Preparedness, cooperation are key

James Kon

Since the first COVID-19 case emerged on March 8, 2020, 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 has shown its preparedness to address the pandemic.

Around the world, there have been 25,118,689 confirmed COVID-19 cases, including 844,312 deaths globally, according to the World Health Organization (WHO) on August 31.

As of yesterday, Brunei Darussalam’s confirmed COVID-19 cases are at 144, including three deaths and two active cases receiving treatment at the National Isolation Centre.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar in an interview with the Bulletin recently shared insights on the current success of the government’s efforts in curbing COVID-19.

He said the government learnt about the presence of COVID-19 as it was reported internationally when China announced their first case.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar during an interview with the Bulletin. PHOTO: BAHYIAH BAKIR

Speaking on the preparations and strategies in place before the first case was reported in Brunei, he said, “The most important thing when we first became aware of COVID-19 was to find if we had the capacity to test for the virus. When we knew that we can’t, we acquired testing kits after contacting a Chinese company.

“Initially the virus was in China, so we thought it would be contained. By January 2020, it started to spread beyond China. That is when we said that we must have the capacity to detect it.

“When we had our first case in March this year, a few countries in our region had already experienced or had positive COVID-19 patients. Because of travel – and there were no restrictions then – it was just a matter of time when the virus would land in Brunei.

“So when it happened, we were quite prepared because by then we had the capability to test the virus and from our disaster management plan for pandemics, we allocated where they should be. We also had discussions with all the ministers on how each ministry should work together to control the virus.”

Like any other infectious disease, he said the key is to quickly detect and isolate those carrying this virus. “The more and quicker we do it, the better the chance of us controlling and managing the spread of the pandemic.”

Speaking on how the Government of His Majesty came up with the stages of restrictions implemented throughout March and April to control the spread of the virus, he said, “When the pandemic occurred, we had a few brainstorming sessions and before we introduced any restrictions, we gathered to set a plan and decide why the restrictions should be there. All ministers and ministries were aware and understood why we should be doing this.

Alhamdulillah, with the consent of His Majesty, it was quite smooth how we contained the pandemic.”

The minister also spoke on the importance of the daily press conference to help build public confidence and transparency in the government handling the situation and in disseminating crucial information.

“The daily conferences helped breakdown any false news or rumours which could cause more anxiety or panic in the local community. Having the daily conferences was not only for being transparent on the number of cases and how we manage them but also to allay anxiety.”

He said the media also plays an important role as a mediator between the government and the public, to ensure the latter fully understands how the pandemic is being managed, “because we need the support. It is not only whole-of-government, it’s a whole-of-nation approach so each and every one in Brunei must play a part, must play their role in togetherness to controlling this pandemic.”

Testing has played a crucial role in early detection of the virus and isolating positive cases. To date, Brunei has tested over 50,000 people, which is more than 10 per cent of the population. Speaking on the testing regimen in Brunei, the minister said, “Throughout the period, we not only test people who supposedly have the virus. We are also quick to test the contacts. Our contact tracing team works very hard and usually within 24 hours, they already know who the contacts are. Of course, patients who are admitted to hospital because of the illness may take a lot of time (for contact tracing) because we need them to answer all the questions. But usually within 24 hours, we will know and because of the distance of Brunei, they can easily spread around the country.”

“Once the pandemic was under control, we started carrying out testing on others who are of higher risk of getting the virus, for example, those in detention centres or prisons. We also go to businesses that have close contact with people like barbers, beauticians, and restaurants. We also went on early testing to get a proportion or percentage of foreign workers. All companies having a high index or proportion of foreign workers were prioritised for swabbing. Not all of them, but a percentage and at random. Through this, we were able to sample foreign workers population.

“Before we de-escalated, we increased our surveillance where all patients going for surgery were swabbed and all patients who have slight symptoms were also swabbed.

To ensure consistency, the minister said they dedicated a few health centres for swabbing. “Only the government lab can do this testing because we need to have a very good control or standard operating procedures. We don’t want to have many variables.

“For us, if it’s positive, we don’t take it as face value. We will repeat the test. Sometimes we carried out two or three tests and that is why our testing takes longer. Once it’s positive, we confirm it again at least twice or three times to ensure that those who are positive are really positive.”

Currently, Brunei Darussalam is easing restrictions through its de-escalation plan. Asked how the plan took shape, the minister affirmed that this involved all ministries.

“We set up the plan for de-escalation period between levels one to two and so on. There is a grace period and how we de-escalate was explained. Now, we are actually in level four and the next level is the norm. At the moment the pandemic is still ongoing. We need to wait and see if we will release to the next level.

“Every step before we de-escalate, permanent secretaries will meet and discuss what has happened, like things that have been done and should be improved. They will have brainstorming sessions and once they agree on the next plan, they will present to us to see if we agree or not. Then the plan will need to get the consent of His Majesty.”

With COVID-19 cases still surging globally, the minister was asked whether he thinks life will go back to the old normal again in the country.

“With the availability of vaccines, we can be more aggressive with the opening especially the border and hopefully by then, it will be near normal,” he said. “With this experience of COVID-19, I think that there are some positive changes like how we dealt with mass gatherings and how we behave in public, where people have improved their ethics in terms of sneezing and coughing. The wearing of masks is no longer something bizarre. Hopefully it will become a positive trend for people. Hopefully people will become more responsible when they are not well, like with fever or flu, they should stay at home. It is fine for them to stay at home because our culture can sometimes be difficult, especially when there is a wedding reception where it’s like an obligation for us to attend.

“Now people understand that if you are unwell, you stay at home. For me as well, if I am unwell, I stay at home. That is the expectation now, that they don’t expect you to be at the function so this is something positive.”

Among others things he mentioned were that the use of online classes and payments were on the rise. “This has helped us to fast-forward to the 4th Industrial Revolution.”

With many people eager and anxious for the borders to re-open, the minister was asked whether there are any requirements for this to happen.

“The border opening is controlled by a special taskforce involving several ministers. We look at a few things, especially the number of infections in the particular countries that allow to travel like our neighbouring countries. So the main things are the local community spread within that particular country and how long they have been free from infection. They need to be free for some time before we can even consider fully opening.

“We are discussing with some neighbouring countries. We are talking about bilateral arrangements like the green lane, which is ongoing.”

The minister highlighted the need to still be responsible, especially in terms of mass gatherings like in mosques, especially during the Friday prayers.

“At the moment, it is still mandatory for people to wear a mask and bring their own prayer mat as well as getting their temperature checked. We don’t want any outbreak, especially from mosques. That is why we try to safeguard places of worship. We still insist on temperature checks and scanning the QR code.

“With the pandemic still around us, we have to be careful. We only closed the border in mid-March and this virus has been around since late December to January. People were still travelling then. When we did our antibody survey, we did find a few positive cases around that, meaning there are people with the virus who managed to pass through the border undetected before we actually closed the border.

“At the moment, those who have flu-like symptoms are swabbed in the health clinic. Of course, it’s not compulsory unless you are a point of contact with someone positive. In a way, we are still monitoring this and at this moment, our influenza-like illness is back on the rise, which is expected because we usually have two peaks (December to January and August to September) so we still have to be careful. There are also other illnesses that can spread like the normal flu, H1N1. This illness still can kill so we should not take
it lightly.

“Although COVID-19 is under control, people still must practise good ethics of social responsibility. If you are ill, you should not go out of your house especially to attend mass gatherings at mosques or others.”

On a lighter note, asked what he thinks of the many memes of himself created by the public, the minister said, “Well, it shows that our people are quite creative. It’s very interesting and, of course, in a way it’s very enlightening and gives you a break from the stress.”

On how he manages his time as a surgeon, the Minister of Health and as a family man, he said, “This is a difficult question. I am still learning on this. It needs the support of everyone, especially the family – my wife and children. Alhamdulillah, they understand my job as a surgeon before this and as a minister as well. The support of colleagues from the ministry and from the hospital helps to co-manage the patients. It needs the cooperation of everyone for it to work, from the family side, from the doctors, colleagues as well as people from the ministry. It’s a lot of time management.

“Everyone needs to be socially responsible. Follow the advice of the Ministry of Health (MoH), especially in mass gatherings. The public as well as vendors should wear face masks. I hope that people will follow the MoH’s advice of using the BruHealth app for us to better trace and contact individuals if any outbreak occurs,” the minister said.