Asian Journal of Psychiatry 54 (2020) 102272

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Asian Journal of Psychiatry

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Letter to the Editor

Psychosocial support for healthcare frontliners during COVID-19 pandemic in Malaysia T

On 11 March 2020, the World Health Organization (WHO) declared
the outbreak of Coronavirus Novel 2019 or COVID-19 as a worldwide
pandemic. The declaration served as a worldwide red flag that all na-
tions are potentially-affected and therefore to be equipped with stra-
tegic action plans in order to counteract the widespread of the novel
virus. Malaysia is one of the Southeast Asian countries affected by
COVID-19. As a preventive measure, the Malaysian government has
gazzetted the implementation of Movement Control Order (MCO)
commencing on 18th March 2020. Based on the viral widespread curves
and supported by medical advices of the Malaysian Ministry of Health
think tanks, the MCO phases have already been extended five times
from its original plan and the current phase is expected to end on 9th
June 2020. This is eminent in order to deprive the spreading of the virus
by breaking the ‘chain’ in the community (Brooks et al., 2020) through
daily practices of social distancing and health-consciousness routines
such as the normalization of face-masks and hand-sanitizers usage
during this movement control period.
MCO has shown positive trend in flattening the curve of the pan-
demic in Malaysia proven as per the the illustrated statistics in Table 1
dated 7th June 2020.
Although Malaysia had past experiences in handling several epi-
demic outbreaks such as Severe Acute Respiratory Syndrome (SARS),
Japanese Encephalitis (JE), influenza A H1N1, Ebola, and Zika (Abdullah
and Rahim, 2016), the pandemic COVID-19 is an unprecedented health
fiasco faced by the local health crisis management system. It is inter-
esting to note that the existing national standard operating procedures
(SOP) of crisis management are centralized on the physical prepared-
ness of the crises such as organizational structures, communication
networks, food supplies, and other logistic apparatuses. However, it is
alarming to find that spiritual quotient awareness amongst the
healthcare frontliners such as psychological, emotional, social and
spiritual aspects are seemingly considered to be of lesser importance.
Healthcare ‘frontliners’ inclusive of doctors, matrons, nurses, and
medical assistants are the ‘unsung’ heroes during this continous battle
against COVID-19. The long working hours under uncomfortable and
stressful conditions may jeopardize their psychological well-beings as
well as their morale and work performance (Waleed et al., 2020). Apart
from the social pressures faced at home and in the society due to the
implementation of MCO, these critical frontliners are also at high risks
of to be exposed to serious mental health issues resulted in symptoms
such as being stressful, severe depression, decline of work motivation,
fatigueness, and over-anxiety (Jianbo et al., 2020). As a matter of fact,
since the virus had started to spread from Wuhan, China in late 2019
(Cuiyan et al., 2020), many quarters including WHO and International
Council of Nurses (ICN) produced guidelines and manuals to provide
the healthcare frontliners with sufficiently holistic psychosocial support
system in order to minimize the effects that may disrupt their psycho-
logical well-being. This action addressed on the relationship of COVID-
19 and mental health (Tandon, 2020), particularly focusing in
healthcare frontliners’ population.
All in all, the holistic preparedness of healthcare fronftliners in
battling the pandemic COVID-19 in Malaysia must comprise a holistic
approach of both ‘hardware’ elements – skills and knowledge to be
utilized in job routine – as well as the ‘softskills’ in terms of self psy-
chological management. Although there is reactive support system in
terms of Psychological First Aid (PFA) and online counseling services
provided throughout this period of COVID-19 pandemic, there is a vital
need of a more proactive provision for these frontliners in the future
(Bakar, 2020). It is more beneficial if a psychoeducational training
module, for instance, could be developed and integrated in the national
SOP for health crisis management. This training module could help
these frontliners to enhance their self-psychological management skills
so that they could manage their mental, emotional, social, and spiritual
capacities prior to entering the uncertain conditions of battling other
pandemic health crises in the future. The psychological support training
could also internally prepare the community at large to be more ready,
if the similar pandemic were to happen again (Yanping et al., 2020).
Table 1
COVID-19 Cases in Malaysia (as of 7th June 2020, 12 PM).
Sources: Malaysian Ministry of Health.
Cases Total Numbers
Recovered/Discharged 6,674
Active 1,531
Death 117
Confirmed (Positive) 8,322
Financial disclosure
None.
Declaration of Competing Interest
None.
Acknowledgment
None.
References
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Brooks, S.K., Webster, R.K., Smith, L.E., Woodland, L., Wessely, S., Greenberg, N., Rubin,
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https://doi.org/10.1016/j.ajp.2020.102272
Received 28 May 2020
Available online 01 July 2020
1876-2018/ © 2020 Elsevier B.V. All rights reserved.
Letter to the Editor Asian Journal of Psychiatry 54 (2020) 102272

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Corresponding author.