Malaysia was ranked one of the best prepared nations to cope with a pandemic by the Economist in 2018, and this is proving to be true. Fatalities have been very low, and the spread of the virus has been limited compared to neighbouring countries.
One part of the nations’ response was quick contact tracing, and it partnered with the private sector to build tech tools to deal with this. These have been named MySejahtera – meaning my well being – and centre around a mobile application.
Dr Mahesh Appannan, Senior Principal Assistant Director of the Disease Control Division at Malaysia’s Ministry of Health shares five ways the MySejahtera app has supported the country’s efforts to reign in the spread of Covid-19.
1. Risk assessment
Image by MySejahtera Facebook page
One of the main functions of the app allows citizens to assess their risk of contracting Covid-19. The app asks citizens to fill in a basic survey on symptoms, travel history, and whether they’ve been in contact with a confirmed case recently. It then classifies them into risk categories and informs them of the next steps to take.
Those under surveillance would have to stay at home for 14 days and complete the survey every day. “If you do not comply, the app will ping you,” Dr Appannan says. If they ignore the notifications for too long, they might get a ring from the local health authority, he adds.
People who are likely to have contracted the coronavirus will have to be tested at a hospital. The app shows the nearest healthcare facilities where they can be screened.
Initially, there were some people who would lie about coming into contact with a confirmed case to get tested, Dr Appannan reveals. “The survey asks for the patient’s name and phone number. That will be verified with our database of confirmed cases,” he says. This ensures the hospitals aren’t overwhelmed, and that their resources go to those who need them.
2. Contact tracing
The app’s second main function is contact tracing. Users scan a QR code before they enter a premise, and the system logs where they have visited in the last 14 days. They can register dependents who don’t have a smartphone on their app, so they can be accounted for as well.
The Ministry of Health only pulls this data out after a patient tests positive, says Dr Appannan. “Otherwise, the data is archived after 30 days and flushed out after 90 days.”
On top of the recording where citizens have been, the app assigns individual QR codes that show whether someone is high risk or low risk. This depends on whether they live near a Covid-19 hotspot, and the number of vulnerable people in their household. Premise owners can choose to scan this QR code to decide if citizens are allowed to enter, Dr Appannan shares.
3. Future research
Citizens have to include detailed demographic information, including age, gender and ethnicity, when they register for the MySejahtera app. This can be used for future analysis and medical research, says Dr Appannan.
“We need to know, for example, the predominant ethnicity that might have a higher affinity to contract a particular disease,” he explains. “These data would be very useful later.”
4. Teleconsultations and online appointments
Malaysians can chat with an online doctor through the app, Appannan says. If they’re worried about their symptoms, they can get a teleconsultation without having to leave the house. This reduces the risk of transmission, and eases the demand for healthcare services in hospitals.
Citizens can also book doctor’s appointments online, including for non-Covid related matters. These two features have helped to reduce congestion in clinics, Dr Appannan says. “Now we have to be very particular about the number of people coming into our clinics.”
5. Educate and inform
Finally, the app includes a hotspot tracker that shows where confirmed patients likely contracted the disease. It uses machine learning to come up with a probable source of infection for every positive case, Dr Appannan shares. This is a dynamic map – red zones turn blue after 14 days with no new cases, then green after 28 Covid-free days.
This feature helps citizens plan their travels better. They might choose to avoid going to a hotspot, or ensure they bring along a bottle of hand sanitiser. “[The map] has millions of requests per day, so we know that the people of Malaysia actually use this particular function to plan their travel,” he says.
Citizens can also check the number of Covid-19 cases in each state, nationally and globally. This keeps them updated on the latest spread of the virus.
MySejahtera is the first government-built app of this scale in Malaysia, and Dr Appannan is excited about the possibilities in digital health in the future. “We’re looking forward to how we can empower one to take charge of their health, not only for Covid but for other diseases like non-communicable diseases,” he says.
Could a new era of public health, led by mobile apps and empowered citizens, be upon us?