Improve Home Quarantine Procedures

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Media Statement by YB Kelvin Yii:

Improvements are urgently needed in the Ministry of Health’s (MoH) and Sarawak Disaster Management Committee (SDMC) handling of Covid-19 patients in Categories 1 and 2 — meaning those with mild symptoms — as well as their close contacts to eliminate confusion and prevent possible flouting of the home quarantine standard operating procedures (SOPs) which can lead to an increase in community transmissions in Sarawak.

This includes improvement of Covid-19 Assessment Centre (CAC) as well as to devise better procedural requirements and disciplines to better manage, and monitor patients and close contacts that are undergoing home quarantine.

Currently, with the surge of cases in Sarawak due to the Delta variant and lack of quarantine centres especially in Kuching, more and more are required to undergo home quarantine. However, the existing advisory, restrictions, and monitoring for home quarantine are inadequate and ineffective and may give rise to a possible increase in community transmissions.

We know that isolation itself is not sufficient. The health status of all close contacts should be established early or there can be risk of infections spreading among family members in the household and into the community if they breach the quarantine. Screening close contacts will also improve management of early symptoms of Covid-19

That is why, to improve things, I have 5 main suggestions.

(1) Increase the numbers of Covid-19 Assessment Centre (CAC) in outbreak areas (Red Zones) and integrate technology to implement virtual assessment especially for those in Category 1-2. This will ensure early monitoring of all positive cases, decongest the physical CACs, minimise physical contact and enable these CACs to focus on symptomatic and sicker patients.

Such congestions are like what we see at the Covid-19 One Stop Centre at MBKS.

Majority of patients have minimal or no symptoms, but a proportion will progress to the severe stage, usually in the second week of the illness. But with better monitoring through a virtual CAC, we will be able to detect them early before they progress to such a stage where they can no longer be treated.

Currently, the system used in Sarawak is patients are asked to fill up a digitised google forms or ‘home assessment tool to monitor symptoms daily’. However, there is very little monitoring, and many are not given proper explanations on their conditions and what to do next.

In order to help relieve the already overstretched workload of medical professionals from the Ministry of Health (MoH), they must consider roping in private GPs (general practitioners) to test and monitor patients and close contacts virtually if it is faced with a shortage in manpower.

With better monitoring and more manpower, we can reduce the risk of patients not getting the medical attention they need if their symptoms get worst as well as reduce the possible Bring in Dead(BID)

(2) Release a clear and comprehensive “Home Quarantine Advisory” and it has to be clearly communicated to all.
Efforts must be increased to educate the public on the home quarantine SOPs and even publishing them on all available media, and all languages to ensure it is understood by all Malaysians.

(3) Increase manpower at the Helpline and Call-centres at the CAC.
The current hotline is very hard to reach and many times the public tried calling for hours without getting an answer.

This is where GPs play an important role to help answer medical questions if they have any. The State Government can also mobilise more officers from other Ministries to help in the call-centre to answer non-medical questions as certain inquiries by those under home quarantine are not medical related but more of the necessary SOPs that they need to follow.

(4) The State Government must must provide “Care kits” to all those that must undergo home quarantine. This includes face masks, a thermometer, an oximeter, and saliva test kits.
Oximeter and thermometer are important to monitor the symptoms and they can also report their symptoms better to those monitoring them.

The Government must also subsidise RTK Ag Self-test Kits to make it affordable and accessible for all as part of the new normal that we need to be prepared for.

(5) Better enforcement and surveillance of those under home quarantine.

The Government must explore the usage of technology for surveillance and also enforcement for those that are quarantine so that they do not break their quarantine order. Constant monitoring and random spot-checks must be conducted by all agencies to make sure they do not go out and expose others.

Kelvin Yii Lee Wuen
MP Bandar Kuching