ON May 4, the federal government announced two weeks of movement restrictions in six districts in Selangor, and on the following day announced the same for Kuala Lumpur and other areas.

Communication-wise, the government seems to have the habit of making new announcements every few days. This keeps the public bewildered and confused.

For example, the order to close down pre-schools in Selangor was overturned the next day. The ultimate resolution came on May 10 when Prime Minister Muhyiddin Yassin announced on social media a nationwide movement control order, known as MCO 3.0, starting May 12.

Prior to that, former prime minister Najib Razak had made fun of the MCO 3.0 situation in the Klang Valley, using fences and doors to denote the increasingly less stringent rules from the first MCO to the third. He likened the MCO 3.0 situation to loosely fenced farmland.

On social media, many also made creative memes laughing at the MCO3.0 measures. So the public opinion seems to be that MCO3.0 will not work. Is that really so?

First, we have to ask what is the function and purpose of the MCO. Not denying the fact that the public health threat we are facing right now is a major one, but the MCO measures also have to deal with many socio-economic issues and satisfy the social expectation.

Almost one and a half years after the pandemic began in our country, our government and society have gained some experience and knowledge in handling the situation. The pandemic is expected to be prolonged until next year though that is the most optimistic view.

The vaccination rate of the national immunisation programme is low, just 5.86% of the population have received at least one dose of vaccine as of May 14. Although it is mainly due to vaccine supply issues, the current low coverage of the population is a cause for concern.

Even the strictest lockdown a la MCO 1.0 would not eradicate the virus in the country. At most, it would bring down the number of daily new cases to a manageable level at a faster rate for our Health Ministry.

Given the current local disease burden in the country (42,135 active cases with an average 4,000 new cases in the past seven days) even MCO 1.0 measures for a month would not sufficiently suppress the numbers to  the level where the government could allow interstate travel. If that is the case, how much longer should the measures be enforced?
 
Let’s say if that would work just after one month, what if the situation warrants it again two or three months later? Repetitive cycles of going through MCO 1.0 every three month is not an ideal solution or the correct way to handle this pandemic because the economic and social cost is simply too great for the whole country to take.

But does that mean that the looser restriction measures of MCO 3.0 cannot buck the rising trend of pandemic?

To understand whether disease control measures could work, we have to go back to the basics of disease transmission. For Covid-19, the infection and spread is most possible whenever there is interaction and close contact between people.

So logically any broad policy which contains strategies to effectively reduce a significant number of the population going out to interact should help, because the viruses will find fewer people to infect. The temporary shutdown of social gathering places (restaurants, pubs, cinemas) and banning of social events (wedding banquets, festivals, birthday celebrations, exhibitions, meetings), should remove the incentives for people to go out and interact with one another except for work, food, personal outdoor exercise or running household errands.

In addition, the interstate and inter-district travel restriction would ensure disease transmission is a local issue, hence strategies can be devised specifically at containing the local spread, while protecting other “green” zones from exposure to risk of local import.

As of May 15, more than three quarters of districts are categorised as “red” zones in Peninsular Malaysia, more on the west coast. The dire situation presents increasingly weaker rationale for the government to do a “targeted approach”, should they persist, announcing a separate MCO on specific areas every now and then. This could lead to more public confusion.

It is true that the prime minister has broken his promise not to impose another nationwide MCO but the obviously worsening disease trends in the country must have him with no other choice.

But the government also has promised that the MCO measures would not affect the operation of most economic sectors.

In other words, the disease control measures should only be “compromised” due to people’s livelihood reasons. That also implies that, what could be expected in near future is the return of workplace clusters dominating the categories of daily new clusters, while the current increased number of social clusters, such as those from community, religious and education institutions, would be curbed and reduced due to MCO 3.0. By then, it would make things easier for the government to do contact tracing and handle the local disease transmission.

If we go by the observation of past trends following the MCO 1.0 and 2.0, we should first expect the numbers of daily new cases to actually keep rising for up to two weeks (this mainly reflects the infection and close contact history prior to the MCO), and by the end of fourth week only then could we be more confident that it is on an obvious downtrend.

What concerns the Health Ministry most is the active cases and surveillance case load, as well as the patient burden reaching the critical healthcare capacity in terms of hospital beds, ICU wards and ventilators.

In the past week, the average daily new cases have been exceeding 4000 and mostly affecting the Klang Valley. This acutely demands healthcare resources especially from the dedication of medical frontliners, which are currently working under considerable strain.

With a total of 144 persons having died from Covid-19 in four days (May 12-15), MCO is a justifiable necessity, and it could provide a great relief to the Health Ministry and the medical frontliners in coming weeks.

The public need to have a reasonable expectation that the MCO 3.0 measures would eventually do good to reduce the alarming disease burden and patient load, not really to the level that we could see double-digit low daily new case numbers.

Do not say that the MCO 3.0 will not work, as time will prove that the measures would take effect to reduce the number of new cases and clusters, and hence relieve our healthcare sector and our public health concerns and worries. More importantly, people in the society at large could still keep their jobs and make a living to feed their family.

The only “complaint” I would have is that the government should have acted more decisively on May 4 and announced the nationwide MCO at least one week prior to current enforcement.

Timing is everything when it comes to pandemic response as any delay could have significant consequences for the number of people infected and the death toll.

The writing is on the wall, and the government could have forecasted such an upward trend given that they have all the necessary numbers and analysis to come to such a prediction. 

Now a greater wave is upon us to overcome, and together we will. – May 17, 2021.

* Lim Chee Han is a founding member of Agora Society and a policy researcher. He holds a PhD in infection biology from Hannover Medical School, Germany, and an MSc in immunology and BSc in biotechnology from Imperial College London. Health and socioeconomic policies are his concerns. He believes a nation can advance significantly if policymaking and research are taken seriously.