Is there a concern with the recent rise in COVID-19 cases in Malaysia?

On 13 April 2021 the Director-General of Health, Dr Noor Hisham Abdullah mentioned that Sarawak topped the list with 607 new Covid-19 infections reported, the most reported in a single day in Malaysia’s largest state. In an interview with Shivani Supramani from the Sun Daily newspaper, Prof Dr Sanjay Rampal and Prof Dr Victor Hoe discuss the current surge, the 4th wave, workplace-related clusters and Ramadan bazaar.

Sarawak has seen a steady rise in daily reported cases from January 2021. The average 14-day cumulative COVID-19 reported cases had increased from 2 per 100,000 from September to November 2020 to 44.7 per 100,000 from December 2020 to February 2021. The cases have been increasing steadily to more than 168 cases/100,000 population up to 13 April 2021. This is the highest in the country.

This is reflected in the R of higher that 1 since 31 March 2021, this means that the transmission of the COVID-19 disease is continuing. The R of 1 means 1 COVID-19 patient will spread the disease to one other person.

With the sustained rise in cases, there may be a need to monitor the public health capacity for contact tracing and the availability of ICU beds.

There needs to be closer monitoring of the Testing Positivity Ratio for Sarawak to estimate whether this increase in reported daily cases is artefactual to changes in screening strategies. It is also important to ascertain the degree of community transmission among the new cases in Sarawak.

The fourth wave is inevitable. Based on the evolving knowledge of the virus and vaccines, there is a continuous likelihood of large outbreaks for the next few years. This is because of the susceptibility of a large proportion of the Malaysian and global population to this virus. Herd immunity of a country may not be enough as a high global infection rate may introduce new mutations that make the current vaccines less efficacious.

A longer-term and more sustainable strategy may be to improve our public health capacity, governance, and economy.

Interventions such as work-from-home and state travel bans should be reserved for periods of movement control orders

Although the work-from-home order has been lifted, this should not be the excuse for not following the SOP. All workplaces that have planned for their workers to return to the workplace, should ensure that all the SOP have been adhering to. We know that if the workers adhere to the SOP then the chances for transmission of the COVID-19 is very low. The SOP is very simple and all of us know what to do, it is just that sometimes we put our guard down as we may feel that the risk is lower when we are with our colleagues at work. We experienced this issue earlier in UMMC where the transmission happened when the workers did not follow SOP at the workplace. After that, we have reviewed our SOP and have improved the SOP to reduce the chances of transmission.

We must understand that it does not matter where we are and what we are doing. If we do not follow the recommended SOP we will see possible transmission and spread of the COVID-19 disease. The main thing that we need to be to ensure that everyone follows the SOP. It is important for us to understand that there is risk in everything we do. We just need to understand the risk and know how to manage the risk.

The pillars of prevention for Ramadan Bazaars are similar to any other shopping area – access to good hand hygiene, physical distancing, and face mask for congested areas.

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