It is time to prepare for the possibility of wider transmission of novel coronavirus in Malaysia

This may mean planning to switch away from medically isolating or quarantining everyone who is infected, to encouraging people with mild illness to stay at home to recover – so that health care facilities do not become overwhelmed. Steps must also be taken to ensure health facilities do not become places that amplify the virus’ spread, infecting staff and other patients.

Dr Takeshi Kasai

WHO Regional Director for the Western Pacific

Our Region is at a critical juncture in the coronavirus disease (COVID-19) outbreak. The majority of cases are still in China, but the virus has now been confirmed in many parts of the world. While we must continue efforts to contain its spread, it is also time that all countries, including Malaysia, prepare for the possibility of wider transmission.

There are now reports of clusters of cases with no apparent link to China. The latest information suggests that the virus may be more transmissible than early data suggested. This does not mean that the virus will start spreading easily within Malaysia or elsewhere tomorrow, or perhaps ever – of course, we hope that it won’t. But while countries are still working hard on containing the virus, we must be ready in case there is wider spread. This requires action today, because preparation takes time, especially to ensure that the response reaches everyone in all parts of the country.

Responding to wider transmission would require shifting the focus of activities to protect the vulnerable and minimize the health and social impact. If we don’t prepare now, we will not be able to activate those plans when they are needed.

For example, in case of wider community transmission, we would need to ensure health facilities can focus on treating the most vulnerable and severe cases. This may mean planning to switch away from medically isolating or quarantining everyone who is infected, to encouraging people with mild illness to stay at home to recover – so that health care facilities do not become overwhelmed. Steps must also be taken to ensure health facilities do not become places that amplify the virus’ spread, infecting staff and other patients.

We must also be ready to make a switch away from testing all suspected cases and tracing the contacts of every person who has the virus, to instead applying limited testing capacity to monitor geographical spread and trends – and using this information to inform decisions about the most appropriate public health response.

In addition, we need to be ready to consider the possibility of closing schools or postponing mass gatherings, if necessary, to reduce opportunities for the virus to spread.

I understand why people are worried, as this is a new disease and there is much we still don’t know. The best thing we can do is to be prepared. In addition to those measures governments can take, we all share a collective responsibility to take simple measures to protect not just ourselves as individuals, but our communities, including the most vulnerable. Wash your hands – frequently, and thoroughly. If you are coughing or sneezing, cover your nose and mouth with a tissue or your elbow. Keep your distance – we recommend at least 1 metre – from people who are unwell. If you’re sick, stay home so you don’t risk infecting others – and seek medical care if you have trouble breathing. And please, don’t circulate rumours and misinformation online and to your friends and family. When people have the wrong information, they can make decisions which actually harm themselves, and others.

In addition to looking at the virus’ transmissibility, we are closely monitoring its severity. Of all cases reported in China to date, around 2% of people have died. Outside of Hubei province, the death rate among those infected is around 0.4%.

We must continue to watch the transmissibility and severity of the virus closely and assess the situation as it evolves. In the meantime, we urge countries to prepare. Even if, in the end, there is no need to switch on these measures in response to the COVID–19 outbreak, this is always time and effort well-spent – because it makes us better prepared for the next new disease or outbreak, whenever that may occur.

WHO will continue to support Malaysia and all countries in their preparedness and response efforts. The current outbreak is a test for all of us, but by focusing not only on what confronts us today, but planning ahead for tomorrow, taking steps to ensure preparedness efforts reach every corner of every country, together we will be able to limit the health, social and economic impacts.