MP SPEAKS | 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 for the coronavirus into safe haven 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 are 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 need 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 Covid-19 cases and cluster locations are vague and ambiguous. Thus, astute planning requires data.

What data is required?

A granular, but anonymous case line-listing (information on time, place, etc) would do the trick. We have no interest in personally-identifiable-data (PID). Rather, our concern is to identify the locations of clusters within a district.

What if we don't have the data?

The publicly available data, as suggested by the MOH, means very little for logistic and mobilisation purposes. To cite an example is like saying, “Kluster Merbok is described to have taken place across five districts, namely Kuala Langat, Klang, Hulu Langat, Petaling and Kuala Selangor.”

Community-based testing

This wouldn't 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 - towards a proactive community involvement

The fact remains that we are 'to co-exist' with the virus for quite some time. Infection risks, 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 with their livelihood during the pandemic.

With consultations alongside local authorities, experts and most importantly - community leaders - Selangor is in the midst of rolling out a default set of practices for schools, public spaces, businesses and places of worship - known as the Selamat guides - depending on the number of active cases in the surrounding locale.

This is built 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 within communities.

However, for Selamat to be operationalised alongside MOH statistics 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 reduces 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 risk duplication. As alluded to by the Health 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 a certain news portal mistakenly categorised district code by 'cumulative numbers', rather than 'active cases numbers'.

The Selangor 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, which was initially rolled out as a pioneer QR-based contact tracing, now provides multi-functionalities for the state's Covid-19 coordination.

Local authorities rely on a centralised dashboard to monitor overcrowding, while contextual surveys are intermittently posted to the public to remind, educate and alert the people of the need for compliance with SOPs. Public findings were used to determine the areas of non-compliance so that the authorities can be mobilised when and where 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-sources public non-patient data, Selangkah looks to the federal agency that regulates data privacy - Jabatan Perlindungan Data Peribadi - and complies with its advisory published in May 2020. This is the assurance of privacy, provided under the current framework.

Integration

To reinforce MOH's contact tracing activities, while concurrently monitoring the SOP compliance digitally, we proposed an application layer integration. This means all scanned log data of Selangkah will be shared with MySejathera. This means contact tracing can be done as 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 Selangorians to navigate their way through this pandemic.

It is 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 deploy community-based testing so as to test, identify, and isolate faster. We forward our findings to the state Health Department so that a single dataset can be compiled. Our digital tools empower the community, which supports and enhances the CAPP strategy.

And since the Health DG is frequently concerned about the rakyat's failure to comply with SOPs, Selangkah, among others, is a smart tool monitor SOP compliances and they inform academicians 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, so as to protect the lives and livelihood of the rakyat through this unprecedented pandemic.

DZULKEFLY AHMAD is Kuala Selangor MP and chairperson of the Selangor Task Force for Covid-19 (STFC).

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.