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What does a country really need to do during a pandemic?

Commentary from Prof Dr Awg Bulgiba Awg Mahmud, Professor of Epidemiology at the Dept of Social and Preventive Medicine, University of Malaya, and, Secretary-General of the Academy of Sciences Malaysia.

The COVID-19 pandemic is causing a lot of concern among the medical community and the public. A steep rise in the number of locally transmitted cases in all countries affected by the pandemic is leading to a lot of outcry and lots of actions have been suggested to combat the pandemic. Lots of analysis have been done by experts and non-experts and healthcare staff are reporting a great strain on resources.

Health ministries all over the world are issuing daily updates on the situation.  There have been pronouncements of actions to be taken by various parties including businesses whose staff have been infected and whose businesses are affected by movement restrictions introduced to ensure some kind of social distancing. Governments are scrambling to introduce various stimulus packages to avoid or mitigate an expected economic recession.

Despite this, there is widespread feeling that the pandemic does not seem to be under control. There is also a lot of confusion on where the management of the pandemic is heading i.e. whether countries are still trying to contain the pandemic or whether they are now in the mitigation phase.

The way I see it, this confusion results from two main deficiencies – lack of clear Pandemic Management Strategies and lack of clear Crisis Communication. There are certainly many health guidelines which dwell a lot on managing individual persons suspected of being infected but many countries do not appear to have clear overall strategies in managing this pandemic. A clear overall pandemic management strategy needs to answer the following questions:

  1. What stage of the pandemic is the country in now?
  2. How is each stage determined?
  3. What is the capacity of the country’s infrastructure to cope with the current stage?
  4. What are the strategies for each stage of the pandemic?
  5. What is the goal of the strategies at each stage?
  6. What is the trigger for announcing a change of stage?
  7. Does each stage need to have different grades?
  8. How do we decide how long we should continue strategies for each stage?
  9. How do we emphasize individual responsibility for implementing recommended personal-level actions?
  10. How do we empower businesses, schools, and community organizations to implement recommended actions, particularly in ways that protect persons at increased risk of severe illness?
  11. How can we optimize critical infrastructure or services for individuals who are at increased risk of severe illness?
  12. How can we optimize scarce testing and treatment facilities which are scattered across several ministries and government agencies?
  13. When do we start doing triage for severely ill patients to separate those who can be saved and those who cannot?
  14. How do we minimize disruptions to daily life?

It would appear that some countries are failing to answer these questions adequately or if they are, there is no clear communication to the public, businesses and organizations. The current pandemic cannot be managed by the country’s health ministry alone. All parts of the government machinery with the help of public health experts, the private sector and NGOs need to work together to tackle this pandemic. It is our health at stake and it is our collective responsibility to take care of that health.

The Academy of Sciences Malaysia is a member of the International Science Council and is celebrating its 50th anniversary in 2020.

Image by Martin Sanchez on Unsplash

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