THE current bottleneck in public health response is not unexpected following various avenues of Covid testing, which cannot match the ongoing limited, strained capacity in tracing and isolating as per the find, test, trace, isolate and support (FTTIS) framework by the World Health Organisation (WHO).
Battling with the emergence of the Delta variant, silent hypoxia and increasing “brought in dead” cases, vaccination along with double masking are the latest public health intervention introduced.
The vaccine breakthrough infection rate, based on a follow-up study among a quarter million of Health Ministry healthcare workers with higher exposure than the normal population, is low (1.26% February-July; 3.05% February-August). Such finding is reassuring as most of theses cases are consistently in the mild category and are usually allowed home isolation.
While stakeholders are exploring various innovative ways to clear the backlog in tracing and isolating positive cases, patients in home isolation can benefit from some essential tips on self-care.
1. MDA-approved equipment
About 3.5% of the low-risk patients may deteriorate into category 4-5 with warning signs. Thus, patients need to be empowered to self-monitor and be alert, report those warning signs (e.g: persistent or new onset fever, extreme fatigue, respiratory compromise, profuse sweating, blue lips or change of colour in skin) that warrant immediate medical attention. The Health Assessment Tool (HAT) in the MySejahtera app is developed for that purpose.
Medical Device Authority (MDA)-approved pulse oximetre is an essential tool to identify the need for medical evaluation, oxygen therapy or hospitalisation, even before the onset of warning signs. It is a safe and non-invasive way to assess oxygen saturation in the blood.
It is also recommended by WHO to prevent silent hypoxia. Therefore, setting a ceiling price for such essential device is certainly timely and helpful. High-quality equipment consistently provides results within minimal margin (+/-2%). However, factors such as movement, temperature or nail polish are known to impact its accuracy.
2. Equip patients with self-care tips
Firstly, staying calm, positive and being aware of the baseline oxygen saturation is important. Generally, SpO2 above 95% is considered normal. Practical breathing exercises, rehabilitation tips and self-management after Covid-related illness can be obtained from WHO’s self-management leaflet (www.shorturl.at/hryG4).
A simple, easy-to-follow method on effective breathing techniques and guide on self-proning (helpful in improving SpO2) that can be referred by patients at home should be provided.
The Occupational Therapy Unit under Penang General Hospital has produced a video to ensure all Covid patients have access to rehabilitation tips.
3. Social responsibility
Self-isolation is a great social responsibility, for the purpose of public health, that requires awareness and discipline, though continuous enforcement does play a role. Non pharmacological interventions applied globally are rather similar.
The main difference, perhaps, is the compliance of these measures, which ultimately falls back to discipline and awareness of its society. Finally, it is high time for all stakeholders to recognise and accept digital Home Surveillance Order as part of a digitalisation initiative as the nation moves towards a recovery plan.
Dr Chow Sze Loon is a
Public Health Medicine Specialist. Comments: letters@thesundaily.com
