December 7, 2020

Step in Safely: Community-Driven Solutions to COVID-19 in Malaysia

An Interview with Dr. Helmi Zakariah, CEO of AIME

When COVID-19 reached Dr. Helmi Zakariah’s home country of Malaysia in January 2020, he was consulting in Brazil as CEO of Artificial Intelligence in Medical Epidemiology (AIME).  A trained physician, public health professional, and digital health entrepreneur, Dr. Zakariah found himself in high demand as the Malaysian government began to mount it’s COVID-19 response. He was asked to return home to his state of Selangor to lead the Digital Epidemiology portfolio for the Selangor State Task Force for COVID-19, and upon arrival immediately began to address the many challenges COVID-19 presented.

Like much of the rest of the world, the Malaysian economy struggled, and local businesses were forced to shut their doors as COVID-19 spread rapidly and governments prepared to respond. What became instantly evident was the urgent need for businesses to reopen and operate safely. In his new position, and with a vast array of skills in digital epidemiology, Dr. Zakariah set out to develop a system that would do just that. The solution: a QR-based contact tracing tool aptly named ‘Selangkah’ or ‘Step in Safely.’

Selangkah presented a seamless method for contact tracing for local businesses, who were able to obtain their own unique QR code and place it at the building entrance for customers to scan. Once scanned by a customer, the only required input field was a phone number, allowing for increased anonymity.

So how does it work? The platform relies on a machine-learning algorithm to sift through all positive COVID-19 cases and identify what is deemed a ‘close contact’. Those individuals are then notified of their exposure and are recommended to be tested. As Dr. Zakariah notes, “with contact tracing, it’s not only about how big your uptake is but how efficiently you sift through all of your data.” 

Despite early resistance from members of the Malaysian government, largely due to skepticism of whether businesses would use the platform, Selangkah was piloted with enormous success. In Dr. Zakariah’s home state of Selangor, the most populous state in the country home to 10 million people, a staggering 7.3 million utilized the system, with over 88.7 million total uses to date. When asked why he thought there was such a successful adoption of the platform, Dr. Zakariah explained that there is precedent for this type of information logging in Malaysia. “If you are visiting a friend in a condominium before you step in, you give your name and contact information for security reasons at the guard house. We just created a digital guestbook that was centralized. That makes it easy to be understood by the community.” All the data is shared with consent and individuals are not continuously tracked.

Upon successful pilot implementation, increased collaboration with the Malaysian government has allowed for the expansion of Selangkah. Not only has the tool been scaled and replicated nationally, but it has been adapted to collect additional safety data. For example, it now has survey capability; when the QR code is scanned a survey appears inquiring about other COVID-19 precautions taking place at that business. Data on mask-wearing, sanitation processes, and more are also now collected. “The idea is not for enforcement, but rather to measure public compliance,” said Dr. Zakariah. Additionally, Dr. Zakariah shares that the decision to scale the tool and utilize it for the purpose of resource allocation is indicative of a larger mindset shift within the government: “We have seen a lot less resistance from the government to new digital health solutions. They are seeing that some things work if you just give it a try.”

Dr. Zakariah ultimately attributes the success of Selangkah to three distinct, yet connected factors – data, cost, and community. “You can’t do this without data” Dr. Zakariah exclaimed, referring to mounting a strategic COVID-19 response. Good quality data that is truly representative of the challenge at hand is essential to allocate resources and take appropriate precautions to stop the spread of disease. Cost was another important element that led to the ubiquitous use of the QR system. “The cost for a shop owner is extremely cheap. It is one piece of paper. All you have to do is go to a website, register, and print a code,” shared Dr. Zakariah.

But perhaps the most important element to the platform’s success was the community-driven approach. “In the early stages there was less intervention by the government, it was really a crowd-sourced, community-driven solution that was later adopted by the government,” Dr. Zakariah said. Empathy and reassurance were essential tools that Dr. Zakariah equipped himself with to achieve local business buy-in, once that was acquired, everything else followed. “When you come up with a solution that is ‘people-centric’ you need to actually go to the ground level, the recipe for success is community first.”

To learn more about Selangkah, visit their Twitter @SELangkah_cvd19