KUALA LUMPUR, April 17 — The Ministry of Health (MOH) today released several conditions before the government can lift the Movement Control Order (MCO) that is scheduled to end on April 28.
Health director-general Dr Noor Hisham Abdullah said a reduction of active infectious Covid-19 cases is among the indicators for a lockdown exit strategy.
He pointed out that Malaysia currently has 2,198 active infectious patients who are all kept in hospital, regardless if they need treatment or not. This figure is derived from deducting fatalities and recoveries from the total 5,251 coronavirus infections in the country.
MOH projected 2,033 active infectious cases on April 14, but its prediction was exceeded by some 150 cases.
The Health DG said MOH aimed to reduce infectivity to below 2,000 or 1,500 cases, or even to below 1,000 or 500 cases during the third phase of the MCO, so that health authorities can focus on high-risk groups and locations, as well as Covid-19 clusters.
“If we can control infectious cases, there are no positive cases in the community. If there are no positive cases in the community, there is no transmission in the community,” Dr Noor Hisham told a press conference.
MOH is also planning border and movement controls during the MCO, where green zones without any Covid-19 cases — be it a state, district, mukim, or village — can be protected.
The second indicator for ending the MCO, Dr Noor Hisham said, is a drop in coronavirus infections detected during surveillance of severe acute respiratory illness (SARI) or influenza-like illness in the community. Currently, 114 Covid-19 cases have been detected.
“If we look at our screening or monitoring, if SARI cases are dropping, this is another indicator for us to advise the NSC (National Security Council) to end the MCO.
“We also look at certain areas and their density, whether or not there are new infections or clusters. One case may be detected, but what’s more important is that it doesn’t turn into a new cluster.”
Thirdly, MOH will also look at hospital capacity in treating patients and laboratory capacity in detecting infections quickly before advising the NSC to lift the nationwide partial lockdown.
Dr Noor Hisham noted that the number of Covid-19 patients in the intensive care unit (ICU) have dropped, now comprising about 4.9 per cent of total cases. The number of patients on ventilator support have also declined. As of today, 51 coronavirus patients require intensive care, including 26 who are ventilated.
He added that whether the MCO will end on April 28 or is extended, mass gatherings still need to be avoided to prevent Covid-19 transmission. Social distancing of at least one metre from each other must also still be practiced, including when speaking to another person and avoiding enclosed spaces with poor ventilation.
The Health DG pointed out that a cluster of 14 Covid-19 infections in Likas Hospital, Sabah, comprising frontliners like doctors and nurses, may have included virus transmission in enclosed spaces like the pantry, where staff eat.
The cause of the infection may have come from a staff who attended a wedding in Ipoh, Perak, and subsequently spread the disease to coworkers in the hospital.
The World Health Organization (WHO) recently recommended six conditions to governments before ending lockdown measures, which are Covid-19 transmission is under control; health systems can detect, test, isolate and quarantine every case and trace every contact; hotspot risks are minimised in vulnerable areas, like nursing homes; physical distancing and hand washing are practiced in workplaces; new import cases from travellers are controlled; and populations agree to living under a new normal.
MOH’s indicators when deciding to end the MCO mostly follow WHO’s guidance. The Health DG said yesterday that MOH was looking at testing residents in aged care facilities, since Covid-19 incidence is highest among senior citizens in Malaysia. The elderly are also more likely to have underlying health conditions that make them more vulnerable to developing severe disease from Covid-19.
Dr Noor Hisham also said today that MOH’s testing capacity remained at 11,500 tests daily from 43 labs. MOH conducted 9,717 tests today. Health authorities have also changed their discharge requirement to using antibody tests on the 13th day of quarantine, upon which the quarantined person will be released if results are negative. If they’re positive, a PCR test will be run and if a positive result is yielded again, they will be hospitalised.
Dr Noor Hisham added that MOH was still negotiating with South Korea for cheaper prices of its antigen rapid test kit, citing volume and scale, that has been offered to Malaysia at below RM50. He did not say how many tests MOH has ordered.