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WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively.

Previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. During the 2014-2015 Ebola outbreak, the increased number of deaths caused
by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola
^[1,2].

“The best defense against any outbreak is a
strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus.
“COVID-19 is revealing how fragile many of the world’s health systems and
services are, forcing countries to make difficult choices on how to best meet
the needs of their people.”

To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating
the risk of system collapse. This includes a set of targeted immediate actions that countries should consider at national, regional, and local level to reorganize and maintain access to high-quality essential health services for all.

Countries should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts to ensure that increasingly limited resources provide maximum benefit for the population. They
also need to comply with the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment This requires robust planning and coordinated actions between governments
and health facilities and their managers.

Some examples of essential services include: routine vaccination; reproductive health services including care during pregnancy and childbirth; care of young infants and older adults; management of mental health conditions as well as noncommunicable diseases
and infectious diseases like HIV, malaria and TB; critical inpatient therapies; management of emergency health conditions; auxiliary services like basic diagnostic imaging, laboratory services, and blood bank services, among others.

Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality.

The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public can maintain trust in the system to safely meet their
essential needs and to control infection risk in health facilities. This will help ensure that people continue to seek care when appropriate, and adhere to public health advice.

1. Elston, J. W. T., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014–15 Ebola outbreak. Public Health, 143, 60-70.

2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging infectious diseases, 22(3), 433.

For interviews please contact: Tarik Jasarevic

To access the full guidance please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health-services-and-systems

For further information and guidance on COVID-19 please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

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March 31, 2020
Work together, practise social discipline to curb Covid-19: Health DG

PUTRAJAYA: Malaysians must work together and practise social discipline in order to flatten the Covid-19 infection curve, said Health director-general Datuk Dr Noor Hisham Abdullah.

He said that in the past two weeks Malaysia had recorded around 150 to 200 positive Covid-19 cases daily and the Ministry of Health (MOH) had been monitoring the trend closely to ensure there is no exponential spike.

“Now we have completed two weeks, so another two weeks to go. It is up to us and if all of us come together and we practise and embrace (the advice) that you stay at home, and we, MOH, will continue our public health activity like active case detection, increase testing, finding targeted groups and isolate them early, then we can actually break the chain of Covid-19 transmission in this country.

“So the next two weeks is all up to you and me; if we can all have a social discipline, I am sure that we can actually flatten the curve to avoid the exponential spike. If not, we may see a surge in Covid-19 positive cases in mid-April like (that) predicted by JP Morgan and the Malaysian Institute of Economic Research,“ he said at a press conference on Covid-19, here today.

Dr Noor Hisham said that thanks to MOH’s active case detection, Malaysia had not recorded any exponential spike like 900 to 1,000 cases in one day.

“That means we continue to go to the community identified as a high-risk group through targeted approach and then test them. There will be some cases that will be detected as positive; our detection of positives is about 8%,“ he said.

Dr Noor Hisham also urged all Malaysians returning from overseas to home-quarantine for 14 days.

“We fear that the second wave is all imported cases. Malaysians coming back from overseas, that is the group that we are worried about as we fear they may bring back the Covid-19.

“Although they are negative, we still have to quarantine them for 14 days. Those positive we isolate them in our hospitals,“ he said.

He said MOH was aware that some Malaysians who returned from overseas broke the home quarantine rule.

When asked about the possibility of the MCO being extended until Ramadan, he said it was too early to make any conclusions now.

“We will only know after the first week of April. If we continue to flatten the curve or there is no exponential increase, then I think we can safely make a decision.

“In terms of the Ramadan bazaars, they need to follow MOH standard operating procedure or guideline and have to take all precautionary measures to break the Covid-19 infection chain,” he added.

Asked on calls for the imposition of Enhanced Movement Control Order (EMCO) in red zones, he said this would be done if there is a rapid increase in positive cases in these areas.

The government enforced the EMCO in the area from Batu 21 to Batu 24 Sungai Lui, Hulu Langat, Selangor, yesterday, the second area to be placed under such restrictions after Simpang Renggam, Johor where Kampung Dato’ Ibrahim Majid and Bandar Baharu Dato’ Ibrahim Majid were subjected to similar curbs for 14 days beginning Friday. – Bernama

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March 30, 2020
BREAKING: Buhari’s Chief Of Staff, Kyari, Says He Is Transferring To Lagos For Medical Treatment, Confirms SaharaReporters Story

Abba Kyari, Chief of Staff to Nigeria’s President, Muhammadu Buhari, who tested positive for Coronavirus, has said that he will be moving to Lagos for “additional care and observation”.

Recall that SaharaReporters had exclusively reported that Kyari was seriously ill and tested positive for the virus after returning from a trip to Germany and Egypt.

SaharaReporters had also reported that the Presidency was making plans to move Kyari to Lagos for intensive care.

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EXCLUSIVE: Presidency To Move Abba Kyari To Lagos For Treatment After Testing Positive For Coronavirus

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Kyari in a statement on Sunday said, “I am writing to let you know that on medical advice I will transfer to Lagos later today for additional tests and observation.

“This is a precautionary measure: I feel well, but last week I tested positive for Coronavirus, the pandemic that is sweeping the world. I have followed all protocols government has announced to self-isolate and quarantine.

“I have made my own care arrangements to avoid further burdening the public health system, which faces so many pressures.

“Like many others that will also test positive, I have not experienced high fever or other symptoms associated with this virus and have been working from home. I hope to be back at my desk very soon.

“Like the whole world, we are dealing with a new disease. Our experts are learning more all the time about Coronavirus, what it does and how we can combat it.

“This is a disease that recognises no difference between North and South, men or women, rich or poor. We are all in this together.”

Nigeria so far has 97 confirmed cases of the virus and one recorded death.

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March 30, 2020
UPDATE: Buhari Orders 14-day Lockdown In Lagos, Ogun and FCT Over Coronavirus Outbreak

President Muhammadu Buhari on Sunday during a nationwide broadcast ordered the restriction of movement in Lagos, Ogun and Federal Capital Territory, Abuja, following the outbreak and continued spread of Coronavirus in the country.

The restriction is expected to last for two weeks in the first instance to enable the Federal Ministry of Health, Nigerian Centre for Disease Control and other stakeholders rally all available resources to control the spread of the disease.

Buhari urged citizens in these areas to stay in their homes in order to reduce the risk of contracting the virus.

He equally advised that inter-state travels should be postponed.

According to the President, the containment period will be used to identify, trace and isolate all individuals that had come in contact with confirmed cases, including ensuring the treatment of confirmed cases while restricting further spread to other states.

He said, “Based on the advice of the Federal Ministry of Health and NCDC, I am directing the cessation of all movements in Lagos and FCT for an initial period of 14 days with effect from 11pm on Monday, March 30, 2020.
“This restriction will also apply to Ogun State due to its close proximity to Lagos and the high traffic between the two states.”

Nigeria currently has 97 confirmed cases of Coronavirus and one recorded death.

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March 30, 2020
Can debt-burdened millennials afford to invest?

In this episode, Joel and Maria talk with a trio of millennials about their individual challenges around saving and investing and share their advice on balancing short- and long-term priorities to stay on track.

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March 29, 2020
(Video) Covid-19: Family of seven stays cheerful despite virus infection

KUALA LUMPUR: Although this family of seven has been tested positive for Covid-19, the five siblings who are currently quarantined at the Teluk Intan Hospital sure know how to stay cheerful instead of being despondent.

Since yesterday, the TikTok video of Erika Syamim Samsu Ambia, 17, and her siblings has been trending on Twitter.

“Even though we’re Covid-19 positive, we as a family will go through this together. Plus, our health condition is okay. Here’s a TikTok (video) we made to entertain ourselves in hospital,” she wrote.

The eldest among the five siblings admitted they had to be strong-willed and pray constantly during these trying times.

In a conversation with Bernama via Twitter, she said her father Dr Samsu Ambia Ismail, a Specialist and Head of the Emergency and Trauma Department at the Teluk Intan Hospital, was the first in the family to have tested positive for Covid-19 and has been quarantined at the hospital for the past six days.

Erika Syamim, four siblings, aged between eight and 15, and their mother were quarantined a day later.

“We are fighting the virus with our own antibodies and hope we’ll be fine after the 14-day quarantine,” she said.

At the time of writing, Erika Syamim’s Twitter feed has received over 208,000 views, 14,800 retweets and 19,000 likes.

Asked by a netizen about the symptoms of the disease, she said her father had fever, cough and breathing difficulties while the rest of them just had a fever.

Netizens flooded her Twitter post with words of encouragement, prayers and hoped they would stay strong and recover soon.

Erika Syamim also had some advice for other patients, especially Muslims, to continue to pray and recite the al-Quran.

“If you are in the ward, don’t be ‘lemau’ (sluggish). Be cheerful, insya-Allah (God willing) we can fight the disease too,” she said. — Bernama

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March 28, 2020
Sokoto Government Closes Entry Points Into State Over Coronavirus

The Sokoto State Government on Friday announced the closure of entry points into the ancient city in order to curtail the spread of Coronavirus in the country.

Governor Aminu Tambuwal in a broadcast said that only the movement of medical supplies and essential food items will be allowed into Sokoto from other parts of the country.

He said the closure will stay in place for an initial two weeks pending observations on the pattern of the disease in the state and country.

Also, all civil servants on grade level 12 and below have been directed by the state government to work from home for two weeks from Friday, March 27 to Friday, April 10, 2020.

The governor said all further measures to be taken by the state will be based on expert advice from the state’s Ministry of Health, Nigerian Center for Disease Control and Federal Ministry of Health as and when the need arises.

He admonished citizens to cooperate with relevant authorities and adhere to measures in the interest of the general well-being and survival of the human race.

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March 28, 2020
Patients who recover from Covid-19 can get infected again if guidelines not followed

PUTRAJAYA: Patients who fully recover and from Covid-19 and are discharged from hospitals can be infected by the virus again if they defy advice issued by the Ministry of Health (MOH).

Health director-general Datuk Dr Noor Hisham Abdullah (pix) said although the possibility of them being infected again is very low, they are advised to maintain cleanliness and self-hygiene to prevent getting the virus again.

“There is the possibility of the patients to be re-infected, but before they are discharged from the ward, we advise them to take preventive measures by maintaining their self-hygiene and cleanliness to avoid being infected by the virus again.

“If those who have been discharged do not maintain their cleanliness and do not take precautions, they can be re-infected, but the chances of them to be re-infected is slim,” he told a daily press conference here today.

He advised patients who have recovered from Covid-19 to adopt a healthy lifestyle and to always take precautionary measures as advised by MOH.

So far, he said, there have been no cases of recurrence during the first and second wave of the outbreak in the country.

On the cause of the Covid-19 infection in Kampung Datuk Ibrahim Majid and Bandar Baru Datuk Ibrahim Majid in Simpang Renggam, Kluang, Johor, he said the matter was being investigated.

“From preliminary investigation, we have found that there may be four clusters associated with the tabligh congregation.

“There are four index cases who attended the tabligh assembly at the Sri Petaling Mosque. Perhaps, they returned to the village to attend weddings and also joined mosque congregation for prayers that the virus spread to villagers in the area,“ he said.

On the latest number of tabligh participants who were screened, he said MoH screened 13,762 individuals with a total of 12,317 samples taken.

Of the total samples screened, 1,137 were positive, 6,623 negative and 4,557 still pending, he added. — Bernama

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March 27, 2020
International working group on Ethics & COVID-19

The response to the COVID-19 pandemic raises a number of difficult ethical issues, related to e.g. clinical trials, social distancing, priority-setting, health-care workers’ rights and obligations etc. WHO has established an international Working Group on Ethics & COVID-19 in order to develop advice on key ethical questions that Member States need to address.

Related document

Distilling existing guidance to support COVID-19 Research & Development [pdf, 263kb]

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March 26, 2020
Do not take RTK test for Covid-19 without doctor’s advice: MOH

KUALA LUMPUR: The Health Ministry (MOH) has called on the people not to undergo rapid test kit (RTK) tests arbitrarily without seeking the advice of medical practitioners.

Health director-general, Datuk Dr Noor Hisham Abdullah (pix) said it has the potential to a give wrong interpretation from the result obtained.

“The test via RTK technique which is now available in the market is to detect antibodies produced by the body as a result of an infection. The antibodies will appear in the body in five to eight days after infection.

“The RTK test which detects antibodies, cannot detect virus and it is administered for quick confirmation. As such it cannot help in the detection of initial Covid-19 cases. Therefore, RTK test is not recommended for diagnosing Covid-19,” he said in a statement today.

Elaborating further, Dr Noor Hisham said MOH is using the Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) technique at government health laboratories to detect the presence of Covid-19 virus found in the body of patients.

If the rRT-PCR COVID19 test is found positive, it means the individual has been infected by Covid-19 virus.

“The result of the rRT-PCR technique is very important in managing Covid-19 patients effectively,” he said.

In this regard, Dr Noor Hisham advised the people not to discriminate members of the tabligh congregation following the spread of Covid-19 from the cluster and should in fact assist MOH in tracing close contacts among them.

“We should not blame tabligh members, do not discriminate them, we should not stigmatise the tabligh congregation. What is important is for us to assist, trace and treat Covid-19 infection among tabligh members, their families and their contacts,” he said.

Apart from that. Dr Noor Hisham said KKM is cooperating with MERCY Malaysia to provide psychosocial support to the people especially frontliners and individuals emotionally affected by Covid-19.

They can obtain the service by contacting 011-63996482 / 011-63994236 / 03-29359935 from 8am to 5pm daily.

Members of the public can also contact the virtual health advisory team for a webinar session daily from 9am onwards at http://www.doctoroncall.com.my/coronavirus. – Bernama

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March 24, 2020