MOH Dismisses Imperial College’s Covid-19 Model

By CodeBlue | 16 November 2020

The Health DG also says Covid-19 is not circulating in the community in the Klang Valley, but that the virus is concentrated among construction workers.

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KUALA LUMPUR, Nov 16 — The Ministry of Health (MOH) claimed today that its Covid-19 epidemiological model was more accurate than the one by Imperial College London.

Health director-general Dr Noor Hisham Abdullah said Malaysia only reported 869 Covid-19 cases on November 10, compared to Imperial College’s projection of 4,413 infections on that day.

“The Imperial College modeling is also dependent on our activity and public health intervention. If our intervention is good, for example, on 10 November, it projected about 4,400 cases. But we only had 869 cases, which means our modeling is much more accurate as compared to Imperial College,” Dr Noor Hisham told a press conference today.

Dr Noor Hisham added that the Conditional Movement Control Order (CMCO) has reduced the nationwide infectivity rate from 2.2 to 1.5 and that it is currently holding around 1.0.

“If in the next two weeks, we can increase our activities and intervention, I’m sure we can bring down our cases. This is our modeling,” he said, adding that MOH targeted to reduce Malaysia’s infectivity rate to 0.5 within a fortnight.

An infectivity rate of 1.0 means that one Covid-19 case on average leads to one other infection, whereas a value below 1.0 means that the outbreak is dying out.

Imperial College London’s MRC Centre for Global Infectious Disease Analysis said in its Malaysia Covid-19 situation report as of November 14 that it estimated a total of 78,183 Covid-19 infections over the past four weeks prior to its report. Officially, MOH only reported 28,669 Covid-19 cases in that period, nearly three times lower.

“Importantly, the estimated infections include both asymptomatic and mild cases that would not necessarily be identified through surveillance. Consequently, the estimated infections are likely to be significantly higher than the reported cases in all countries,” said Imperial College.

Imperial College, a science-based institution that is considered one of UK’s leading universities, said a significant proportion of Covid-19 infections would likely either show no symptoms at all, or were mild enough not to seek care, which it estimated to comprise about 40 to 50 per cent of all infections, based on early analysis of data from China.

“Of those infections that are symptomatic and would seek care, the surveillance underway in each country is likely to pick up a fraction of these. In countries that are testing widely in the community, we would expect this fraction to be much higher than in countries that are focusing testing in hospitals,” said Imperial College.

Imperial College said it used various pieces of information from ongoing epidemics, including the proportion of infections that require hospitalisation, to “back-calculate” from the reported deaths, in order to estimate the total number of infections.

Dr Noor Hisham today did not offer comments to the press on Imperial College including asymptomatic and mild cases in its Covid-19 projections.

MOH has maintained the same testing strategy throughout the various waves of the Malaysian epidemic by focusing screening on contacts of confirmed cases, certain high-risk groups and communities, as well as screenings in certain public hospitals and clinics.

The Health DG also said today that 43 out of 52 positive cases in the Merpati cluster in the Klang Valley were migrant workers. As of yesterday, 734 out of 747 positive Covid-19 cases in the Damanlela construction site cluster were foreign workers.

The Damanlela construction site cluster in Kuala Lumpur racked up another 385 Covid-19 cases today, after reporting 460 cases yesterday. The index case for this cluster, according to Dr Noor Hisham, was a documented migrant worker who tested positive for Covid-19 after getting arrested by the police.

“Looking into the Klang Valley, it’s not in the community yet, but it’s in the construction site workers,” Dr Noor Hisham said today. “Hopefully we’ll contain the infection within construction workers as soon as possible.”

The Health DG’s comments today contradicted his previous comments on October 21, when he posted on Facebook that the coronavirus was already in the community, as 69.2 per cent of active clusters in Selangor then were local transmissions, compared to 30.8 per cent of clusters with previous Sabah travel history.

He also said MOH has not decided to reopen a temporary hospital in MAEPS in Serdang, as a few hospitals have been identified to accommodate the increase of Covid-19 patients in the Klang Valley, such as Institut Latihan KKM, Sungai Buloh Hospital’s Leprosy Centre, an old maternity block at Kuala Lumpur Hospital, Cheras Rehabilitation Hospital, and the Malaysian Armed Forces Hospital.

Klang Valley CMCO Did Not Fail

The number of average daily Covid-19 cases in the Klang Valley has risen from 38 cases in the week of October 3 to 9, to 265 infections five weeks later in the week of November 7 to 13, despite a CMCO imposed on the country’s economic centre since October 14.

“I don’t consider CMCO as failed,” Dr Noor Hisham said today.

He said the government opted for CMCO over a strict MCO lockdown due to the impact on the economy from the latter.

Dr Noor Hisham also said the CMCO on Sabah has managed to reduce Covid-19 infections in the state. Sabah began reporting daily infections above 100 since the start of October, with the country’s poorest state reporting the highest incidence rate per 100,000 population in Malaysia.

“We have not seen an exponential surge of cases,” Dr Noor Hisham claimed about the Sabah situation. “We had a surge of cases on 24 October, 26 October, and 6 November, but this is due to outbreaks and massive screening done in prisons.”

Frontliners have previously described Sabah as “Ground Zero” of Malaysia’s Covid-19 epidemic at the height of the state’s coronavirus crisis last month, with claims of severely ill patients waiting a maximum of two days to be admitted into intensive care at Queen Elizabeth Hospital. Sabahans have also complained on social media about waiting days to get their test results, besides waiting days to get admitted into hospital or a quarantine centre after testing positive for Covid-19.

National Covid-19 Highlights

MOH reported 1,103 new Covid-19 cases today, pushing the number of active cases to 12,601. A total of 48,520 total Covid-19 cases have been officially reported in Malaysia as of today.

The Klang Valley reported 49.3 per cent of today’s tally at 544 cases. A total of 385 cases came from the Damanlela construction site cluster.

Sabah reported 288 cases, or 26.1 per cent of today’s cases, which MOH attributed to aggressive infection prevention and control measures.

A total of 139 cases (or 12.6 per cent) reported today were linked to prison clusters: Tembok cluster (111 cases), Matambai cluster (15 cases), Sandakan prison cluster (four cases), Seberang Perai prison cluster (four cases), Kepayan prison cluster (two cases), Rumah Merah cluster (two cases), and Benteng LD cluster (one case). The Benteng LD cluster in Sabah is still active, about two and half months after the index cases were first discovered on September 1.

The 1,102 local transmissions according to states are as follows:

  • Kuala Lumpur: 392 cases
  • Sabah: 288 cases
  • Selangor: 150 cases
  • Perak: 116 cases
  • Negeri Sembilan: 90 cases
  • Penang: 26 cases
  • Kedah: 10 cases
  • Labuan: 8 cases
  • Johor: 8 cases
  • Kelantan: 7 cases
  • Terengganu: 4 cases
  • Sarawak: 1 case
  • Melaka: 1 case
  • Putrajaya: 1 case

Four new Covid-19 deaths were reported today, all in Sabah. A total of 102 Covid-19 patients are in intensive care, including 39 on ventilator support. Total Covid-19 fatalities in Malaysia have reached 313.

One new cluster was discovered today — Matambai cluster in Kota Kinabalu and Penampang in Sabah, with the index case discovered through a symptomatic screening. A total of 24 cases have tested positive, including 15 new ones today.

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