By Datuk Dr. Chong Chee Kheong

KUALA LUMPUR, Malaysia--It has been just over 2 weeks since we have formed the Greater Klang Valley Special Task Force (GKV STF) to deal with the huge COVID-19 outbreak in the region.
The GKV STF has a good team from the Ministry of Health (MOH), the Army and experts from outside the MOH. We have been working continually to put into place measures to contain the impact of the outbreak - saving lives is our priority.

The rising numbers of infections and deaths indicates the dire situation, one that is very evident to the public. COVID-19 infections are very widespread in the community and our hospital capacity in the Greater Klang Valley, including intensive care unit (ICU), is stretched to the maximum.

Why are numbers still rising in the Greater Klang Valley despite vaccination ramp-up?
Many are asking this question. It is important to appreciate that the size of the outbreak is far larger than the numbers detected each day. Many asymptomatic or pre-symptomatic individuals, who are not aware of their infection, are spreading the virus. 
Remember that the vaccine effectiveness is best 2 weeks after the second dose, so this takes time. An important contribution is the Delta variant that has a high infectivity rate. In addition, we recognise, from the experience and data of nations with high vaccination rates, that infections can still occur due to the Delta variant although the hospitalisation and severe infections are significantly reduced.
What are the Key Measures We are Taking to Stem the Outbreak?

The GKV STF has put in place a number of strategic measures to optimise care services, reduce virus transmission and support the community and health staff. Given the current situation, outbreak management interventions have shifted from containment to mitigation efforts with the objective of preventing death and minimising the spread of disease. Some of the key initiatives include:

1. Increased capacity of beds, ICU care, oxygen supply, manpower deployment and use of volunteers. Moving non-COVID-19 patients to the private sector is also helping to free up beds. The help from our army colleagues has been invaluable in logistic and manpower support;

2. Strengthen COVID-19 Assessment Centres (CAC) by offering a virtual CAC for asymptomatic and mildly symptomatic patient and enhanced home monitoring management;

3. We hope to offer more RTK-Ag tests to health clinics and general practitioners via sales of MDA approved test kits to allow for wider testing. Home saliva test kits for self-testing are also available in pharmacies for the public to purchase and test themselves;

4. Improving support for frontliners, both hospital and health, as well as strengthening the social and emotional support systems for the public;

5. Acquiring and allocating funding for the purpose of procuring additional medical equipment and medication; and

6. We are also attempting to improve our communication with the public on critical issues and keep you updated.
Our staff from the hospitals, health facilities and management areas are exhausted but we are still here for you and will continue to work to overcome this crisis.
What Can You Do as the Public?

We would like to thank the members of the public that have cooperated in this emergency by limiting their social contact and following standard operating procedures (SOPs). There are some key measures you can take to help yourself, your family, the community and the health services listed below. The key message is to help us break the transmission of this virus to others:

1. At this time if you are in the Greater Klang Valley and have any symptoms of COVID-19 you should consider yourself as possibly infected and get tested;

2. Once you are confirmed positive, please home isolate, notify yourself and do self-monitoring frequently through the MySejahtera application. Home isolation is for asymptomatic and mildly symptomatic patients who do not need hospitalisation and will recover. We do not want to congest hospitals with mild cases so that treatment for the severe patient can be prioritized. Our staff will contact those that are ‘red flagged’ as high risk and request them to come to the nearest CAC or hospital;

3. If you are positive, please inform all those you have been in contact with to quarantine for 10 days. Testing is not necessary unless they develop symptoms. What is important is to stay at home and monitor your condition daily;

4. Members of the public who think they have been exposed but are not identified as close contacts are encouraged to test at private health facilities; this may include doing a saliva-based self-test;

5. Vaccination will greatly reduce the risk of infection, so register and get vaccinated as soon as you get an appointment. Those who are contacts of positive cases should defer vaccination for at least 10 days;

6. We appeal to the community to support us. Some can volunteer to help in the health system at the CAC, health centres or hospitals. Others can volunteer to help boost the social and emotional support systems for the public.

As we encourage more self-testing and RTK-Ag use, we can expect the number of cases to rise in the next few days. Do not be alarmed by this; we need to identify as many cases as possible to reduce transmission in the community. 
As more of these positive cases and their contacts are isolated and quarantined, cases will start to gradually come down in the weeks to come. Once that happens, the testing will be re-strategised to ensure effective detection of cases for isolation and monitoring.

This crisis has been the worst that we have faced as a community and health service in our generation. We have not given up and will persevere to offer the best that we can. We thank you for understanding our limitations and for the enormous ground swell of support that we have seen.