Health systems response when COVID-19 hits Malaysia: Public perspective of border control during early phase of infectious disease threat

ABSTRACT

Introduction: In the early phase of the pandemic, confirmed COVID-19 cases spread globally from Wuhan, China. Similarly, Malaysia's first three cases were Chinese nationality travelers entering from Singapore to Johor. As the coronavirus spread rapidly across borders, World Health Organisation (WHO) declared the outbreak a Public Health Emergency of International Concern on 30th January 2020. One of the measures imposed to curb the spread was travelling restrictions between countries. Objective(s) This study aimed to explore the public's perspective on Malaysia's border control or point of entry during the early phase of COVID-19 pandemic. Material(s) and Method(s) WHO's Strategic Preparedness and Response Plan (SPRP) pillars were adopted to develop an online survey. The online survey was distributed to public respondents and identified healthcare experts from March to April 2020 via social media and email invitation. The survey includes open-ended questions where respondents gave their opinions with regards to eight pillars of SPRP strategies taken during the early phase of COVID-19. The fourth pillar emphasizes on country's point of entry. A qualitative content analysis approach was performed using NVIVO-12 software. Result(s) and Conclusion(s) Four domains were identified namely Entry/Exit Control, Screening Measures, Quarantine Policy and Information. Issues on the timeliness for border closure, quarantine policy and dissemination of information regarding disease management as well as Standard Operation Procedure were highlighted by the respondents. Respondents felt that the screening mechanism at points of entry was lacking in stringency and inconsistent. Respondents raised concerns regarding the competency of frontliners in implementing the screening process. Respondents believed that clear quarantine instructions and traveler tracking system are necessary upon entering the country. Containment of infectious diseases like COVID-19 during the initial phase of the pandemic were critical to slow down the spread of the disease. Country's authorities were expected to make judicious decisions on travel restrictions, border controls, travelers quarantine and point of entry screening to reduce imported cases.