On August 16, the Health Ministry of Malaysia announced that it had detected D614g — a mutation of SARS-CoV-2 virus that causes COVID-19 — in three patients in what was termed the ‘Sivaganga cluster’. The cluster is named after the hometown of the index case or patient zero (the first patient identified within a population during an epidemic) – Sivaganga in Tamil Nadu. Ahmed* had come to Sivaganga in late February to meet his wife and children, and returned to Malaysia on July 13.
Today, with 45 persons being infected after coming in contact with him, 57-year-old Ahmed, who has a permanent resident (PR) status in Malaysia, is not only termed a COVID-19 superspreader but has been sentenced to five months in prison with a fine of 12,000 Malaysian Ringgit (over Rs 2 lakh). His crime is that he flouted the 14-day mandatory quarantine period on returning from India and visited the restaurant he runs at Napoh in the Malaysian state of Kedah and three banks.
Ever since a picture of Ahmed sitting in his restaurant during his quarantine period surfaced on social media, and subsequently his contacts started testing positive, he has come under heavy criticism, with many demanding that his PR status be revoked. While some residents are planning to sue him, social media users have already created several memes on him and some even used racial slurs.
While the Malaysian government has termed Ahmed's infection as an “imported” case, health officials in Sivaganga district refuted this, stating that he was diagnosed with COVID-19 in the second test in Malaysia and that no one in Sivaganga has tested positive so far.
When Ahmed arrived at the Kuala Lumpur International Airport on July 13, he tested negative for the virus in the rapid antigen test done at the airport. He was then issued the mandatory pink quarantine wrist band (marked with the quarantine date). People who are issued this wrist band must wear it throughout the 14-day home quarantine period, until the second test on the last day.
According to reports, on July 23, Ahmed visited his restaurant, Restoran Nasi Kandar Salleh, in Napoh. However, a few residents in the area noticed the pink band on his wrist and suspected that he was violating the quarantine period. They immediately alerted the police. While he told the police that he visited his restaurant to monitor the business, he was slapped with a fine and was directed to go into home quarantine.
By then, the images of Ahmed sitting in his restaurant started circulating on social media, drawing criticism for violating the quarantine norms.
Multiple sources in Malaysia told TNM that people in Malaysia get angry and upset with quarantine violators. In fact, on August 14, a 72-year-old Malaysian woman who flouted quarantine in July was sentenced to a day in jail and fined. The woman, who was seen with the pink braclet, was spotted dining at a restaurant. When the photo went viral on social media, she not only faced criticism but was also dubbed the 'pink wristband woman'.
Later, it was also found that Ahmed had violated home quarantine on July 14, a day after he returned from India. He had visited four places – three banks and the Inland Revenue Board office that day.
The restaurateur was later diagnosed with COVID-19 in his second test and admitted to a hospital.
However, by July 28 health officials in Malaysia became aware of the formation of a new cluster when five out of 28 close contacts of Ahmed tested positive. The Malaysian government identified the Sivaganga native as an imported case and patient zero of the cluster. Of the five contacts who tested positive, four are Indian nationals who work at the restaurant and another is a family member, said Dr Noor Hisham bin Abdullah, Malaysia’s Director-General of Health.
Incidentally, according to reports, Sivaganga cluster is only one of the clusters in Malaysia. Other clusters, where the patient zero is someone who returned from abroad, are also named after those places, such as, 'Melbourne cluster', 'Ramnad cluster', 'Al Khobar cluster', 'Novogrod cluster' and 'Pitakwa cluster'.
While Ahmed’s restaurant was shut, those who visited the eatery between July 13 and 24 were urged to go to Klinik Kesihatan, public primary care clinics in the country, for COVID-19 testing.
By the time more people were detected with the virus, many had already travelled to other places, taking the COVID-19 cases from this cluster to two more neighbouring states, namely Perlis and Penang.
The D614g mutation, which was first detected in Europe, is believed to be 10 times more infectious (although less potent) than SARS-CoV-2.
In view of the rising cases associated with the cluster, five schools have been closed till August 29 and four sub-districts in Kedah have been placed under a targeted enhanced movement control order to restrict the movement of people and prevent further transmission of COVID-19.
Sources also said that there were allegedly threats of violence as the residents were upset that their area was placed under movement restrictions because of the cluster. Some residents have filed a lawsuit against the Sivaganga native for loss of income due to the movement restrictions, said a source.
On August 13, Ahmed pleaded guilty to four separate charges. He will pay a fine of RM 3,000 (over Rs 53,000) and serve a jail term of five months for each charge, although the sentences will run concurrently, reported the New Straits Times. He will start the sentence once he is discharged from hospital.
“The first test of the patient in Malaysia was negative, so we cannot say that he contracted the infection from Tamil Nadu. If he was diagnosed with COVID-19 in India and then travelled to Malaysia, his first result there should have shown positive for the virus. However, he tested positive only in the second test. So he may have contracted the infection in Malaysia,” Dr Yasodha Mani, Sivaganga District Health Officer, told TNM.
Irrespective of the source of infection, the district officials swung into action by the first week of August when they learnt about the Sivaganga connection.
“We have identified four primary contacts and four secondary contacts of the patient. The primary contacts are his family members residing in Sivaganga, including his wife and children. We’ve sent the samples of all eight people for testing, and the results will arrive on Thursday,” Dr Yasodha said.
She also added that Ahmed is the only person found to have tested positive for coronavirus in his area in Sivaganga. “No resident from his neighbourhood here has tested positive. His family members are also asymptomatic currently. So only the test report can conclude if the source of infection is from Sivaganga,” she said.
*Name changed