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Sunday, April 12, 2020

We can flatten the curve in mid-May, says expert

Public health workers on an empty street in Kuala Lumpur on Saturday night. A shutdown of public activities has slowed the spread of Covid-19, according to a UM expert.
PETALING JAYA: Malaysia’s efforts to “flatten the curve” of Covid-19 cases may see results in the middle of May, if the government and the people continue enforcing the safety measures in place, says a public health specialist.
Dr Rafdzah Ahmad Zaki, of Universiti Malaya, said the number of new cases may drop at the end of April, before the curve flattens in May.
“At the moment, the number of new cases seems to be at a constant level – over 100 cases every day – it is still high,” she said, adding that it might be the result of poor public compliance with stay-home orders in early March.
She said the estimate about flattening the curve was based on the current situation and on certain assumptions behind the models used to predict the statistics.
Associate Prof Dr Rafdzah Ahmad Zaki, who lectures in epidemiology at Universiti Malaya.
“Flattening the curve” describes the process of controlling the spread of Covid-19 so that the number of cases is spread out and does not suddenly spike, resulting in public health facilities, hospitals and emergency wards being overwhelmed.
Rafdzah said Malaysia’s national shutdown of public activities under the movement control order, and total lockdowns in high-risk areas, had managed to slow down the rate of transmission of Covid-19.
“When we slow down the rate of transmission, as expected, the time taken to get zero cases will be longer,” she said.
Malaysia’s pattern of Covid-19 infections differed from other countries such as China, which suffered a faster spread of the disease.
However, there could be a resurgence in new cases of infection if control measures were lifted and the people did not continue to take protective measures, said Rafdzah, who is an associate professor and lecturer in epidemiology at the Department of Social and Preventive Medicine.
Comparing Malaysia to other countries
Rafdzah said the distribution of the new cases in Malaysia was not the same as in China and South Korea.
Daily new cases in China (worldometers.info pic)
China saw a peak in mid-February before the numbers levelled out and dropped in March. South Korea similarly saw a peak of new cases in early March with the number dropping and the curve flattening by mid-March.
Daily new cases in South Korea. (worldometers.info pic)
Malaysia experienced a rise in cases in March, followed by a big increase in mid-March. There was a sudden spike on March 15 at 190 new cases, compared to 35 new cases on March 14. Most of the cases were linked to a tabligh convention held at the Sri Petaling mosque in early March.
“Singapore and Japan seem to flatten their epidemiological curve much lower than Malaysia’s. Although their cases were progressing at much lower rates, their trends are still going up.”
However, it was difficult to make direct comparisons with other countries because of different population densities, healthcare systems, resources and cultures, Rafdzah said.
What has Malaysia done right so far?
Malaysia’s swift implementation of the movement control order had managed to slow down the spread of the disease.
“The ‘doubling rate’ (the increase of new cases nearly doubling in a day) was not as rapid as in China or Italy,” she said.
“The timely decision in implementing the MCO and identifying red zone areas has helped to flatten the curve.
“Extensive contact tracing and isolation also reduced the transmission within the community, preventing the situation from become worse as in Italy and Spain.”
She said the health ministry had been wise to give priority to testing suspected cases and the contacts of clusters, because of the limited resources.
“Although there is pressure to implement mass screening in the community, the ministry did not rush in making their decision,” she said.
The capacity of laboratories to handle test samples must also be considered. “With the current screening criteria, we still have a lag of four to five days in obtaining the result.”
Rafdzah said Malaysia had done well in preparing public hospitals to cope with any surge of severely-ill patients who might require isolation, oxygen, and mechanical ventilation. -FMT

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