(1) Only 20% of the 11,500 daily test capacity we have are used to look for community spread. “The remainder are used to re-test confirmed cases with a view to determine discharge ability, treatment response and possibly repeated tests for suspected cases that are negative the first time (polymerase chain reaction (PCR) tests depends on quality of the sample and have only 60-70 per cent positivity for nasal swabs or sputum).”
(2) The number tested positive (daily or cumulative) is dependent on the number of tests we conduct. Some modelling studies estimate the actual number in any country to be 10 times that.
(3) If we used death rate and assumed 1 death per 100, we would have 6,200 cases (as at April 6) but this figure is distorted by other factors. E.g. we could have missed out counting Covid-19 among other pneumonia cases. Pneumonia accounts for 11.8% of deaths in Malaysia or 390 per week.
(4) There are two lag times that affect the figures: (a) First, “it takes about 7-14 days before an infected person presents clinically. It takes another 7-14 days before illness severity and dying (ventilation and ICU care).” (b) Second, there is a backlog of testing. “Some say it takes 5-7 days to get results. Even health care staff that have potentially been exposed may have to wait for 4-5 days to get their status known.”
(5) We have community spread: “From MoH Influenza-Like Illness (ILI) & Severe Acute Respiratory Infection (SARI) surveillance that is conducted at selected sites, about 1.2 per cent of these patients have been Covid-19 positive in the past week. This indicates community spread, as these persons have no contact with known cases. We do not know how many patients with pneumonia and severe respiratory illnesses (influenza-like illness) we have missed in the past 4-6 weeks.”
Point 5 justifies a lockdown because, given community spread, gatherings of people could become “transmission amplification events”.
(6) We need to do more to protect our front-line workers. “Many staff have had to rely on homemade (not all reliable) or donated PPE. We are still struggling with the distribution of national PPE supplies. Even as far back as March 20, MoH reported that 15 HCPs had been infected by Covid-19 as part of their work.”
Read here (Malay Mail, April 7, 2020)
