Covid-19 Case in Penang: Tracing the Evolving Tawar Cluster — Boo Soon Yew
Posted On August 16, 2020
AUGUST 16 — It is sometimes perplexing when we try to comprehend and piece together information, what’s more if it is about a disease that can be right at your doorstep.. or even next to you at your hospital bed !!
That’s what happened in Penang last Thursday when news broke of a positive Covid-19 case in a private hospital who have since been transferred immediately to the Penang Hospital.
But the commendable way it happened was how the alert was sounded by the Kedah Health Inspector who had alerted hospitals (probably in the northern region) at 7.30pm on Aug 12. And this was a reaction to the index case 9113, who would prove to be starter point of the Tawar Cluster which has since reached a total of 33 positive cases on Aug 15 after contact tracing was done.
Now back to our Penang case at the private hospital.. it must be truly commendable of that establishment to take such proactive step, making the announcement in all languages via their social media. Plus undertaking immediate cleaning up and disinfection of the facilities affected. And we just read today, 16th Aug, that they even had their medical team, all 59 of them, undergo home quarantine on top of putting them through the antigen test.
It was case 9129, the sister in law of index case 9113 that was warded in Penang for a leg wound infection on Aug 7, well before case 9113 himself was detected on Aug 11. Four days of not knowing you carry the virus.. Four days of opportunity for the SARSCoV to spread to persons unsuspecting or who were unprepared. And that was what happened in Kedah, the primary location of this Tawar Cluster. Yet Penang was not spared as on Aug 14, one day after the private hospital announcement, there was one case from Barat Daya (South West) district reported by the MOH. Many thought this was the same case 9129 a 56-year female, but it was not !! The Barat Daya case was case 9149, 58-year female.
Finally it was explained that case 9149 was a visitor to case 9113 when he was in hospital. Question now is which hospital?
We know from chronology, case 9113 attended a funeral wake from July 31 to Aug 1. He developed symptoms of chest pain and fever on Aug 8(just one day after case 9129 was admitted to the Penang private hospital).. and was duly admitted. He was tested on Aug 9, result came back positive on Aug 11 and subsequent close contact tracing activated. That’s when the Penang private hospital was also alerted.
However, case 9113 was in fact hospitalised initially in a private hospital in Kedah, who was detected together with case 9114 as they both had symptomatic screening done on them. These two cases were reported as part of only three local transmissions on Aug 12. Case 9114 himself, the police officer, would soon be the index case of the Muda Cluster which currently has three positive cases as of Aug 15.
This would be the very same private hospital in Kedah that would add on six cases to the Tawar Cluster, one patient and five staff.
What a difference these few days can make.. from the point of not knowing one has the virus till the moment one knows !
High infectivity, which prompted our DG to post the latest news on his Twitter handle at 12.45am today! It was tested by our very own IMR (Institute of Medical Research) that the strain that infected some patients from the other Sivagangga Cluster had the D614G mutation, one known for its high infectivity. It would turn out to be a point mutation, a change of a nitrogenous base of the DNA which changes sequence of amino acids from Aspartic Acid to Glycine!
One small change.. with enough time.. creating so much effect & havoc! And things are still evolving as in changing, while you are reading this article.
May we in Malaysia show continued resolve to maintain our masking and social distancing, to do our part in breaking the chain! Plus observing our washing of hands regularly. Let us once again pull through this, together.