Countries need to prepare for the second wave of infection, just as how reinfection has now started in certain countries. The same will happen to Malaysia if the Movement Control Order is not withdrawn in a slow and stepwise manner, and our healthcare system will once again be overwhelmed.
One of the lessons learnt thus far is that healthcare systems have to be fast-reacting, highly flexible, and be able to deliver high quality care in great capacities. Our healthcare system must be supported to match this configuration.
As healthcare professionals who have served in the Ministry of Defence and the Ministry of Health, we make seven suggestions to prepare our country for a possible surge in COVID-19 infections.
First, the Ministry of Health needs to be supported adequately. Sufficient and reasonable budget allocations should be made available to prioritize the acquisition of modern technologies and the best available medication. Training should also be sustainably funded for all frontliners to improve preparedness for crises. Standard operating procedures and clinical practice guidelines need to be in par with the best available evidence.
Second, the Ministry of Health should bring about realistic and logical partnerships between public and private health sectors into practice. It is commonly termed as Public Private Partnership (PPP). PPP summates both public and private health centres and is able to greatly increase the nation’s capacity towards healthcare response. A contracting model should be initiated for PPP to happen urgently in times of need. It is highly encouraged for PPP to be initiated now than never, and sustained to ensure proper deliverance of healthcare.
Third, interagency coordination must be optimized. Expertise and industries essential to sustaining the healthcare system must adopt modern technology to mount a rapid response against a surge of infections. The government must guarantee a robust and efficient supply chain to support the healthcare system and increased demands despite the crisis.
Fourth, the Malaysian Armed Forces can be primed to enhance the nation’s healthcare capacity and capability. These massive reserves of manpower can be deployed to set up field hospitals in infection hotspots if there is ever a need. Greater national hospital capacity provides more opportunities for treatment of the infected, thus aiding the mitigation of COVID-19.
Fifth, the separate military healthcare system can be utilized to increase capacity if necessary. Military hospitals can be open to civilians to share the case load with designated COVID-19 hospitals. Military healthcare workers can also be deployed to join the frontlines in handling the surge in cases.
Sixth, the military medical personnel should be mobilised to facilitate efficient human resource allocation to areas of greater need, particularly the red zones. This can act to relieve any healthcare staff shortages in the event of a spike in cases. They should be included under the national financial aid plan for full PPE equipment and welfare.
Seventh, a well-organised emergency national logistical plan must be established under the deployment of military services. Logistical skills of the military are pivotal to transport vital medical supplies to rural areas. Transportation coverage should spread equally across East and West Malaysia.
Currently, our infection rates are stable. Malaysia is at the position to consider this possibility and prepare the appropriate responses. We must continue to remain one step ahead.
Finally, we quote Israelmore Ayivor, “Leaders don’t venture without vision. They don’t pray without plans. They don’t climb without clues. They are always prepared.”
MAJOR GENERAL PROFESSOR DATO’ DR MOHD ZIN BIDIN (RET’D) (Dean of Faculty of Medicine, University of Cyberjaya, and former Health Director of the Malaysian Armed Forces Health Services)
LOW WEN YAN (fourth-year medical student)
MARJORIE ONG (third-year medical student)