LETTERS: WHILE the novel coronavirus (2019-nCoV) outbreak is making headlines, catching our attention and causing mass fear of the unknown, perhaps we should put things into perspective.
In Malaysia, between 20,000 and 25,000 new tuberculosis (TB) cases are recorded each year claiming about 1,500 to 2,000 lives annually, with an average of six deaths occurring every day, according a report last year.
It is one of the most contagious diseases spread by air droplets. People at the highest risk of developing TB are those with a weak immune system such as HIV patients, kidney patients, diabetics, senior citizens residing in institutions and smokers. TB can affect any human body organ.
Healthcare workers face special risk because of their inherent job nature coming close to proximity with patients.
Transmission has been documented in health-care settings where healthcare workers, patients even medical students come in contact with persons with infectious TB who have unsuspected TB disease, have not received adequate or appropriate treatment, or not been separated from others.
It is a recognised health care occupation risk. Transmission usually occurs over a prolonged period in the following days and months of exposure. Compared to household contacts, healthcare workers exposure is comparatively brief but can be subjected to multiple exposures in the health care setting such as hospitals or clinics.
The Health Ministry should continue to step up efforts to improve the surveillance, screening, diagnosis and treatment aspects of the contagious disease but at hospital level it is important to consider the environmental factors that enhance the probability that Mycobacterium tuberculosis can be transmitted.
For example, exposure in small, enclosed spaces may increase the concentration of infectious bacilli in the air. Also, inadequate local or general ventilation results in insufficient dilution or removal of infectious droplets nuclei.
To protect oneself healthcare workers should wear respiratory-protective devices with filter characteristics that meet the United States CDC performance criterion of >95% efficiency at 1 micron particle size.
Please note that surgical masks have neither the fit nor the filtration properties to provide protection of the wearer from airborne transmission.
All in all, we can agree that overcrowding and congestion in wards pose health and safety hazard to patients, family and staff. Even though the hospital is a public place, visitors entry should be restricted and controlled.
The public has to be educated and that though healthcare institutions are places to seek medical treatment and heal, hospitals do pose certain risk. Those who have underlying diseases such as diabetes, chronic lung disease, recently gotten sick or immune-compromised should be cautioned from visiting those ill in wards.
Children should not gain permission to enter. Unauthorized personal such as business peddlers of whatever sort should be barred from hospital lobby area or ward entrance.
The first and most important level of a TB infection control program is the use of administrative measures to reduce the risk of exposure to persons who might have TB.
Hospital and clinic administrators should act to protect patients, staff and the public's safety and interest. Strict policies are necessary. We all must be self aware, maintain discipline, heed proper advice and practice cleanliness. These are just as applicable when facing new threat.
CHEAH CHUN FAI
The views expressed in this article are the author’s own and do not necessarily reflect those of the New Straits Times