Paediatrician Disputes Health DG’s Suggestion Of Covid-19 Curve Flattening

By CodeBlue | 02 April 2020

It is slowing but not reducing substantially.

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KUALA LUMPUR, April 2 – Paediatrician Dr Musa Mohd Nordin has disagreed with Health director-general Dr Noor Hisham Abdullah’s view that Malaysia’s Covid-19 epidemic curve is showing early signs of flattening.

Dr Noor Hisham yesterday supported this analysis by the Malaysian Institute of Economic Research (MIER), an economic think tank.

“I however would dispute though on @DGHisham and MIER suggestion that our epi curve is flattening,” Dr Musa, who is also former president of the Federation of Islamic Medical Associations, said in a Twitter thread, using “epi” to refer to “epidemic”.

“What i would suggest is that the MCO has impacted by preventing an exponential surge of covid cases i.e a linear progression of cumulative cases.”

MIER projection of the Malaysian Covid-19 epidemic, as of 1 April 2020. CREDIT: Dr. Noor Hisham Abdullah Twitter account

Describing the trajectory of reported cases as being arithmetic rather than exponential as originally projected, Dr Musa opined that the curve was still on the uptrend despite the implementation of the Movement Control Order (MCO) since March 18.

“It is slowing but not reducing substantially JP Morgan suggests as a move from acceleration to late accumulation.”

In March, JP Morgan said that Malaysia is at the “acceleration phase”, and that cases would peak by the middle of April.

It added that the acceleration phase of the curve would last for only the next 1½ to two weeks. The epidemic would then enter the accumulation stage, where the overall infection growth rate would drop to between 100 and 250.

“We expect the peak infection to be by the middle of April, at approximately 6,300 cases,” JP Morgan said.

Dr Musa also opined that Ministry of Health (MOH) should be analysing its own data, as it has many of its own experts.

“I cannot hide my disappointment that @KKMPutrajaya is not analyzing its own big data which it guards jealously and instead relies on big boys e.g MIER and JP Morgan to analyze and report on MOH statistics,” he asked.

“I personally know of a bunch of young data scientists, public health physicians and artificial intelligence experts in MOH who could easily crunch these numbers @DrDzul @ProfAdeeba and offer an inhouse perspective of #COVID19Pandemic epidemiology, what it takes to dampen the curve in terms of testing-tracking-isolating- MCO-EMCO but alas why are they not allowed the microphone?”

Dr Nordin also expressed his concern regarding the increase of patients in intensive care and needing ventilator support. A total of 102 Covid-19 patients were in the intensive care unit (ICU) as of yesterday, out of which 66 were on ventilator support.

“What is worrying next is our rising nos nursed in the ICU and rising Case Fatality Rate (CFR) from a low 0.4% to 1.5% Academics and data crunchers at MIER @jpmorgan etc would welcome better access to @KKMPutrajaya big data base like here in the case of US-CFR stratified by age.”

Yesterday, Dr Noor Hisham said that early indications that the Movement Control Order (MCO) may have been successful in containing the Covid-19 outbreak, even as experts have called for mass testing.

He referred to MIER’s data analysis which claimed a “flattening of the curve” by comparing the trajectory of official confirmed coronavirus cases and its own projected trajectory from March 24 to March 31.

“The average D2D day-to-day increase in cases that was projected was 12.51 per cent, while the actual reported rate of increase is 7.49 per cent with a point margin difference of 5.02 per cent (a change of 0.34 per cent from the previous day average).

“This shows that the growth of new cases for the first eight days of tracking (24.3.2020 – 31.03.2020) has shown a lower rate than that was projected. Although this is still very early in the actual vs simulation projections, it does show that there has been significant impact of the Movement Control Order (MCO) in the rate of new patients as well as flattening of the curve,” MIER said.

As at yesterday, 7,660 coronavirus patients’ test results were pending, while a total of 43,462 people have been tested as of today; 2,908 tested positive and 32,894 tested negative as of April 1.

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