Follow stay home order…or you may face total lockdown


(NST) – The Movement Control Order (MCO), if carried out successfully, could see a decline in the number of new Covid-19 cases, medical experts say.

However if the number of cases does not decrease, fluctuates or increases, indicating the MCO has failed in breaking the transmission, the government may need to prolong the order or even impose a total lockdown.

Former deputy director-general of public health Professor Datuk Dr Lokman Hakim Sulaiman said there might be a small spike following the MCO because of enhanced contact tracing of existing cases, but it should continue to go down after that.

He stressed that the success of the MCO in flattening the curve is determined by one key factor – the public must stay home.

“The MCO is critical at this stage, when the number of cases are still manageable from the public health perspective.

“With the MCO, the uninfected person will be prevented from being exposed to infection, while the infected and exposed individuals can be easily detected, traced and isolated in hospitals and quarantine centres.

“If we do it properly and the public cooperate completely, I expect the number of new cases will progressively drop over the next two weeks.

“We should not expect it to become zero new cases on D14 (Day 14), but (decline to) a small number that it does not risk a new wave of infection. This number will be based on the epidemiological pattern of the disease distribution, among others. If it becomes zero on D14, that is excellent.”

Dr Lokman said if the number of new cases does decrease but not to a level significant enough to suggest a break in transmission, the MCO may need to be continued for another two weeks.

The government, he said, may consider various options, depending on the epidemiology of the infection, if the MCO fails to contain the spread.

“If the transmission is localised to a certain geographical area, only that area needs to extend the MCO or in worst case impose a total lockdown and curfew.

“If the transmission remains widespread, the government may not have many choices but to extend the MCO or carry out a total lockdown (curfew).

“I am anxious to know the impact of the mass exodus on the eve of the implementation of the MCO. If that uncontrolled crowd movement helps in the spread of Covid-19 outside the Klang Valley, we will see new infections, just like the spread following the tabligh, but maybe limited to Peninsular Malaysia.

“This might compromise the effectiveness of the MCO because new cases might just appear before or on D14, in which case the MCO may need to be extended,” he told the New Straits Times.

Professor Dr G. Jayakumar, who is a professor of Community and Occupational Medicine at the Faculty of Medicine in Melaka Manipal Medical College, said the next two weeks was crucial to break the transmission chain and if the situation worsens by March 31, a total lockdown has to be considered.

“An analogy of the transmission chain is a set of bottles decked in a straight line. There should be sufficient distance from one bottle to another (akin to social distancing). If not, if one bottle falls, there will be a cascading effect on the rest of the bottles and they tumble.

“Likewise, if social distancing is not practiced diligently, there is a ripple effect on society.

“The ‘tidak apa’ attitude of the rakyat has to be curtailed. It is time the government takes the bull by the horns. If not, a complete lockdown with the assistance of the army seems inevitable for me. A difficult decision for the government and society but there remains little choice later.”

Former Deputy Health Minister Dr Lee Boon Chye said the current MCO would give authorities an idea of how big the cluster case of Sri Petaling is as attendees who tested positive would have transmitted the virus to others.

He also hoped that the government would “fine-tune the MCO” to give maximum impact and minimal disruption to the economy and daily livelihood of citizens.

“The implementation of the MCO is to halt

further transmission. Failure is not an option,” he said.

Dr Swee Kheng Khor, who specialises in health systems, policies and global health, and is currently based at the University of Oxford, said if Malaysians do not start behaving responsibly by staying home, there may be a need to implement additional, more stringent measures.

“We can also see some unintended consequences which must be quickly mitigated, such as panic-buying and confusion from contradictory government policies.”

 



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