Case counts continue along a similar trajectory of increase from week 14. A 7-day moving average of 1516 cases (10th April 2021) increased to 1963 cases (17th April 2021). This trend has been driven primarily by outbreaks in Sarawak, and Kelantan and to a lesser degree Selangor, W.P. Kuala Lumpur. and Sabah. Sarawak remains the only state reporting a 14-day incidence density exceeding 100 cases per 100,000 population. Whilst, Sarawak, Pulau Pinang, W.P. Putrajaya, W.P. Labuan, W.P. Kuala Lumpur, and Selangor hover just above 90 cases per 100,000 population. Nonetheless, these states, by-and-large exhibit plateauing trends. Trends of concern are observed in both Sabah and Terengganu, both of whom have reported an approximate increase of 1.5x in incidence over the last week. Estimated bed-capacity and active cases in Sarawak, Selangor, W.P. Kuala Lumpur, Pulau Pinang, Negeri Sembilan and Kelantan suggests strain in healthcare capacities within these states currently.
Transmissibility in Malaysia, as measured by the Rt, has been observed to have increased by approximately 0.3 to 1.37 within week 15. Only Pulau Pinang, W.P. Putrajaya, Melaka, and W.P. Labuan report Rt’s below the epidemic threshold of 1. Perlis reports high Rt but these are highly uncertain with large confidence intervals. Negeri Sembilan records the highest Rt at the end of the week at 1.6. Selangor, W.P. Kuala Lumpur, Kelantan, Pahang and Sarawak also reports Rt close to 1.5. All states have exhibited an insidious rise in mobility over the last 8 weeks that correspond to the increasing incidence and Rt. Intriguingly, on the 13th of April 2021, an approximate 8-14% drop in all forms of mobility has been observed in all states- coinciding with the start of the month of Ramadan.
The current upgoing trend of cases will likely continue for the foreseeable future. Outbreaks in the eastern region and Sarawak will likely peak in the coming weeks. Effective public measures in the eastern region and Sarawak have paradoxically meant susceptibility in these states remain consistently high- akin to a tinder box. Health authorities must practice the greatest vigilance in these two regions as outbreaks will likely be more challenging to control here. That is not to say that other regions such as Selangor and Sabah can be ignored. These two regions have exhibited increases in transmission in week 15 and have proven historically to have important characteristics that support the effective transmission of COVID-19. Finally, the indirect consequence of Ramadan on reducing mobility may provide some respite to transmission in Malaysia – although it is far too early to be sure of this.
The report was written by Dr Vivek Jason Jayaraj, DrPH Candidate, and Prof Dr Sanjay Rampal from the Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya. The report is based on the information obtained from the COVID-19 Epidemiology for Malaysia dashboard.