COVID-19 Epidemiology for Malaysia – Epidemiological Week 25, 2021 (20–26 June 2021)

The Overall Situation This Week

Malaysia is currently in the fourth week of a full movement control order (FMCO), which extends from June 15 to 28, 2021. This FMCO is needed to ensure a reduction in cases of COVID-19 infections, particularly of the variants of concern. Based on the recent government announcement of the Malaysia COVID-19 Recovery Plan, three indicators will be reviewed in order to move to the second phase of the lockdown: fewer than 4,000 new daily cases, moderate usage of ICU beds, and 10% of the population fully vaccinated. More than 5000 new cases were reported on most days in week 25; thus, continuous strict compliance to SOPs must be continued and more vigilant preventive measures must be introduced to prevent a surge in COVID-19 cases in the upcoming weeks.

New This Week

As of June 26, 2021, 728,462 cases of COVID-19 have been reported. This week, the highest number of cases (5,841) occurred on June 24, and the lowest number (4,611) occurred on June 21. The number of deaths for epidemiological week 25 stands at 536, which is an increase of 32 over week 24’s count of 504 deaths. From 21 March 2020, until June 26, 2021, the total number of deaths stands at 4,884. The number of brought-in-dead (BID) cases continued to rise this week, with 68 cases. The highest number of BID cases recorded for this past week, 17, was on June 25. A possible reason for this may be that some of those infected with COVID-19 did not take their initial symptoms seriously and consequently faced a rapid deterioration in their medical condition, followed by death. The second reason may be that the presence of more virulent variants of COVID-19 is now widespread. This week, workplace clusters remained high, with 100 new workplace clusters out of 151 new clusters (66%).

Trends in Reported Cases and Hospitalisation

The seven-day moving average for the week shows a rising  trend of 5425 cases on June 20, 2021, and 5705 cases on June 26, 2021. All states reported an uptrend in the cumulative incidence of COVID-19 cases. As of June 26, in Sabah, Kedah, Kelantan, Johor, Malacca, Perak, and Penang, the number of cases exceeded 1,000 per 100,000 population; in Putrajaya and Sarawak, cases exceeded 2,000 per 100,000 population, Negeri Sembilan and Selangor, cases exceeded 3,000 per 100,000 population and Kuala Lumpur; cases exceeded 4,000 per 100,000 population. In Wilayah Persekutuan Labuan, the number of cases continued to rise alarmingly, standing at over 7,000 cases per 100,000 population.

As for the capacity of Malaysia’s health system, the intensive care unit (ICU) utilization rates appear to have slightly decreased this week compared to previous weeks. However, demand remains high, with current ICU utilization rates of 51%. The ventilator utilization rate has plateaued over the past two weeks at approximately 21%.

After the implementation of the FMCO on June 15, the national time-varying reproductive number (Rt) stabilized to slightly below 1.0. In May, this number was above 1.0. In week 25, Pahang’s Rt increased to its highest number, 2.02, on June 26. Putrajaya, Malacca, Penang, and Perlis all reported Rts of over 1, at 1.87, 1.28, 1.16, and 1.06, respectively.

As of June 21, 2021, the average mobility of people to grocery, pharmacy, recreation, retail, and parks shows an average drop of 38%. However, this average mobility is increased by 2 % compared to the last week.

Reflection

The Ministry of Health projected that Malaysia could see over 13,000 cases per day of COVID-19 cases by June 14. Therefore, the current FMCO has proved to be somewhat effective in controlling cases. However, after four weeks of the FMCO, daily cases are still above 5,000, with workplace clusters contributing to the majority of these. Manufacturing enterprises are essential services and thus continue to operate, while other economic sectors contribute little to the clusters remain closed. A more proactive strategy is needed to combat workplace clusters. Based on the Malaysia COVID-19 Recovery Plan, the country can only move to phase 2 of the lockdown when the number of COVID-19 cases has dropped to 4000 or less per day, which is still a very high number.

The public cannot be locked down for an extended time. Depression, a mental health condition of which many may not be aware, are occurring. A recently published study by Wong et al (2021) showed that the COVID-19 pandemic has put a strain on people’s mental health; for example, Malaysia has seen a rise in cases of suicide and attempted suicide due to financial distress and family issues arising from long isolation and other factors linked to the COVID-19 pandemic.

An astringent proactive strategy is needed to combat workplace clusters and protect the public’s financial and mental health. Clearer SOPs for each lockdown phase must be readily available. It is unfair to issue compounds when the public is not made aware of multiple changes to SOPs. The public should be continuously educated regarding 3Cs (avoid Crowded places​; close-contact settings; Confined and enclosed spaces), 3W (Wash, Wear and Warn), and the benefits of vaccinations. Malaysia continues to expand the National COVID-19 Immunisation Programme (Programme Imunisasi COVID-19 Kebangsaan [PICK]) to ensure that at least 80% of the population is vaccinated. The vaccination programme should also be further expanded in closed settings like prisons. With regards to mental health, the Ministry of Health should spearhead a task force comprising of the Prime Minister’s Department, Education Ministry, Youth and Sports Ministry, Women, Family, and Community Development Ministry, and non-governmental organisations to develop suicide prevention guidelines to prevent more suicides.

References

• Wong, L. P., Alias, H., Md Fuzi, A. A., Omar, I. S., Mohamad Nor, A., Tan, M. P.Cheong, K. W. J. P. o. (2021). Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey. 16(3), e0248916.
• Aris,A.N.(2021,March 19).Health DG expects daily COVID-19 cases to increase to 13,000 by June 14. Retrieved from https://www.theedgemarkets.com/article/health-dg-expects-daily-covid19-cases-increase-13000-june-14

This report was prepared by Dr. Rowena John, a DrPH candidate at University Malaya, and revised by Assoc. Prof Dr. Nik Daliana Nik Farid and Dr. Nur Afiqah Mohd Salleh, Family Health Discipline, SPM Department.

The report is based on the information from Covid-19 Epidemiology for Malaysia dashboard (SPM website) and the Ministry of Health Malaysia daily updates.