PETALING JAYA: As the nation prepares to transition to the endemic phase from April 1, health experts have advised the government to have a specific Covid-19 control programme to help manage possible future outbreaks.

       Former deputy health director-general Datuk Dr Lokman Hakim Sulaiman said like with any other endemic disease such as dengue, malaria or leptospirosis, Covid-19 cases could spike at certain times.

       This is described as an “epidemic state of an endemic disease”, he said.

       “The endemic state means that infections are still occurring in the community and cases will be reported all year round.

       “Are we certain we are going into an endemic state after April 1? I am not sure, but will the current Omicron wave end by April 1? Perhaps,” he said.

       Dr Lokman said it is very important for the healthcare system to be able to monitor cases effectively to detect and manage a potential epidemic.

       “Like with dengue – localised epidemics can occur after the rainy season, so at times we must expect the occurrence of outbreaks or epidemics and be prepared to deal with them.

       “We must have a Covid-19 control programme in place as we did for dengue and tuberculosis,” he added.

       “The Health Ministry must develop a long-term strategy to live with Covid-19.”

       The emergence of new variants should also be managed through effective and comprehensive genomic surveillance.

       This, he added, is not something of which we have done enough.

       Dr Lokman said focus should also be given to managing symptomatic cases through improved case detection.

       “The current numbers of brought in dead (BID) cases are not acceptable after our experience with the Delta variant from July to September last year.

       “We need to also improve our capacity to manage severe cases,” he added.

       On Thursday, Malaysia recorded 27,004 new cases and 120 deaths, with 35 of the latter being BID cases.

       Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said the government needs to inform the public of the possibility of movement control orders being put in place again if the number of cases reaches a certain threshold.

       “And it is very important that this threshold level be communicated to the public,” she said, adding that Malaysia must also ensure that self-test kits are widely available.

       Dr Malina said the government will have to make sure the vaccination rate for booster and coverage among children is at least 70% to 80%.1

       “On top of that, we have to make sure those who are unable or refuse to be vaccinated are protected as well from any possible infection.

       “For example, if their parents have yet to receive their boosters, they should not be allowed to go back to their hometowns – the unvaccinated should not be allowed to come close to the elderly,” she said.

       Public health expert Datuk Dr Syed Mohamed Aljunid said our healthcare system is much better than those in other developing countries and we should be ready to move on to the next stage.

       However, he said a comprehensive health financing mechanism is needed to provide adequate financial resources for people to access public and private healthcare services.

       “As we move to the endemic state, more people will be going to private facilities.

       “Currently, whenever we go to private clinics or hospitals, we have to pay for it ourselves, and this is a problem.

       “Vietnam, Indonesia and Thailand have an additional advantage compared to Malaysia since they have a strong health financing system through their national health insurance that covers Covid-19, too.

       “Their people can choose to go to public or private facilities and all will be covered by the insurance health programme – and it is very cheap, too,” he said.

       Dr Syed Mohamed said this is important to reduce the burden on public facilities as well as to allow those with “long Covid” to get proper treatment, referring to those suffering from lingering health problems after recovering from the acute phase of the illness.

       “The endemic phase will last about five to six years.

       “It is a very long process, so the issue is we have almost four million cases and many suffer from long Covid – how are they going to get treatment if we don’t have a proper health financing system?

       “Let’s say they need to see a psychiatrist – we don’t have an adequate number of them in public sector facilities, while the private sector is expensive.

       “This will create more issues with mental health,” he added.

       Dr Syed Mohamed also emphasised the need to improve the Covid-19 surveillance system to help detect any outbreak, including the use of the MySejahtera app.

       “The current standard operating procedure (SOP) will soon be relaxed, the public will be given more freedom, the country’s borders will be opened to travellers – if the surveillance system is not strengthened, we may not be able to detect any outbreak that might occur during the endemic stage,” he warned.

       Dr Syed Mohamed also suggested decentralising the decision-making process to the state and district health system in order to efficiently manage Covid-19 cases in the local population.

       As at March 17, 83.8% of the total population in Malaysia has received at least one dose and 78.9% has received two doses, but only 46.2% have got the booster shot.

       Also, 34.4% of children aged five to 11 had received their first dose, while 94.5% of those aged 12 to 17 have received their first dose and 91.3% have completed their vaccination.

       Still, the Health Ministry has constantly stressed the need for older folk to get their boosters as most deaths have occurred among those aged 60 and above.