IN his Twitter account on Sunday, director-general of health Dr Noor Hisham Abdullah called on the public to trust the data and the vaccine.

How do you expect the public to trust the data when he himself was quoted to have said in a television programme that the Health Ministry expects daily cases to DECLINE within a week or two on July 10, only to contradict and offer a complete reversal of the assessment three days later, saying MoH expects cases to increase over a week or two?

In May 2020, he was quoted to have said widespread testing is redundant while emphasising MoH’s targeted testing strategy when earlier, the director-general of the World Health Organisation at a media briefing on Covid-19 on March 16 last year, had this simple message for all countries: test, test, test. Test every suspected case.

In the same briefing, the director-general of WHO also said they have seen countries with advanced health systems struggling to cope with this pandemic.

On June 16 last year, Noor Hisham, writing in his column, proclaimed the following:

1. Malaysia is one of the countries in the East that have shown innovative and speedy pandemic responses that have kept infections and deaths relatively low compared with the West,
2. Planning and preparedness began in December 2019, including coordination with public health teams, plans for renovation of hospitals for surge capacity done in February 2020 and plans for procurement of reagents in January 2020,
3. The country’s experience in containing past infections such as SARS (Severe Acute Respiratory Syndrome), Nipah virus encephalitis and MERS (Middle East Respiratory Syndrome) made Malaysia more prepared to deal with such situations, including having more thermal scanners that have been placed at all entry points into the country, as well as its actions in isolating Covid-19 cases and placement of suspected cases under quarantine,
4. The ability to keep deaths low was partly attributed to the early planning and preparedness of the public health and hospital facilities and services where from December 2019 to April 2020, in addition to increasing capacity and the number of diagnostics laboratories, MoH increased the number of hospitals treating Covid-19 patients from 26 to 40 hospitals, including seven that function as full Covid-19 hospitals; MoH also increased the number of screening hospitals from 56 to 120, which is a 53% increment; and increased the ventilator numbers from 526 units to 1,034 units, which is a 49% increment,
5. Contact tracing as a method to control infections was evident throughout Malaysia’s Covid-19 response. Dr Suresh Kumar, infectious diseases physician at Sg Buloh Hospital was quoted to have said in the column that MoH has a big, very good and very experienced public health team that has been doing contact tracing regularly at the scale for disease outbreaks,
6. Communicating effectively with the public and engaging with communities, local partners and other stakeholders to help prepare and protect individuals, families and the public’s health during early response to Covid-19, is essential to the country’s collective success in responding to this pandemic.

In June last year, when the proclamation was made, the total reported Covid 19 cases were 8,556, of which 289 are active and infective and 121 deaths.

Fast forward to Monday, July 19, slightly more than a year later, the total reported cases is at 916,561, of which 124,593 are active and infective and 7,019 total deaths.

The increase can’t be attributed to the highly contagious Delta variant, which made its “appearance” on Malaysian shores only in late May.

It is obvious that despite the optimism of the director-general of health in his column June 16, 2020, the sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed the country’s public health services in ways that he and MoH never imagined.

The touted contact tracing developed and used regularly eg for SARS and MERS where secondary transmission occurred mostly in the hospital setting, did not work for Covid as transmission occurs more among close contacts.

Knowing this where each infected person could have numerous close contacts over a protracted time and vaccines were not yet widely available, the director-general should have but failed to prepare the public health for its response tactics for one of the most important holiday of the year for majority of Malaysian Muslims. The speed and magnitude of the eventual response were woeful as evidenced by the increased infections and deaths and the economic losses from the various forms of movement-controls thereafter.

Reuters, in a report dated July 14, stated that officials, citing low testing rates and insufficient testing capacity, warned Malaysia’s infection figures could be much higher than reported:

• as many suspected and clinically diagnosed cases are not yet counted, and
• inherent difficulties in identifying and counting mild and asymptomatic cases.

Even though MoH began releasing data on the severity of symptoms of the new Covid-19 cases daily, the fact that there is insufficient testing is likely to have a significant influence on the accuracy of the case fatality rate as the number of confirmed deaths excludes deaths and its causes in homes, giving the possibility that the actual death toll from covid could be higher.

Maybe it is time MoH provides its data against a longer time span – since reporting can vary significantly from day to day – so that it provides a clearer picture of where the pandemic is accelerating, staying the same, or reducing to the public.

As WHO said in their simple message in March 2020 to all the countries around the world, it is test test test. Testing is the window onto the pandemic and how it is spreading. Without testing, there is no data. Without data, the public has no way of understanding the pandemic, how well we are doing and whether MoH are under-reporting cases and deaths.

Would the current efforts to increase vaccinations help the country buy time before the variant or any possible mutation becomes too widespread?

Is the director-general of health adjusting their tactics and strategies with new evidence emerging almost on a daily basis? In this environment of imperfect information, for the people to trust the data, it is also important for the director-general of health to be ingenious and have the persistent attitude to learn and readjust as new evidence emerged.

It cannot be one-way traffic asking the people to trust the data alone. – July 20, 2021.

* FLK reads The Malaysian Insight.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.