MoH Must Redefine Close Contact, Expand Mass Testing To Stop The Spread

Last week I called for our Ministry of Health (MoH) to increase its mass testing after SOCSO announced compulsory testing for foreign workers. As can be seen in this past week alone, the number of cases has exponentially risen with the increased testing of foreign workers. Most of the cases currently detected are in category one (non-symptomatic) or category two (having mild symptoms).[1]

If such testing was not made compulsory, these cases would have gone undetected and the spread would have continued. 

Given the current situation, MoH must now redefine their existing definition of close contact. Currently, MoH has defined close contact as:

  • Health care associated exposure, including providing direct care for 2019-nCoV patients, working with health care workers infected with 2019-nCoV, visiting patients or staying in the same close environment of a 2019-nCoV patient.
  • Working together in close proximity or sharing the same classroom environment with a with 2019-nCoV patient
  • Traveling together with 2019-nCoV patient in any kind of conveyance
  • Living in the same household as a 2019-nCoV patient

The Centre for Disease Control (CDC) in US defines close contact as “someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.”

There is a big difference in the two definitions above, with the CDC covering a wider range of potentially exposed people. Which is exactly what MoH needs to emulate and redefine its criteria for close contact. 

As a case study, take the example of the One Utama Shopping Centre cluster. It started with a foreigner working as a security guard on October 10. As of December 2, there were 283 positive Covid-19 cases detected in this cluster, with a positivity rate of 23% – even spreading to Melaka.[2] Most of those infected were locals.

By targeting mass testing only to foreign workers, MoH is missing out on the bigger picture. We need to test more people and the only way to do that is to make testing more available and to expand the definition and scope of the term close contact. 

MoH has the necessary resources if it enlists all private healthcare personnel in the country, namely the Genral Practitioners ie private clinics. MOH can use the antigen rapid test kits for this expanded definition of close contacts, better than not testing them at all. And with tests costing the government less than RM60/person, we shouldn’t be turning away anyone who wants to get tested. And if the Ministry of Finance knew how to prioritise during a pandemic, it certainly would have the necessary budget to purchase enough test kits for the whole country. 

Now that MCO has been relaxed and inter-state travel is allowed, more and more people are at risk of being infected or infecting others. When not enough people are being tested, those who do not know that they are infected will continue spreading the infection.

Rajiv Rishyakaran

ADUN Bukit Gasing

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