Eradicating COVID-19 with Science and Technology

Agenda Awani in collaboration with the Academy of Sciences Malaysia (ASM) engaged ASM Fellows to show how science and technology plays a role in Malaysia’s fight against COVID-19.

Hosted by Mr Kamarul Bahrin Haron, the show featured ASM Fellows Professor Dato’ Dr Adeeba Kamarulzaman FASc, Professor Datuk Dr Awg Bulgiba Bin Awg Mahmud FASc and Professor Dr Mahendhiran Nair FASc.

Professor Dato’ Dr Adeeba Kamarulzaman FASc
ASM Fellow and Dean of the Faculty of Medicine, University of Malaya

Prefacing the session, Prof Adeeba noted that Pusat Perubatan Universiti Malaya (PPUM) is among the 26 front-liner hospitals that are dealing with COVID-19. PPUM is currently treating 40 COVID-19 patients, five of which are placed in the Intensive Care Unit (ICU).

Prof Adeeba stated that COVID-19 is very different from other diseases that she has faced before, such as the Nipah virus, HIV-AIDS, and H1N1. She noted that the SARS-CoV-2 virus (the virus that causes COVID-19) is highly contagious and easily transmitted to other patients as well as medical personnel.

Prof Adeeba provided a brief introduction to polymerase chain reaction (PCR) testing, a common method of diagnosing COVID-19 in patients. A PCR test is carried out with throat swabs that will identify the presence of virus throat and nasopharyngeal area. Another test thatcan be used is the antibody test which tests for the presence of antibodies against SARS-CoV-2. This test will identify whether that person carries the virus but will not identify when the person is infected.

Prof Adeeba elaborated on how South Korea and Singapore succeeded in containing the COVID-19 outbreak. One reason is the active use of technology in contact tracing and surveillance. These countries require existing patients in quarantine to report to the central government to ensure that they are complying to their quarantine period. In Malaysia, manual contact tracing is still the main method of contact tracing, which could be difficult and time-consuming. That said, she applauded the personnel in district health centres who are carrying out this difficult and time-consuming procedure.

Prof Adeeba clarified that most infected patients are not always asymptomatic; they may have fever, sore throat, dry cough, and also fatigue. But within the 1-2 days before their symptoms appear, they are very contagious. Having said symptoms does not make detection easier; the similarities between COVID-19 symptoms and symptoms of the common cold makes it harder to identify people affected by COVID-19.

Viewing the highly contagious nature of COVID-19, Prof Adeeba stressed on the importance of swit testing and isolation procedure. However, this is almost impossible to carry out manually. With technology, specific hotspots of the COVID-19 outbreak can be identified so that the necessary interventions can be carried out.

Prof Adeeba confirmed that the Ministry of Health Malaysia (KKM) has accepted the recommendations of Director Tedros (World Health Organisation) by carrying out more tests in the weeks to come, to continue controlling the spread of the disease.

Professor Datuk Dr Awg Bulgiba Bin Awg Mahmud FASc
ASM Secretary General, Council Member for the Academy of Medicine Malaysia, and President of Asia-Pacific Academic Consortium for Public Health-Kuala Lumpur (APACPH-KL)

According to Prof Awg Bulgiba, COVID-19 cases are increasing exponentially. It must be noted that some COVID-19 patients are asymptomatic, making epidemiological control measures much more difficult compared to during the SARS outbreak. Patients may have already transmitted the disease to others before showing symptoms, making controlling the disease difficult.

The number of positive cases that were reported were those whose samples have been taken and sent for laboratory testing; more worrying is the possible number of people who have not shown any symptoms but have already transmitted the disease. This is why social distancing and the movement control order (MCO) is put in place to limit the spread of the disease.

Prof Awg Bulgiba stated that Malaysia has the opportunity to flatten the curve to ensure the disease’s transmission rate is lowered, hence enabling the Malaysian healthcare facilities to cope with the patient load and improving the chances of treating patients.

Flattening the curve means lowering COVID-19’s transmission, reducing new infections and reducing the load on healthcare facilities, hence increasing chances of treating patients. (Source)

Prof Awg Bulgiba explained how countries such as South Korea effectively flattened the curve despite having no strict lockdown or movement restriction order in place. South Korea has already prepared itself for future outbreaks ever since they were stricken by the Middle East Respiratory Syndrome (MERS) a few years ago. Therefore, all they had to do was activate a group of laboratories that are prepared to run diagnostics on the virus. Once they have gotten the protocol from WHO based on the genome sequence provided by China, these labs were able to carry out up to 20,000 tests in a day. Once a patient was tested positive, that patient is swiftly isolated and admitted to a hospital to break the chain of transmission.

In Malaysia, KKM has been entrusted with maintaining the country’s health. KKM will identify positive patients and then isolate and treat them to break the chain. Together with the diagnosis of patients, the Director General of KKM has advised the National Security Council to carry out an unprecedented measure: a movement control order (MCO).

Prof Awg Bulgiba also stated that he has gathered a team of 25 to 28 people to study whether the MCO measure will be successful. He notes that this drastic measure will only be successful if the Malaysian population can comply to the measures put in place.

In addition, Prof Awg Bulgiba also highlighted the Malaysian Health Data Warehouse, a database of health records that links hospitals under KKM as well as several private hospitals in Malaysia.

Despite having this database in place, it has yet to be utilised to its full potential as the database is not connected to an application that enables swift tracking of patients.

Prof Awg Bulgiba highlights the use of Big data to track clusters of people with the assistance of a geographic information system (GIS). This allows authorities to see where the population of infected persons is most concentrated so that drastic measures to contain the disease can be carried out.

Professor Dr Mahendhiran Nair FASc
ASM Fellow and Vice President (R&D) of Monash University

Concerns about the economic impact of COVID-19 may be the cause why The United States did not want to take early precautionary measures in mitigating COVID-19. Once we truly understand how the COVID-19 outbreak impacts the economy, then we will understand why the US was reluctant to carry out the lockdown.

Prof Mahendhiran explained that the COVID-19 outbreak adversely impacts the global economy on two fronts:

• Impact on supply chain: workers cannot go to work, causing impaired goods and supply services delivery.
• Impact on demand: Companies especially small and medium enterprises (SMEs) will have to lay off part of their workforce or close down completely. This leads to less people working, translating into reduced income.

In essence, the outbreak deals a double whammy to the economy – supply and demand are adversely affected, sending the economy into a tailspin. A partial or complete lockdown might not be ideal, but this disruption is necessary at this moment in life to stop transmission of COVID-19.

In all, Prof Mahendhiran stated that this pandemic has the potential to shift the long-term economic trajectory downwards. Overall, a global recession is inevitable thanks to the supply chain disruption. He forecasted that this recession would be more severe than the 2008-2009 global financial crisis; indeed it will be a major volatile and challenging period for the world.

Nevertheless, to assist its population, governments across the globe are laying out stimulus plans and packages to weather this economic tsunami. The US’s reluctance is understandable, however if they do not initiate a lockdown, it would have a major explosion of infections, affecting its national and global economy.

Before the session ended, Prof Mahendhiran elaborated on the best economic measures that are necessary to empower the Malaysian public healthcare system.

Economic development and health & wellbeing are very closely tied. However, it is still possible to ensure that the economy is functioning well despite a having a lockdown in place. Prof Mahendhiran calls for a review of the various plans that Malaysia has put in place e.g. digitisation strategies. He cited the Industry 4.0 Plan laid out two years ago to help firms adopt new technologies. This could help industries build smart factories and utilise frugal technologies to become more technology intensive.

The COVID-19 pandemic has made it clear that we need to hasten the process of digitisation to help us adapt to the restrictions brought about by the pandemic. In the past few weeks, many organisations have revamped their business models  to adapt to a remote working and learning environment. Moving forward, firms could adopt more “smart factory” and industry 4.0 technologies to remain operational. To quote Prof Mahendhiran, “people are now moving from places to spaces”.

The departure towards a remote working and learning environment would work well with our need to practice social distancing. However, we need to ensure that the right physical infrastructure, digital connectivity, and human capital development are well developed to create a fully operational and effective space.

Prof Mahendhiran also noted that the supply chain is inevitably impacted by a longer MCO. However, short-term programmes and plans have been put in place to ensure funds are sufficient for the people to maintain purchasing power to keep the economy going.