New record

We are entering new records for the number of weekly cases both nationally and for the central region.

If you think of exponential growth, then this week's figures are very much higher than last week as you can see from the chart below.

Nationwide

For the central region (KL, Selangor, and Putrajaya), we also have record cases although the increase from the previous week is not so great compared to that for the whole country.

Central region

If history repeats itself, both charts showed that it would take about 2 months to get the current number to below 10% of the current week's number.  This is assuming that the current week is the peak.

What is there to say anymore? 

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Here we go again

We all know that the number of Covid-19 cases we see today is due to people who got infected a week or 2 ago.  In other words, any chart showing the number of cases is a picture of how the people behaved or misbehaved a week or two ago.

The chart below shows the weekly Covid-19 cases since the start of the current wave in Malaysia in Oct of last year.

• You can see the number of cases going up to peak towards the end of Jan 2021. 

• The number of weekly cases started to decline till the end of Mac 2021

As you can see, since then the number of cases has started to climb. We are now into the 3rd week of the continuous uptrend. 

The question then is whether it would start to decline or continue upwards or plateau at the current 15,000 cases per week level?

To forecast what is going to happen for the coming week, you need to ask yourself whether Malaysians behave differently last week compare to 2 weeks ago?  If we had behaved in the same manner, why would the number of cases come done?

I am not confident in predicting a lower number of weekly cases for the coming week. But I think that there is a good chance that the numbers would come done in time for Raya.  Why? Because MCO had been declared in some of those areas with high infections.  We also have action been taken for schools.

The challenging question is why the number of cases for the current wave far exceeded those in the Mac 2020 wave.  The chart below shows the contrast.

You know what was done in Mac 2020.  We had a complete nationwide lockdown.  If nothing else the chart illustrates the effectiveness of a completed lockdown vs what we have been doing for the past few months.

Of course, we could argue that we may have a different strain of virus this round. Some may argue that the political situation is different this time.  The point is that we can see the vast differences in the choices that the country had made.

Ignoring the impact of the vaccine, I would think that it is unlikely for us to get the virus down to double-digit daily infections with the current approach. It was an economic choice and given this choice the only way forward are

• more conscious efforts in social distancing and wearing masks

• getting more vaccinated

• more self-control in not going out 

• no more relaxation of the rules

Slowly coming down

Given the new Covid-19 Fake news law in Malaysia, I will just post the chart and let you make your own judgement about how we are performing

A couple of points to note:

• It is almost one year since we had the first MCO.

• We are still experiencing 4 digits daily cases

• After so long Sabah is having < 50 cases for the week.

You have to figure out whether the Central region and the Others are going to have a sharp decline in the number of cases or whether there is going to be some period of "plateau"

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

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Vaccinate - the current MCO, CMCO, RMCO are not effective.

I have previously divided the country into 3 regions for tracking Covid-19:

• Sabah & Kedah.  These were the states that first had the rise in Covid-19 in Oct 2020

• Central - Selangor, KL, and Putrajaya.  These were the second region to experience the Oct 2020 wave

• Others - the rest of the country

If you look at the trajectory of the virus for these 3 regions you will notice that

• It has come down significantly in Sabah & Kedah

• It appears to be coming down in the Central zone

• But the trend for the cases in the Others is not so clear cut. I hope it is coming down. Given the ban on interstate travel, I suspect that the authorities are not sure that the cases are coming down in the Others region. 

I know that the restrictions in many places in the country have eased.  But with 4 digits daily infections nationwide, there is nothing to shout about.  It is still bad and I think that the authorities are easing the restrictions because of economic pressures.

When you look at the current progress relative to what was achieved in Mac/Apr of 2020, the conclusion is that this time the MCO, CMCO, RMCO, etc are not as effective as previously.  

• In Mac 2020, it took about 3 to 4 months to get down to single digits daily infection nationwide

• We have passed the 4 months since the start of the Oct 2020 wave and we are nowhere near single digits daily cases nationwide.

This is where the vaccination comes in.  

Will there be great benefits for getting all Malaysians vaccinated?

If vaccination does not prevent you from catching Covid-19 but only prevents death or hospitalization when you catch it, is there any need to rush the vaccination in Malaysia? 

I can imagine why the US is having to expedite the vaccination as they have high death rates

• The US has 1,593 deaths per million population

• Malaysia has 35 deaths per million population

OK the US has a higher infection rate with 88,386 cases per million population c/w with Malaysia of 9,317 cases per million population.  We can debate why the US infection is 10 times higher than Malaysia or why the death rate is 46 times higher than Malaysia.  It cannot be the test rates as Malaysia has relatively better testing performance compared to the US.

• US has 8.1 % positivity rates

• Malaysia has 4.8 % positivity rates

This is one mystery for some Ph.D. students to solve. 

From what I can gather, while you can still get infected after vaccination, the viral load is supposed to reduce.  In other words, you become less infectious.  

The advice is that you still have to wear masks and social distance to prevent the spread of the virus, but the lower viral load means a lower risk of spreading it even without the masks or social distancing. 

So for the US where wearing masks and social distancing is a challenge getting all vaccinated will help the spread of the disease apart from reducing the mortality and hospitalization rates.

But for Malaysians where there is supposed to be good compliance for masks and social distancing, I would have argued that the benefits of vaccination may not be so great.

However, the mystery for Malaysia is that we are still having the virus spreading despite the mask-wearing, social distancing, and all the SOP compliance.  I think that because of this mystery, the authorities have figured that vaccination is the way to go. 

Ya. Let us not spend time figuring out why we still have high cases when there is a simpler vaccination route. 

If everyone is vaccinated, there is no need to curb activities because when people get Covid-19, it will be like catching a cold - you fall sick, maybe spread to those you come into contact with, but for most (?) people it will not be a serious illness ie can still go about doing most things.

My view is that we need to rush the vaccination because the current measures have not been effective. If we have to rely on the measures to open up the economy it will take a longer time. So vaccination will speed the opening of the economy.

But I think the priority for vaccination should be different from the US

• yes, get all front liners vaccinated first

• senior citizen should not be the priority since we have lower mortality rates

• rather get the foreign workers and all those with problems on social distancing when at home to be vaccinated first

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Don't be fooled by the numbers

We ended the week with fewer cases than the week before. On 15 Feb it went as low as 2,176 cases for the day. But don't be fooled by the numbers because this is the holiday week.

The number of tests conducted was significantly lower.  For example, on 15 Feb when we had 2,176 cases, the number of tests carried out was about 24,000.  This is half the normal number of tests.

The table below shows the comparisons. 

• The number of Covid-19 cases for the week was 17 % lower compared to that for the week before

• The number of tests carried out for the week was 24 % lower compared to that carried out for the week before

This is the ex-President Trump famous fewer cases if there were fewer tests phenomenon.

Items	Week in 2021		% reduction
	4 to 10 Feb	11 to 17 Feb
No of Covid-19 cases	24,692	20,559	17 %
No of tests	381,500	388,350	24 %

We should wait for the results for the coming week to see whether it has really come down.

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Excluding the backlog, we still have high cases

We ended the week with the national number of cases at about the same level as those 2 weeks ago.

Week             No of Covid-19 cases

21 - 27 Jan                24,735

28 Jan - 3 Feb           32,798

4 - 10 Feb                  24,692

Although the number of cases is about the same as that 2 weeks ago, the current positivity rate is higher than that 2 weeks ago as can be seen from the chart below.  I have marked the one 2 weeks ago in a red oval so that you can see the difference.

Don't be misled by the positivity rates.  The actual number of tests carried out currently is less than that 2 weeks ago. 

Week                 No of Tests

21 - 27 Jan                442 k

28 Jan - 3 Feb           370 k

4 - 10 Feb                  381 k

You can interpret the results in 2 ways

• the current number of cases is not higher than that 2 weeks ago because the number of tests carried out was 14 % lower.  Less test = fewer cases.  This could also be due to delays in reporting the test results so that we could have more "backlog" in the coming week. If true, expect a spike in the coming week.  But I can't think of a reason why the number of tests should be lower. 

• If you assume that there are valid reasons for fewer tests (eg not many reported clusters of infection) then the incidence in the population is getting worst compared to that 2 weeks ago. If true, there will be more cases in the future since the MCO is being relaxed. 

It makes you wonder whether anyone is correlating the data with the SOP being introduced and/or the relaxation of the lockdown.

Central zone

If you look at the Central Region we have the following picture.

We can conclude that there was certainly some backlog last week, but the number of cases for the current week is still higher than that 2 weeks ago.

Conclusion - The number of cases is not coming down yet. The backlog excuse seems weak for the current situation.  For the Central region, the MCO is not really working.

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Is the backlog the real cause for the record week?

Just when you thought that we went past the worst, we are surprised by another record day in the past week. 

The chart below showed how record-breaking the past week was. When you look at it pictorially, you can see the significant increase in cases from the week before.  It is about 1/3 higher. 

.

The authorities have "explained" that the large increase was due to the backlog of cases. This then caused delayed reporting by the private centres that did some of the testings.  

We had the MB of Selangor saying that the private centres would be fined for late reporting. The private centres, in turn, said that they sent the test samples to the govt labs for analysis and any backlog was due to the labs being swamped with the increased testing.

I have previously mentioned that there was a jump in the number of weekly tests (almost doubled) starting from mid-Jan 2021.  So if there was any backlog, it would have started in mid-Jan.  I would have thought that if the labs were been overwhelmed, we would have a rolling backlog from the start of the MCO week (week 15 as per the above chart). So the backlog and late reporting do not sound like a good reason.

If the backlog is the real reason, then in the coming week we should see a drastic drop in the weekly number of cases. In theory, it should be lower than the 24,000 odd cases reported for the week of 21 - 27 Jan 2021.

• If the number of cases is lower than 24,000 for the coming week, it would mean that there was really a backlog

• If the number of cases for the coming week is higher than the 32,000 odd cases, the virus is really running wild

• If the number of cases for the coming week is between 24,000 to 32,000 then either we have a rolling backlog or the MCO is really not effective.

Central region

If you think the national figures were bad, look at the weekly number of cases for the Central region as shown in the chart below. It is almost doubled that the week before.

It makes you hope that it is due to a one-off backlog of cases rather than some other ominous reason.

Let us wait for the coming week.

Positivity rates

Not only did we have a record-breaking number of cases, but we also had a record-breaking weekly positivity rate as can be seen from the chart below. So it is not only more testing leading to more cases, but the % of cases detected for a given test population has gone up. 

The uptrend in the positivity rates suggests that the % of people with the virus currently is higher than all the previous times in the past. I hope that this is an abnormal situation. 

Where is the science?

Listening to the new penalties and more stringent SOP, you would think that it is the general public who is mainly misbehaving and causing the spike in cases.

You would have thought that with all the data, the authorities would be able to pin point the source of the infections.  The only info released is the cluster information.  Reading in between the lines, I would guess that the main source for

 the large increase is the factory and construction sites. 

If so, catching the general public for misbehaving seems like a distraction.

Where is the science?

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Signs that MCO is working

The week of 21 to 27 Jan 2021 was one where Malaysia had the record in terms of daily Covid-19 cases.  This was on 23 Jan when we had 4,275 cases for the day.  But despite this daily record, I think the statistics show that the virus is getting under control. 

If you listen to the comments (including those for some govt officials), you wonder whether people understand the meaning of "lagged" indicators.

Covid-19 has a 10-days incubation period (it was 2 weeks when it first started but now health officials all over the world are saying that it is 10 days with the corresponding 10 days quarantine).

So what we are seeing in the week of 21 to 27 Jan 2021 are those people who got infected sometime from 18 Jan 2021.  

• The current lockdown was implemented on 13 Jan 2021.  

• Thus the infections for the period 21 to 27 Jan 2021 were all after the lockdown.

As you can see from the chart of weekly cases below,  the number of weekly cases the week of 21 to 27 Jan is comparable to those a week before that ie 14 to 20 Jan.  Those cases from week 12 to 20 Jan were from infections before the lockdown.

The statistics show that the number of weekly Covid-19 cases is no longer showing exponential growth.  The "restrictive measures" have prevented the number of cases from going higher.  Now whether it will really bring it down is still not so clear.

If nothing else, at least we got it not to increase. 

Malaysia - No of Weekly Covid-19 cases Nationally

Regional performance

But when you look at the weekly cases by regions as shown in the chart below, you can actually see that the cases for the Central and Sabah/Kedah in the week of 21 to 27 Jan 2021 are lower than those the week before.

On an optimistic note, I would say that the "restrictive measures" are slowing down the spread of the virus.

No of Weekly Covid-19 cases by Regions
Central - KL, Selangor, Putrajaya

But if you compare the national chart with that for Central & Sabah/Kedah, you will see that

• nationwide, the number of cases the current week is the same as that a week ago

• for Central, Sabah/Kedah, the number of cases for the current week is less than that a week ago

The only way the "anomaly" can be reconciled is that the number of cases for the rest of the country is still increasing.

If I was MOH, I will ensure that we do not have inter-state travel

Positivity rates

I mentioned last week that Malaysia had somehow doubled the number of daily tests.  This was sort of confirmed by the govt who said that they are now using the rapid testing kits as well.

The other good news is that the positivity rates also seemed to be coming down.

Weekly Positivity rates

OK, we have doubled the number of tests which means more Covid-19 cases (in terms of numbers) have been detected.  But the detection rate has reduced.  This means that the % of people with the virus is coming down.

Let us hope that this time it is a real trend down and not like what we experienced in end Nov / early Dec when the downtrend was short-lived.

Vaccine

For those of you who have not been following the news, vaccination does not mean that you will not get Covid-19.

What vaccination does is prevent you from falling seriously ill and dying if you are infected.  But you can still get infected and thus spread the virus.

I have come across articles that said that however, the viral load is lower if you are vaccinated ie you can still spread the virus but the lower viral load means being less contagious.

So if we all get vaccinated, it means that nobody is going to die (?) but we can still get infected and be mildly sick (?).  

I am not sure what this means in our daily lives - does it mean that with 100 % vaccination, there will still be some form of mask-wearing and social distancing?

BTW, in the context of vaccination, I think Malaysia should adopt a different strategy than what the western world is doing.  I think the priority after the front liners and politicians (since politicians talk a lot, they must be potential spreaders), the next group should be the foreign workers.  

They stay in cramped quarters and we are pretending that somehow they will be able to social-distance when they go home.  They are the most likely to be infected as well as be the source of new cases.  So we should get them all vaccinated first.

Let's see whether the authorities will recognize this.

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Here we go again

We have just completed the first week of the new MCO in Malaysia and we are having a record number of Covid-19 cases as can be seen from the chart below.  

We should not be surprised by this as these were from people infected a week or two before the start of the MCO.  Expect the number of cases in the coming week to be high as well.

The impact of the MCO will be seen in the first week of Feb. 

Looking at the chart, you can see that the number of cases for Sabah & Kedah is also trending up. I find this the most strange. You would have thought that with them experiencing serious numbers in Oct/Nov, the "controls" in place would have kept the numbers low.

If nothing else, I would conclude that the CMCO are not really effective ways to control the spread.

How long will the MCO last?

The second point I want to make is that the last time, it took about 5 weeks after the MCO before we saw a significant reduction in the number of weekly cases.  This is illustrated in the chart below.

There is nothing to suggest that history won't repeat itself.  In fact, I would argue that the MCO this time is less stringent than the Mac/Apr one.  

Accordingly, do not surprised that the current MCO will have to be extended to at least mid-Feb 2021.  Yes, MCO during the Chinese New Year.

Increased testing

Malaysia is indeed a country of miracles.  In the Mac/Apr phase, there was concern about the number of beds to treat the Covid-19 cases when the highest number of people under treatment reached about 2,500.

On 20 Jan 2021, we had 41,087 under treatment. OK, the govt is not getting the private hospitals to help and people with "mild" symptoms are asked to quarantine at home.

But these should distract the picture that we somehow created additional 30,000 beds.

The other miracle I wanted to point out can be seen in the chart below that shows the number of daily tests carried out.  As you can see, it has almost doubled over the past month. 

I have not seen any news about this new testing capacity. I suspect it could include the rapid testing kits. 

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Is history about to repeat itself?

There is a technique commonly used by traders in the stock market to help them see whether there is a change in the direction of the price movement.

It is called a trendline break.  What it means is that if you see a break in the trendline, the rule is that there is a change in the price movement.

The chart below shows the number of weekly Covid-19 cases for 2 regions in Malaysia where I have drawn some trendlines to show the path of the infection.

• Sabah and Kedah

• Central zone comprising KL, Putrajaya and Selangor

Using the same stock trading technique, you can see from the chart below that there are breaks in the trendlines for both Sabah/Kedah as well as the Central zone. What this means is that the number of weekly cases is expected to go up instead of continuing to come down.

You will notice that the trendline for Sabah/Kedah covered several weeks of declining cases so that a break in the trendline is more ominous than that for the Central zone.  The trendline in the Central zone covered 3 weeks and you could dispute the trendline.

But you cannot dispute the fact that the current weekly level of infection is the highest since the start of the pandemic.

• In Mac 2020, we are seeing about 1,000 odd cases weekly

• In the 7 days from 28 Dec 2020 to Jan 6, 2021, we have 14,953

• This is more than 10 fold larger

And the worst thing is that the positivity rates (number of positive cases as % of the tests carried out) has been rising.

• We are about 8.5% for last week 

• WHO standard is 10%

• There are some states in the USA with 50% 

So what does it all mean? 

• The CMCO, RMCO, and all the other "alphabetic MCO" are not working in terms of getting the virus under control.

• If we continue to do the same, there is no reason for the number of cases to come down.

• Instead of quarantining every sick person, the authorities are allowing the sick to be quarantined at home.  This will just help the transmission as I don't expect Malaysians to be very disciplined. 

We have hit the capacity of the medical services. If the current medical capacity cannot be quickly expanded, the other option is to have more drastic measures to "flatten the curve".

It is a no brainer to expect more stringent measures if the authorities are serious about controlling the pandemic. 

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

Another 2 months of CMCO?

We have passed week 8 of the CMCO and can see the first sign of the decline in the number of weekly cases - refer to Chart 1.

We all know that the CMCO is not going to be as effective as the MCO.

For those who have forgotten, it took week 5 of the MCO to see the first sign of weekly decline.

Mathematically you can say that the CMCO is taking 60 % longer to bring the number of cases down

Chart 1

Positivity rates

The other good news is that after so many weeks, we are beginning to see a drop in the test positivity rates as can be seen in Chart 2.

The current weekly rate of 6.3% is close to the Mac 6.7% but at least is it coming down. 

I hope that this is the start of a downtrend and not some temporary decline like that for the week of 29 Oct - 4 Nov. 

Chart 2

The positivity rate together with a decline in the number of weekly cases is supposed to be a leading indicator.  So we are likely to see a weekly decline from now onwards

Keep our fingers crossed.

Regional Performace

If you breakdown the number of weekly cases by regions as shown in Chart 3 below, you can see that for Sabah & Kedah, the decline from the peak has been slow.  

At the projected rate as shown by the blue trend line,  it will probably take another month for the number of weekly cases in Sabah & Kedah to get below 500 cases per week.

Chart 3

If you follow the same trendline for the Other region, it would another 2 to 3 months before the Other regions reach a stage of fewer than 500 cases per week.

If correct we will have the CMCO ending only around Chinese New Year 2021. Is this too long?

The point is that for the Peninsular part of the country, we seemed to have new hot spots.  For example, Johore is coming up as the next area to be hit.

And for the central region of Selangor, KL, and Putrajaya, the 7 days moving average as can be seen from Chart 4 below has yet to show any real decline.

Chart 4

Conclusion

If you believe that numbers don't lie, then you would conclude as follows

• For the central region, I expect the CMCO to be extended for at least another month 

• For the whole country, expect to see more than 500 cases per week for another 2 months.

Note that during the Mac wave, we went from MCO to CMCO 8 weeks after the MCO was implemented.

If we accept that the current CMCO is taking 60% longer to bring the virus under control, then we would expect the virus to be under control after 13 weeks from the CMCO period ie around mid-Jan. 

OK, the above is a simplistic analysis but I have yet to see anyone providing a statistical or another mathematical model to predict how long the CMCO will last.

I am sure it will not end on 9 Dec for Selangor and KL

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.

We have dumb luck

This post is about how lucky we are to be staying in Malaysia during the Covid-19 pandemic because of the following:

• While the CMCO has not been as effective as the MCO in controlling the virus, it has managed to bring the number of cases in Sabah to a plateau.  Better than going up!

• While the number of cases for the rest of the country are still increasing, at least most of the economy is still able to function. It would have been sad to have a total lockdown with the cases still increasing. 

• Although the positivity rates are rising, it has yet to hit the Mac 2020 high.  So the spread within the community is not so bad comparatively. 

• During the Oct period while the number of cases were increasing, we had the ability to “create” beds to ensure that this does not become a medical capacity bottleneck.  We apparently did not have this ability during the Mac spike. 

• Despite the large number of sick patients, those that needed ventilation is very low.  So we can cope with even larger number of sick patients. 

If the whole purpose of the CMCO is to enable the economy to function as much as possible while keeping a lid on the spread of the virus, we have achieve this aim.

Whether the goal is to bring the virus down to single digits (excluding imports) is something interesting to watch as there is no evidence yet that this is working. 

I present my analysis below to support the above views.

Number of cases not really coming down

In my previous post, I compared the current weekly number of Covid-19 cases with those in Mac/April 2020.

An update of the comparison is shown below.

 

If it obvious that in terms of the time taken to bring the virus under control from the start of lockdown, the CMCO has not been as effective as the MCO.

• We are into week 5 of the current CMCO and the number of weekly cases is still increasing

• In Mac/Apr MCO lockdown, by the respective week 5, the virus had definitely been brought under control

But if you look at the performance of specific regions, you can see that 

• It does not appear to be increasing in Sabah/Kedah.  But looking at the chart, I would not conclude yet that it is trending down. It appears to be at a plateau.  

• It is growing in other areas

If you look at the chart for the Central region as per below, you would agree that there is no sign of any downtrend yet.

I don't think anyone should be surprised that the number of cases is still not coming down.  After all, the CMCO was originally a relaxation from the MCO.

We may have to learn to live with the virus while having the CMCO till the end of the year.  My view is because the positivity rates are still increasing. 

Positivity rates still increasing

The positivity rate is computed by dividing the number of Covid-19 cases detected by the number of tests carried out for the same period.

As can be seen from the positivity chart, the positivity rate has been trending upwards since the end of Sep 2020.

I would interpret this to mean that the number of cases within the general public is still increasing.  The "good news" is that

• It is lower than the 6.7% we had in the second half of Mac this year

• It is much lower than the 20% in some states in the US

• It is still below the WHO standard of 10%

MOH has been reporting that the R0 is coming down, but I have yet to hear any news about bringing the positivity rates down.

Mathematically, I would have thought that you could not have R0 coming down without the positivity rate trending in the same direction.

But then I am not an epidemiologist.  Sadly no one is mentioning this.

Maybe it is not important

Sabah bed magic

The objective of any lockdown is to flatten to curve so as not to stress the medical capacity.  One of my concern at the onset of this round of infection was the number of beds available. 

It seems that my worry is unfounded as we now have this "magic formula" that was not apparent during the Mac wave. 

There are 8,600 people under treatment currently in Sabah.  I am surprised that we have been able to cope because on 7 Oct when the CMCO was coming into effect, MOH had reported that there were 2,600 Covid beds with about 46% utilization.  

We now have about 8 times more patients than previously and there has not been any news about bed shortage.  Hats off to those that created the additional 6,000 odd beds.  Where did these come from? 

• On 13 Oct MOH reported that in Sabah there were 1081 beds at the 9 hospitals with 71 % utilized.  There are another 4,161 beds at 19 low risk quarantine and treatment centres. 

• Code Blue reported on 23 Oct that “Sabah has even broken away from federal MOH protocol on admitting confirmed coronavirus cases into a hospital, or quarantine and treatment centres for low-risk patients, as the state began allowing early-stage Covid-19 patients to be treated at home."

• On 28 Oct, the Sabah Local Govt and Housing Minister had told the press that the state had 7,273 beds for Covid-19 patients across 9 hospitals and 35 quarantine centres.  Source: Code Blue

• On 2 Nov, MOH reported that in total for Sabah there are 8,539 beds, which includes 1,111 at the nine hospitals and 7,428 at the low-risk centres.

Reading in between the lines from the above  reports, I would think that the additional beds are non-hospital ones. 

I guess these could be like those “temp” centres created in China or New York at their peak to cope with the number of patients.

So what does this all mean?

With the ability to "create" beds at low risk treatment centres, we will not run out of beds in the country.

So the challenge is PPE, ICU beds and ventilators should the number of cases in the rest of the country spike. 

Ventilator mystery

Secondly with respect to ventilators, we are lucky as the current usage has been very low.

Nationwide, during the month of Oct, the highest number of patient requiring ventilation was less than 40 when the number of patients ranged from 10,000 to 11,000.

I am not a doctor but the comparative numbers for Mac/April seems strange.  At that juncture we had about 50 to 60 ventilators in use when the number of people in treatment ranged from 2,000 to 3,000.

So do we have a different strain of virus, or are the people being infected today more healthy? 

The moral of the story? We only need to worry about staff and may be PPE when it comes to medical capacity.

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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia

Disclaimer:  I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis.  The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.