Malaysia could have avoided MCO2.0 if had ramped up testing and tracing in April 2020

1. The Movement Control Order (MCO) is a blunt tool – wrecking the most collateral damage without necessarily solving the main problem. It should be employed as the last resort, not as a first response.

2. As the whole citizenry, especially those who are living a hand-to-mouth existence, are paying for the MCO, we Malaysians have a right to be informed if the Government has chosen the right tool.

3. I wrote on 1 April 2020, at the start of the second two-week MCO period, that the Government must ensure it mobilises all resources possible to do testing. It is “testing, testing, testing”!

“The second MCO period should be about testing, testing and testing! The suppression/containment strategy via MCO is meant to “buy time” to avoid any sudden exponential spikes of cases which would result in the collapse of the health system.

“But without expanding testing and tracing massively, we still won’t know how many carriers out there who can spread the virus the moment MCO ends as we can’t isolate and treat them.

“Private hospitals, military hospitals, and possibly some private clinics can be roped in to do tests, such as setting up drive-through test centres.

“Police should be brought in to do more contact tracing work.

“Testing should be the number one priority in the next two weeks, at all costs. No point spending on any other item if we can’t get testing and tracing right. Without testing massively, we are in a situation of “we don’t know what we don’t know”.

I was warning that if we don’t conduct sufficient number of tests, we might end up heavily relying on a lockdown strategy that doesn’t bring much benefit. Whatever I wrote 10 months ago is still applicable today. We are in the same hole, probably worse than 1 April 2020.

4. Recently, Health Director-General Tan Sri Dr. Noor Hisham Abdullah claimed that the Health Ministry’s labs are now nearly reaching the maximum capacity of 76,000 tests daily while we need to ramp up testing to at least 150,000 to 200,000 tests daily.

5. Dr Noor Hisham lamented that so far the testing capacity at university hospitals was at 27 per cent, private laboratories (31 per cent) and laboratories in the Malaysian Armed Forces hospitals (24 per cent). These facilities are underutilised and could increase their capacity up to 100 per cent to achieve the daily test target.

6. I have long argued against a Health Ministry-dominated approach and have been calling for a whole-of-government approach in the war against Covid19. To put it into context, it doesn’t inspire confidence if halfway into a war, the army general (in this case, the Health DG) complained to the media that the air force (the other health institutions/labs) has forgotten to provide for air cover. The Prime Minister must lift his finger and not sit back while these turf wars are happening under his watch.

7. Ideally, the whole-of-government approach could possibly be conducted and coordinated via Majlis Keselamatan Negara (MKN). But somehow the head of security cluster and Defence Minister Dato Seri Ismail Sabri is only announcing SOPs and how many people were arrested, without injecting much overall strategic thinking. Since the buck stops at the Prime Minister’s desk, if the target is to reach 200,000 tests daily, Tan Sri Muhyiddin Yassin will have to communicate to the nation the roadmap to get to 200,000 tests daily.

8. Frankly, while the Health DG says the Health Ministry is not against the usage of rapid tests, there is no sign that the Government is ramping up rapid tests to the necessary level. I fully understand the differences between the two, and the accuracy of PCR and rapid test’s lesser accuracy. There are ways to deploy rapid tests in places such as prisons and other big clusters. This obsession with PCR tests and the obvious aversion to rapid tests do not appear to be science-based.

9. And, I would like to repeat my criticism against the Health Ministry’s SOP of not testing close contacts who do not show symptoms. All close contacts of Covid19 positive patients should be tested and isolated. Rapid tests can be deployed in such circumstances.

10. MCO 2.0 could actually have been avoided if Malaysia’s testing capacity was ramped up in April 2020 and massive testing were constantly conducted throughout the whole period since 18 March 2020.

11. It is now time for the Prime Minister to treat testing as the No 1 defensive mechanism in our “war” against Covid19. The Prime Minister must report to Malaysians what he is doing about testing and what is his game plan to ramp up capacity.