4/4 Covid risk management and risk communcation

1. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 1
COVID-19
RISK MANAGEMENT
AND RISK
COMMUNICATION-
What we know and what
we don’t know
Part V
Prepared by:
Tengku Hanidza Tengku Ismail, PhD.

3. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 3

4. New COVID-19 manifestations? COVID toes
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 4
Most of the patients were children (median 13 years) and
young adults (median 31, average 36, range 18–91 years
old).
Hypothesis: these lesions could be a late manifestation of
COVID‐19.

5. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA
5
A rare syndrome affecting children that could be linked to COVID-19 has been reported in several European
countries. UK: The Pediatric Intensive Care Society UK (PICS) warned about a small rise in the number of cases
of critically ill children, some who had tested positive for Covid-19, presenting "overlapping features of toxic shock
syndrome and atypical Kawasaki disease with blood parameters.
(www.euronews.com).

6. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 6
ACE2 (an enzyme) is a receptor on the surface of cells which
binds to COVID-19 and allows it to enter and infect cells.
Researchers from Minnesota reported mutation caused the
virus to attach more securely.
ACE2 is found in the lungs, heart, kidneys, in tissues lining blood
vessels, and in particularly high levels in the testes.
ACE2, was much higher in men than in women.
Human
cell

7. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 7
Boost immunity with
“convalescent” plasma from
recovered COVID-19 patients or
monoclonal antibodies directed at
SARS-CoV-2. Given to patients
unable to generate their own
antibodies against the virus.
Remdesivir (Ebola drugs and
related virus)
Chloroquine/ hydroxychloroquine
(Malaria drugs)
Lopinavir - ritonavir (HIV drugs)
Interferon-beta (produced by
human white blood cells, help
cripple viruses)
SARS-CoV-2 cell entry depends on
ACE2 and TMPRSS2 (present on
human cells). Camostat mesylate
(Japanese encephalitis drugs/hepatitis
drug) block the virus to enter lungs
Outside
human cell
Inside
human cell
Step 4 inhibited: The virus will not
able to replicate, i.e. no new virus
formed, if those drugs effectively
destroy them.
Step 2&3 inhibited if convalescent
plasma/Camostat mesylate
effectively destroy them.
DRUGS on trial for
COVID-19
Convalescent
Plasma
Camostat
mesylate
Chloroquine/
hydroxycholoroquine
Lopinavir-ritonavir
Remdesivir

8. 13/5/2020
COVID-19 RISK COMM4/TENGKU HANIDZA
8
COVID-19 vaccine
R&D landscape

9. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 9

10. USA is still leading in COVID-19 cases but the country is ready
for re-opening. It’s the matter of economic survival over health.
13/5/2020 COVID-19 RISK COMM3/TENGKU HANIDZA 10

11. Guidelines for Opening Up America Again: Phase 1
13/5/2020 COVID-19 RISK COMM3/TENGKU HANIDZA 11

12. 13/5/2020 COVID-19 RISK COMM3/TENGKU HANIDZA 12
Guidelines for Opening Up America Again: Phase 2

13. 13/5/2020 COVID-19 RISK COMM3/TENGKU HANIDZA 13
Guidelines for Opening Up America Again: Phase 3

14. How to beat COVID-19 disastrous effect? Lessons
learned from Taiwan (one of the best health care) and
Greece (weak health care).
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 14

15. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 15
• Lessons learned from SARS epidemic (2003), quick early respond to
COVID
• Recognize COVID as dangerous and more seriously as compared to
the rest of the world (Government and society)
• Quick decisive action while the rest of the world is still debating
• Early Border control (January).
• Travel bans from China.
• Wearing masks as routine
How Taiwan avoid disastrous COVID-19?

16. • Extensive electronic tracking
• Strict punishments for anyone found breaching home quarantine
orders
• Extensive production of PPEs for local use
• Island-wide testing, proactive surveillance and contact tracings
• Reassure and educate the public. Punishments for spreading
disinformation about the COVID.
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 16

17. How Greece avoid disastrous COVID-19?
• Prioritising science over politics. Listen
to experts.
• Good communication strategies: Early
warnings, daily updates
• Quick respond: Before the first case was
diagnosed, they started examining
people and isolating them.
• Strict bans on movement.
• Incoming flights, especially from China,
were monitored.
• Those repatriated from Spain were
quarantined in hotels.
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 17

18. • Early lockdown ahead of other European
countries
• Sufficient PPEs and ICUs (despite weak
health care system)
• Greeks abiding to the enforced regulation.
• High level of collective responsibility.
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 18

19. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 19

20. COVID-19 invades the White House
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 20

21. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 21
"He's a unique individual," one White House official said.
"He can't be seen walking around wearing a mask."

22. WHICH COUNTRIES DO BEST IN BEATING COVID-19? (AS OF MAY 4)
https://www.endcoronavirus.org/countries
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 22
WINNING AGAINST COVID-19
ALMOST, BUT NOT THERE YET
*May 4
*Apr 27
*Lockdown Exit strategy
Easing complete/partial lockdowns/ Movement
Control Order/ Stay Home
order/restrictions/Schools reopen.
Slow opening of selected non essential businesses
begin earlier. No mass gathering.
*Apr 14
*Apr 20
May 4
schools
*May ?
Level 3
*Apr 15
Jun 9
MCO5
*Apr 15
schools
*Apr 20
schools
*Apr 27
May 11
schools
*May 11
schools
*Apr 8
*May 4
*No
lockdown
*May 11
schools
*No
lockdown
*Early May *Apr 30*May 13
schools
*Apr 4
*Apr 27
*May 1 *May 4 *Apr 19
*May 10
*Apr 20 *Jun 1
*Apr 20
*May 31
*Apr 20
*May 3
*May 1 *May 4
*Apr 20
*May 18
*May 11 *May 11
*May 11
*May 2
*May 4
*May 11
*May 11
*lockdown
under review

23. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 23
COUNTRIES NEED MORE ACTIONS TO ACHIEVE DECLINING PHASE
*May 7
*Apr 24
Selected regions
*May 13
schools
*Apr 19
*May 17
*May 10
*June 1
*May 10
*May 4
*lockdown
under review
*no
lockdown
*Apr 21
*lockdown
under review
*extend May
15
*lockdown
under review
*May 15 *May 12
*lockdown
under review
*May 7
*night curfews
*lockdown
under review
*May 5
*no
lockdown
*lockdown
under review
*May 25
*May 22
*night curfews
*May 9
*May 24
*lockdown
under review
*lockdown
under review
*May 11

24. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 24
COVID
INFECTION
WORLD
SITUATION

25. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 25

26. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 26
• The Health DG said the Institute for Medical
Research (IMR) had found a mutation that might
have caused the virus to become more aggressive
in the case of Patient #26.
• 120 people were infected (3 generations)
• The virus in were of strain B, which come from Wuhan.

27. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 27

28. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 28
(2/5/20)
(EMCO)
The recent trend of confirmed COVID-19 cases reported
daily has shown an increase in imported cases and cases
detected from EMCO localities.

29. MCO 4:
Recovery phase
(Apr 29 – May 12)
13/5/2020
COVID-19 RISK COMM4/TENGKU HANIDZA
29

30. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 30
Of these 105 additional cases reported today, 11 are imported cases. The remaining 94 cases are due to
local transmission, of which 60 cases were detected in Enhanced Movement Control Order (EMCO)
localities.

31. Prohibited activities
during EMCO Phase 4
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 31

32. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 32

33. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 33

34. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 34

35. Are we financially prepared?
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 35

36. Have we adapted
to COVID-19?
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 36

37. Impact of COVID-19 on Malaysian Consumers
Vodus Insights conducted a survey of 16,000 Malaysians to understand how the impact of recent Movement Control Order
(MCO) on work pattern, sentiment, lifestyle and media consumption behavior. https://vodus.com/article/detail/7
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 37

38. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 38
Containing COVID-19
vs. migrants workers:
A Challenge

39. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 39
Everyone living in EMCO
localities will be tested for
Covid-19, as part of the
ministry’s targeted
approach
(Health DG)
KUALA LUMPUR (Reuters) – Malaysian authorities are rounding up undocumented migrants as part
of efforts to contain the spread of coronavirus. The arrests followed public anger in recent days over
the presence of migrant foreigners, particularly Rohingya refugees, with some in Malaysia accusing
them of spreading the coronavirus and being a burden on state resources.

40. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 40
28 cases in "Kuala Lumpur construction site"
cluster, but had yet to identify its source. "It could be
the Sri Petaling gathering cluster, the Selayang
Wholesale Market cluster, or even the Kampung Baru
cluster. However, we have no strong evidence that it is
linked to any of them (Health DG).
The infected patients are migrant workers

41. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 41
The minister pointed out that there
were recent spikes in Covid-19 cases
and the emergence of a new cluster linked
to migrant workers.
“As I said, this is prevention, because we
don’t want what happened to Singapore,
where previously they had a flat trend of
positive cases but because there is a new
cluster, which is the foreign worker cluster
in Singapore, their positive Covid-19
cases rose sharply.”

42. Migrant Workers (legal or otherwise) Covid-19
Cluster Hits Malaysia
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 42

43. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 43

44. Relaxing MCO4 (known as Conditional MCO) on May 4, 2020:
the Pros & Cons
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 44
We have lost about RM63bil since the MCO was
enforced on March 18, and will lose another RM35bil if
the MCO is extended by another month (PM Malaysia).
2.7 million people would lose their jobs due directly
or indirectly to Covid-19’s impact on the economy
(Min. Human Resource
We are now in the recovery stage and have to manage
the virus within the community. The socio-economic
needs of the rakyat must also be managed. (Health
DG).
Too Fast, Too Soon. Covid-19 pandemic to worsen
and put workers lives at risk (MTUC)
It wasn't fair to impose the same strict rules in an area
free of the disease (Senior Minister [Security Cluster]).
Can we adopt the new norm lifestyles?
We did not end the MCO. The perception that we have
lifted the order is wrong (Health DG).
Social compliance and self-discipline
approach be sustained?
Complying with the SOPs stipulated by the MOH.
How far?

45. Update:
May 10
8th EMCO
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 45

46. End of CMO Phase 4: May 12
13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 46

47. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 47

48. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 48
POSSIBLE
OCCURRENCE
OF 2ND WAVE?
...WE CAN’T LET
DOWN OUR
GUARD

49. 13/5/2020 COVID-19 RISK COMM4/TENGKU HANIDZA 49
STAY HOME. STAY SAFE. STAY COVID FREE