MALAYSIA is facing a major public health crisis, and much like the rest of the world, we learnt that we are stronger, together.
Upon the conclusion of the first movement control order (MCO), the Health Ministry (MOH) tabled a plan on how to phase-off from MCO to our new normal.
The plan was named CAPP (Cegah & Didik, Amal, Patuh dan Pantau) approach for District Risk Reduction Programme (DRRP).
The tagline was #AttackRedProtectGreen. The endgame was to convert red zones into safe havens green zones, and to protect the local community from the threats of imported Covid-19 cases.
Local teams and resources were strategised at the district level to empower decentralisation.
Fast forward to today, five districts in Selangor have been categorised as red zones, while another three are yellow zones.
Considering the increasing burden of cases, the overstretched health capacity and the limitations of personnel to enforce SOP compliance, priorities of work processes needed to be undertaken.
We disclose here our past practices on how we utilise the anonymous data provided in the past, for your kind perusal and understanding to debunk the allegations of breaching of patient confidentiality, leaking data to the press, etc.
Why we needed the data?
It requires planning in order to mobilise personnel to monitor SOP compliances, to better target community education, to deploy community-based screening, and to organise welfare distribution to the affected community.
It would be difficult to mobilise resources and protect the local community when cases and clusters locations are vague and ambiguous. Thus, astute planning requires data.
What data is required?
A granular, but anonymous case line-listing (info on time, place, etc) would do the trick. We have no interest in personally-identifiable-data (PID), rather our concern is to identify the location of clusters within a district.
What if we do not have the data?
The public available data as suggested by MOH means very little for logistic and mobilisation purposes. To cite an example is like saying, cluster Merbok is described to have taken place across five districts, namely Kuala Langat, Klang, Hulu Langat, Petaling and Kuala Selangor.
Community-based testing
This would not be the first time the state is allocating its resources to boost testing and screening when required. When faced with a Covid-19 cluster in Hulu Langat during the MCO period, we worked in tandem with the federal health authorities and complemented the screening process so that cases can be identified faster, and isolated swiftly.
Every individual that was tested and identified as positive, means one less case for the district health office to process. And all the identified cases were referred to the district health office, for case management. Where health resources are overstretched, it makes sense to unify our resources.
The ‘Selamat’ guide
The fact remains that we are “to co-exist” with the virus for quite some time. Infection risk, however must be constantly managed, and this will require a set of guidelines and practices for the community to self-execute their respective measures, on how they can continue livelihood during the pandemic.
With consultations alongside local authorities, experts, and most importantly – community leaders, the state is in the midst to roll out a default set of practices for schools, public spaces, businesses and place of worships – known as the Selamat guides – depending on the number of active cases in the surrounding locale.
This build into the state medium-term strategy in educating and empowering the public to take proactive actions. Selamat builds on MOH’s CAPP strategy and zone- ranking system, with the intention to fortify public preparedness and business resilience, and to minimise ad-hoc SOPs issuance that proves to be difficult to comply by community.
However, for Selamat to be operationalised alongside MOH statistic and zone-ranking (we aim to keep in-line with MOH level of 0, 1-40 and >40) , the number of active cases in each locale remains as a crucial indicator. This again underlines the need for anonymised, granular location data.
Data-sharing reduce redundancy
Undoubtedly, the CPRC is the repository (keeper) of all Covid-19 cases. This is the very reason we requested that data be shared from a central authority so as to reduce redundancy or risking duplication, as alluded to by the DG, “for smooth coordination and messaging, we need one source of health data”.
The state of Selangor has never published its own numbers and statistics.
We have religiously aligned ourselves with the statistics issued by the state Health Department. We have been misquoted, when certain news portal mistakenly categorised district code by “cumulative numbers”, rather than “active cases numbers”.
The state government doesn’t own a separate patient dataset. Technically, it is not equipped to validate diagnosis and notifications since both are a pre-requisite for “case” definition.
Instead, it runs its previous community testing initiative through a network of trained GPs and private labs – which eventually will notify any positive findings to the MOH, so it can be appended into the MOH statistics. We are committed to a singular, centralised patient line-listing.
What about Selangkah?
The state-owned Selangkah platform – was initially rolled out as a pioneer QR-based contact tracing, now provides multi functionalities for the state’s Covid-19 coordination.
Local authorities relies on a centralised dashboard to monitor overcrowding, while contextual surveys were intermittently posted to the public to remind, educate, and alert the public of the need for SOP compliances.
Public findings were used to determine the area of non-compliances, so authorities can be mobilised when and where it was needed (We, unfortunately, don’t have eyes everywhere, but we can mobilise the community to support this effort).
This is truly community empowerment and runs in harmony with the CAPP strategy – Cegah, Amal, Patuh dan Pantau.
Data privacy
As a digital tool that crowd-sourced public non-patient data, Selangkah looks to the Federal Agency that regulates the issue of Data Privacy – Jabatan Perlindungan Data Peribadi – and complies with its advisory published on May. This is the assurance of privacy, provided under the current framework.
Integration
To reinforce MOH’s contact tracing activities, whilst concurrently monitoring the SOP compliance digitally, we proposed an application layer integration. This means all scanned log data of Selangkah will be shared with MySejahtera. This means contact tracing can be done per MOH’s SOP, by MOH personnel.
Meanwhile, the other functionalities of Selangkah can continue to exist as a data source to guide the state government and Selangorian to navigate its way through this pandemic.
It’s all about sharing and complementing, not competing
In responding to the pandemic, the state government functionaries remain steadfast towards complementing the MOH efforts and realising its DRRP aspiration.
We deployed community-based testing to test, identify, and isolate faster. We forwarded our findings to the state Health Department so a single dataset can be compiled. Our digital tools empower the community which supports and enhances the CAPP strategy.
And since the health director-general is frequently is concerned of the rakyat’s failure to comply with SOPs, Selangkah among others is a smart tool monitor SOP compliances, and informs academician and researchers to conduct studies on public awareness, knowledge, skills and compliance with SOP.
These were the spirit of cooperation and collaboration that existed before, where we built on each other’s strength. Our only hope is to resume what was started before, to protect the rakyat lives and livelihood through this unprecedented pandemic. – The Vibes, October 21, 2020
Datuk Seri Dr Dzulkefly Ahmad is chair of Selangor Task Force for Covid-19 and former health minister.
