Abstract
Introduction: Most COVID-19 disease were quarantined to prevent mortality in Malaysia during 2020-2021, but bed occupancy rate were high. COVID-19 Case Assessment Center (CAC) is a community triaging service which asseses the suitability of COVID-19 patients for home quarantine. CAC service was not well-accessible in Kuantan, while virtual CAC service is not widely acceptable to the technology iliterates. Most unreached group to CAC service were the dependents, of extreme age group and institutional dwellers. After the household breadwinners were admitted to quarantine centers, their dependents were illegible to attend to CAC service. Besides, cluster areas required prompt environmental health risk assessment. The Kuantan District Health Office Primer team took an innovative approach to expand CAC service to the unreached group using mobile CAC team. This study aim to evaluate the effectiveness of mobile CAC as a district-specific-approach strategy to manage COVID-19 cases in Kuantan.
Methodology: This is a cross-sectional study conducted in January to December 2021. A total of 14 teams were formed, each from a clinic. Each team consist of medical officer, medical assistant, staff nurse and driver. The teams were arranged by three zones, namely town center zone, Gambang zone and Beserah zone. Three mobile CAC teams were arranged for daily mobilization to locations of referral after office hour, weekend or for urgent special project such as risk assessment for cluster areas such as institutions, hostel, factories, academy. The mobile CAC team in charge of COVID19 environmental health risk assessment, stakeholder engagement, sampling, referral, health education and stakeholder empowerment for proper quarantine.
Results: There were total of 833 mobile CAC referrals from January to December 2021, 2.1% of total cases in 2021. Amongst, 72.25% were from Town center zone, 18.3% from Gambang Zone, 9.45% from Beserah zone. There were 20% referred from institution, 35% from cluster area, 27.75% non-accessible, 10% uncontactable, 7.25% from disaster rescue. From the referral, 80% were referred to quarantine centers within Kuantan district, 20% were referred across districts.
Discussion: The mobile CAC service in Kuantan helped to expand triage service for COVID-19 cases to the women, children, elderly, disabled and institutional dwellers. The service enables early intervention before further deterioration, augment the prevention of COVID-19 mortality in Kuantan. The mobile CAC team also served as a support system for the manager in COVID19 clusters area, institutions, enhanced movement control area (EMCO) on the isolation of closed contact and premise risk control. The mobile CAC team served as first responder to retrieve flood victims at green zone to isolation block in the quarantine center during flood disaster in December 2021. This strategy effectively prevented COVID-19 transmission during flood disaster in Kuantan 2021.
Conclusion: In conclusion, the mobile CAC team is an effective district-specific approach strategy in Kuantan District Health Office to increase accessibility to CAC service, reduce case mortality indirectly through early intervention, and ensure case safety through effective risk communication with stakeholders.
Recommendation: Mobile CAC service should be recommended to complement virtual CAC service in community triaging and COVID19 case management.
Links
- https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-O-38.pdf
- https://apcph.cphm.my/events/oral-session-4-ballroom-A/
BibTeX (Download)
@proceedings{APCPH2022-O-38, title = {Mobile COVID-19 CAC Team Kuantan, the Speedy Gonzales to the Rescue}, author = {Mardiatuniza Mohammad Dani and Syed Mohd Azharudin Syed Zahir and Rohaida Abdul Rahim and Wong Chin Mun and Rashidah Abd Rahman and Mohd Rahim Sulong and Nor Azimi Yunus and Husnina Ibrahim}, url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-O-38.pdf https://apcph.cphm.my/events/oral-session-4-ballroom-A/}, year = {2022}, date = {2022-08-01}, urldate = {2022-08-02}, issue = {7}, abstract = {Introduction: Most COVID-19 disease were quarantined to prevent mortality in Malaysia during 2020-2021, but bed occupancy rate were high. COVID-19 Case Assessment Center (CAC) is a community triaging service which asseses the suitability of COVID-19 patients for home quarantine. CAC service was not well-accessible in Kuantan, while virtual CAC service is not widely acceptable to the technology iliterates. Most unreached group to CAC service were the dependents, of extreme age group and institutional dwellers. After the household breadwinners were admitted to quarantine centers, their dependents were illegible to attend to CAC service. Besides, cluster areas required prompt environmental health risk assessment. The Kuantan District Health Office Primer team took an innovative approach to expand CAC service to the unreached group using mobile CAC team. This study aim to evaluate the effectiveness of mobile CAC as a district-specific-approach strategy to manage COVID-19 cases in Kuantan. Methodology: This is a cross-sectional study conducted in January to December 2021. A total of 14 teams were formed, each from a clinic. Each team consist of medical officer, medical assistant, staff nurse and driver. The teams were arranged by three zones, namely town center zone, Gambang zone and Beserah zone. Three mobile CAC teams were arranged for daily mobilization to locations of referral after office hour, weekend or for urgent special project such as risk assessment for cluster areas such as institutions, hostel, factories, academy. The mobile CAC team in charge of COVID19 environmental health risk assessment, stakeholder engagement, sampling, referral, health education and stakeholder empowerment for proper quarantine. Results: There were total of 833 mobile CAC referrals from January to December 2021, 2.1% of total cases in 2021. Amongst, 72.25% were from Town center zone, 18.3% from Gambang Zone, 9.45% from Beserah zone. There were 20% referred from institution, 35% from cluster area, 27.75% non-accessible, 10% uncontactable, 7.25% from disaster rescue. From the referral, 80% were referred to quarantine centers within Kuantan district, 20% were referred across districts. Discussion: The mobile CAC service in Kuantan helped to expand triage service for COVID-19 cases to the women, children, elderly, disabled and institutional dwellers. The service enables early intervention before further deterioration, augment the prevention of COVID-19 mortality in Kuantan. The mobile CAC team also served as a support system for the manager in COVID19 clusters area, institutions, enhanced movement control area (EMCO) on the isolation of closed contact and premise risk control. The mobile CAC team served as first responder to retrieve flood victims at green zone to isolation block in the quarantine center during flood disaster in December 2021. This strategy effectively prevented COVID-19 transmission during flood disaster in Kuantan 2021. Conclusion: In conclusion, the mobile CAC team is an effective district-specific approach strategy in Kuantan District Health Office to increase accessibility to CAC service, reduce case mortality indirectly through early intervention, and ensure case safety through effective risk communication with stakeholders. Recommendation: Mobile CAC service should be recommended to complement virtual CAC service in community triaging and COVID19 case management.}, howpublished = {published online at https://apcph.cphm.my}, note = {Type: ORAL PRESENTATION; Organisation: Kuantan District Health Office, Kuantan, Pahang, Malaysia.}, keywords = {CAC, COVID19 assessment center, mobile CAC, mobile CAC team, quarantine center}, pubstate = {published}, tppubtype = {proceedings} }