RAYA OR NOT, MUHYIDDIN & CO SHOULD NOT PLAY WITH FIRE: FURTHER EXTENSION OF MCO INEVITABLE – ONLY THE UNWISE & POLITICALLY DESPERATE WOULD FIND REASONS TO LIFT LOCKDOWN, SOCIAL & ECONOMIC HARDSHIP OR NOT

As at the time of writing, the Movement Control Order (“MCO”) is expected to be in place until 14th April 2020. The Health Director General, however, has not ruled out the possibility of a further extension of the MCO. It is all dependent on whether Malaysia succeeds in flattening the curve and preventing any exponential spikes, thus breaking the chain of infections.

It cannot be denied that COVID-19 is highly contagious. The virus has an estimated R naught of somewhere between 2.0 and 2.6, with the average being 2.2. This means that for every 1 infected person, COVID-19 could spread to 2.0 to 2.6 other people. 

Early figures have shown that the MCO is successful in flattening the curve. However, the World Health Organisation has also stated that it expects the number of COVID-19 cases in Malaysia to peak in mid-April. 

Apart from the expected peak in cases, a persuasive reason for extension in and of itself, the following are some reasons why a further extension of the MCO is inevitable. 

There are untested infected individuals

With regard to the tabligh cluster, the Health Director General stated on 27th March 2020 that 13,762 individuals were screened with 9,327 samples taken to be tested. 1,117 of the samples tested positive, 5,646 tested negative, while 2,564 were still pending results.

As at 28th March 2020, 5,084 individuals connected to the tabligh cluster (including attendees, their family members, and other close contacts) had yet to be tested. 

1,117 out of the 6,763 individuals whose results are available were found to be infected with COVID-19 (16.50%). Assuming 16.50% of the remaining 7,648 individuals (2,564 awaiting results and 5,084 untested) from the tabligh cluster are infected with the virus, this would mean an addition of approximately 1,262 COVID-19 cases. 

Not forgetting individuals who may have contracted COVID-19 from inter alia having travelled overseas. 

Some of these untested infected individuals may be asymptomatic. Others may only have mild symptoms and are able to manage their illnesses at home. However, during that time, these untested infected individuals will certainly be in contact with their family members who may then be out and about during the MCO period thereby further spreading the virus. 

There are false negative infected individuals

Individuals who have tested negative for COVID-19 could also subsequently test positive. This has reportedly occurred in Japan and Australia. 

Carolyn Y. Johnson, a science reporter at The Washington Post notes: 

“There are a number of reasons a test might be negative when a person is sick with the coronavirus. It might be too early in the illness, when the amount of virus in the airway is still small. It could be a problem with how the swab was done. Different types of swab collection — the back of the nose, the throat, the outer nose — may also have different levels of accuracy, an issue doctors are actively debating given limited evidence. Then, there could be issues with the handling or transport of the swab. There could be laboratory error.”

There are MCO-period infected individuals

It is reasonable to assume that there will be individuals who contract COVID-19 during the MCO as people are inter alia still allowed to leave their homes to purchase, supply or deliver food or daily necessities. Some of those individuals may be asymptomatic and are unknowingly spreading COVID-19 to those around them. 

A number of researches have shown that the percentage of asymptomatic COVID-19 cases is not negligible. According to a study which looked into 575 Japanese nationals that were evacuated from Wuhan, China: 

“Using a binomial distribution, the asymptomatic ratio is thus estimated at 30.8% (95% confidence interval (CI): 7.7%, 53.8%) among evacuees.” (emphasis added)

Conclusion

In view of all the above, if the MCO were to be lifted on 14th April 2020 and Malaysians return to their routines pre-MCO, this could be the start of the next wave of COVID-19 cases which will undo the hard work and results achieved in the four weeks of the MCO. The entire healthcare system could be overwhelmed as seen in Italy and Spain.

In light of COVID-19’s incubation period, the MCO should only be lifted when there have been x consecutive days of no new infections. On 24th March 2020, the Chinese Government announced that the lockdown in Wuhan will officially be lifted on 8th April 2020. This comes after Wuhan reported no new cases of COVID-19 through domestic transmission from 18th March to 22nd March. Even then, experts have warned that zero reported cases does not equate to zero risks. 

Therefore, economic impact notwithstanding, it is inevitable that the MCO has to be further extended until COVID-19 is truly under control. 

WRITER: Joshua Wu Kai-Ming