done adequately, as currently prescribed by MoH.
The cluster was undetected due to most of them being asymptomatic with Patient Zero unknown. Those workers were carrying on with their day- to- day activities unaware that they had contracted the virus due to them being asymptomatic or mildly symptomatic as was mentioned by Tan Sri Dr. Noor Hisham [4].
This is why I am calling for the expansion of the definition of close contact and thus mass testing on everyone as most of the carriers now are only showing mild symptoms or no symptoms at all. Mass testing would allow us to identify more mildly symptomatic and asymptomatic patients thus breaking the chain of infection earlier.
I continue to urge MOH to open up mass testing to everyone, throughout the county.