With 10% Positive Rate, Malaysia Severely Under-Testing For Covid-19

By Tony Pua |

There is a stark difference between “targeted testing” and “limited testing”; what MOH has in effect been practising is “limited testing”.

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Based on the rising positivity rate of around 10 per cent today, we are severely under-testing for Covid-19 to detect cases and outbreaks in the community.

Yesterday, the Ministry of Health (MOH) reported 12,366 Covid-19 positive cases from 124,519 test samples. This translates into a positivity rate of 9.93 per cent.

The positivity rate continues to increase compared to the weekly positivity rate, as shown in the chart below.  And the increase is despite a recent increase in test sampling since last week.

As can be seen from the chart, during the first week of Movement Control Order (MCO) 3.0, which started on May 23, 2021, MOH carried out 109,601 average daily tests to return 7,631 average daily positive cases, or 6.96 per cent positivity.

However, for the subsequent six weeks until July 10, MOH actually carried out significantly fewer tests, despite high and rising positivity rates. The positivity rate is well above the World Health Organization (WHO) threshold of 5 per cent, whereby the spread of Covid-19 is deemed under control.

It was only last week that MOH finally carried out more tests than they did during the first week of MCO 3.0. For the week starting July 11, an average of 120,165 tests were carried out daily, which returned a positivity rate of 9.35 per cent or 11,237 positive results daily.

The data tells us a few simple facts.

The significant drop in testing, a massive drop of 34 per cent for the week starting June 20, compared to the first week of the MCO, has contributed to a major failure to detect tens of thousands of cases in the community, which then caused more infections, as reflected in the rising positivity rate.

When comparing the testing data between the first week of MCO 3.0 and the last week (July 11 to 17), the positivity rate has increased by more than 34 per cent, from 6.96 per cent to 9.35 per cent. However, despite an increase in testing last week, it was increased by an average of 9.6 per cent only.

This simply means that we are still severely under-testing for Covid-19 in the community, based on the current number of cases uncovered.

MOH has repeatedly dismissed calls for mass testing across the country since last year. Health director-general Dr Noor Hisham Abdullah favoured the ‘targeted’ approach in Covid-19 testing.

We would like to highlight that we do not have an issue with a ‘targeted testing’ approach. However, there is a stark difference between ‘targeted testing’ and ‘limited testing’. 

What the MOH has in effect been practising is a ‘limited testing’ approach.

A ‘targeted testing’ approach has to correspond to test outcomes and results. When the tests returns a positivity above 5 per cent, the targeted testing approach should automatically increase the number of tests to a sample size that will return and reduce the positivity to less than 5 per cent.  

Hence, if the positivity rate has effectively risen to 10 per cent, as it has over the past few days, it the number of targeted samples to be tested has to effectively double as well, in order to meaningfully and effective record and determine the number of infected in the community.

This is the first step towards quarantine and isolation, and where possible, contact tracing, to prevent the infection rate from spiralling out of control, as it has over the last two months.

We call upon the MOH to drastically increase its targeted testing and put in place a National Testing Plan, as part of a whole of government and whole of nation approach to fighting Covid-19 and its variants.

This plan is not for the MOH to execute alone, as all stakeholders must be involved, including private hospitals, private GPs, factories and workplaces, and even individuals, via the now available self-test kits. 

We must build a national capacity to test at least 1 per cent, that is approximately 300,000 tests a day, as a contingency measure to deal with any further outbreaks in the future.

Tony Pua is the Member of Parliament for Damansara.

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