MOH Projects 6,000 Covid-19 Cases In One Week

By CodeBlue | 04 November 2020

Dr Noor Hisham Abdullah says MOH is using the same public health strategy it utilised in the previous waves of the Malaysian epidemic.

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KUALA LUMPUR, Nov 4 — The Ministry of Health (MOH) has predicted more than 6,000 new Covid-19 cases in this next one week, based on projections of slightly fewer than 1,000 daily infections.

Health director-general Dr Noor Hisham Abdullah said the nationwide Covid-19 infectivity rate, or R0, has declined from 2.2 on September 20 to 1.0 today.

According to MOH’s case projections based on an R0 of 1.0, a total of 971 Covid-19 cases were predicted yesterday on November 3; reported cases were slightly higher at 1,054.

An R0 of 1 means that each Covid-19 case on average is expected to lead to another case, which indicates that the outbreak is not growing. An R0 below 1 signifies that the outbreak is dying. MOH reported today 1,032 new Covid-19 cases nationwide.

“If we get 900 or 800 cases [daily], our forecast should be 971 cases [daily]. So, in a week, more than 6,000 cases. This is our forecast,” Dr Noor Hisham told a press conference.

“We may take some time, two to three weeks, to flatten it. If we can reduce the R0 from 2.2 to 1 in more than two weeks, maybe two to three weeks, then we can flatten it to 0.5.”

The targeted R0 of 0.5 means that 100 cases on average will lead to 50 cases, and then 25 cases, and so on, he said.

Dr Noor Hisham was responding to a reporter who highlighted Universiti Sains Malaysia (USM) that projected last Monday 5,000 active Covid-19 cases within two weeks. The reporter had also asked the Health DG in the Conditional Movement Control Order (CMCO) in the Klang Valley — which is now entering its fourth week since it was implemented in Selangor, Kuala Lumpur and Putrajaya from October 9 — was ineffective in controlling the Covid-19 outbreak.

Since October 11, new Covid-19 cases reported nationwide exceeded 500 daily. Four days — October 24, October 26, November 3, and today on November 4 — exceeded 1,000 cases each. This week, from November 2 to 4, Sabah comprised between 60 to 64 per cent of nationwide reported cases.

According to CodeBlue’s calculations, the average daily new Covid-19 cases in the Klang Valley in the past three weeks from October 10 have risen from 83 infections in the week of October 10 to 16; to about 129 cases in the week of October 17 to 23; and increasing further to about 137 cases in the week of October 24 to 30.

Dr Noor Hisham said today that the CMCO has led to a decrease of the nationwide R0 from 2.2 to 1.

International epidemiologists have said the basic reproductive number R0 — the initial spread of an infection in a completely susceptible population — is problematic for predicting the spread of Covid-19, as the number of people one comes into contact with varies significantly, based on their activities, populations, and structures of their towns and cities, according to TheScientist magazine.

Stockholm University mathematician Pieter Trapman was also quoted saying that super-spreaders have an exceptionally high individual R, which can inflate estimates of R0 that is the mean of a population. Hence, this variation makes it impossible to predict the overall disease spread just from R0 alone.

Malaysian paediatrician Dr Musa Mohd Nordin recently raised a phenomenon “k”, known as dispersion, in which 5 to 10 per cent of super-spreading persons or events can be responsible for 80 to 90 per cent of cases. He highlighted a study in India on 85,000 positive Covid-19 cases that found only 5 per cent of the positive cases were responsible for 80 per cent of Covid-19 infections.

Dr Noor Hisham said today that MOH was using the same public health strategy it utilised in the previous waves of the Malaysian epidemic.

“We enhance the strategy better, tighten our border control, and we’re looking into inter-district control. If we have a good strategy in place, working together, everyone contributes, we can break the chain of transmission.”

Dr Noor Hisham did not state if the projected 6,000 new Covid-19 cases in this next one week would overwhelm Malaysia’s health care system. As of today, Malaysia has 10,399 active cases.

Last Monday on November 2, Malaysia reported 834 new Covid-19 cases and 900 recoveries, followed by 1,054 new infections and 875 recoveries on November 3, and 1,032 new cases and 820 recoveries today.

According to Health Minister Dr Adham Baba’s written parliamentary reply yesterday to Bintulu MP Tiong King Sing, Malaysia has a total of 12,136 beds for Covid-19 patients across 44 Covid-19 hospitals (3,678 beds) and low-risk quarantine and treatment centres (8,458 beds) nationwide.

It is unclear if these are the latest nationwide statistics, as Sabah beds appear to comprise 68 per cent. The Sabah state government reported today that there are 909 beds in Covid-19 hospitals and 7,398 beds in low-risk quarantine and treatment centres in the state, totalling 8,307 beds, with a bed occupancy rate of 36.26 per cent.

National Covid-19 Highlights

MOH reported 1,029 local transmissions nationwide today, as well as eight Covid-19 deaths, seven of which were reported in Sabah. One fatality was reported in Ipoh, Perak.

Six new Covid-19 clusters were reported today:

  1. Sandakan Prison cluster in Sabah (identified through a prisoners’ screening)
  2. Dialysis cluster across Sandakan and Lahad Datu in Sabah (identified through a health workers’ screening)
  3. Sepanggar cluster in Kota Kinabalu, Sabah (identified through a symptomatic screening)
  4. Aero cluster in Petaling, Selangor (identified through a close contact screening)
  5. Lengkuk cluster across Sepang, Selangor; and Seremban, Port Dickson, and Rembau in Negeri Sembilan (identified through a symptomatic screening)
  6. Gading cluster across Putrajaya and Seremban, Negeri Sembilan (identified through a close contact screening)

The breakdown of 1,029 locally transmitted Covid-19 cases according to state is as below:

  • Sabah: 646 cases
  • Selangor: 231 cases
  • Negeri Sembilan: 44 cases
  • Labuan: 28 cases
  • Kedah: 25 cases
  • Penang: 23 cases
  • Sarawak: Nine cases
  • Kuala Lumpur: Seven cases
  • Perak: Six cases
  • Putrajaya: Four cases
  • Terengganu: Three cases
  • Kelantan: Two cases
  • Johor: One case

A total of 82 Covid-19 patients are under intensive care, including 27 on ventilator support. The eight new Covid-19 deaths reported today has pushed up the country’s overall coronavirus death toll to 271 fatalities. The cumulative Covid-19 cases in Malaysia is now at 35,425 infections.

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