Helmy Haja Mydin
Let us be clear about one thing: the lifting of Malaysia’s Movement Control Order (MCO) will not mean that the Covid-19 pandemic is over.
Viruses do not follow arbitrary deadlines set by us humans, and will continue to propagate. Over time, we can anticipate thousands more cases.
However, there is a difference in treating 1000’s of cases a day vs a 1000 cases spread out over a month.
The rationale of the MCO is to ‘flatten the curve’ i.e. to stretch the cases out over time so that our healthcare facilities and frontliners are not overwhelmed nor exposed to unmanageable viral loads, increasing their risks of contracting and succumbing to Covid-19.
Stretching cases out is also particularly crucial for those who require a ventilator or to be admitted into the intensive care unit (ICU). We have less than a thousand ventilators across the country, and these are needed by non-Covid-19 patients as well.
It is a mark of success that the number of Covid-19 patients requiring ventilators has remained less than 100, despite the increasing overall number of cases in Malaysia.
This does not mean that we should rest on our laurels. This is especially true as we approach Ramadan and Hari Raya. Iranian’s experience with Nowruz this year should give us food for thought.
Iran instituted a MCO-equivalent in late February, approximately a month before Nowruz, or the Persian New Year, which fell on 20th March . On February 20th, Iran recorded 5 Covid-19 cases and 2 deaths, by March 20th, this number had spiralled into a raging epidemic with 19,644 cases of infection and a staggering 1,433 deaths.
This spike in Covid-19 cases occurred towards Nowruz as there was mass movement of people and families back to their hometowns for the celebrations. In fact, more than 1.2 million Iranians were recorded taking to the roads, despite pleas by the Iranian government for citizens to stay at home. Not helped by a lack of manpower to enforce the MCO and compounded by the government’s lack of resources to provide welfare payments to low-income workers the virus was thus spread to all parts of the country. Northern Iran, a more rural area with less medical facilities and a more elderly population, has been hit particularly severely by a pileup of cases at the hospitals.
A similar scenario of human calamity is likely to occur in Malaysia should the government relax MCO restrictions prior to our traditional ‘balik kampung’ period during Ramadan and Hari Raya. Just try and imagine the tragic effects should urban dwellers in Covid-19 red zones like Lembah Pantai and Cheras disregard advisories and drive across the country to visit elderly relatives in states to the north and east of Malaysia, bringing with them the Covid-19 virus that is particularly lethal to those above the age of 65.
However, we must also acknowledge that the continuation of the MCO in its current form is not without consequences either. There are many tales of woe regarding daily wage earners and SMEs that are unable to sustain their daily existence due to a lack of revenue. This does not even take into consideration the homeless, the stateless and the refugees who are very dependent on the largesse of society.
With the above in mind, it becomes increasingly clear that although the MCO should continue for public health reasons it should be done in a less constricting fashion in order to minimise the socioeconomic repercussions.
Social distancing must continue and be strictly enforced by security forces. This includes a ban on non essential interstate travel leading up and beyond Hari Raya. It may be heartbreaking to not visit elderly relatives during the festive season, but it will be more heartbreaking if the virus you transmit prevents your elderly relatives from living to celebrate Raya next year.
The Ministry of Health can also work closely with the Ministry of Communications and Multimedia and the security forces under the centralised monitoring and management by the National Security Council to utilise location-based services to identify and track Covid-19 cases and their contacts. Identification of red zones based on live data and big data predictive analysis will allow for flexibility in imposing enhanced MCOs appropriately.
Red zones can be targeted for increased levels of screening as well as more stringent restrictions on travelling and business operations. Conversely, green zones should be allowed greater freedom of movement and choice. The technology for real time adjustments already exists – it is a question of implementing it in a dynamic fashion that works across silos without being hampered by bureaucratic red tape.
Mass congregations must continue to be prohibited – from religious activities such as tarawih prayers at mosques to retail such as Ramadan bazaars to cinemas, fitness classes, hedonistic nightclubs. More creative solutions can be tried and tested out to increase social distancing such as online digital Ramadan bazaars and online platforms for teleconferencing religious sermons.
The public health and economic impact of the Covid-19 pandemic are two sides of the same coin, and must be managed concurrently. As the government moves to ease restrictions on businesses to ensure that supply chains are up and running and revenue streams are not exhausted, it is worth remembering that a study of the economic impact of the 1918 Spanish Flu in the United States found that cities that implemented early and extensive social distancing measures suffered less adverse economic effects over the medium term.
The government must continue active measures of social distancing, including the MCO albeit in a more relaxed fashion. We have to accept that our social lives will have to change for the long haul and continue to be vigilant. Removing the MCO or falsely believing that the worst is behind us will likely lead to an overturning of all that we have achieved so far, and any future government stimulus will be used up for medical and funerary expenses.
This article was originally published in The Malay Mail Online.