The Health and Sciences COVID-19 Advisory Group of Experts (EAG) is disturbed by the sharp surge in cases which has led to major hospitals in the Klang Valley surpassing 70% capacity for COVID-19 patients.

Despite the wide array of public health measures in place, the pandemic has not subsided.

This calls for a re-evaluation of our COVID-19 response strategy. The evolving nature of the pandemic requires that we evolve in our public health responses too.

Therefore, it bears repeating that a blanket movement control order (MCO) is not the answer to addressing the impending wave.

The national COVID-19 response must instead be a targeted basket of solutions informed by granular, risk-stratified epidemiological data.

We commend the work done by the Hotspot Identification for Dynamic Engagement (HIDE) team at Bank Negara Malaysia in this area.

As HIDE launched in March 2021, there is not yet definitive data on its effectiveness, but it has immense potential in supporting rapid COVID-19 response.

So, we strongly urge the integration of HIDE tools and findings across all health authorities in the country, as in the following:

1. Integrate HIDE with digital, automated find, test, trace, isolate and support (FTTIS) protocols.

After over a year, there is still insufficient testing and surveillance measures in place. This prevents authorities from effectively containing potential outbreaks and stemming the escalation of clusters.

There must be more rapid antigen tests deployed in areas identified by HIDE analysis, which will allow for early interventions such as swift isolation of persons-under-investigation and targeted MCO. Highly targeted MCO at the district or mukim level will reduce the burden on hospitals as outbreaks are contained.

Moreover, automated contact tracing must be quickly deployed across the board to phase out manual contact tracing so resources can be better utilized in other areas.

There must also be greater emphasis on the Support stage for persons-under-surveillance (PUS).

PUS' and casual contacts, need clear instructions on testing and isolation to maximize compliance.

Those who are isolating must also be given access to resources to support them mentally, emotionally, and financially during the isolation period.

2. Train and empower state and district health authorities to utilize HIDE data.

HIDE technology and data must be shared with health authorities at all levels. On top of that, decentralize decision-making and empower health authorities at the state and district level to manage and make decisions that impact their respective populations.

Should some states or districts not have the public health or epidemiological expertise, the Ministry of Health (MOH) should provide training support to their personnel on the ground.

Alternatively, invite experts from outside MOH and leverage upon existing networks from various fields, ministries, and universities to provide analytical support.

It is imperative that the local health authorities are equipped to monitor and evaluate COVID-19 data on the ground.

Local health authorities can also collaborate with non-government organizations (NGO) for operational tasks such as mass targeted testing. There must be sufficient resources allocated to ensure that decentralized data-driven decision-making can happen on the ground.

3. Improve granularity of data by integrating with MySejahtera.

Once there is proven result of HIDE analysis effectiveness, its functionality should be better integrated with MySejahtera.

Currently, HIDE provides a 7-day advance notice of large outbreaks based on MySejahtera data. However, there is still a lag between the analysis and response on the ground. Premises and casual contacts should be notified as soon as there is any hint of an outbreak, and they must be given clear instruction on how to proceed in the FTTIS process.

On the other hand, MySejahtera data can provide greater granularity to the hotspots and clusters that occur, and better-inform experts on behaviors surrounding public health measures.

With Hari Raya celebrations around the corner and the vaccine rollout underway, we cannot risk being complacent.

The vaccine is not a panacea, and the current rollout rate requires that we deploy all public health tools at our disposal.

We must not be fixated on the unrealistic goal of zero cases, rather channel all our resources on inhibiting severe illness and deaths as well as preventing our healthcare system from being overwhelmed.

We must act swiftly to deploy the new predictive tools in our arsenal for an improved rapid pandemic response.

We the undersigned members of the Health and Sciences COVID-19 Advisory Group of Experts:

1. Tan Sri Dato' Dr Abu Bakar Suleiman, Chairman

2. Professor Dr Rosmawati Mohamed, Academy of Medicine of Malaysia

3. Dr Mary Cardosa, Malaysian Medical Association

4. Dato' Dr Fadzilah Kamaludin, Malaysian Public Health Physicians' Association

5. Datuk Dr Kuljit Singh, Association of Private Hospitals of Malaysia  

6. Datuk Dr Christopher Lee, Malaysian Society of Infection Control and Infectious Diseases