Dear Malaysians,

PLEASE take 20 seconds of your precious Sunday to see this table produced by the Health Ministry three days ago. I have highlighted the important region so that I will only take 10 seconds of your time… GO!

Allow me to first congratulate and thank you for your precious time. Now, I request five minutes of your time to justify your precious 10 seconds taken.

It is time we face facts, figures, numbers and the bitter reality. Whether you like it or not, it has happened – we are now seeing asymptomatic cases that are perhaps already at large in our community. I have been saying this since the beginning of the MCO – it will happen if we do not take precautionary steps. Even with so much control, the reach of asymptomatic cases has happened, what more during a lax of these control measures.

From a brief calculation, a 95% Confidence Interval (CI) for the above 84.9% of asymptomatic patients (meaning to say, if we were to do this test 100 times randomly), we would have obtained a positive asymptomatic percentage of between 81.82% and 87.55% (520 to 556). Having said that, let us be optimistic, and I mean overly optimistic. Let us halve that lower percentage of 81.82% to 40%. Now, assuming that this figure of 40% is the figure currently in the community, calculating from the 6,872 cases that we have (assuming they are all symptomatic), we will have approximately 4,582 patients out there (range of 95% CI possibility 4,479-4,685) who are asymptomatic. Hey, it is going to be Hari Raya, let’s be even more generous – we shall halve it and you will begin with the calculations. Yes – you got it right – 2,291 asymptomatic people in the public (and that is the 20% figure of the total cases we have till today). Sadly, without mass screening and without the right kind of tests, we will never know this exact figure. A near estimation can be made with antibody testing kits but then again, we would be underestimating. Let us not get into the argument about the number of tests that we must be conducting right now; I have only another three minutes of your time (I am keeping my side of the bargain). 

These asymptomatic cases – fortunately or unfortunately (most of them) – will never know that they have/had Covid-19, which is not a main cause of concern at the moment. It is the imminent spread that could arise from these individuals to the vulnerable population that is the major concern: young children, the elderly (60 years and above) and those with an immuno-compromised status (those with uncontrolled diabetes/on long-term immunosuppressants like oral or inhaled steroids for medical conditions/chronic respiratory health issues/HIV). Thus, non-compliance with the SOPs (especially the 3Cs: gatherings in Confined, Crowded and Closed areas) are hazardous. It is best the Malaysian public accept that we are all responsible for combating Covid-19. Please (and I am putting my hands together begging you) show some love for the vulnerable in our population. Opt for more stringent rules than the ones already set, on-top of the 3Cs. You can do so by mask-ing yourselves (preferably with surgical masks), social distancing (1m away at least), strictly practising hand hygiene, either by hand scrubbing with alcohol scrubs or with simple soap and water, along with the habit of disinfecting materials. 

I know it is Raya and, trust me, I love this time of the year with all the fantastic fellowship and food, but we must accept that if we are going to win this battle, we must opt for more stringent rules and make sacrifices, including spending Raya at home this year with our core family members only. Avoid travelling (even if it is intra-state) and become that Malaysian Olympic hero that you always wanted to be. We’ve never had an Olympic gold medal, but with this upcoming event – and if we all opt with more stringent guidelines to keep the numbers extremely low – Malaysia will be the first country in the world to go from 0 gold medals to 32 million-odd gold medals overnight. This is your chance to be part of a glorious historic event. I hope that you will not disappoint.

Salam Ramadhan and Salam Hari Raya; moderate numbers in celebrations equals a greater number in victory over Covid-19. 

Tahun ini, Rayalah dengan sederhana,

Rakyat kita akan hidup dengan lebih lama, 

Salam Ramadhan, Salam Sejahtera,

Maaf Zahir Batin dan Salam Hari Raya. – May 17, 2020.

* Dr Arvinder-Singh HS is a medical officer with a Masters in health research and is currently pursuing a PhD in community health.