JUNE 20 — Malaysia has been fighting the Covid-19 pandemic for over a year. The frontliners (both healthcare and non healthcare) are worn out and drained, both mentally and physically.
The Prime Minister has recently drawn up a National Recovery Plan for the country with three parameters: case numbers, ICU usage and percentage of rakyat vaccinated.
There have been many calls to officially publish and use the positivity rates of Covid-19 cases – number of cases/number of tests x 100%. Why is this important?
Here is a graph of the 7 day moving average of positive cases and the positivity rates. Number of tests were calculated from the CPRC telegram channel by looking at the difference in total tests between days. Ideally we would want to see a reduction in absolute number of cases AND positivity rates. Both numbers should not be considered in isolation as it can give us a false sense of security, eg. Post FMCO – case numbers are coming down but the positivity rate is fairly static. This means that the reduction in case numbers could be due to reduction in the number of tests and not that the pandemic is under better control.
Here are my suggestions:
1. Positivity rates AND absolute case numbers should be taken into account when gauging the progress of our nation in the fight against the pandemic. The WHO recommendation is a positivity rate of less than 5% before opening borders/relaxing restrictions. A quick look at https://coronavirus.jhu.edu/testing/international-comparison will show you that nations doing pretty well against Covid-19 have uniformly low positivity rates.
Besides the positivity rates there are also many other complex parameters suggested by the Malaysian Health Coalition (https://www.malaysiakini.com/letters/579607) which must also be taken into consideration.
2. The rise of BOTH absolute case numbers AND positivity rate during Ramadhan leading up to Raya was a warning sign to us. Yet bazaars during the fasting month were still allowed to operate; students who were allowed to travel home for Raya ended up causing clusters and even infecting the bus drivers that were appointed to send them home.
There must be no exceptions to SOPs that are enforced; even frontliners were NOT allowed to cross borders to return home – relaxing the rules for students has just caused more harm than good.
We must learn from our past mistakes. It is better to stop a gathering than to allow it with “strict SOPs” and expect adherence. All it takes is for a single person with Covid-19 to break the SOP to cause another outbreak.
3. We need to EDUCATE the rakyat! Positivity rates should also be emphasized to the rakyat for them to realise that case numbers are not the only thing they look at – many feel relaxed by a reduction in case numbers; increasing mass movement of people and thus the risk of the spread of the virus. Let’s not risk misleading the public by overemphasis on absolute case numbers. We must win this together.
*Dr Timothy Cheng is an orthopaedic surgeon who has recently completed his training. He can be reached at [email protected] and welcomes corrections to his writings and analyses.
**This is the personal opinion of the writer and does not necessarily represent the views of Malay Mail.
