Is there any need to worry about Covid-19?

If you look at the number of daily cases in Malaysia over the past 2 weeks, you can be forgiven if you think that the number of cases seems to be increasing.

I think the danger of listening to the US news and about what is happening in other countries can sometimes confuse you about what is happening in Malaysia. 

I know that the virus is hard to eliminate.  Just a few days ago, I heard the news that Vietnam had its first case after 100 days of zero cases.  

Should we be worried about what is happening in Malaysia as we seem to be having about 10 to 20 daily cases recently?

I think we should look at the 10 to 20 daily cases in 2 context

• Are the cases increasing at a rate that will lead to another round of MCO?

• Are the 10 to 20 cases deadly to our daily lives?

Another MCO

The MCO was done at a great cost to the economy and while there have been rumblings by the authorities that we can have another shutdown if we don’t follow the SOP, I would be very surprised if we resort to this.

If you look at the chart, there are imported and local transmissions.

We cannot avoid the imported ones if we continue to allow Malaysians to return and/or allow certain foreigners to come to Malaysia.

As long as we have strict quarantine measures to control the incoming traffic, even if there are cases among them, I am confident that it will not spread to the locals.

So we only need to be worried about the local transmission.

I have previously shown that if it is only 10 to 20 cases and the number does not increase exponentially, we are safe from a second wave.

This means there is no reason for the MCO

.

Besides, if you look at the current cases, many are due to clusters and they seem to be mainly in Sarawak.

The clusters are proof that our contact tracing and isolation program is working. As long as the number of cases doesn’t overwhelm this system, we should be ok

  

This is even if the contact tracing is slow such that we are only able to isolate all after they have gone into the second generation.  The number of generations is not the main point. The critical point is to catch all of them.

The second point is that if the majority of the cases are located in a particular district, there is the option of having the MCO only for the particular district.  

There is no reason for a national shutdown.  This is the current Australian practice to control the second wave and I think it is a good one. 

Finally, there seems to be a “new” option based on what Dr. Fauci said recently.  I saw him on TV to say that the US doesn’t need to shut down if people social distance and wear masks.  

In the US, certain areas were reported to have positivity rates of 20%.  This means that the virus is widely spread in the community. 

So if it is possible to control the transmission with such a high positivity rate without a lockdown, there is no reason for another MCO in Malaysia. Our current positivity rate is around 1%.  OK, course we have yet to see whether Dr. Fauci's idea will actually work in the US. 

The conclusion is that the virus in Malaysia is at a rate where we can easily cope with both from the contact tracing and treatment perspectives.

Unless the surge is such that it would overwhelm it, we should not be unduly alarmed by the current numbers. 

Is it deadly?

The other point about our numbers is that we should look at it in comparison with other illnesses in the country. 

As of 27 July 2020, Malaysia had 8,904 Covid-19 cases with 124 deaths.  

While I don’t want to play down the significance of Covid-19, it is useful to look at the comparative incidence of sickness and mortality in the country. 

The table below shows the impact of Covid-19 compared to the other major causes of deaths in Malaysia.  

• There are more people who died in transport accidents in 2018 c/w Covid-19. 

• The current total Covid-19 cases are equivalent to 275 cases per million population. There are more who got TB or Dengue 

You can see that we have "accepted" the risk of other illnesses without having to shut down the economy.   Nobody said we should cut down the number of cars due to the high transport accidents deaths. 

There is an argument for learning to live with Covid-19 like how we have lived with Dengue, TB and HIV. 

Causes	Reference year	Cases per million population	Deaths per million population	Source
Covid-19	2020	275	5	Worldodometer
Cancer	2016/18	1,370           (c)	592	Malaysian National Cancer Registry
Ischaemic heart disease	2018		590           (a)	Statistics Dept
Pneumonia	2018		450            (b)	Statistics Dept
Cerebrovascular disease	2018		300            (b)	Statistics Dept
Transport accidents	2018	17,400         (d)	140           (b)	Statistics Dept
Dengue	2016	3,181		MOH Health at a glance 2018
HIV	2016	107		MOH Health at a glance 2018
Malaria	2016	73		MOH Health at a glance 2018
TB	2016	813		MOH Health at a glance 2018

 Notes

a) 18,627 deaths reported out of 31.53 million population

b) These were derived based on 11.8 % (Pneumonia), 7.8 % (Cerebrovascular) and 3.7 % (accidents) c/w 15.6 % for the Ischaemic heart disease.

c) Globalcan 2018

d) 548,598 road accidents were reported to the Police

Of course, this “not so deadly” comparison was the argument that Fox News made at the start of Covid-19 in the US ie why fuss when we don’t really fuss about the flu.

I think that at that point in time, Covid-19 was still new and there was much that the world did not know about Covid-19.  

Today we know much more.  

If you look at the mortality is Malaysia, it is not as serious as what was thought initially. 

Of course, Covid-19 is more contagious and more deadly than the normal flu.

And you will argue that the comparative number is low for Covid-19 because we had the MCO to control it.  I suspect that without the MCO, it may be many times larger.

Having said, this, now that we have brought it under control, there is also no need to overreact and panic ourselves.

We know social distancing, wearing masks and public hygiene can prevent the spread.

It will not eliminate it. But I think we have to accept that the virus is here and the people's job is to keep the numbers low so that economic activities can resume.

If you look at the table, we have learned to live with Dengue,  cancer, and TB.  

We just need to learn to live with Covid-19  ie have it as part of the low risk in our daily lives.  I think the number of cases will never be as high as traffic accidents.

Technically, President Trump was right to think that the virus is not as serious as what the doctors are saying.  The mistake he made was not to control it to a level where they could live with it.  He allowed it to get to a point where the mortality became large.

- - - - - - - - - - - - - - - - - - - - - - - - - - -

Be fearless to get more to Stay Safe, Share this Blog

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.