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MCO bearing fruit, say epidemiologists

KUALA LUMPUR: Epidemiologists say Malaysia’s sacrifices in the first two weeks of the Movement Control Order (MCO) have borne fruit.

Now, a ray of hope is discernible through the plateauing trend of new Covid-19 cases, which has been somewhat consistent since March 27.

But experts have cautioned Malaysians against getting carried away by the numbers as it remains very much in the red zone.

Epidemiology and biostatistics expert Dr Malina Osman said the MCO had halted further infections in the community.

“This is proven by the new cases showing a somewhat plateauing trend. We hope the numbers will further decrease by April 14. If this is sustained, the new cases are expected to hover between 50 and 150 cases a day.”

On Thursday, the World Health Organisation (WHO) said Covid-19 cases in Malaysia were expected to peak in the middle of this month, with the number of critically ill patients expected to also peak in that week.

It was reported that there were signs the infection curve for Malaysia was flattening. Malaysia is the worst-hit country in Southeast Asia, with 3,116 cases.

Dr Malina said the MCO compliance rate should be at 98 per cent or above, with leeway given only to those in critical sectors.

“This is because of the insidious nature of the disease. There are those who are positive, but are asymptomatic.

“There are also those who went overseas during the recent school holidays (and have returned), as well as those from the tabligh gathering who have yet to come forward.

“A number of these people may show no symptoms, but they may have already transmitted the virus to surrounding (close contact) groups.”

Earlier, Health director-general Datuk Seri Dr Noor Hisham Abdullah said more than 5,000 attendees at the tabligh gathering at the Seri Petaling Mosque in Kuala Lumpur had yet to undergo Covid-19 screening.

He said up to five generations of transmissions had been traced to the gathering, which was reportedly attended by 16,000 people.

Dr Malina said the MCO was crucial to pursue contact tracing, discover new clusters and weed out cases of people who returned from abroad, adding that it would also reduce the risk faced by healthcare workers from asymptomatic carriers.

Dr Malina, a Universiti Putra Malaysia professor, cautioned Malaysians against being complacent with the situation and suggested that the MCO should be extended beyond April 14.

She said the MCO could be extended by four to six weeks or two to three months in the worst-case scenario as Ramadan and Hari Raya were approaching.

“Up to Wednesday, we still have more than 2,000 active cases being treated in hospitals, with almost 100 of them in the Intensive Care Unit. And we are still waiting for the results of more than 7,000 cases.

“Identifying new cases requires an incubation of about 14 days. A person who is already infected can create new clusters of infection during this period,” she said, adding that the number of cases at this point did not necessarily give a full picture of the situation.

She said extending the MCO would buy time for new cases to be identified and for contact tracing to be done to prevent new infection clusters.

She said during this period, social gatherings, which had been cited as one of the main reasons Malaysia’s rates were staggering, should be stopped.

She advised Malaysians to take a page from the people in Japan and South Korea who managed to curb the Covid-19 outbreak by practising strict social distancing.

“As the virus is still present in the environment, clusters of new cases are like time bombs waiting to explode.

“European countries like Italy, Spain and the United Kingdom did not respond to WHO when it sounded the global emergency alarm on Jan 30.

“They still gathered in big numbers, with huge crowds at football matches and went about their daily lives casually. As such, they suffered the most rapid increases in new cases.”

She said Malaysians should be committed to the MCO and observe social distancing during Ramadan and Hari Raya.

“The priority for Malaysians now is to have no new cases and be free of new infection clusters for 14 consecutive days.

“Most likely there will be no balik kampung for Hari Raya this year,” Dr Malina said, drawing on decisions already made by some states that there would be no Ramadan bazaars this year.

“For Muslims, we have to accept and prepare for Ramadan without going to mosques (for Terawih prayers). Malaysians should prepare for the possibility of a very modest Hari Raya.”

Epidemiologist Datuk Dr Awang Bulgiba Awang Mahmud said it was too early to talk about how the outbreak situation would develop by Hari Raya.

“I am against traditional Ramadan bazaars (in light of the Covid-19 outbreak), simply because it will undo all the social distancing work we have been doing for the past two weeks.

“I also think balik kampung is not advisable in the current situation, as new cases can immediately flare up when the virus is brought back to the kampung.”

He cautioned people against complacency and overconfidence, as Malaysia was only in day 16 of the MCO.

He said epidemiologists were trying to determine whether the positive signs in the trend of new cases could be sustained.

Dr Awang Bulgiba, a professor from Universiti Malaya, said he agreed with the opinion that there was a growing and substantial number of pending tests.

On the MCO compliance rate, he said it should be at 99 per cent or higher.

“If even one per cent of our population of 32 million people does not comply with the order, it means there is an additional 300,000 people compounding the effects of the transmission.”

He said because of this, he advocated for the MCO to be enforced for six weeks.

“We may see some effect after the fourth week, but to see any sustained effect, we need six weeks. It is not just the number of positive cases that needs to be reduced, but also the reproduction number.

“If the reproduction number drops below one, we know the epidemic is dying out.

“Of course, to accurately compute this reproduction number, we need accurate data.”

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