Why 6,976 Daily Covid-19 Cases May Not Be Malaysia’s Peak

On 23 May, 106,208 individuals were screened in Malaysia, but the positive rate was 6.57% with 6,976 positive cases, the country’s top daily tally.

KUALA LUMPUR, May 24 — When Malaysia reported its top 24-hour increase of 6,976 Covid-19 cases yesterday, 106,208 individuals were screened that day, among the highest daily testing.

However, the positive rate yesterday was 6.57 per cent, exceeding the World Health Organization’s (WHO) maximum benchmark 5 per cent rate, indicating undetected coronavirus infections in the community.

On May 20, the nation recorded the second-highest daily increase throughout the epidemic with 6,806 new coronavirus infections, with the positive rate at 6.11 per cent from 111,381 individuals screened respectively.

In the 20th epidemiological week from May 16 to 22, a total of 655,117 individuals were tested for Covid-19, a 41 per cent increase in testing from the previous week. The positive rate from the week of May 16 to 22 was 5.9 per cent, with 38,785 coronavirus cases.

During Epidemiological Week 19 (May 9 to May 15), the total number of individuals tested was 464,596, a 6.7 per cent decline from the previous week. The decline in the number of individuals tested from the previous week could be attributed to the Hari Raya festivities. During this period, a total of 29,386 Covid-19 cases were detected, translating to a positive rate higher than the previous week at 6.33 per cent.

During Epidemiological Week 18 (May 2 to May 8), the total number of individuals tested was 498,193, with an average of 71,170 people tested per day. During this period of time, a total of 25,350 new Covid-19 infections were recorded, translating to a positive rate of 5.1 per cent.

The nationwide positive rate from May 7 to 23 remained above 5 per cent. The positive rate is the share of tests that are positive.

Between May 16 and May 20, more individuals were screened for Covid-19, including the Selangor state government that also started the initiative of conducting mass screening in the state.

Between May 8 and 20, out of the 14 mass screening programmes conducted by the Selangor state government that screened 19,858 individuals in the Hulu Langat and Gombak districts, six programmes reported a positive rate above five per cent: Gombak Setia (8.24 per cent), Kajang (8.08 per cent), Hulu Kelang (8.06 per cent), Taman Templer (7.99 per cent), Bukit Antarabangsa (7.58 per cent), and Sungai Tua (5.63 per cent).

Overall, 1,171 Covid-19 cases were found among the 19,858 people tested, translating to a 5.9 per cent positive rate. These screenings by the state are separate from federal Ministry of Health (MOH) testing programmes.

Public health expert and epidemiologist Dr Lokman Hakim Sulaiman told CodeBlue that the positive rate reflects if there’s enough testing being done.

“One important measure of coverage (adequacy case detection effort) is test positivity rate. I think in Week 19, we exceeded the five per cent benchmark suggested by the World Health Organization (WHO),” Dr Lokman said.

Dr Lokman also explained that although there’s an increase in the number of individuals screened, the positive rate is still above five per cent, which means that testing is not keeping up with the increasing number of coronavirus cases.

Sarawak, which is the only state that releases their daily testing rates, also has a high positive rate. During Week 18 from May 2 to 8, Sarawak screened 29,472 people for Covid-19 and a total of 3,602 cases were detected, translating to a positive rate of 12.2 per cent.

During Week 19 from May 9 to 15, Sarawak tested 28,918 people and detected 3,272 positive cases. This also translated to a high positive rate of 11.31 per cent.

Sporadic Cases In Community Rises To 82% Week 19

On May 11, Health director-general Dr Noor Hisham Abdullah announced that 80 per cent of Covid-19 cases recently reported were unlinked, whose source of transmission was unknown.

During Week 18 from May 2 to 8, about 79.9 per cent of 25,350 Covid-19 cases reported nationwide were sporadic. The sporadic proportion rose to 82.23 per cent among 29,386 reported infections the following week.

Sporadic cases indicate that the source of the infection of a case is unknown and local health authorities were not able to track people who had spread the infection to the case, or to isolate them before they go around infecting others.

During the 18th epidemiological week, most of the country in 11 states and territories reported sporadic proportions below the national rate of 79.9 per cent. These included:

  • Terengganu (27.48 per cent)
  • Melaka (48.72 per cent)
  • Kedah (52.99 per cent)
  • Sabah (56.54 per cent)
  • Labuan (60.87 per cent)
  • Pahang (61.85 per cent)
  • Johor (65.87 per cent)
  • Perak (69.20 per cent)
  • Perlis (69.23 per cent)
  • Negeri Sembilan (71.77 per cent)
  • Penang (77.35 per cent).

Meanwhile, for the 19th epidemiological week, 10 states and federal territories reported a proportion of sporadic cases below the 82.23 per cent national rate:

  • Sabah (51.5 per cent)
  • Labuan (51.61 per cent)
  • Melaka (55.05 per cent)
  • Terengganu (55.30 per cent)
  • Perak (57.01 per cent)
  • Pahang (60 per cent)
  • Johor (67.79 per cent)
  • Negeri Sembilan (74.38 per cent)
  • Penang (75.38 per cent)
  • Kedah (79.93 per cent).

An anonymous medical doctor explained to CodeBlue that states or federal territories that have been reporting proportions of sporadic Covid-19 cases below national rates could possibly mean that these states are under-testing.

However, MOH does not reveal testing rates by state in their daily reports.

The doctor pointed out that all states should follow the strategy of the Selangor state government to mass test their residents, especially during the Movement Control Order (MCO) period.

“When we do a MCO, it must be an MCO of substance that means at the end, when we open up, we are opening up safely,” the doctor, who requested anonymity due to the government’s gag order on civil servants, told CodeBlue.

The doctor suggested that the government can switch to performing pool testing instead, in which samples of around 10 people are combined and processed as one test as a whole batch.

Then, if a positive result is found, all 10 people will have to undergo individual screenings. If the pool test is negative, it is presumed that the 10 are not infected.

The Selangor state government, as well as former health minister Dzulkefly Ahmad, also told the federal government that if it were to have a strict lockdown, then a more effective and targeted approach, such as an increase in Covid-19 testing and vaccination, should be implemented.

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