Four States Severely Under-Testing Covid-19, Above 20% Positive Rates

Sabah, Kedah, Kelantan, and Perlis recorded seven-day average positive rates exceeding 20% in the 34th epid week (Aug 22-28); Sabah, Kedah, Kelantan, Perak, and Selangor recorded daily positive rates above 10% from August 15-28.

KUALA LUMPUR, August 30 — Every state and federal territory in Malaysia, except Labuan, appears not to be testing sufficiently for Covid-19 due to high positive rates exceeding 5 per cent in the past two weeks.

Sabah, Kedah, Kelantan, and Perlis, in particular, may be severely under-testing their surging coronavirus outbreaks with seven-day average positive rates above 20 per cent in the 34th epidemiological week (August 22-28).

The World Health Organization (WHO) recommends a benchmark 5 per cent positive rate as an indicator of sufficient testing, while the Ministry of Health (MOH) believes that a maximum 10 per cent rate is adequate.

The high positive rates across nearly the entire country — amid spiking infections and deaths in multiple states — indicate likely far more infections than the 301,157 cases officially reported nationwide in the fortnight of August 15 to 28. Covid-19 intensive care units (ICUs) in Kedah, Sabah, Perak, Kelantan, Johor, and Penang ran at over-capacity as of August 29.

Malaysia’s positive rate — based on the number of tests done (both Rt-PCR and RTK-Ag) — hit a record high 16.76 per cent on August 28, based on 22,597 positive cases among 134,804 tests done. On a seven-day average basis, the national positive rate stood at 13.61 per cent in the 33rd epidemiological week (August 15 to 21), before rising slightly by 0.6 percentage points to 14.22 per cent in the 34th epidemiological week (August 22 to 28).

Kedah, Kelantan, Perak, Sabah, and Selangor recorded double-digit positive rates every day for the past two epidemiological weeks, while Perlis, Penang, and Sarawak also reported positive rates exceeding 10 per cent on most days over the same period from August 15 to 28.

Surprisingly, Perlis recorded the highest daily positive rate of 36.98 per cent on August 28 in the past two weeks, based on 98 positive cases among 265 tests done.

This means that about 37 of 100 people screened in Perlis that day tested positive for Covid-19, more than seven times the WHO’s recommended 5 per cent positive rate. A higher positive rate indicates there are more undetected Covid-19 infections that weren’t captured through testing, as surveillance strategies may be focused on symptomatic cases as outbreaks grow across the country.

In other words, Perlis likely has far more Covid-19 infections than the 742 cases officially reported from August 15 to 28.

Perlis’ incredibly high single-day positive rate is followed by Sabah at 29.16 per cent (on August 26), Kelantan at 28.22 per cent (on August 26), Kedah at 28.01 per cent (on August 28), and Sabah at 27.18 per cent (on August 24). All five states saw an uptick in their daily cases in the past two weeks.

Most states — namely Sabah, Kedah, Kelantan, Selangor, Penang, Perak, Sarawak, Melaka, Terengganu, Kuala Lumpur, and Negeri Sembilan — registered double-digit seven-day average positive rates — for both weeks between August 15 and 28.

Kedah recorded the top seven-day average positive rate of 18.32 per cent for the 33rd epidemiological week, while Sabah reported the highest positive rate the week after at 24.29 per cent. Sabah authorities previously complained about backlogged tests.

Sabah likely has far more Covid-19 infections than the 36,924 cases officially reported from August 22 to 28, the second-highest in Malaysia after Selangor’s 86,119 confirmed cases.

The data on the number of tests done in Malaysia and the positive rate by state from August 22 to 28 as revealed by MOH showed that only Labuan is testing adequately to detect Covid-19 cases. Labuan reported an average positive rate of 1.01 per cent for the week of August 15 to 21, and an average 1.03 per cent for the August 22-28 week.

Perlis, where daily infections rise from 21 cases on August 15 to 98 cases on August 28, saw its seven-day average positive rate more than double from 9.23 per cent in the 33rd epidemiological week from August 15 to 21 to 20.88 per cent in the 34th epidemiological week, an increase of 11.65 percentage points.

Seven states reported a drop in average positive rates in the past week from August 22 to 28, with Melaka recording the highest decline, down by 4.4 percentage points, followed by Kuala Lumpur (-2.61 percentage points), and Pahang (-2 percentage points), due to a mix of increased testing and lower cases.

CodeBlue reported last Friday that Labuan is the only territory with declining Covid-1 infections and deaths, together with extremely low case incidence and mortality rates, as more than 64 per cent of its total population has been fully vaccinated to date.

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