Safeguarding health of the people through whole-of-nation approach

James Kon

Since the first COVID-19 case was discovered on March 9, Brunei Darussalam has deployed all its resources through a whole-of-nation approach to contain the contagious and deadly disease that has impacted the whole world.

The Ministry of Health (MoH) placed stringent measures in stages, and the efforts yielded success with the country recording no new COVID-19 cases for over two months.

As of yesterday, 3,169 individuals completed mandatory self-isolation at the monitoring centres, and some 34,484 SARS-CoV-2 virus laboratory tests carried out since January.

In addressing the pandemic, the government of His Majesty Sultan Haji Hassanal Bolkiah Mu’izzaddin Waddaulah ibni Al-Marhum Sultan Haji Omar ‘Ali Saifuddien Sa’adul Khairi Waddien, Sultan and Yang Di-Pertuan of Brunei Darussalam built a new isolation centre in Tutong costing BND11,317,514. It stretches for seven blocks and boasts 160 beds. A National Virology Reference Laboratory was also built in Kampong Sumbiling to increase testing capacity, and a BruHealth app launched to improve contact tracing in the case of new cases.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar shared Brunei’s experience in curbing the spread of COVID-19 during a video conference at the ASEAN Health Ministers Meeting (AHMM) in early April.

The new extension to the National Isolation Centre in Tutong District. PHOTO: BAHYIAH BAKIR

“Our approach is a whole-of-nation response based on two fundamental principles. First, we aim to reduce morbidity and mortality through early detection,” he said. “To do this, we do our best to find, test, isolate and treat every case as well as trace every contact. We scaled up testing services, converted a sports complex into a dedicated 24-hour sampling centre, implemented sampling in primary healthcare centres and opened a new Molecular Diagnostic Unit for respiratory viruses that increased testing capacity by 10 folds.

“Secondly, we aim to slow and limit the spread of disease to reduce stress on the healthcare system. We are using a combination of travel restrictions and social distancing measures, such as using digital technology to support remote learning and working and public communications campaigns to encourage better hygiene and social distancing practice.

“At the same time, we continue to invest in healthcare, prepared for additional capacity in our system with an extension of our National Isolation Centre, increasing its bed capacity six-fold and equipped with critical care beds and intensive care unit (ICU)-capable beds.”

During the virtual 73rd World Health Assembly in May, the minister again revealed Brunei’s strategies and approaches in containing the outbreak through enhanced surveillance, testing and effective community engagement.

“Since the start of the outbreak in the country, we detected 141 cases. Thankfully, through a careful programme of testing, isolation, contact tracing and treatment, we have managed to control our first few clusters.”

While the battle is not yet over, the minister shared two lessons in Brunei’s experience.

Firstly, he highlighted the importance of enhanced surveillance and testing.

“We are an early adopter of testing even with the absence of symptoms,” he said, “We also conducted random sampling in community health centres and among the foreign worker population.

“Our test-per-capita ratio is among the world’s highest and we believe that containment efforts have been crucial in preventing widespread community transmission.”

Secondly, the minister said, “We employ an effective community engagement strategy with daily press conferences, a dedicated 24-hour hotline for public inquiries, and a self-screening mobile application integrated with artificial intelligence and data analytic capabilities.

“Civic society also plays a key role in the grassroots movement that sparked a surge in volunteerism and community advocacy.”

With an emphasis on containment along with community engagement, Dato Seri Setia Dr Haji Mohammad Isham said, “This has allowed us to control the disease, without resorting to ‘lockdowns’. Although we have implemented some level of moderate physical distancing, public services and businesses remain open and no movement restrictions within the country were imposed.”

“The combination of targetted approaches can be a useful way forward in the months ahead. Adopting a phased approach to de-escalation and leveraging technology for swift contact tracing could be a viable strategy to sustain the response to the COVID-19 pandemic,” he added.