1.

0 Introduction

Covid-19 is one of the latest pandemics that has happen in this modern day.
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered
coronavirus. Most people infected with the COVID-19 virus will experience mild to
moderate respiratory illness and recover without requiring special treatment.  Older
people, and those with underlying medical problems like cardiovascular disease,
diabetes, chronic respiratory disease, and cancer are more likely to develop serious
illness. The best way to prevent and slow down transmission is to be well informed
about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself
and others from infection by washing your hands or using an alcohol-based rub
frequently and not touching your face. 

The virus was confirmed to have reached Malaysia in late January 2020, when it
was detected on travelers from China arriving in Johor via Singapore on 25 January,
following the outbreak of COVID-19 in Hubei. Reported cases remained relatively low at
first and were largely confined to imported cases until localized clusters emerged in
March 2020; the largest cluster at the time was linked to a Tablighi Jamaat religious
gathering held in Sri Petaling, Kuala Lumpur in late February and early March, leading
to massive spikes in local cases and exportation of cases to neighboring countries. [5]
Within a few weeks, Malaysia had recorded the largest cumulative number of confirmed
COVID-19 infections in Southeast Asia,[6] breaching the 2,000 active cases mark by the
end of March, from fewer than 30 cases at the beginning of the month. By 16 March,
presence of the virus was reported in every state and federal territory in the country

The COVID-19 virus spreads primarily through droplets of saliva or discharge

from the nose when an infected person coughs or sneezes, so it’s important that you
also practice respiratory etiquette (for example, by coughing into a flexed elbow). To
prevent and try to control the virus to spread more in our community, ministry of health
(WHO) has come with a few planning and strategy to manage COVID-19 pandemic in
Malaysia.
2.0 Planning

Malaysia was one of the first countries to come out with various quick responses
to protect its citizens from COVID-19. The main aim was to minimize economic and
social impacts, limit its spread, and provide care for its citizens. Many contributions were
made by the citizens to overcome this pandemic, and this section discusses the
responses from other organizations and communities.

Planning for a potential emerging infectious disease pandemic, like COVID-19, is

critical to protecting the health and welfare of our nation. To assist state, local, tribal,
and territorial partners in their planning efforts, the U.S. Department of Health and
Human Services (HHS) Office of the Assistant Secretary for Preparedness and
Response has developed the following checklist. It identifies specific activities your
jurisdiction can do now to prepare for, respond to, and be resilient in the face of COVID-
19. Many of the activities in this checklist are specific for COVID-19, however many,
pertain to any public health emergency.

The first planning Malaysia ministry of health has taken is by develop a

pandemic safety plan and appoint a safety officer to modify as required. Follow by
develop an agency/facility pandemic safety plan and appoint a safety officer to modify
as required. The ministry of health also needs to Provide staff education about COVID-
19 infection control and update polices as required. The ministry of health also plan to
support N95 respirator fit-testing for all agency/facility employees and just-in-time
education on recommended infection control precautions including fit checking, applying
simple mask to patients with cough, and hand hygiene. Monitor availability of N95
respirators/powered air purifying respirators (PAPRs) and other supplies including
alcohol-based hand disinfectants, gloves, etc., and watch and alert coalition members to
supply shortages. Make recommendations on possible alternatives. Prepare guidelines
for conservative and re-use of N95 respirators/PAPRs if severe shortages are imminent
(ideally regionally and in conjunction with local public health, occupational safety, and
infection prevention providers and agencies - for example, consider use by only the
highest-risk staff, re-use in selected situations, continued use while working on cohorted
units, etc.). Plan contingencies if appropriate levels of respiratory protection are
unavailable. Develop guidance for staff monitoring for signs of illness (including self-
reporting, self-quarantine, and start/end of shift evaluation) and create a mechanism for
reporting both illness and absenteeism.

The ministry of health also determines screening process and location (e.g., curb
side screening prior to entry, supplemental screening at intake, etc.). Determine how
suspect cases will be isolated from other waiting patients and during ED care.
Emphasize hand and respiratory hygiene and other infection prevention techniques
through education, policies, signage, and easy availability of supplies. Develop referral
plans for patients that do not need emergency care. Develop care plans that reduce the
number of staff caring for suspect/confirmed cases and protocolize care. Adjust daily
nursing expectations/duties as required to meet demand. Develop environmental
services room decontamination and waste stream plans. Assure the specific needs of
pediatric and at-risk populations are addressed in surge capacity planning. Provide
patients and families with information about stress responses, resilience, and available
professional mental health/behavioral health resources. Develop palliative care plans for
implementation when needed.

The Health Ministry (MoH) will re-strategies its plan in preventing and controlling
Covid-19 pandemic within a week or two, its director-general Datuk Dr Noor Hisham
Abdullah said. He said the plan would involve manpower, health equipment, labs' ability
and public health. Our medical front liners and MoH staff have been working non-stop
for about five months now and today we see a positive outcome from their sacrifices.
The number of cases have reduced and occupancy rate at the intensive care unit and
Covid-19 wards have also dropped. The ministry will also be giving counselling sessions
to the medical front liners to prepare them if there is a sudden spike in cases. MoH
prepare for the worst but hope for the best. This is a challenge not only for the medical
frontliners but also the MoH staff. Front liner the last line of defense to avoid a big
disaster, huge number of fatalities and sudden spike in cases, from happening in the
country.
 3.

The MoH played a crucial role in ensuring maximum readiness to contain the
spread of the virus. Among the earliest efforts taken by the MoH to prevent disease
transmission was the enforcement of health screening at all points of entry. According to
the Director-General of the MoH Datuk Dr. Noor Hisham Abdullah, one of the strategies
was the placement of thermal scanners ( Bernama, 2020a). This was done to further enhance
the detection of fever amongst tourists and/or locals returning from abroad. Malaysians
who returned from Wuhan were screened, identified, and isolated in special quarantine
areas for COVID-19. This measure also involved airline crews as well as the staff of the
MoH (Kaos, 2020).

The subsequent key step taken by the MoH along with the government to
overcome the spread of COVID-19 was to increase the number of hospitals that could
treat COVID-19 cases. There was also a group effort between public and private
hospitals to accommodate the growing numbers of cases of infection, comprising
university hospitals and Ministry of Defence hospitals ( The Edge Markets, 2020).

To enhance the MoH efforts in keeping the spread and mortality under control, a
Movement Control Order (MCO) was implemented on March 18, 2020. The MCO
related to the restriction of movement of people into or out of an area. The Director-
General of the MoH emphasized that the order enforced came under the Prevention
and Control of Infectious Diseases Act 1988 and the Police Act 1967 and would help to
control the spread of the virus ( Bernama, 2020b). This step was significant, as the situation in
China had proved that by isolating the infected group of individuals and practicing social
distancing, the pandemic could be contained ( WHO, 2020a).

Moreover, an alliance involving 38 professional medical societies was

established on March 1, 2020 to support the MoH in the area of healthcare ( Malaysia Health
Coalition, 2020
). The intention of this coalition was to keep the community well-informed and
to ensure that information made available was true and accurate.

Another measure taken by the MoH to cushion the impact of COVID-19 was the
setting up of a special fund known as the COVID-19 Fund, to raise money to be
channelled to patients, particularly those affected financially due to the quarantine
procedure. This fund initially received RM 1 million from the government and private
sectors. NGOs and individuals were welcomed and encouraged to direct their
contributions too. Through this fund, RM 100 was given daily to those who had no
source of income throughout the quarantine and treatment processes. In addition, the
money collected was used to cover medical expenses such as buying crucial equipment
and other supplies. To further encourage contributions, the Inland Revenue Board (IRB)
took up the initiative of offering tax deductions for cash and item donations to help the
affected communities in meeting their basic needs and help build their resilience ( The Star,
2020b
). In addition, the MoH arranged various disinfection activities to be conducted by
the Ministry of Housing and Local Government, local authorities, and the DBKL (Kuala
Lumpur City Council). This procedure has been conducted mainly in high-risk areas
(Bernama, 2020e).

One of the initiatives agreed after the Economic Action Council meeting held on
March 23, 2020 was the allocation of RM 600 million to the MoH to battle COVID-19.
According to Prime Minister Tan Sri Muhyiddin Yassin, RM 500 million would be utilized
to buy ventilators and personal protective equipment (PPE) and another RM 100 million
would be used to appoint 2000 nurses on a contract basis ( Yusof, 2020).

On March 27, 2020, when announcing the RM 250 billion PRIHATIN Package to
support micro, small, and medium-sized enterprises struggling to retain their
employees, the Prime Minister announced an additional budget of RM 1 billion to cater
for medical needs, such as the purchase of equipment and services to overcome
COVID-19. The Ministry also received support from the insurance sectors, both
conventional and Islamic insurance, whereby a RM 8 million fund was set up to bolster
COVID-19 testing. Each policyholder could go for a screening test worth up to RM 300
in private hospitals and laboratories. Other than that, policyholders with financial
problems and disruption to their income as a result of the MCO and coronavirus
outbreak were given a 3-month deferment on their policy payments. The government
also showed its gratitude to healthcare employees by increasing their monthly
allowance from RM 400 to RM 600 per month beginning April 1, 2020, to be continued
until the epidemic ends (Sunil, 2020).

Some NGOs have helped by providing protective masks, disinfection chambers

(Bernama, 2020c), and helping to educate citizens on COVID-19 ( The Star, 2020c). All frontliners are
required to wear PPE. However, due to the rapid increase in COVID-19 cases, there
have been shortages in PPE equipment. This shortage could have endangered the
health of frontliners. Therefore, several NGOs and public figures have helped to sew
PPE for medical frontliners. For example, several Malaysian fashion designers
associated with the Malaysian Official Designers Association (Moda) have produced
PPE for local medical staff (Cheong, 2020). Prison inmates have also been involved in sewing
protective gear for frontliners regardless of their current situation ( Chalil, 2020
). Volunteer
tailors have helped to prepare PPE for frontliners.
 4.

Strategies in the control of an outbreak are screening, containment (or

suppression), and mitigation. Screening is done with a device such as a thermometer to
detect the elevated body temperature associated with fevers caused by the coronavirus.
Containment is undertaken in the early stages of the outbreak and aims to trace and
isolate those infected as well as introduce other measures to stop the disease from
spreading. When it is no longer possible to contain the disease, efforts then move to the
mitigation stage: measures are taken to slow the spread and mitigate its effects on the
healthcare system and society. A combination of both containment and mitigation
measures may be undertaken at the same time.[186] Suppression requires more
extreme measures so as to reverse the pandemic by reducing the basic reproduction
number to less than 1.

Dr Adham said the MOH was also constantly increasing laboratory capacities to
detect COVID-19 patients early by engaging other agencies, the universities and private
laboratories to perform reverse transcription polymerase chain reaction (RT-PCR) and
antigen rapid test kit (RTK Ag) testing. Despite the public healthcare providers being
understaffed and their staff being overworked, especially in Klang Valley, he said the
MOH strived to overcome this situation in managing the pandemic. A total of 3,617
health personnel have been mobilized from the MOH, as well as individual volunteers
and others from non-governmental organizations (NGOs), the armed forces and other
agencies since 2020. “The MOH has also requested for additional staff and training of
existing staff to handle more responsibilities. “In handling emotionally affected
healthcare workers and those with burnout symptoms, the ministry has set up the
Psychosocial Support Helpline at the national and state levels and also collaborates
with other relevant government agencies and NGOs in these activities. “In addition, the
Mental Health and Psychosocial Support teams are also mobilised to hospitals and
health facilities to provide psychological first aid to the healthcare workers and
frontliners in need,” he said. Dr Adham said the MOH implored the public, employers
and individuals to assist in identifying close contacts in their localities for early action by
the nearest District Health Office. “MOH will continue to work with all government and
non-governmental agencies to manage this pandemic. “We would like to urge all
Malaysians to comply with all the health advice given and adhere to all the SOPs
outlined by the government, such as practising the 3Ws (wash, wear and warn) and
avoid the 3Cs (crowded places, confined spaces and close conversations),” he added.
(bernama).
To prevail against COVID-19, we need an approach that unites in common cause
every individual and community, every business and non-profit, every department of
every government, every non-governmental organization, every international
organization, and every regional and global governance body, to harness their collective
capacity into collective action. Governments try to lead and coordinate the response
across party lines to enable and empower all individuals and communities to own the
response through communication, education, engagement, capacity building and
support. Governments must also re-purpose and engage all available public, community
and private sector capacity to rapidly scale up the public health system to find and test,
isolate, and care for confirmed cases (whether at home or in a medical facility), and
identify, trace, quarantine and support contacts. At the same time, governments must
give the health system the support it needs to treat patients with COVID-19 effectively
and maintain other essential health and social services for all. Governments may have
to implement blanket physical distancing measures and movement restrictions
proportionate to the health risks faced by the community, if they need more time to put
in place the above measures.
 5.

During the MCO period, Malaysians were encouraged to stay at home and
reduce unnecessary hospital visits. Due to the movement restrictions during the MCO,
some of the essential pharmaceutical care services in MOH facilities, such as
ambulatory pharmacy, Medication Therapy Adherence Clinic (MTAC) and Home Care
Pharmacy Services (HCPS), were disrupted. As a result, several measures were taken
by the PSP to ensure the continuity of pharmaceutical care services. For instance,
patients with appointments for medication refills or any other pharmaceutical services
were given longer appointment dates. The medication supplies to patients were also
increased to two-month supply or more whenever possible to reduce the patient loads
and crowds at the pharmacies in both MOH hospitals and health clinics. On the other
hand, extra effort has also been made to ensure the constant supply of Methadone for
patients on Methadone Treatment Programmed. To help patients to minimize travelling
during the MCO, more Daily Observational Therapy (DOT) patients who were stable
were dispensed with take away doses (dos bawa balik, DBB) with the approval from the
psychiatrists and Family Medicines Specialists.

The first move government of Malaysia has taken is to announce a nationwide

Movement Control Order (MCO), a soft cordon sanitaire or partial lockdown that went
into effect on March 18 to reduce social mixing (Ministry of Health Malaysia (MOH,
2020). The MCO strictly didn't allow any citizen to get out from their house to do any
activity outside. The MCO order must follow by all the Malaysian citizens. This is one of
the strategies by government try to prevent the virus to spread among citizens. After
MCO the next step followed by a stricter version called the enhanced MCO, the
enhanced MCO is collaboration the ministry of health and ministry of national security,
which is to let the soldiers to guard the certain places that under enhanced MCO. The
soldiers or PDRM must bring the groceries to the citizen who under enhanced MCO.
Every employed must work from home and no one can go to workplace, because it will
against the rules. Following the decline of cases, the MCO was subsequently relaxed
and replaced by a Conditional Movement Control Order (CMCO) on May 4. The CMCO
is more loose order, on CMCO citizen can travel from state to state by permission from
PDRM, PDRM must issue the permit for the person who want to travel from state to
state or from division to other division. After CMCO the country become more further
relaxed under the Recovery Movement Control Order (RMCO) on June 10. After the
recovery movement order, the government and the citizen slowly get to their new
routine which we call as a new norm.

Among the earliest efforts taken by the MOH to prevent disease transmission
was the enforcement of health screening at all points of entry. According to the Director-
general of the MOH Datuk Dr. Noor Hisham Abdullah, one of the strategies was the
placement of thermal scanners (Bernama,2020a). This was done to further enhance the
detection of fever amongst tourists and/or locals returning from abroad. Malaysians who
returned from oversea were screened, identified, and isolated in special quarantine
areas for COVID-19. This measure also involved airline crews as well as the staff of the
MOH (Kaos, 2020). The government is responsible for all international travelers’ costs
related to appropriate quarantine or isolation requirements, as well as the costs related
to medical or supplementary examination, certificates, and health measures applied to
baggage accompanying the traveler, and any new vaccinations or other prophylaxis
requirements that have been published for less than 10 days. Countries may, however,
seek reimbursement for expenses incurred from conveyance operators or owners
regarding their employees or from applicable insurance sources. Quarantine can be
implemented at a traveler’s place of stay or in designated facilities. Designated facilities
should be located away from the county’s points of entry if possible. In either case, the
facilities should be designed, and other measures should be taken, to limit the risk of
potential disease transmission. Quarantined travelers should be separated from
symptomatic individuals or contaminated goods. Travelers’ place of stay shall be
recorded for potential follow-up in case of illness. Travelers becoming ill or with
underlying medical conditions might be at increased risk if quarantine alone. Medical
and other monitoring should be provided throughout the enforcement of quarantine.
Individuals developing symptoms while in quarantine should be able to seek appropriate
care and be separated from others.

The government strictly give order to all the premises in town to places the
thermals scanner in their premises, if they don't follow the order the owner of the
premises can be compound by the authorities which is PDRM. The thermal scanner and
write down every customer name are mandatory in any premises, like shopping mall,
restaurant etc. before entering any premises, customer must scan their temperature and
also scan the MySejahtera app.

KKM also has conducted a community swab test on people who have been
exposed to covid-19. the authorities also have taken precautions by conducting swab
tests in workplaces where involved a lot of foreign workers, for example the factories
and supermarkets. this is one of the authority’s action to curb the spread of covid-19. all
foreign workers nationwide are required to undergo mandatory Covid-19 screening, with
their respective employers bearing the cost of the procedures. This follows the
increasing number of positive cases among them, particularly at factories and
construction sites, said Senior Minister (Security Cluster) Datuk Seri Ismail Sabri
Yaakob. He said the first phase of Covid-19 screening will be carried out in Selangor,
Kuala Lumpur, Penang, Labuan and Negri Sembilan and the Human Resources
Ministry will enforce the ruling from Dec 1.

The government had previously decided to conduct a Covid-19 screening test

using RTK Antigen for all foreign workers in the country. the government has agreed to
make it compulsory for all foreign workers (in all sectors) to undergo the Covid-19
screening test, which will be done in stages. On the mechanism for implementing the
screening test, he said to prevent overcrowding, employers should arrange for
appointments with private healthcare facilities for the Covid-19 RTK-Antigen test.
Strategies in the control of an outbreak are screening, containment (or suppression),
and mitigation. Screening is done with a device such as a thermometer to detect the
elevated body temperature associated with fevers caused by the coronavirus.
Containment is undertaken in the early stages of the outbreak and aims to trace and
isolate those infected as well as introduce other measures to stop the disease from
spreading. When it is no longer possible to contain the disease, efforts then move to the
mitigation stage: measures are taken to slow the spread and mitigate its effects on the
healthcare system and society. A combination of both containment and mitigation
measures may be undertaken at the same time. Suppression requires more extreme
measures to reverse the pandemic by reducing the basic reproduction number to less
than 1.

The private health facilities would then send their staff to the factory or
construction site to conduct the test according to the standard operating procedures
(SOP) set by the Health Ministry, he said. would check on companies and industries
which fail to make the necessary preparations to address the living conditions of migrant
workers. The authorities also remind the employers, that they should ensure foreign
workers are given basic housing facilities to ensure safety and hygiene. The Human
Resources Ministry has identified some companies which had failed to meet the
minimum standard for space requirement for workers' accommodations. Action was
taken against several factories in a few states for not complying with the standards set
under Act 446.

The ministry of Health also starts a campaign and give awareness to public. One
of the campaigns is Avoid ‘3C’, which are crowded place, confined space, and close
conversation. Practice ‘3W’, which are frequent handwashing with soap; wearing a face
mask in public or when showing symptoms; and remember the warnings of the ministry
of health strongly urges the public to remain in compliance with the Movement Control
Order (MCO). Masks can help prevent the spread of the virus from the person wearing
the mask to others. Masks alone do not protect against COVID-19 and should be
combined with physical distancing and hand hygiene. For heads of households who
need to go out to buy everyday necessities, they should always take precautionary
measures such as avoid leaving the house if unwell or have any symptoms avoid
leaving the house, use hand sanitizers or wash hand with water and soap before and
after purchasing products. Practice safe social distancing at least 1 meter away from
others. The MOH regularly remind to all citizen through press conference about social
distancing, no handshaking policy, enforced sanitization of hands at entrance, hold
necessary meetings outside in open air if possible, avoiding crowding through booking
and scheduling, online pre-purchasing, limiting attendance numbers. Avoid the 3C’s
which is Crowded places, Confined spaces, and Close conversations (face-to-face
conversations). Limit time spent outside in public and crowded places. The use of
facemasks is encouraged, especially in public and crowded areas. These measures
can help to break the COVID-19 infection transmission chain.

Public communication. The government also has taken more step in manage this
COVID-19 outbreak by doing Public communication. Use public communication to help
educate communities about the case investigation and contact tracing process,
reinforce trust in public health departments, and encourage a sense of ownership and
personal responsibility in the process. Establish a media and community engagement
campaign, includes advertises branded caller ID designation. Engages local community
leaders, public officials, and influencers who can identify important communication
channels as well as act as trusted messengers to amplify clear and empowering
messages. Uses all available communication channels including television, radio, and
social media, along with official websites, to regularly reinforce messages. Develops
and shares messages that dispel local misinformation and direct the public to reliable
sources. Uses cultural sensitivity and language diversity when developing messages
and outreach materials. This campaign is designed to support risk communication,
community engagement staff and responders working with national health authorities,
and other partners to develop, implement and monitor an effective action plan for
communicating effectively with the public, engaging with communities, local partners
and other stakeholders to help prepare and protect individuals, families and the public’s
health during early response to COVID-19.
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