Overall situation (11-17 July 2021)
Malaysia has entered the seventh week of full movement control order (FMCO) while Enhance Movement Control Order (EMCO) that was imposed in selected sub-districts and localities within Selangor and Kuala Lumpur from 3rd July has been lifted on 16 July 2021. The number of new cases continued to surge in this Epid Week 28. It recorded daily new cases more than 10 thousand per day for five consecutive days with highest recorded on 15 July (13,215 cases) that equated to 409 new reported cases per 1 million population. The number of active cases at the end of Epid week 28 was 119,814. This week also recorded the highest daily mortality (138 deaths on 17 July 2021) since the start of the pandemic last year.
Highlight of the week
A cumulative of 905,851 cases and 6,866 deaths of COVID-19 have been reported as of 17 July 2021. The daily reported new cases continued to escalate vastly ranging from 8,574 to 13,215 cases. The highest number was recorded on 15 July 2021 while the lowest number documented on 12 July 2021. The number of reported deaths also increased in trend with 799 deaths compared to 633 and 550 in Epid Week 27 and 26 respectively. From the 799 deaths, 13.8% (110) were brought in death cases. The daily reported death ranged from 91 (11 July 2021) to 138 (17 July 2021). The case fatality rate (CFR) for this Epid Week 28 is 1.02%, which is slightly lower than the previous weeks (1.16% in week 27 and 1.25% in week 26) in light of the growing numbers of daily new cases.
Trends in Reported Cases, Incidence, Transmissibility and Testing
The overall 7-day moving average of daily new cases for the week shows a rising trend from 9,682 cases (11 July 2021) to 11,237 cases (17 July 2021). The increment has been driven primarily by the cases from Selangor, WP Kuala Lumpur and N. Sembilan.
As of July 17, 2021, the 14-day incidence rate of Negeri Sembilan has exceeded 1,000 per 100,000 population; WP Kuala Lumpur, Selangor, WP Labuan and Melaka have incidence rate between 500 to 1,000 per 100,000 population; Kedah, Pahang, Pulau Pinang, Sarawak, Johor, Perak, Kelantan, Sabah have incidence rate between 100 to 499 per 100,000 while Terengganu and Perlis incidence rate below 100 per 100,000 population.
The time-varying Reproductive number (Rt) of COVID-19 in Malaysia had increased by approximately 8.3% from Rt value 1.20 (10 July 2021) in previous week to Rt value of 1.30 (17 July 2021) this week. All states recorded Rt value above 1.0 except for WP Labuan with Rt value of 0.56. Penang recorded the highest Rt value of 1.61 followed by Perlis (Rt value 1.57), Terengganu (Rt value 1.57), Negeri Sembilan (Rt value 1.51), Putrajaya (Rt value 1.42), Kelantan (Rt value 1.42), Kedah (Rt value 1.40), Johor (Rt value 1.39), Sabah (Rt value 1.34), Melaka (Rt value 1.32), Selangor (Rt value 1.29), Pahang (Rt value 1.26), WP Kuala Lumpur (Rt value 1.21), Perak (Rt value 1.08) and Sarawak (Rt value 1.02).
The overall Test Positivity Ratio (TPR) for Epid Week 28 ranged between 8.89% to 9.82% which the highest was recorded on 15 July 2021. The TPR for this week was very high compared to the TPR recommended by the World Health Organization (WHO) at 5.00%. The general bed utilization for COVID-19 has surpassed 320%, while ICU bed and ventilator utilization has reached 53.4% and 19.9% respectively.
Despite the enforcement of FMCO and EMCO throughout Kuala Lumpur and the majority of Selangor subdistricts, the number of new cases reported daily continued to surge dramatically. This increase in number may be partly attributed to the high community-wide transmission and mass screening of high risk groups during EMCO. The mass screening among high-risk groups/areas also indirectly lead to the vast increase of TPR. Increment in mortality and brought in death cases may be due to the present of more virulent variants of Covid-19 and lack of awareness of severe symptoms among the community. The escalating number of new cases and deaths may predict a surge in healthcare demand in the upcoming weeks.
Thus, the capacity of our public health workforce and healthcare system need to be increased immediately. The screening and vaccination programs should be made more available, accessible and affordable to all. Detection of cases and contact tracing should be accomplished as soon as possible. Better-equipped healthcare facilities with more trained health care workers and increased public health personnel should be available to flatten the curve of this epidemic. A more comprehensive and integrated effort is required from the whole society to minimized the pandemic fatigue. Holistic and sustainable standard operating procedures (SOPs) combined with more compassionate health-promoting approaches are important to avoid lower trust and compliance from the community.
With this coming Aidiladha celebration, the number of cases is expected to continue to rise if the community do not comply to the SOPs and violate the cross-district restrictions. Public including individuals who have been vaccinated with the Covid-19 vaccine are advised to strictly comply with the SOPs and health advice that are often emphasized namely: avoid 3C; Crowded places, Confined spaces and Close conversation as well as practice 3W; Wash, Wear and Warn.
This report was prepared by Dr Zakiah binti Othman, a DrPH candidate at Universiti Malaya, and revised by Prof. Dr Moy Foong Ming, Professor of Epidemiology, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.
The report is based on the information from Covid-19 Epidemiology for Malaysia dashboard and the Ministry of Health.