KUALA LUMPUR: On Thursday, Melbourne was forced to undergo a second lockdown in four months when it recorded 191 coronavirus cases within 24 hours on Tuesday.
Bloomberg reported that factors in the resurgence of Covid-19 cases included missteps in the handling of travellers returning from overseas and complacency in some neighbourhoods.
Victoria state Premier Daniel Andrews said the lockdown was necessary and expected to cause enormous damage to the economy and people's welfare.
Health officers predicted that the measures were poised to be harder on the city's five million residents.
Apart from closing state borders, 3,000 residents of public-housing tower blocks have been barred from leaving their homes even for food.
Malaysian experts, drawing on lessons from Melbourne, are warning against complacency.
Epidemiologist Datuk Dr Awang Bulgiba Awang Mahmud, a Universiti Malaya professor, reminded Malaysians to stay the course through self-discipline and adherence to standard operating procedures (SOP) as a spike in cases like Melbourne's could force the authorities to re-impose measures similar to
the Movement Control Order (MCO).
"There are two main things that can go wrong in this pandemic and it happened in Melbourne. Complacency and imported cases.
"Complacency has led to the relaxation of strict procedures."
"As in other parts of Australia, people who returned from overseas were quarantined for 14 days in hotels leased by the government. However, unlike in other parts of the country, private security firms, instead of police, were entrusted with the quarantine."
"Lapses in procedures were alleged to have taken place, including improper use of Personal Protection Equipment and allowing families to mix in each other's rooms."
Dr Awang Bulgiba said the similarities between Melbourne and Malaysia in socio-economic areas could not be ignored.
"Malaysia has a large migrant population and there are many economically-disadvantaged people from multi-cultural backgrounds.
"These are the very same people who are being infected in Melbourne."
"If the messages about SOP and physical distancing don't get through to the people due to language or cultural barriers, which allegedly happened in Melbourne, the same thing can easily occur here too."
In Malaysia, migrant rights activists argued that the wide-spread raids and deportation following the MCO had forced undocumented workers, including those with infections, to go into hiding, instead of coming forward for testing as encouraged by the health authorities.
He said the true infection rate in the community was unknown, compounded by the fact that the nation was not fully equipped to do mass testing.
"We have to be on guard until the pandemic dies down globally.
"This is a pandemic.
"We can't be certain until all other countries have brought their outbreaks under control," he said.
He urged people to exercise self-discipline because it was uncertain whether a Covid-19 vaccine could be found.
"If the virus loses its virulence and the illness become less severe, there will be some hope for us to ride this out.
"But if it becomes more virulent and the illness becomes more severe, we may be in for a long pandemic."
He said that the new risk groups were school-going kids and university students, who may be asymptomatic carriers.
This is a major concern as around 80 per cent of Covid-19 carriers don't show any symptom.
He said a large number of migrants in Malaysia, estimated at between three million and four million by the International Labour Organisation, were the chief source of worry for Malaysia as the "true status of the pandemic among them remains a mystery".
BORDER REOPENING
On whether borders should be reopened after the Recovery Movement Control Order ends, he said that hinged on the infection rates in other countries.
"It's likely that our borders with countries with high infection rates will remain closed.
"Borders may be opened with those that have managed (to reduce) their (infection) rates, but as we can see from Melbourne, things can get out of hand quickly.
"So we need to be cautious about reopening borders."
Epidemiology and biostatistics expert Dr Malina Osman, a Universiti Putra Malaysia associate professor, said borders should remain closed, except for emergencies or critical reasons, and for travellers from green zones that recorded zero or a low number of cases consistently.
She cited Thailand and Vietnam, as well as New Zealand as examples of countries that had consistently recorded low number of cases.
Dr Malina said the key point about Melbourne's experience was for Malaysia to monitor returnees under home quarantine.
"I believe this is the main risk group."
Noting the similarities in risk profiles, population density and demographics between the city and Malaysia, she said they were crucial factors following the decision to do away with state-imposed quarantines in hotels and government facilities.
As the nation's SOP compliance was between 60 and 90 per cent, depending on the location, she said it was important for everybody to be vigilant.
She suggested that the government continue giving tracking bracelets to those under home quarantine until the completion of the order.
She said it takes only one per cent of the population not to adhere to the SOP to raise the number of infections and overwhelm healthcare services.
This, she said, was the reason behind Melbourne's second lockdown.
EXERCISE CAUTION DURING HARI RAYA AIDILADHA
Dr Malina said as long as everyone followed the SOP, Malaysia could avoid a spike in cases during the Hari Raya Aidiladha and Merdeka Day holidays.
Holidaymakers tended to let their guard down and slacken off on adherence to the SOP, said ear, nose and throat specialist Dr Kuljit Singh.
"People should be allowed to go on holiday, but they must prioritise the SOP. When they are done eating at restaurants or on crowded beaches, they should put their face masks back on.
"They also can't balik kampung and meet 20 people from different households under the same roof. Every other person on the beach and in their hometown could be an asymptomatic carrier."
The Association of Private Hospitals Malaysia president agreed that borders needed to be eventually reopened to rehabilitate the economy.
However, he urged that it be done in a measured way and that they should involve countries deemed "green" Covid-19 zones.
Epidemiologist Dr Sanjay Rampal, a Universiti Malaya professor, said as the threat of the disease would always be present, it was crucial for Malaysia to implement a robust and extensive surveillance system to enable it to predict the next big outbreak.
This, he said, would allow policymakers to adopt prevention strategies, such as imposing lockdowns when the system's indicators issue alerts.
He said the indicators would be gleaned from rigorous testing by setting up sentinel clinics to provide real-time data from screening and tests, as well as the computation of information to gauge infectivity rates.
"An example is the screening of serious acute respiratory illness or influenza-like illness cases for Covid-19 in healthcare centres.
"If there are positive cases, they can represent the tip of the iceberg for Covid-19 incidence estimation."
"Monitoring trends of these numbers may allow us to predict the next big outbreak and institute preventive measures."
He said the data analysis, however, should be able to distinguish the signal of an impending outbreak from the background noise of sporadic transmission.
He said he believed that preventive measures such as social distancing and wearing of face mask by the public lacked efficiency as community transmission was low.
He said the development and implementation of SOPs by organisations had made their execution confusing, as they could be subjected to different interpretations by enforcement officers.
"We should keep these preventive measures for a time when there is a real spike in community transmission of Covid-19."