COVID-19 Epidemiology for Malaysia – Epidemiological Week 29, 2021

Overall situation (18–24 July 2021)

Malaysia is now transitioning into the National Recovery Plan (NRP) which aims to steer the country out of the health and economic crisis caused by the global COVID-19 pandemic. The plan has four phases and the transition from one phase to another hinges on three main threshold indicators – COVID-19 transmission within the community based on the number of daily cases, the capability of the nation’s public health system based on the occupancy of intensive care unit (ICU) wards at health facilities across the country and the rate of the population who are fully vaccinated against the virus.

Most states are in Phase 1 of the NRP, except for Perlis, Perak, Pahang, Kelantan, Terengganu, Penang and Sabah, which have moved into Phase 2. An enhanced movement control order (EMCO) is enforced in localities with a spike in COVID-19 cases. The number of new cases continues to surge dramatically, finally breaching the 15,000 mark on July 23 (15,573 cases). The number of active cases at the end of epidemiological (epi) week 29 was 153,633. This eventful week also hit a record high on daily mortality (199 deaths on July 21) since the start of the pandemic last year. On a brighter note, Malaysia’s daily vaccination rate per 100 population was 1.26 on July 23, surpassing that of many countries, including the US, according to Oxford University’s Our World in Data website. As of July 23, 46.7% of Malaysian adults had received at least one dose of vaccination, and 21.8% had completed two doses.

Highlight of the week

A total of 996,393 cases and 7,902 COVID-19 deaths have been reported. The daily reported new cases continue to escalate. The highest number was recorded on July 24 (15,902), whereas the lowest was documented on July 18 (10,710). Workplace clusters continued to dominate the number of new cases. In an effort to cope with the increasing number, Selayang Hospital is the third in Selangor to be converted to a full COVID-19 hospital after the Sungai Buloh and Ampang hospitals. The number of reported deaths has also increased, with 1,036 deaths this week compared with epi weeks 28 (799 deaths) and 27 (633 deaths). Nearly 14% (142) of the 1,036 deaths were brought-in-dead cases. The case fatality rate for epi week 29 was 1.14%.

Trends in reported cases, incidence, transmissibility and testing

The overall seven-day moving average of daily new cases for the week showed an increasing trajectory from 10,710 cases (July 18) to 15,902 cases (July 24). Three states (Selangor, WP Kuala Lumpur and Negeri Sembilan) reported 14-day incidence densities exceeding 1,000 cases per 100,000 population. 

The national time-varying reproductive number (Rt) of COVID-19 in Malaysia, however, showed a slightly decreasing trend, from Rt value 1.24 (July 18) to Rt value 1.12 (July 24). All states recorded Rt values above 1.0 except for Melaka (Rt 0.93), WP Labuan (0.80) and Negeri Sembilan (Rt 0.70). Terengganu recorded the highest Rt value of 1.66, followed by Kelantan (Rt 1.39).

The overall test positivity ratio (TPR) for epi week 29 hovered above 9%, higher than the average COVID-19 testing positivity rate of 5% set by the World Health Organisation. A TPR of less than 5% is the benchmark for sufficient testing being conducted.

In terms of bed utilisation, our health system capacity continues to bear the brunt. The general bed utilisation rate recorded was more than 400%, whereas the ICU bed and ventilator utilisation rates had reached 55.9% and 21.9%, respectively.

Reflection

Recently, 409 cases with variants of concern (VOC) have been identified in Malaysia. The prevalence of the Delta variant of the COVID-19 virus, which is twice more transmissible and able to infect the next person within 15 seconds, should be a grim reminder for everyone to maintain a safe family and work bubble. With the availability and affordability of COVID-19 self-test kits in the market, any suspected persons can now quickly test, diagnose and self-isolate. Although the government is planning on relaxing some restrictions for those who have completed the two-dose vaccination, we must continue to be vigilant lest we regress into the cycle of repeated MCOs.

It is now clear that all public health and social measures would be ineffective in reducing the number of infections unless everyone in society assumes the responsibility to break the chain. Therefore, all individuals must be socially responsible by continuing to engage in safe public health practices, such as physical distancing and mask wearing, for the benefit of society at large and assisting the government in getting out of this crisis by supporting their initiatives. The message is clear: “IT IS ALL ON YOU!’’

This report was prepared by Teoh Soo Peng, a DrPH candidate at Universiti Malaya, and revised by Associate Professor Dr. Nik Daliana Nik Farid from the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.

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

Reference

Hannah Ritchie, Esteban Ortiz-Ospina, Diana Beltekian, Edouard Mathieu, Joe Hasell, Bobbie Macdonald, Charlie Giattino, Cameron Appel, Lucas Rodés-Guirao and Max Roser (2020) – “Coronavirus Pandemic (COVID-19).” Published online at OurWorldInData.org. Retrieved from: ‘https://ourworldindata.org/coronavirus’ [Online Resource]