The Devil and the Deep Blue Sea - choosing how to control Covid 19 among the foreign workers

MOH has said that the govt will set up an inter-dept group to address the increasing number of cases among the foreign workers.  Considering that we had several about turns by the govt during the course of tackling the virus, I am concerned about whether the various govt depts see the issues. 

So let me give my 2 cents worth based on what has happened in Singapore.

In Singapore, they have identified that the foreign workers at risk are those staying in the dorm, numbering about 300,000 of them.   As of 4 June there are about 34,000 odd cases from these foreign workers.  

 

Chart for the number of daily infected dorm residents in Singapore.  The grey shaded area is the lockdown period. Note that for the current week, there are about 500 cases daily

Singapore strategy for this group appears to be to contain them in the sense that all those in the dorm at not suppose to work and/or move in and out of the dorm -  this was from 21 April to 1 June ie about 6 weeks.

The first thing that stood out is that during this period, these 300,000 could not go to work.  It was Ok in Singapore as the country was on lockdown.

But in Malaysia, most of the sectors in which many of the foreign workers are employed have already started work.  I hope our authorities recognize this constraint. 

Secondly, despite this containment measure, the number of daily infections among the foreign workers (ie those in the dorm) continued "steadily" over the 6 weeks period in Singapore as can be seen from the chart.   This meant one of two things

• They were already infected when the "stay in place" order was effected

• But then considering that they continue to have daily number of infections for more than 2 weeks since the "stay in place" order, it must mean that the virus has been spreading within the community

So while restricting the movements prevented the foreign workers from spreading it to the locals, it did not seem to prevent it from spreading it among themselves. 

Now come to Malaysia. 

The foreign workers stay together.  I am not sure whether we have places where there are exclusively foreign workers, but looking at the news for the various EMCO areas, it looks as if there are also locals staying within the residential areas.

So what are our constraints?

• In the first place, we cannot restrict the movements for all the foreign workers as the economy needs them.  

• Secondly, we don't have enough facilities where we can re-locate the 2 to 4 million workers so that they are separated from the locals accommodation-wise.  

• And l think any talk about providing ample living space is not an immediate thing that can be done. 

So we are stuck with them living close together and being able to move in and out.

We also have to look at how we are going to detect the cases.

a) do we have a testing programme to cover all the foreign workers?  This comes back to our lack of testing capacity.  Assuming we can only do 10,000 tests a day, (ie use up all our effective capacity) it will take 200 to 400 days (assuming 2 to 4 million of them) to complete one cycle.  This is not practical.

b) Do we then react ie whenever there is a case involving foreign workers we then do one of 2 things

• Option 1 - Follow the current protocol ie contact tracing, hospitalize the sick, and quarantine the rest of the contacts. We do this for the locals.  But when it comes to the foreign workers, the sheer numbers would overwhelm any quarantine facilities we have.  

Can you imagine what would happen with a ratio of 1 infection to 30 contacts?  (a number based on our history) 

If we have 40 cases daily, (based on the past 3 weeks average cases among the foreign workers) we will need accommodation for 1,200 contacts.  Over a 14 days quarantine period we will need 16,800 beds.   OK, I am over simplying the numbers to prove my point.  

The point is that we may not have the quarantine capacity if there is a serious outbreak among the foreign workers. Remember we have 2 – 4 million foreign workers which is very different from the 300,000 odd in Singapore. 

 

• Option 2 -  to EMCO the residential areas where the infected stay.  With this, we will still face the continued cases within the EMCO areas like what happened in Singapore but we prevent the spread to the rest of the public.  We don't have to worry about creating special quarantine facilities.  

And this can be applied throughout the country immediately.  

The reality is that any EMCO will affect the locals staying there and other foregine workers working elsewhere.  This mean that other company’s operation (involving the foreign workers) will also be affected. 

It looks as if there are no good choices. There are costs implications, impact on opening the economy, and timing issues. 

It is between the devil and the deep blue sea

I think we will have to continue with our "reactive" testing protocol and secondly, the Option 2 containment idea is better than the current practice of contact tracing and isolating only those with COVID 19. 

Does anyone have a better idea?

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

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. 

We have a Covid 19 pattern that researchers have earlier forecasted

We had 277 new cases yesterday with 270 cases from the detention centre.  OK, the majority are not only foreigners but are also in a "confined area". 

For you and me, the risk comes from community spread ie those sick walking about freely.  It does not come from those in the "confined area" since we don't have any business to go there.

So DON’T PANIC

In the history of COVID 19 in Malaysia, there are two types of "confined area"

• those established during the infection period eg quarantine centre, EMCO area

• those that were established a long time ago to restrict the movements of certain groups of people eg jail, detention centre

So when the infection spread within a "confined area", the majority of the cases will, of course,  be members of the "confined community".  Members in this context refer not only to those confined by the authorities but also to the staff working there and possibly the visitors.

I think we should give our thumbs up to MOH for having a track record of not letting the number of cases within the "confined area" spread to you and me.

This is not to say that it cannot spread out from the "confined area" since the staff and visitors are able to move out of the "confined area".  But there would be SOP and other measures to minimize this.

So don't' worry about the 277 cases spike. Afterall I had in my posts of the past few days prepared you for the spike. 

Go and look up my 9 May and 1 June posts.

We had expected this given: 

• The propensity for cases to spread within the old clusters. Ha! Reflects slow contact tracing

• The number of people still waiting for the test results eg prison.  Not MOH fault since this is a feature of the PCR test.  We could use the Rapid Test Kit but somehow this is reserved for some yet-to-be-announced purpose.  MOH did previously said it was to be sent to Sabah and Sarawak since their PCR test had to be sent to the labs in Peninsular.  But now that these states have their own lab, this transportation constraint is no longer there. 

• The “spontaneous” new cases.  OK, I am being facetious, but it is intended to show that there is much that we still don't know about how the virus is transmitted.  

- - - - - - - - - - - - - 

I came across an article by the  Business Insider.com (refer to Note 1) some time back about the future of the virus.  At that time, I did not give it too much attention as it was American-centric, but given the new pattern of cases in Malaysia, I thought it might be relevant now.

According to the article, researches in the US forecast that the pandemic will last 18 to 24 months with 3 scenarios which Business Insider illustrated as follows:

Peak and Valley – the current wave will recede and then to come back with the same magnitude over the next 1 to 2 years. 

Fall peak – The current peak will recede over summer (remember that this is the US) and then come back with a more severe peak.  This is like the Spanish Flu of 1918 – 1919.  

Slow burn – after the current peak, there will be smaller waves.  

BTW, the pictures are illustrative and it does not mean that there are different numbers of cases in each of the current peaks under the 3 scenarios.

While we may argue about how high our peak is c/w the US, I think the 3 scenarios are also applicable to us. 

I want you to now take a look at the pattern of the number of daily new cases in Malaysia as below where I have also superimposed the 7-days moving average line.  

The 7-days moving average line smoothed out much of the daily noise, so you can see that we have a major peak followed by a few smaller ones.  BTW the 7-days moving ave will not have captured the full impact of yesterday 277 cases or else we will see a higher peak for the 1st week of June period. 

You get to choose the wave pattern for Malaysia in comparison with the 3 scenarios

We can draw the following conclusion about the virus pattern in the country

• It is not going to zero any time soon
• There are repeated "up and down" 
• There are black swan daily numbers - yesterday was the highest we ever got

Sad to say, what the US researchers said are already coming true in Malaysia now. No need to wait till after "summer". 

What do I think is the appropriate scenario?

WE ARE IN THE SLOW BURN TERRITORY

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

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

Note
Business Insider actually summarized an article that appeared in the Stat News. You can follow the article yourself if you want to. 

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 change the Covid 19 goal post by talking of only the local cases

We had 93 cases yesterday so that we ended Wk 11 of the MCO with 351 cases for the week.

So what if this is lower than the 610 cases for the week before.

We were given the impression that the 610 cases were due to the one-off detention cluster and we should see lower numbers very soon.

False hope.

If you look at the chart showing the number of weekly cases you can see that the 310 cases are actually higher than the number of cases for Week 9 (14 – 20 May) and the same number as for Week 8 (7 – 13 May). See the part circled in red in the chart. 

I first started my analysis of the COVID 19 cases in Malaysia sometime in March as I wanted to get a sense of what was happening to the virus trajectory.

So I actually started with some standard Excel curve fitting programme to try to plot the path of the virus based on the daily data reported by MOH.

It was the early days of COVID 19 in the country so there was not much data – those available were mainly the daily number of cases. In those days, MOH had yet to report cluster-info.

Then as time went by, with more data I “improved” my curve fitting model. I even used weekly cases (so that we have less “noise”). As you can see a bell shape pattern appeared over time as shown by the blue line in the chart. 

If I was still in school, I would have gotten an A for the curve fitting model. 

But then came May, when the number of weekly cases sort of yo-yo. Refer to the part circled in red. 

So now the model for the virus trajectory doesn't reflect what is happening anymore. 

I have sort of resigned to the idea that we will see a long term up and down pattern that I initially talked about in a tongue-in-cheek manner in my Mon 1 June posting. Now it looks like it will be a reality as

• Firstly we will continue to have ‘spontaneous new clusters” that I mentioned yesterday

• Secondly, we will have next-generation cases from the old cluster – we have now the Pedas and the Detention clusters as proof

• As we further relax the CMCO, there will be more cases not only among the foreign workers but also among Malaysians.

Quite depressing. 

Do you realize that with 7,970 cases we are almost on par with Morocco with 7,910 cases?
But when you look at the pattern of daily cases in both countries, you can see that the Morocco virus pattern looks more like a Bell curve. Malaysia looks as if there is a 2nd wave.



Of course, each country is unique but I will say that for someone who has been looking at the curves for some time, I am not convinced that it will go down to 10 cases (on an overall basis) any time soon.

I think MOH is trying to change the goal post by talking about the number of cases among Malaysians is getting close to zero.

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

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. 

Prisons - source of a coming spike in Covid 19 cases?

Designed by Freepik

I think we are going to see a new cluster from another “closed off area” soon. This time it will be from the prisons. MOH is conducting tests on all 700 staff and 800 inmates at the Sungai Buluh Prison after a prisoner was confirmed positive there.

You and I know that the one positive case must have gotten infected a week or two ago.  So he would have time to infect others in the prison compound. Ya, the cluster is forming. 

How prevalent is this infection among prisoners?

• Singapore had 4 cases in April and May all unlinked. This is fantastic considering that Singapore had more than 32,000 foreign workers living in dorms affected

• I saw an article saying that 80% of inmates in US prisons tested positive. But then there are many cases among the general public in the US so this could be reflective of what is happening to the population

• The prisons in England and Wales were reported to have nearly 1,000 cases in mid-May. But then the UK also had lots of cases among the general public

So we cannot just say that all prisons will have cases. 

I think Malaysia's situation is due to what I call  “spontaneous” COVID 19 cases – I said this is cos in those places where no one expects it, we suddenly get cases.

• A good example is the detention cluster where I think MOH is still trying to figure out how the infection started,

• Yesterday we had the Cheras apartment cases

• We have the same issue with the prisons. On 12 May, the Prison Dept had said that there were no reported cases among the 72,000 inmates in all its prisons. They had put in stringent measures to ensure that it is Covid 19 free. Yet a new case sprouted up.

Of course our Defense Minister said that there is no need to test all the prisons as the infection was only in Sungai Buloh.  He is merely looking at it from the angle that the cases in Sungai Buloh prison could not spread to other prisons.  He does not believe in this “spontaneous” theory.  

Well, for the detention cluster, it started with Bukit Jalil centre.  Then about a week later, we also had cases in 2 other detention centres.

Ya! "Spontaneous" appearance of new cases. 

You all may laugh but my point is that we have been in MCO for so long that all those who were infected (irrespective of whether they were hospitalized) would have recovered.  So in theory with the MCO there should not be any more infected people

Yet we have cases all over the country.  So until we have an explanation, there will be new cases “spontaneously" sprouting in the country.  Our experience over the past few weeks is that it can even happen in green zones.

This will put an end to any speculation that we have brought the virus under control.

I see that MOH is making the argument that the number of cases among Malaysians is low and all the ones reported recently were either due to returnees or to foreign workers.

I think we should not get complacent about this low Malaysian count.  The country is no better off if that while we have zero Malaysian cases every day, there are foreign workers cases.

If there is doubt just look across the causeway where the case count among the locals in Singapore is very low.  The majority are from the foreign workers who have even been “contained in their dorms”

Yet Singapore is still having its lockdown – ok they started P1 opening. 

My point is we should be looking at total cases and not be happy cos the ones among the locals are low.  Apart from the risk of infecting the locals, how can we have the economy running if one part of the workforce is sick? 

Secondly, there are also treatment costs. 

So two important takeaways

• It is the total cases that really matter. Do not be misled by the low numbers among the locals

• As long as we don’t understand this “spontaneous” of cases, we cannot lift the CMCO

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

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. 

Malaysia foreign workers Covid 19 cases is 1/17 of Singapore. Yet Malaysians are more at risk of infection by them

Singapore is opening its “Circuit Breaker” today and 75 % of the economy is expected to open. What may look strange is that it is doing so when currently it has about 500 daily new cases which are only about half of what it had at the height of the infection in mid-April.

In contrast, Malaysia with about 7,800 cases to date and about an average of 50 daily new cases is still cautious about ending the MCO.


Remember Malaysia went into MCO when we had about 100 daily new cases (when CMCO was announced it was about 60 odd cases).

Both countries have an issue with infection among the foreign worker

About 93 % of the cases in Singapore are migrant workers and I suspect this ratio is “steady” for the daily cases
In the case of Malaysia, although on an overall basis the foreign workers account for about ¼ of all the COVID cases, MOH has said that recently about 80% of the cases are foreigners.

For those who have forgotten, I had earlier said that the main difference between Singapore and Malaysia was that we got the first spike in the foreign workers during our MCO and hence were able to contain it better. But Singapore went into lockdown after the first spike from the foreign workers.

The impact is vastly different as can be seen from the table.

	Singapore			Malaysia
	Cases	Population	Prevalence	Cases	Population	Prevalence
Foreigners	32,104	0.3 m	9.94 %	1,948 (b)	2 – 4 m	0.06 % (d)
Locals	1,682  (a)	5.4 m	0.03 %	5,342	32 m	0.02 %
Imported	580			472 (c)
Total	34,366			7,762

COVID profile as at 30 May 2020

a) include work permit and non-dorm foreign workers eg maids. Link cases ie cluster = 1077

b) 35,028 nationwide screened

c) 45,383 quarantined with 35,615 completed quarantine

d) Based on the midpoint of 3 m



Singapore has about 17 times foreign workers cases c/w Malaysia – you would think that the locals in Singapore are 17 times riskier than Malaysians when talking about getting infected by a foreign worker

But you cannot look at statistics like that.

If fact Malaysian are more at risk

We should not look at sheer numbers when it comes to the likelihood of infection. The source is important

In Singapore, the infections (or at least the past few weeks) are from migrant workers who are quarantined or kept apart from the general public. So sad to say, the infection is within this “contained crowd”

Most Singapore foreign workers cases come from those staying in dormitories and on 21 April the Singapore govt had told all those staying there to stop work and not move in or out of the dorm until 4 May. This was later extended to 1 June.

So the Singapore foreign workers case is like our case of the foreign workers in our detention centres – ie they get sick among themselves. OK I know this is badly put but this is the reality

So with all the potential cases isolated, the locals in Singapore have a very low risk of getting infected by foreign workers.

But this is not the case in Malaysia with the CMCO, where the foreign workers can go anywhere. 

Secondly, our foreign workers' cases come from all over the place

• Maran 
• Pedas 
• Cheras 
• Setia Alam. 

Thirdly for Malaysia, with 10 times more foreign workers, the numbers are too big to be confined to some dormitories.

So, free to roam, dispersed all over the country, too large to be “contained”

What it means is that even though the number of foreign workers who are infected is 1/17 the number in Singapore, Malaysians have a greater chance to be in contact with the infected foreign workers.

Too bad for Malaysians.

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

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. 

Dawn of a new pattern of daily new Covid 19 cases.

Something amazing happened yesterday.  MOH had found 3 clusters all involving foreign workers in Pahang

• 7 from a plantation in Bera
• 6 from a timber factory in Maran
• 1 from a construction company in Maran

What was so amazing about a group of foreign workers getting COVID 1?

Well for a long time, I have suggested that MOH should complement its targeted testing programme with some random sampling so that we can identify new cases before they become too large.

Guess what.  

MOH said that the 3 clusters in Pahang are part of its surveillance or random sampling.  At least we now know that this form of testing is being done. Maybe there are some clued on people in MOH.  I am very confident that if MOH has a well planned random sampling plan, coupled with  testing initiatives by some companies, we will be able to nip clusters in the bud.

Over the past week, there seems to be a new pattern appearing in the chart of the daily cases

• There will be days of low cases – possibly due to sporadic spread or old clusters
• And then there will be jumps due to a new cluster

You know the history of clusters.  They seemed to be discovered not only suddenly, but also when the numbers are big enough cos the members tend to be infected about the same time thru either staying or working together.  So when new clusters are found, we have the jump in the number of daily cases. 

The worst part of such clusters is that most likely there will be more cases as MOH will then sweep in to do the testing and isolating of the contacts.

Again you know that the index case to contact ratio.  It is something like 1: 30 (For the 1 Wisma Putra case, MOH tested 46 contacts).  So the "follow up" cases will not be small.

Then come the 3rd step - in 2 or 3 weeks time, the next generation of infection will be reported. Just look at the Pedas cluster, the Cheras Mall cluster.

From a curve-fitting perspective, I have not figured out what to do. I would need to mirror a 3 stage process with first a base sporadic cases and then a cluster spike that lasts for a few days initially.  Then the cluster spike will re-appear 2 or 3 weeks ago.  I don't think I am being facetious.  It is what the data says.

·    Probably too complicated!

So I do wonder how MOH is going to forecast the number of cases as it contemplates the end or extension of the CMCO sometime in the coming week.

The only good piece of news is that we now have the additional testing capacity sorted out.  Hopefully, more of the spare capacity can be channeled to random testing.

MOH had these statistics the day before

• MOH is now able to carry out nearly 30,000 PCR tests daily and has a stockpile of up to 200,000 rapid test kit (RPT) antigens
• Of the 200,000 RTK, less than 5,000 have been used.
• As at Friday (May 29), the lab max capacity was 29,789 with 29,015 samples being tested

So can anyone explain why the average number of daily tests reported by Worldodometer for the past 5 days averaged only 6,700?  

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

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. 

Are you more likely to be infected by a foreign worker?

Designed by Freepik

MOH said yesterday that only 1 in 5 of the new COVID 19 cases since May 4 – the start of the CMCO- involved Malaysians. Reading this simplistically, it means

• Have more CMCO as this will reduce the number of Malaysians getting COVID 19
• You are 5 times more likely to be infected by a foreigner than a Malaysian

OK, I am not being serious. But you have to wonder why it is not 5 times more likely to be infected by a foreign worker.

IT IS ONLY CORRECT if the foreign workers are well (and probably randomly) dispersed throughout the country. Statistically, it means that if you select a group of people randomly, the number of foreign workers in the group would in the proportion of foreign workers to Malaysians in the country. I guess it would be about 3 – 4 million foreign workers c/w 32 million Malaysians.

So if you have such a distributed sample, then I would say that you are 5 times more likely to be infected by contact with a foreign worker c/w contact with a Malaysian. But in reality, the foreigners are not dispersed throughout the country.

So, is there a way to gauge this foreign worker: Malaysian risk?

I think that most likely Malaysians would get infected by foreign workers as follows

• Staying with them (very few Malaysians expect for our maids)
• Working with them (good chance)
• Being served by them (good chance)

I think it is more correct to look at those cases where Malaysians have got COVID 19 by being in the same cluster. MOH doesn’t really report such statistics regularly but I picked up the following

• In the Detainee cluster, there are about 384 cases, with almost all foreigners. I read that so far there is one local infected

• In the Pedas factory where 219 total cases were reported since MOH did not provide a breakdown, my guess is less than 10% are Malaysians (based on May 9, MOH report that 7 were Malaysians out of 88 infected)

• Cleaning service company – all the 24 cases were foreigners

• 3 Construction clusters – of the 88 cases at 26 May, only 1 was a Malaysian

• Cheras Mall cluster – this is among the security guards with about 37 cases as of 26 May. So far I saw a report of 1 Malaysian

• Wet markets – this is the biggest cluster with 271 cases among the traders and workers. Residents in the surrounding areas of some of the markets were also tested. Again there is no breakdown from MOH but PJ market had 25% Malaysians

So are you more likely to be infected by coming into contact with a foreign worker as compared to contact with a Malaysia?

• Very very good chance if you are staying with them

• In the work environment, there is less than 3 % chance of getting infected by the foreign co-worker

• If your contact is with a foreign worker serving you, there is not enough data yet although going by the market cluster you probably have a 25% chance. We do need more info from MOH. The good news so far is that there is hardly any cluster from retail outlets. 

There is another piece of news for the past 2 days that we should all worry about. The day before yesterday, MOH announced this new cleaning company cluster with 24 cases. The cluster was detected when the company on its own initiative sent 150 of its foreign workers for testing, 128 of whom were found negative. Of the 24,

• 20 lived in a dorm in Kuala Langat while
• the remaining 4 shared an apartment in Nilai. 

MOH did its PUI testing for 428 people from close contacts and form residents in the areas concerned. I infer the following

• there are probably more cases from this cluster in the next few days as the test results come back,

• the 24 must be asymptomatic since MOH said that it was part of a test of all the workers

• More importantly, 24 people were infected about 2 weeks ago Since there was no mention of people being sick from these areas two weeks ago, it meant that the 24 caught it from either the asymptomatic or those who were sick and refused to seek treatment.

I guess it should as no surprise that there are many asymptomatic cases. MOH in its analysis of the Tahfiz cluster already concluded that over 85% are asymptomatic.

That is why I was surprised to see an article where researchers from several Australian universities studied the infections on a cruise ship and concluded that 81 % had no symptoms. The results we published in the "Thorax", one of the world’s leading respiratory medicine journal. A Professor Alan Symth, joint editor in chief on the Thorax commented that the findings also have implications for the easing of restrictions currently taking place around the world. If Prof had spoken to our DG of MOH, he would have found this out much earlier!!

We know we have asymptomatic cases walking about with the CMCO.

Since we are only doing targeted testing, I think the cluster-type reporting would be a feature in the coming months ie some group is going to be infected by an asymp


- - - - - - - - - - - - - - - - - - - - - - - - - - -
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.