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81

VOLUME: 18 NO. 2/2021Journal of Health Management, IHM

80   VOLUME:  18  NO.  2/2021  –  Journal  of  Health  Management  

LESSONS  LEARNT  FROM  AN  EPIDEMIOLOGICAL  INVESTIGATION  OF  COVID-­‐19   OUTBREAK  AMONGST  HEALTH  CARE  WORKERS  IN  A  MOJOR  SPECIALIST  

HOSPITAL  IN  MALAYSIA   Abdullah,  M.  

1

,  Selvarajah,  T.

1*

,  Mohd,  N.

1

 

1Putrajaya  Hospital.  

*Corresponding  author:  Thinakaran  M  Selvarajah,  Administrative  Office,  Hospital  Putrajaya,  Jalan  P9,  Presint  7,   62250  Putrajaya,  Malaysia.  Email:  [email protected]    

ABSTRACT  

Introduction:   Healthcare   staffs,   particularly   front   liners,   have   been   reported   to   be   exposed   to   emerging   viral   diseases   due   to   inadequate   measures   to   control   infection   during   overwhelming   or   unexpected   initial   encounters   with   infected   patients.   We   report   on   the   experience   of   a   major   specialist   hospital   in   Malaysia   in   the   face   of   COVID-­‐19   outbreak   in   which   our   healthcare   workers   were   exposed   while   close   contacts   between   staff   were   quarantined.   Service   delivery   has   been   challenged  and  new  measures  have  been  in  place  to  mitigate  the  spread  in  healthcare  settings.  

Problem  (Rationale):  The  first  positive  COVID-­‐19  case  in  Malaysia  was  reported  on  24  January  2020,   while   the   first   local   healthcare   workers   (HCW)   death   occurred   on   22   March   2020.   The   trend   of   infected  HCWs  increased  over  the  next  several  weeks,  burdening  the  healthcare  system.  

Approach  (Methodology):  We  identified  that  major  possible  cause  of  spread  was  secondary  to  close   contact   with   colleagues   when   managing   Patient   Under   Investigation   (PUI)   or   Severe   Acute   Respiratory  Illness  (SARI)  patients.  Following  this,  healthcare  workers  and  public  are  encouraged  to   avoid   ‘3C’   areas,   namely   crowded   place,   confined   space,   and   close   conservation   and   to,   practice  

‘3W’,  which  is  frequently  washing  hands  with  water  and  soap,  wearing  face  mask  in  public  places  or   when   encountering   those   with   fever   and   flu,   practice   caution   by   avoiding   handshakes,   staying   at   home,   and   seeking   treatment   if   developing   symptoms   related   to   COVID-­‐19.   Symptomatic   staff   suspected  and  confirmed  cases  were  identified  and  quarantined.  

Relevant  Changes  (Result/Findings):  Within  four  weeks,  (11  HCWs  were  COVID-­‐19  positive  with  550   close  contacts  quarantined.  The  flattening  of  curve  was  seen  after  quarantine  order  was  released  on   9   April   2020.   No   new   cases   were   recorded   after   1   April   and   recovery   was   observed   by   2   April.   All   cases  recovered  by  24  April  with  no  additional  new  cases.  

Lesson   Learnt   (Conclusion):   Identifying   and   managing   HCWs   at   risk   of   infection,   timely   sharing   of   information,  organizing  personnel,  promoting  sanitization,  and  restricted  gatherings  were  critical  for   controlling  COVID-­‐19  spread.  

Keyword:  Healthcare  workers,  COVID-­‐19,  front  liners,  quarantine,  policy    

   

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