How Malaysia Beat Back Covid-19

MOH presents its strategy in successfully flattening the Covid-19 epidemiological curve to prevent overwhelming the health care system.

KUALA LUMPUR, May 29 — Malaysia shored up hospital beds and ventilators while slowing Covid-19 transmission through a stringent lockdown and targeted testing, a Ministry of Health (MOH) official said.

Despite a massive outbreak resulting from a religious gathering early March, with a nationwide lockdown subsequently enforced by uniformed authorities, Malaysia has successfully brought daily new cases down to the double digits in the past few weeks, dropping to a record low of 10 yesterday.

Dr Wan Noraini Wan Mohamed Noor, MOH’s Head of Disease Surveillance Sector in the Disease Control Division, represented Malaysia at a webinar about countries’ Covid-19 outbreak response, hosted by Better Health Programme under the United Kingdom government’s Foreign & Commonwealth Office (FCO).

Other speakers at the webinar included Dr Vincente Belizario Jr., professor and dean at the University of Philippines College of Public Health, and Dr Fu-Meng Khaw, director of Programmes, Places and Regions of Public Health England.

“Our first wave of Covid-19 in Malaysia lasted from January until mid-February. There was a gap of 11 days between (the) first wave and (the) second wave. We are still in our second wave of the infection,” Dr Wan Noraini told the webinar, adding that no cases were reported between February 16 and February 26.

She further presented that “the first confirmed cases of Covid-19 detected in Malaysia involved three travellers from China arriving via Singapore on January 25, 2020”, adding that the first wave of the coronavirus epidemic began then until February 15, as she emphasised the nation’s ability to identify those Covid-19 cases quickly.

“The second wave began on February 27, 2020, and is still ongoing,” she said.

On March 11, Malaysia identified its largest Covid-19 cluster, which was linked to a mass religious gathering, better known as the Sri Petaling tabligh cluster. Dr Wan Noraini reported that this milestone “led to massive spikes in local cases and an exportation of cases to neighbouring countries”.

The cluster from the Sri Petaling mosque accounted for 3,369 out of 7,629 confirmed Covid-19 cases in Malaysia, or about 44 per cent, as of yesterday. Malaysia has recorded 115 deaths from Covid-19, leading to a 1.5 per cent mortality rate from the disease.

Dr Wan Noraini added that since the Covid-19 outbreak, more than 500,000 individuals have been sampled and tested for the virus, with a record of 16.65 tests per 1,000 population, a positivity rate of 1.45 per cent, and a recovery rate of 79.84 per cent.

The MOH official touted the success of “targeted approach screening” as a critical measure during the nationwide Movement Control Order (MCO).

“This is one of the successes in Malaysia’s handling of Covid-19 — [the] MCO that started from March 18 and lasted four phases,” said Dr Wan Noraini, adding that the MCO includes six critical measures:

  1. Complete prohibition of movements and large gatherings across the country.
  2. Complete restriction on all overseas travels by Malaysians; for those returning from overseas, they are required to undergo 14-day self-quarantine (but starting April 3, 2020, 14-day mandatory quarantine at a facility).
  3. Complete restriction on all tourists and foreigners entering into the country.
  4. Closures of kindergartens, nurseries, government and private schools.
  5. Closure of all public and private higher education institutions, as well as skills training institutes.
  6. Closure of all government and private premises, except those involved in providing essential services (including health).

She explained that in addition to the MCO, the implementation of the Enhanced Movement Control Order (EMCO) was an additional stricter measure that was a necessary step in controlling the spread of Covid-19.

“Within the MCO, there is a targeted locality where we do the EMCO. This is a bit drastic as all residents and visitors in the area won’t be allowed to leave and must remain in their houses, all entrances to the area will be shut and outsiders won’t be allowed during the EMCO period,” said Dr Wan Noraini.

She added that this measure was implemented to curb the spread of Covid-19 beyond the locality and “allow for house-to-house tracing activity throughout the allocated time frame.”

She then shared that Malaysia is currently in the Conditional Movement Control Order (CMCO) phase that began on May 4 and is set to end on June 9, during which almost all economic sectors are allowed to resume full operations with enforcement of strict standard operating procedures (SOP) set by the MOH. However, the entertainment and education sectors remain closed at this time.

“We are not yet going into exit strategy, but rather CMCO.

“One of the critical things in this period of CMCO is the social compliance and social responsibility coming from the community, because this is the one that will protect them from the Covid-19,” she explained, adding that it is now time for the community to do their part as well.

In terms of the distribution of Covid-19 cases in Malaysia by nationality, it was reported that nearly a quarter of the total cases involve foreigners, and Malaysian citizens make up to about 75 per cent of the total number of Covid-19 cases in the country.

Dr Wan Noraini also proudly presented Malaysia’s capacities and capabilities in its response towards the Covid-19 outbreak, which includes 120 Covid-19 screening hospitals and 40 hospitals that are actively treating Covid-19 patients, where seven of those are dedicated exclusively to treat patients with the novel coronavirus.

She further added that over 4,000 hospital beds have been reserved for Covid-19 patients, but the current bed utilisation rate is less than 20 per cent. Malaysia yesterday reported a record low of only 10 new Covid-19 cases, with 1,345 active infectious cases.

Flattening the disease epidemiological curve means spacing out the number of cases over time to prevent too many people from falling sick at the same time, which could outstrip available health resources like beds and ventilators.

MOH has categorised seven groups of individuals as “high-risk”, in which Dr Wan Noraini explained that these are the groups that would undergo “aggressive testing” through targeted screening.

The seven identified groups she cited include:

  1. Attendees of a mass religious gathering (i.e. the Sri Petaling cluster), followed by students and personnel of madrasah and tahfiz religious schools nationwide.
  2. Health care workers.
  3. Localities subjected to the Enhanced Movement Control Order (EMCO).
  4. Malaysian returning from overseas and subjected to a 14-day mandatory quarantine.
  5. Market sellers with a possible epidemiological link to Kuala Lumpur Wholesale Market.
  6. Foreign workers in the construction and security sectors within the Klang Valley.
  7. Residents and staff at old folks’ homes nationwide.

When asked to comment on the coronavirus’ impact in 10 to 15 years, Dr Wan Noraini stressed that the community needs to be empowered and so does the health workforce, as “time is of essence at this point in time”.

“This time around, everybody is having the wishful thinking of having an effective treatment and effective vaccine for this disease. The world is on high hope for this too.

“The long term effect would be that people would be hopeful, but how long can they remain hopeful as that is something that we have to forecast in the sense that, yes, in the moment the community is giving their cooperation, so we need to empower the community as well and pump up the morale of the health care workforce to continue dealing with this Covid-19 pandemic, because time is of essence at this point of time,” she said.

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