It is very unfortunate that our MOH already came to the stage where they could hardly keep up with the close contact tracing. They might have worked way past their capacity given what was reported in the news. The challenging situation could be very real and daunting - the average daily positive cases for the past 7 days is 3405 (13-19 Jan) , imagine if one newly confirmed patient has been in touch with 10 persons which could be later identified as close contacts, just on the number of phone calls alone, the ministry has to make over 30 thousands of calls a day!
It is not only the initial phone calls, the MOH officers also have to evaluate and follow up the situation for each and every close contact, and make logistical arrangements for them if required, for example, pick up for quarantine/treatment or arrange for testing.
The amount of workload should not be underestimated, while the number of officers and teams might not get expanded that quickly even if the MOH has done 'redeployment' to help out with the impending COVID-19 disease control tasks. Trying to tackle the overwhelming workload that creates more and more backlog is just not working for the system , in fact it stops making sense anymore (eg. being contacted after one is recovered).
The new directive for asymptomatic close contacts to stay home quarantine without testing may have saved considerable work burden for the MOH and actually this is also in line with the WHO guideline "Home care for patients with suspected or confirmed COVID-19 and management of their contacts" issued on 12 August 2020, Still, this directive does not excuse the task for our health authority to identify, inform, evaluate and follow up with the close contacts. Thus, the backlog of close contacts not made it in time for tracing, this will become a big problem.
Recently, many also probably have heard from someone who had been infected, that he/she had to make personal communication first to notify those who are potentially at risk as close contacts, so that the latter could get prepared to self-quarantine before MOH could tell them so. Some of the contacts could barely live with the fear and uncertainty hanging on their head, decided to go first seek for COVID-19 testing in private settings. Even delayed contact from the MOH could leave many members in the community in great anxiety, and some may make the wrong decision and action for themselves, aggravate the situation.
Public should also understand the rationale for the new directive (on asymptomatic close contacts to stay home), it may not be the most desired thing for the MOH to do, but it could be the temporary solution at the moment. The MOH could no longer scrutinise the movement of the close contacts, hence it is imperative that once the close contact is being identified and notified as such, he or she plays the part of keeping others safe by observing the home quarantine.
It does not mean that asymptomatic close contact should simply go out and break the home quarantine order (given that the person won't even get a pink bracelet on his/her hand to be identified with), the whole community and the health authority would have to count on them having the discipline to observe the quarantine order. The Sivagangga cluster back in August 2020 already informed the nation the cost of personal indiscipline to the communities. Fortunately the plan ('new directive') could work better due to MCO 2.0 being imposed now, such that those close contacts should have no good reason to go out of the house anyway.
KKM should try expanding the local contact tracing teams especially in districts/areas with greater disease burden. If necessary, they should source help from the community and train more volunteers on the tasks performed for contact tracing.
It is true that only if the contact tracing system is still intact, the government could stand a better chance to get the pandemic under control and flatten the curve. The more close contacts not being traced , the greater the risk for community transmission unchecked.
For the time being, stricter MCO may need to be implemented if the situation in the coming weeks is still not yet under control, the government has to look into reducing further number of people going outside and get exposed in the community.
Inputs given above for the final Malaysiakini article:
Experts: Rope in more people to help with contact tracing
https://www.malaysiakini.com/news/559903
...Monash University Malaysia public health and health systems researcher Mark Cheong echoed the Gopeng MP’s proposal, saying other ministries could also contribute human resources.
“The government may want to consider reassigning manpower and resources from other ministries and government agencies to perform contact tracing operations,” Cheong said.
To further target its response, health economist Lim Chee Han proposed that the ministry trains voluntary contact tracers to be placed in red zones.
“The ministry should try expanding the local contact tracing teams, especially in districts or areas with a greater disease burden.
“If necessary, they should source help from the community and train more volunteers,” said Lim, the Third World Network public health researcher.
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