IT took Malaysia just 34 days this year to surpass the entire coronavirus caseload recorded last year.

Malaysia logged a total of 113,010 infections as of December 31, 2020, but the figure was overtaken in 34 days, between January 1 and February 3, when the nation recorded 113,902 cases, hitting 892 cases more and counting. 

Despite implementing a second round of movement-control order (MCO) on January 13, cases continued to soar and as of yesterday, Malaysia reported 151,259 cases – 38,249 more than last year. 

As of yesterday, the caseload since the start of the pandemic was 264,269.

The number of new cases this year alone is a long way from the time experts cited Malaysia as an exemplary country for its efforts in combating the pandemic under the first round of the MCO.

Then, Malaysia managed to report zero local transmissions and kept cases under control.

However, a third wave of Covid-19 hit the nation after the Sabah elections on September 26.

As a result, from January 1, Malaysia has been breaking multiple Covid-19 records.

The daily number of new cases continues to be in four digits, with a record high of 5,728 cases on January 30. 

It also reported the most deaths in a single day on February 8 with 24 fatalities, record high of 17 clusters on January 27 and February 11, and the death of the youngest victim at four months old on February 4. 

Malaysia also surpassed the total number of deaths it recorded last year at 471. 

From the start of the year until yesterday, Malaysia reported 494 fatalities – 23 more than the entire 2020. 

The fatality toll is at 965 – just 35 short of the 1,000 mark.

More than 60% of clusters in the third wave is also linked to workplaces.

From September 20 to February 12, Malaysia recorded 852 clusters, of which 527 were linked to workplaces or 61.8% of total clusters in the third wave.

A total of 315,100 individuals were screened at these workplace clusters and 78,906 found to be positive.

No firm action

Epidemiologist Prof Dr Awang Bulgiba Awang Mahmud of Universiti Malaya told The Malaysian Insight that sporadic cases and asymptomatic transmissions may have caused the spike in cases in the nation, an increasing trend he noticed since last September. 

“Now the unlinked cases have probably resulted in so many other infections, we are having outbreaks in healthcare facilities and care homes, which are unrelated to existing clusters. 

“Another reason is asymptomatic transmissions. I have maintained from the outset of the pandemic that asymptomatic infections probably outnumber symptomatic infections.

“A recent publication by the Journal of the American Medical Association seems to indicate that I was right all along.”

The government failed to act when cases started increasing as early as September and that the infections are now in the community and spreading asymptomatically, he said. 

“When warning signs like unusual increases in unlinked or sporadic cases and reductions in doubling time started appearing in early September 2020, no decisive action was taken.

“Now the infection is well and truly entrenched in the community and this is spreading asymptomatically.”

During MCO 2.0, the number of coronavirus cases did not drop. Instead, more than 3,000 cases are logged daily.

Malaysia imposing a second round of MCO reflects a failure in pandemic management, said Awang Bulgiba.

If lessons were learnt from the first MCO, the country would not be in this perilous situation, he added.

He blames the fact on “outside” experts having no access to data on the third wave and no sophisticated analysis on that part from the Health Ministry either.

“There appears to be a reluctance to engage experts from outside the government and I do not think the lessons from the second wave were heeded.

“This has led to tunnel vision and an inability to look at the entire pandemic management in a holistic manner.”

Epidemiologist and biostatistics expert Dr Jamaluddin Ab Rahman agrees, saying the ministry needs to share the data for them to know the direction of infections in the country.

He said R-naught (R0) statistics alone are not sufficient to measure the severity of the outbreak.

“We urge the ministry to share their findings with other epidemiologists.

“Let us look at the data together. Only when we can see the complete picture, we might know the direction of infections in the country.

“R0 alone is not enough to measure or monitor the severity of the outbreak,” said Jamaluddin, who is also an exco member of the Malaysian Public Health Physicians’ Association.

New testing strategy

Awang Bulgiba also cautions people against resting on their laurels, as the numbers now do not reflect the true picture of community infections.

He said the slight drop in cases could be due to the low number of tests, which is the government’s new testing strategy.

“In this new directive, only symptomatic contacts are to be traced.

“This means fewer people will be traced and tested so the reported number of new cases would be expected to eventually fall.

“So, when the number of new infections were falling in the last few days, it is not necessarily the virus slowing down. It could simply be the lower number of tested contacts leading to a fall in number of reported cases.”

According to a Health Ministry circular, Covid-19 tests will be done only on symptomatic individuals identified as close contacts of a positive case.

The samples will be based on the cohort size, which is the number of individuals exposed to the positive case.

The circular said it was sufficient for up to 20 samples to be taken for a cohort size of fewer than 50 people.

“If there were more than 50 people, only 10% or 30 samples – whichever is lower – will be sufficient,” the circular said.

Jamaluddin also said increasing cases do not necessarily mean it is worrying, but that one must understand how to perceive the data.

“When we see a reduction in the number of cases, we have to take into consideration the number of tests done.

“If the number increases based on additional testing done, then it is not as alarming, as higher cases might be due to an increased number of sporadic cases in the community,” he said.

Malaysia is expecting the first delivery of the Covid-19 vaccine to arrive sometime this month and the vaccination programme would involve three phases.

The first phase will involve vaccinating 500,000 health and non-health personnel.

The second phase will involve high-risk groups, including the elderly and vulnerable aged 60 and above who suffer from co-morbidities and the disabled.

The third phase involves the remaining vaccine recipients – those aged 18 and above.

The government hopes to inoculate 80% of the population, or 26.5 million individuals, by next February.

Despite a rise in cases in the community and workplaces, both Awang Bulgiba and Jamaluddin said it is important to vaccinate front-liners.

Both said front-liners were the ones with the biggest risk as they are exposed to those with the virus.

“We need to protect the healthcare front-liners first. They are the most at risk now. They see Covid-19 patients everyday. Since we are not able to get vaccines for everyone in one go, we have to prioritise,” Jamaluddin said.

Nevertheless, Awang Bulgiba said vaccinations would not be playing much of a role in this scenario until a significant proportion of the population is vaccinated, which is not likely to happen until the last quarter of the year. – February 15, 2021.