PETALING JAYA: With the massive floods and Covid-19 pandemic, Malaysians, especially those in flood-hit states, are facing a twin health threat of being infected with the coronavirus and diseases associated with flooding.

The Health Ministry has warned that there is a high possibility of an Omicron wave, so health experts have urged flood victims to adhere to the standard operating procedure (SOP) for Covid-19 and floods.

Universiti Malaya epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud said whether or not the transmission of Omicron increased during the floods would depend very much on whether the SOP was being properly followed during evacuation, stay at the evacuation centre and flood clean-up.

Due to the sudden nature of floods, he acknowledged that it might have been difficult to follow the SOP during evacuations and that situations such as crowding in boats, people not having masks or the means to clean themselves, and families forced to live very close to each other at the evacuation centres where ventilation might also not be optimal.

“These are all factors which greatly increase the risk of contracting an airborne infection like Covid-19.

“Although vaccination rates among Malaysians are high, with the emergence of the Omicron variant and declining antibody levels, it is imperative that Malaysians take the booster jab when offered and not let their guard down at evacuation centres,” he said.

“Ventilation at evacuation centres is critical due to the airborne nature of Covid-19 and so is the management of crowds at these places.”

Dr Awang Bulgiba said it would be good for evacuees and flood relief volunteers to do regular Covid-19 RTK-Ag self-tests.

“If Covid-19 cases are not detected early and isolated, the spread will be rapid in evacuation centres followed by further community spread when evacuees return home.

“Also, if Covid-19 SOP is not followed, then volunteers may themselves be the source of infections to flood victims or the cause of spread to their own families,” he said.

In addition to the Covid-19 SOP, he said it was important to follow standard flood SOP such as the provision and consumption of safe food and water, vaccination of food handlers and environmental sanitation in order to reduce the risk of food- and water-borne diseases.

Tap water must be boiled before drinking, food such as raw vegetables must be avoided, while fruits should be peeled before consumption, said Dr Awang Bulgiba.

“If there is no refrigeration facility for food, care must be taken during preparation to make sure it is prepared fresh and not consumed more than four hours later.

“We also need to be sure that food handlers are not suffering from food- and water-borne diseases, although making sure that they are vaccinated against typhoid and cholera can be a challenge under these conditions.

“Environmental sanitation is also a challenge during floods as the overflow of sewage tanks or pipes can occur, and human and animal waste will contaminate floodwaters leading to the possibility of many types of diseases,” he said.

Volunteers For Community Engagement and Empowerment For Covid-19 chairman Datuk Dr Zainal Ariffin Omar said flood victims not only face the risk of food- and water-borne diseases such as food poisoning, diarrhoea, typhoid, hepatitis, leptospirosis and melioidosis, but also Covid-19.

“Flood victims, relief agency staff and volunteers should all be aware and undertake preventive measures such as following the SOP at the evacuation centre or at home.

“We also encourage people to complete the vaccination schedule, including getting a booster dose and doing a Covid-19 self-test,” he said.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah said a surge in Covid-19 cases, as well as the transmission of the Delta and Omicron variants, could be expected in flood-hit areas as the emergency situation had complicated adherence to SOP.

“They came in very close contact with each other and some were not wearing masks, and it is hard to maintain physical distance and personal hygiene, so I’m expecting a rise in cases,” he said.

He added that the authorities must step up flood prevention measures instead as it was more effective to tackle the issue at its root rather than to take reactive action after disaster has struck.

As at Jan 1, the Health Ministry recorded 1,975 cases of infectious diseases among flood victims including acute respiratory infection, skin disease, acute gastroenteritis, conjunctivitis and hand-foot- and-mouth disease.

There was also a cumulative 15 Covid-19 cases detected at flood evacuation centres and 451 cases among flood victims as at Jan 1.