I urge the Ministry of Health to review its Guidelines on management of Covid-19 pandemic daily by using emergency measures to conduct mass testing among the affected neighbourhoods in Renggam and Kluang, amidst yesterday’s report of a total of 83 newly confirmed Covid-19 cases in the district of Kluang with 61 cases from Kampung Dato’ Ibrahim Majid and Bandar Baru Dato’ Ibrahim Majid, within the vicinity of Simpang Renggam town.
The Covid-19 has caught many experts by surprise by its extraordinary features, Initially it was thought that those symptomatic Covid-19 infected patients would spread the infection, and it was not air-borne. Nonetheless, it has later been proven that between 15 to 50% (average 31%) asymptotic infected persons could be the super spreaders, and the infection spread extraordinarily faster due to the fact that it is proven to be air-borne. Therefore the authorities concerned have to keep up with the latest information and data to improve efforts in containing the pandemic by reviewing our protocols and guidelines daily.
The derivation from the data available implies that there could be at least 12 to 42 asymptomatic infected individuals among the affected neighbourhoods in Kluang-Simpang Reggam who could become super spreaders. In other words, going house to house in the affected neighbourhoods in order to pick up residents with symptoms only for testing would not be effective enough to contain the local epidemic despite a complete movement control order. It is only effective to contain the local spread if a mass testing is being carried out immediately.
The authorities concerned should utilise the Kluang-Simpang Renggam to carry out mass testing among the affected neighbourhoods with both antibodies-based (IgM-, IgG-basedand, RT-PCR-based rapid test kits in conjunction with Laboratory PCR by the Institute of Medical Research in order to validate the reliability of these tests. RT-PCR laboratory testing could also give a false negative rate of 10 to 30%. And hence, rapid antibody-PCR test kits not only could help boost the accuracy of diagnosing Covid-19 infection, but also help quarantine and treat mildly symptomatic and asymptomatic infected person early by giving test results in 10 minutes. In turn, this would also reduce the community transmission effectively at a very early stage.
The authorities should set up drive-through rapid testing centres for residents with or without symptoms living around the township of of Kluang and Simpang Reggam immediately in order to pick up both symptomatic and asymptomatic infected persons. This approach has been adopted by South Korea,which developed rapid test kits and set up a few hundred drive-through rapid Covid-19 testing centres nationwide with an average of 20,000 rapid screening tests done each day.
Despite tracing, testing and quarantining direct contacts with the initial clusters, mass testing is necessary when community transmission has begun. South Korea has flattened its Covid-19 transmission curve effectively in a matter of 4 days, and it has had the lowest fatality rate among Covid-19 patients by carrying out mass testing campaign and early intervention.
Singapore so far has developed a RT-PCR-based rapid test kits, and it has had a Covid-19 testing rate of 6500 per million. Singapore has also successfully contain the epidemic by proactive contact tracing, mass testing and stringent quarantine and tracking measures. Rapid test kits could provide results in 10 to 20 minutes, in conjunction with more sensitive but time-consuming laboratory RT-PCR testing, could help picking up possible asymptomatic carriers within the Kluang-Simpang Renggam communities and hence halt any further community transmission.
These efforts should inspire Malaysia’s policy makers to take similar stringent measures. The Federal Government has to approach Singapore, China and South Korea for assistance in especially supplying rapid Covid-19 test kits to mass screen the Kluang-Simpang Renggam’s affected neighbourhoods and offer free drive-through tests for any residents living around Kluang and Simpang Renggam. This mass testing and stringent quarantine measures would curtail the spread of Covid-19 transmission within the community.
This is our best opportunity to plateau the rising curve of Covid-19 cases in the country and don’t we miss it. On the contrary, if we refuse to accept new data and latest developments to improve upon our crisis management system, our hospitals will be over-flooded and our health system will face a possible collapse.
Malaysia has to learn the bitter lessons form countries like Italy and the USA, which had been too complacent in responding to this specific crisis, have faced an acute constraint of resources in the midst of exponential surge of Covid-19 infected cases. Malaysia has to seek assistance from other countries such as Singapore, South Korea and China immediately in carrying out mass rapid testing. Kluang-Simpang Renggam would be the best site for community mass testing effort in order to control the epidemic from spreading further locally and nationwide.