The Overall Situation This Week (27 June –3 July 2021)
Malaysia has entered the fifth week of a full movement control (FMCO) with enhanced movement control (EMCO) just initiated at high positive cases areas starting from July 3, 2021. Genomic surveillance has revealed variants of concern (VOC) which were isolated among the positive cases, that could explain the recent surge of new cases and deaths. VOC are more transmissible and virulent, therefore, accelerating the vaccination programme, stringent SOP, and a total lockdown may ease the overloaded healthcare system particularly in the Klang Valley areas.
New This Week
A total of 772,607 cases of COVID-19 have been reported as of 3 July 2021. This week, the highest number of cases (6,988) occurred on July 1, and the lowest number (5,218) occurred on June 28. The number of deaths for epidemiological week 26 stands at 550, which is an increase of 14 cases compared to the total number of deaths of 536 cases at week-25. From 21 March 2020 until June 26, 2021, the total number of deaths stands at 5434. The number of brought-in-dead (BID) cases was 70, a slight difference from the previous week’s figure. The highest number of BID cases recorded for this past week, 14, was on June 29 and July 3, 2021.
This may due to the delay in testing among infected cases and low awareness of the warning sign (silent hypoxia) which leads to rapid deterioration. Next, it could be the presence of more virulent variants of COVID-19 that are now widespread. As of June 30, 2021, a total of 217 positive cases of COVID-19 with VOC and VOI have been detected in this country. The majority of cases were Beta variant (67.7%) followed by Delta variant (18.4%).
This week, workplace clusters remained high, with 87 new workplace clusters out of 146 new clusters (59.6%).
Trends in Reported Cases and Hospitalisation
The seven-day moving average for the week shows a rising trend of 5,705 cases on June 26 to 6,306 cases on July 3, 2021. All states reported an upward trend in the cumulative incidence of COVID-19 cases. As of July 3, 2021, the 14-day cumulative incidence of Sabah, Kedah, Kelantan, Johor, Perak, and Penang, have exceeded 1,000 per 100,000 population; in Putrajaya, Malacca and Sarawak, cases exceeded 2,000 per 100,000 population. Melaka in particular has a surge in cases for the past week. Negeri Sembilan and Selangor, cases have exceeded 3,000 per 100,000 population while Kuala Lumpur; cases exceeded 4,000 per 100,000 population. In Wilayah Persekutuan Labuan, the number of cases continued to rise, standing at over 8,000 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 52%. The ventilator utilization rate has plateaued over the past three 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 26, Pahang’s Rt has dropped from 2.02 to 1.24. Putrajaya, Malacca, Penang, Selangor, Kuala Lumpur and Sabah all reported Rt of over 1.16 at 1.12, 1.02, 1.08, 1.04 and 1.01 respectively.
As of June 21, 2021, the average mobility of people to grocery, pharmacy, recreation, retail, and parks shows an average drop of 37%. A further drop by 44% was noted for mobility to work within this week.
Despite multiple cycles of MCO, EMCO, and CMCO, Covid-19 daily new cases still remain high above 6,000 cases with 5500 total deaths. A big bulk of the new cases were found in the population-dense Klang Valley and the majority of the clusters were detected at the workplace. Beta and delta variants have been isolated from the positive cases of COVID-19. Based on the recent data analysis from CPRC, the current brought in death (BID) cases were soaring at more than 7 times higher from the month of April (35 cases) to June 2021 (246 cases). Selangor and Kuala Lumpur have the highest recorded cases. The current situation has overloaded the healthcare system particularly in Klang Valley and strains the front liners while the public has shown signs of distress by waving “White Flag”.
The respective authority should be vigilant in monitoring and enforce the compliance of SOP and revisit the SOP to identify the gaps that encourage the possible spread. For instance, the capital market was listed as an essential service initially but it was removed within this week for the work can be done from home.
The emerging variants are highly transmissible, cases were more severe and current treatment is not fully effective in neutralising them. UK public health has reported, two doses of Oxford-AstraZeneca and Pfizer-BioNTech vaccines are effective in preventing more than 90 % of severe cases that require hospitalization. Expediting and ramping up the current vaccination programmes ease the overstretched healthcare system.
At the individual level, the public should be made aware of the danger of the new variants, warned of the early sign of COVID-19 and compliance to SOP. It is high time for more drastic measures to be in place to contain the current spread of Covid-19. The public is constantly fearful and uncertain due to the inconsistency in information and prolongs financial distress. A total lockdown for Klang Valley may be painful but it allowed poor citizens to regain livelihood when the cases brought to a controllable level.
This report was prepared by Dr Wong Min Fui, a DrPH candidate at Universiti Malaya, and revised by Associate Professor Dr Mas Ayu Said (Epidemiology Discipline) and Associate Professor Dr Hazreen B Abdul Majid (Head of Centre for Population Health and Nutrition and Dietetics Discipline), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.
6 July 2021
The report is based on the information from Covid-19 Epidemiology for Malaysia dashboard (SPM website) and the Ministry of Health.