Endemic Covid Targets: 1,200 Cases, 10 Deaths, 20% ICU Usage

Khairy Jamaluddin says the Health Ministry is “guided by data, not date”, when asked by the health, science and innovation parliamentary committee on when the targets can be achieved.

KUALA LUMPUR, Nov 3 — The Ministry of Health (MOH) has listed a number of indicators beyond vaccination to determine when the nation can transition into living with Covid-19 as an endemic disease.

Health Minister Khairy Jamaluddin told Parliament’s health, science and innovation committee in a meeting on September 28 that the indicators include Covid-19 hospital admissions, deaths, hospital capacity, as well as vaccination, transmission, and testing rates — most of which have yet to be achieved as of yesterday.

Based on an MOH slide at the meeting, indicators that may be used to determine transitioning into endemicity at either the national or state level are:

  • 1.5 severe cases (Categories 3, 4, and 5) per 100,000 population
  • 5 per cent hospital admissions in Categories 3, 4, 5
  • 10 or fewer daily Covid-19 deaths
  • Less than 30 per cent bed occupancy rate (non-critical)
  • Less than 20 per cent intensive care unit (ICU) bed occupancy rate
  • 2,000 deferred surgeries per 100,000 annual hospital admissions
  • More than 80 per cent of total population vaccinated
  • More than 80 per cent of adult population vaccinated
  • Average 1,200 daily Covid-19 cases
  • Average 3 per cent influenza-like illness (ILI) consultations of total outpatient cases
  • Rt of 1.0 or lower
  • More than four individuals tested with RTK per 1,000 population every week
  • Below 5 per cent positive rate

“So, these are the early suggestions of what it might look like in an endemic state,” Khairy said, according to transcripts of the meeting published in the special committee’s “Transitioning from Pandemic to Endemic Covid-19 Safely and Sustainably” report that was tabled in Parliament on Monday.

More than a month after the September 28 parliamentary committee meeting, Malaysia still has yet to achieve the indicators that Khairy listed for transitioning into a phase of living with Covid-19 as a persistent virus.

According to the CovidNow website, Malaysia averaged at 5,681 daily new Covid-19 cases yesterday, nearly five times the maximum target of 1,200 infections.

Malaysia recorded a seven-day average of 65 Covid-19 deaths on October 25, more than six times the maximum target of 10 daily fatalities.

As of November 2, about 66 per cent of hospital beds nationwide were utilised, more than double the set indicator of a maximum 30 per cent bed occupancy rate (BOR). The national ICU utilisation rate is at about 60 per cent, triple the target of below 20 per cent.

Over the past week, Covid-19 hospitalisation and infection trends have been trending upwards in multiple states, including the central region of Klang Valley, Negeri Sembilan, and Melaka.

Malaysia has exceeded the 80 per cent adult coronavirus vaccination target for shifting to endemicity, as over 95 per cent of individuals aged 18 and above have been fully inoculated. About 75 per cent of the country’s total population have completed vaccination, just five percentage points short of the 80 per cent target.

The national positive rate currently hovers at 4.7 per cent, inching closer to the maximum 5 per cent target after plateauing the past week.

Khairy said additionally, MOH has to ensure that critical care capacity in hospitals is sufficient going forward.

“In this respect, we will have to make sure that the hospital bed capacity is at a stable level and the ICU bed capacity level for endemicity is acceptable. Twenty per cent or less ICU capacity is something that we are happy with in an endemic state. Right now [it] is at 67 per cent. So, we are quite far away,” the health minister told the health, science and innovation parliamentary committee last September 28.

On the national testing strategy, Khairy had then described it as a work in progress as MOH is still sorting out the details of the plan. “But these are some early thoughts. One is, of course, a diagnostic extension of the capacity, surveillance, as well as digitalisation of data.”

When asked by committee chair Bandar Kuching MP Dr Kelvin Yii on when the targets for transitioning to an endemic Covid-19 stage can be achieved, Khairy said the MOH is “guided by data, not date”.

The Dewan Rakyat special select committee told the government Monday that the country is not yet prepared to fully transition into the stage of living with Covid-19 as an endemic disease.

Khairy previously targeted the end of October for the country to move into the endemic Covid-19 phase, but he has yet to make a formal announcement on the transition.

On Covid-19 vaccinations, Khairy estimates the current vaccination ceiling to be at 80 per cent of the total population as about 20 per cent are under the age of 12.

He said the country has secured enough Covid-19 vaccine doses to vaccinate every teenager and adult with a booster dose without the need for any additional procurement. The vaccines are either in stock or scheduled to be delivered in the next three months.

“We can give every single adult a booster dose of mostly either the Pfizer or the AstraZeneca vaccine,” Khairy said at the September 28 meeting with the Dewan Rakyat committee.

The health minister has yet to specify booster policies for AstraZeneca vaccine recipients, after tweeting last Friday that these individuals would soon be offered additional shots. Senior citizens who received two doses of either Pfizer-BioNTech or Sinovac are eligible to receive a third dose with Pfizer, an mRNA vaccine.

According to Deputy Health Minister II Aaron Agong Dagang in Parliament last month, the federal government has procured 87.9 million Covid-19 vaccine doses for the National Covid-19 Immunisation Programme (PICK), as of September 13.

The figure consists of 44.8 million Pfizer doses, 6.4 million AstraZeneca doses via direct purchase, another 6.4 million AstraZeneca doses from the COVAX facility, 20.4 million Sinovac doses, 3.5 million CanSino doses, and 6.4 million Sputnik V doses. The Moderna and Sinopharm vaccines are not included in procurement for PICK.

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