Covid-19, post-Muhyiddin – P Gunasegaram

‘A curious thing happened after Tan Sri Muhyiddin Yassin resigned on August 16 and became the caretaker prime minister, during which period, he should not make any major decisions, but wait for the next prime minister to do so.

‘But that was not to be. He made a major decision to roll back movement controls, relaxing the standard operating procedures for those who have been fully vaccinated allowing them to dine in, and other associated measures. These were announced on August 19, to take effect the following day, when the palace announced that it had picked Datuk Seri Ismail Sabri Yaakob as the new prime minister.

‘What was the great hurry for Muhyiddin? Did he want to steal a little bit of thunder in his last days as prime minister? He should have let his successor make the decision, considering that his handling of Covid-19 was one of the reasons MPs lost confidence in his leadership.’

Read here (The Vibes, August 26, 2021)

What we should do to get a good grip on Covid-19 – P Gunasegaram

‘Can the reported number of Covid-19 cases be manipulated? Is it being done? The short answer to the first question is, yes. For the second question, you get to decide after looking at the data. But whichever way you vote, there can be no argument against keeping politics out of Covid-19 – that is absolutely essential for success in beating back the pandemic.

‘Given the constantly high number of daily Covid-19 cases, it is not at all surprising that the movement control order (MCO) has been extended. But what is surprising is that the numbers have stayed steadily well above 5,000 infections per day despite a lockdown of nearly four weeks. Why is that?

‘What the strict MCO over four weeks has done is severely restrict movement within the community, but daily infections are still resistant to moving below the 5,000 figure. That is a clear indication that the source is elsewhere than the broad community – perhaps factories and the manufacturing sector, which are still allowed to operate? Some are pointing to easy approvals for some industries to open.’

Read here (The Vibes, July 8, 2021)

Wider vaccination, herd immunity vital to recovery — Moody's Analytics

‘A stronger push towards wider vaccination and herd immunity will be key to domestic recovery and should facilitate an economic rebound as emergence of new Covid-19 variants poses high risk, Moody's Analytics economist Sonia Zhu said. Malaysia's economy contracted by 0.5% year-on-year in the March quarter, following a 3.4% slump in the fourth quarter of 2020.

"Despite a gradual easing of gross domestic product (GDP) contractions, conditions will likely stay weak in the coming quarter due to the latest Movement Control Order (MCO)," she said in a statement today... "Hence, a stronger push towards wider vaccination is key," she said, adding that at present, only 3.4% of Malaysia's total population has received at least one dose of a vaccine.

‘The slow vaccination rate casts doubt on the ability to reach herd immunity target by the end of 2021, tilting the balance of risks to the downside for the subsequent quarter, opined Zhu.’

Read here (The Edge, May 14, 2021)

Covid-19: Medical experts call on govt to implement a more targeted MCO to prevent fourth wave of infections

‘The government has been urged to implement a more targeted movement control order (MCO) with mass targeted testing to prevent a fourth wave of Covid-19 infections. The Health and Sciences Covid-19 Advisory Group of Experts (EAG) said the government should prioritise mitigating the spread of the virus as it was no longer realistic to try and get infection rates down to zero. 

‘It said all resources must be focused on enhancing the implementation of targeted MCOs. It recommended that all MCO areas must fully employ the digitised find, test, trace, isolation, and support (FTTIS) system, which includes the proposed targeted mass testing strategy. "A highly targeted MCO will minimise economic disruption, on top of reducing the spread of Covid-19, balancing the wellbeing of both lives and livelihoods.

"State and district health authorities must be empowered to work with external experts and determine clear and transparent thresholds for when an area should be placed under MCO. The thresholds should be defined according to population density, number of cases, and geo-characteristics of the area, and communicated clearly to the public," it said in a statement on Sunday (April 25).

‘EAG comprises representatives from the Academy of Medicine of Malaysia, Malaysian Medical Association, Malaysian Public Health Physicians Association, and the Association of Private Hospitals of Malaysia, as well as two distinguished members of the medical fraternity. It is chaired by former director-general of Health and International Medical University chairman Tan Sri Datuk Dr Abu Bakar Suleiman.’

Read here (The Star, Apr 25, 2021)

Are we losing the fight against Covid-19? – P Gunasegaram

‘With neither vaccinations to provide herd immunity nor control measures to reduce the infectivity rate, it looks like the government has indeed lost control of the fight against Covid 19, and we, the people, may have to pay the price.

‘There is a terribly urgent need to increase the vaccination rate. While this is being done, controls must be reimposed. It is a time for tough decisions, and one can only hope that this backdoor government will put politicking on the back-burner, and prioritise the last big battle against Covid-19 and minimise the damage.

‘To simply wait for vaccination to take its course and stop the pandemic may result in far too many casualties.’

Read here (The Vibes, Apr 20, 2021)

Covid-19: Dangerous dance with complacency – P Gunasegaram

‘Early signals of rising rates of Covid-19 infection should be taken seriously, and appropriate measures enforced to prevent a resurgence in the pandemic. Stronger moves may have to be imposed, such as quickly closing schools when there are cases and delaying giving the green light to interstate movement ahead of and beyond Hari Raya, if necessary. Complacency is perilous.

‘A close look at the figures indicates that we are at a dangerous inflection point, where a wrong premature move in favour of lifting restrictions may send the number of new infections skyrocketing again.’

Read here (The Vibes, Mar 23, 2021)

After a year of MCO, recovery is in sight

‘On March 18, 2020, the first Movement Control Order (MCO) was imposed and there was much uncertainty among the public and business community over what would happen next. One year on, the SARS-CoV-2 virus has taken 1,177 lives and infected 314,989 people in the country (as at March 10). Despite the grim circumstances, many see light at the end of the tunnel as Malaysia rolls out its National Covid-19 Immunisation Programme (NCIP).

‘Speaking to experts, we identify three main areas that beckons attention — healthcare, economy and last but not least politics. Covid-19 is still raging on globally, and the challenge is to vaccinate the community as quickly as possible so as to not allow the more transmissible variants to get a foothold in the community. Meanwhile, vaccine effectiveness is seen as one key driver for economic recovery. When that has effectively been executed, the focus should be on repairing the damage that has been caused by the pandemic.

‘Many also believe that political stability is one challenge Malaysia will face. There is a need to exit from the emergency rule and for the country to be given a clear mandate from a stable government.

‘In the accompanying stories, we take a look at the winners and losers in the post-pandemic era. Will pandemic winners such as the glove and technology players continue to prosper? Will the tourism, retail, hospitality and manufacturing industries as well as small and medium enterprises move away from the dire conditions brought on by Covid-19 anytime soon?

‘Nonetheless, it has been a fruitful year for local equities since the pandemic outbreak, with healthcare and technology stocks being the top gainers. What can we expect for the rest of the year after stock prices for most sectors rebounded significantly from their lows last year? We speak to heads of research to find out what they think about the market direction.’ 

Get the full story in this week’s issue of The Edge Malaysia.

Read here (The Edge, Mar 13, 2021)

Inferring the effectiveness of government interventions against Covid-19

‘Governments are attempting to control the COVID-19 pandemic with nonpharmaceutical interventions (NPIs). However, the effectiveness of different NPIs at reducing transmission is poorly understood. We gathered chronological data on the implementation of NPIs for several European and non-European countries between January and the end of May 2020. We estimated the effectiveness of these NPIs, which range from limiting gathering sizes and closing businesses or educational institutions to stay-at-home orders. To do so, we used a Bayesian hierarchical model that links NPI implementation dates to national case and death counts and supported the results with extensive empirical validation. Closing all educational institutions, limiting gatherings to 10 people or less, and closing face-to-face businesses each reduced transmission considerably. The additional effect of stay-at-home orders was comparatively small.’

Read here (Science magazine, Feb 19, 2021) 

Malaysia in Covid-19 crisis? — Musa Mohd Nordin

‘We are plagued with the Double Whammy. MCO + EO. A poorly managed Pandemic in bed with a poorly managed Politics. Pandemic + Politics. It cannot get any more worse! Yesterday Malaysia was in panic mode! Triggered by the humongous Covid-19 numbers Chill out Malaysia! It is NOT REAL TIME case numbers. These are just BACKLOG cases only just being reported

‘Contact Tracing is virtually at a STANDSTILL. An officer at a PKD had 600 contacts to trace and yesterday was slapped with another 700 to trace These are all the manifestations of a failure of the system. There is a breakdown in the FTTIS work flow! How much longer can we tolerate these failings and lackluster performance?

‘It has been SYSTEMS GO in Selangor over and above the efforts of JKNS. They are our buddies in Selangor to rid Covid-19. Please share this widely with your friends in Selangor.

‘STFO is the Operations arm of STFC [Selangor Task Force on Covid-19] led by Public Health Physician, Prof Farhan [Asst Prof Dr Mohammad Farhan bin Rusli (Consultant Public Health Physician, International Islamic Universiti Malaysia)] to bust Covid-19. It aims TO FLATTEN THE CURVE IN THE COMMUNITY WITHIN 4 WEEKS. The MCO + EO has interrupted STFO operations. With JKNS they are resuming with vigor with the blessings of the State Government.

STFO Blueprint of Action

1. ALL +ve or household that is +ve to register under SELangkah (so that state govt can provide home kits
2. ALL high risk and household with HIGH risk persons, to pre register SELangkah: (a) for B40, we provide voucher (FREE testing) to go to nearest Selcare clinic panel (static) or mass screening (mobile); (b) for non-B40, encourage them to do testing (we provide list of participating Selcare panel clinic)
3. Community mass screening (mobile) to HIGH RISK RANK areas (from ACURA) to HIGH RISK individuals OR HOUSEHOLDS with HIGH RISK individuals (from pre-register SELangkah) e.g. (a) Old folks home (b) Hemodialysis centers (c) Nursing homes for the elderly 
4. Mass screening (mobile) to HIGH RISK super spreaders e.g. (a) communities living in crowded spaces (b) families in PPR flats (c) migrants (d) refugees. Data obtained from community leaders, refugee/migrant centric NGOs, UNHCR.
5. State / Selgate to buy RTK-Ag in bulk. To provide at minimal cost to Selcare Clinic panel. Participating Selcare Clinic panel to provide at standard low cost price. At least 2 participating Selcare panel per district.
6. To encourage ADUN to subsidise the cost and liase with respective participating Selcare clinic panels
7. To increase  Health Education Advocacy to do testing and isolate: (a) SYMPTOMATIC individuals with +ve close contacts must ASAP do testing & treatment (if needed) at nearest KKM's facility. Call 999 if severe symptoms (b) ASYMPTOMATIC individuals with +ve close contacts, encourage to do testing at nearest participating Selcare Clinic panel (c) SYMPTOMATIC inviduals with NO +ve close contacts, must do testing at nearest KKM's facility (or participating Selcare clinic - if KKM reject testing)
8. Activate GEOFENCING via SELangkah AND communicate SELamat warning system
9. Home Kits provided by STFO: Face Masks, Hand sanitiser, Information pamphlet,  Foodpack / vouchers -- for B40, unemployed, does day jobs,  SpO2 monitors include training and monitoring (for high risk patients only)

Read here (Malay Mail, Jan 31, 2021)

The worst of Malaysia's Covid-19 measures is yet to come: Sin Chew Daily columnist (Straits Times, Jan 25, 2021)

‘According to the government, this is to prevent a full-fledged impact the lockdown will have on the country's economy. Finance minister Tengku Zafrul has said the first MCO imposed nationwide last year cost the country RM2.4 billion (S$787 million) a day, but only RM600 million a day this time. While allowing key economic sectors to operate as usual could help arrest the daily economic loss, there is nevertheless a hefty public health price to pay...

‘To break the infection chain, we cannot afford to take things for granted. If the government eventually decides to extend the current MCO, it must tighten the SOPs, even to the extent of locking down all economic activities, or we will stand to lose even more if MCO is extended over and again. The situation now is indeed alarming.

‘From infection clusters mostly linked to migrant workers, factories, shopping malls, prisons and detention centres, we now have new clusters emerging in workplaces and even medical centres. All this highlights the fact that the virus has not only penetrated our communities but is fast expanding its reach, and may soon come to you or your family members, colleagues and friends.’

Read here (Straits Times, Jan 25, 2021)

MCO 2.0 wipes off 90% of retail business volume

‘Malaysia’s second round of the Movement Control Order (MCO) has dimmed any hope of recovery for the local retail scene. Bumiputera Retailers Organisation president Datuk Wira Ameer Ali Mydin said retail businesses have dropped about 90% during the first week of MCO 2.0 compared to before it came into force on Jan 13.

“Although shopping complexes are allowed to open, the retail sector is taking a drastic hit. People are not coming out to shop despite strict standard operating procedures (SOPs) in place. Also, the number of Covid-19 cases which has been increasing tremendously day by day has affected consumers’ confidence,” he told The Malaysian Reserve (TMR).’

Read here (Malaysian Reserve, Jan 22, 2021)

Concerned doctors' open letter to Muhyiddin gets a personal response (Full text included)

‘An open letter by a group of 46 doctors has elicited a personal response from Prime Minister Muhyiddin Yassin. The 46 doctors had, in an open letter on Jan 7, expressed worry at the "very bleak" state of the Covid-19 pandemic in the country.

‘Muhyiddin, in his response tonight, noted that several of their proposals have been implemented or are in the process of being rolled out. The prime minister said he will continue to put aside politics and focus on mobilising an all-of-society fight against Covid-19.’

Read here (Malaysiakini, Jan 17, 2021)

Covid-19: Thank you, Agong, for declaring national state of Emergency — Malaysian Medical Association

‘The Malaysian Medical Association (MMA) wishes to thank His Majesty Yang di-Pertuan Agong Al-Sultan Abdullah Ri’ayatuddin Al-Mustafa Billah Shah for declaring a national state of Emergency to bring the Covid-19 situation in the country under control.

‘We also support the government’s decision to implement the second MCO in six states — most affected by the surge in cases of Covid-19, the CMCO in six other states and the RMCO in Perlis and Sarawak. MMA will provide support in any way it can to assist the Health Ministry and the government manage the Covid-19 situation in the country. We urge the public to give their full support by fully adhering to the MCO’s SOPs that will be announced this evening.

‘A second MCO is indeed necessary as cases of Covid-19 have been consistently on the rise with no sign of improvement. There is also spread in the community and the infection rate has not come down from the current RO of between 1.1 and 1.2. There is also concern over the B117 Covid-19 strain known as the UK strain that has been detected in the country...’

Read here (Malay Mail, Jan 12, 2021)

Noor Hisham’s cry for help answered? – P. Gunasegaram

‘Our top Covid-19 fighter needs to be given leeway to do this. After all, before the ill-fated Sabah election, he was doing a great job of containing the virus, earning not only the gratitude and adulation of the whole country, but also gaining international recognition for successfully keeping the disease at bay in Malaysia. We were justifiably proud of him then, but the politicians have spoiled it, as they have done with so many things over so many years.

‘It is rather peculiar that the PM’s special adviser on public health, Tan Sri Dr Jemilah Mahmood, takes a directly opposite stance to Dr Noor Hisham’s on the preparedness of the health service.

‘When asked what the government should be doing, she told BFM radio yesterday: “My advice is that we have to have a very clear game plan. Right? That means I don’t agree that the health system is at a breaking point – it is  easy to throw these words around. If you look at the situation in the UK, Italy, the US and all that, people, the health professionals, the health system, will find ways to cope.”

‘Surely Dr Noor Hisham, as health director-general, knows much more about the preparedness of the service that he oversees than Dr Jemilah, even if she is special adviser to the PM. And does Dr Jemilah want us to go the way of the UK, Italy and the US? Surely not.’

Read here (The Vibes, Jan 9, 2021)

DG: Health system at breaking point, targeted MCO proposed

‘Rather than the “one size fits all” approach of last year’s MCO, Noor Hisham explained that the proposed new strategy involved different rules for different states. Travel restrictions could be imposed on areas with a high number of infections and clusters.

“We are looking at green and yellow states to see how we can protect them, and control cases from rising. This is important. For states that are red zones, more drastic action will be taken. We might implement more targeted (action) in those states by looking at the clusters in the state. We will also tighten border control by barring people from travelling across states and districts based on the latest (case) trends,” he said.

‘Nevertheless, the decision remained the prerogative of the legislators but Noor Hisham said he had faith in the government making the right call. The goal of the upcoming strategy, he added, was to achieve that precious balance between lives and livelihoods.’

Read here (Malaysiakini, Jan 6, 2021)

Movement control orders are not the way to defeat Covid-19: Academy of Professors Malaysia (APM)

Here are their suggestions in seven parts:

1. Red Zones with more than 40 new daily cases should continue to be under EMCO, but the rest of the country should return to RMCO. Perhaps these acronyms could best be replaced with number codes in order to avoid the misconceptions.
2. The continued detection of localised outbreaks (clusters) should continue. However, since the Covid-19 infection survival rate is 99.9 per cent for healthy people under 70, to achieve an optimal balance between health, social wellbeing, and the economy, the emphasis should be on "focused protection" and "targeted approach" for those at risk while allowing the less vulnerable to work and go to school. (a) Young and healthy adults and children above the age of 12 should be allowed to go back to school and work. (b) People with co-morbidities regardless of age and the elderly should stay at home. (c) People who go to work and school should be taught how to clean themselves and how to approach vulnerable family members when they return home. These measures should be taught on media, at the workplace and at school.
3. As advocated earlier, people should be taught and continually reminded about carrying out the responsibility of protecting themselves against Covid-19 by practicing the 3W and 3C as the daily norms. The public should also be educated on the level of risk of getting an infection from activities so as to avoid the activities that are high risk, for example avoiding bars, indoor close contact, meetings and parties, eating in crowded indoor restaurants, etc. Activities outside, with physical distancing, is generally low risk and since we need the sun to produce Vitamin D, exercising outside should be encouraged.
4. That the SOPs need to be well defined, complete and accurate to avoid confusion. For instance, the misunderstanding on the usage of masks during fuelling at petrol stations, and the restriction of travelling together and eating at a table in restaurants, while the group may be from the same household, hence sharing the same living environment and air. Such restrictions may further increase the risk of depression, lethargy, and family discord of being cooped up for too long.
5. That nutritional education on the right food would assist the development of a stronger immune system. Get nutritionists and dieticians on board in the media to tell people what to eat, how to prepare and cook and when to eat is as important as showing people how to exercise in the mornings.
6. The creation of platforms for people with mental health issues to reach out to either at the university, healthcare, organisational or even individual level and if possible make it free so that anyone can get help when needed.
7. That the message of keeping the vulnerable and high risk groups safe should be constantly reaffirmed and resonated to the public via media and to communities. It is important to make sure that people above 70 and anyone who has chronic diseases do not get infected.

Read here (New Straits Times, Nov 14, 2020)

Is this new CMCO really necessary? – P Gunasegaram

‘Is the re-imposition of the conditional movement control order (CMCO) really, really necessary, especially in Kuala Lumpur, Selangor and Putrajaya? This is a fair question considering the government’s mishandling of the Covid-19 outbreak in Sabah for political reasons by allowing unrestricted movement within Sabah and between there and the peninsula during the recent state election.

‘Is the latest decision to re-impose controls in the three areas related to political reasons, specifically to restrict movement during a time when a change in government is possible with Datuk Seri Anwar Ibrahim claiming he has a majority in Parliament? Let’s see...’

Read here (The Vibes, Oct 15, 2020)

With RMCO extended to Dec 31, here’s a (gentle) reminder of what you can and cannot do

‘Bearing in mind the strict standard operating procedures (SOP) enforced by the National Security Council (NSC), here are some of the things we can and cannot do until New Year’s Eve, or when the government announces otherwise.’ 

Read here (Malay Mail, Sept 11, 2020) 

Families on the edge [Malaysia]: Issue 1 -- The immediate impact of the Movement Control Order period

‘In May 2020 UNICEF and UNFPA jointly commissioned the Families on the Edge study to explore the impact of the COVID-19 crisis on women and children in low income urban families in Malaysia. This report is the first in a series of reports under the Families on the Edge project and describes the immediate socio-economic impact of the COVID-19 crisis on a group of 500 families with children in Kuala Lumpur’s low-cost flats, as well as preliminary insights on the relevance, adequacy and accessibility of key COVID-19 mitigation policies and other critical social services for this particularly vulnerable group. Future reports are expected to monitor the extent to which these families recover and offer critical insights for the general public and policymakers as Malaysia aims to ‘build-back-better’

Read here (Unicef Malaysia, August 2020)

Download the 36-page report here (Unicef Malaysia, August 2020)

Malaysians ignoring SOPs at own peril: R0 at 1.36 on July 23

Health director-general Datuk Dr Noor Hisham Abdullah said the infectivity rate, or R0 (R-naught), was at 1.36 in the country. He said this was an increase from the rate of 0.3 after the Movement Control Order (MCO) and Conditional MCO were enforced.

"If our R0 continues to increase, we worry that more people will be infected. Right now, it is at 1.36, but once it goes above 1.6, there is a risk that cases may spike in the near future," he said at a press conference yesterday. Dr Noor Hisham said before the MCO was implemented, the R0 was 3.55, which meant that one person could infect 3.55 people.

Read here (New Straits Times, July 24, 2020)