My last post was on 10 Sep when I concluded that the Sabah spike will not lead to another wave in the country.
I had expected the pattern to be similar to the ones we had over the Semenyih detention centre since the Sabah spike was also in a “captive” environment.
For reasons yet to be explained by the authorities, the “containment” was not as effective as the Semenyih detention cluster and so we had an increase in the number of weekly cases since then as can be seen from the weekly chart below.
The current pattern is different from the last spike (shown by the red oval).
In the chart, I have also shown by the dotted line the number of weekly cases when we just entered into the MCO.
You can see that
- The current number of weekly cases has gone above the level when we just went into the MCO
- Unlike the last spike, this current one did not “fade” away. Rather it has been building up for the past 3 weeks and I suspect that the numbers will continue to be high for the next 2 weeks until MOH brings the situation under control.
I also know that this is not a normal situation by looking at the number of daily tests reported for Sep 2020. As you can see from the chart below, there has not been any reports for the past week.
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| No of daily tests for Malaysia as reported by Worldodometer |
By right there should be daily reports as we know that Covid-19 tests are being carried out daily.
In the past, we have had times when the tests for a couple of days were not reported. This situation arises when the private labs have yet to report in their test results.
As you can see from the chart, usually there would be missing reports for 2 or 3 days and then all the results for the past few days get reported at one go and you have the jump in the number of tests. When this happens I just average it out to get the daily average.
The issue is not the daily average. The issue here is that there has not been any test report for the past 8 days.
I would interpret that the failure in providing the test reports to mean that we suddenly have an overwhelming number of tests being conducted.
We should not be surprised by the increased number of tests as MOH protocol is to contact trace and tests all. Given the increase in the number of positive cases, there would be an increased in the number of contacts to be tested.
The real question is whether the number of cases being reported reflects the current situation ie are there under-reporting since we don't have all the test results?
What does this all mean?
Is the country facing another exponential growth?
In my last post, I said that it is time to worry if the “sporadic cases” ie those due to unknown causes reaches 30 cases daily.
So far all the large number of cases have been confined to Sabah and certain regions there have been placed under EMCO.
The EMCO has been effective in preventing the spread of the virus in Kedah. No doubt the number of cases would be high for a week or two before the containment effect kicks in.
No matter what you may think about whether it is right to restrict the movement of groups of people, the EMCO together with contact tracing and treatment has been an effective way to control the spread of the virus.
So I am confident that by mid-Oct, the number of cases in Sabah would be brought under control.
As of 29 Sep, there are 888 active cases in Sabah. We have yet to hear any news about whether the hospitals or healthcare workers in Sabah are facing capacity issues.
Based on a conservative 50 cases per day for the next 2 weeks (ie assume 2 weeks treatment) I would expect the total number of active cases to peak at 1,500. If this was the Klang Valley, I would not worry about capacity issues.
But I don’t know enough about Sabah to say whether this would be a problem.
If MOH or the new state govt is transparent, they should state whether they have the capacity to handle all of them.
Spread to the Klang Valley
Leaving aside the question of Sabah, the real concern is the people travelling between Sabah and other parts of Malaysia.
I think that hopefully with the EMCO, the people within the EMCO zones in Sabah would not be able to travel.
But then there are others in Sabah who are travelling. The news has reported about the congestion in KLIA due to people coming from Sabah.
MOH and the govt are practising double standards - they have mandatory quarantine (in quarantine centres) for all those coming in from other countries whereas, for those coming from Sabah, the mandatory quarantine seem to apply to only those tested positive.
I think the Klang Valley is heading for trouble.
- To get immediate results at KLIA, they must be using some rapid anti-gen testing. But this does not detect those who just caught the virus and have yet to show any symptoms. So the likelihood is that we have potentially sick people slipping through
- All those coming back who do not show any signs of the virus are told to quarantine at home. I think we already have a history that home quarantine does not work.
We went from mandatory quarantine at specialized centres to home quarantine for a while. And then back to specialized centres when the authorities realized that we don’t really have civic conscious people.
Now we are making the same mistake of having home quarantine. I hope this is not politically motivated as many of those coming back from Sabah are politicians who went over to campaign for the recent elections.
The conclusion is that we are allowing potential sick people into the country.
So I expect a spike in the number of cases all over the country.
MOH has already reported that the Rt, ie the reproduction number at a particular time t, for Selangor is higher than that for Sabah. I find this surprising but I suspect it is cos Selangor is starting with a small base number and an increase in the number of cases would lead to a faster increase in Rt.
Will we have exponential growth in the Klang Valley?
It depends on how widespread the infection is. The Sri Petaling event led to the nationwide MCO because of the sheer numbers to test and contact trace.
By the same analogy, if we have 15,000 people or more coming back from Sabah over the few days, and there are many who are sick, it could overwhelm our contact tracing capability.
I think this is the weak point - I have not seen any reports on the numbers coming back but it must be substantial as the airport had to arrange for additional counters.
You must remember that while we have data on the number of beds, ventilators and even the healthcare workers, I have not seen any data on the contact tracing capacity.
Yes, we are better off today compared with the Sri Petaling time due to my Sejahtera and other contact tracing SOP.
But the system has yet to be tested for a spike situation like now.
The only good point is that the authorities seem to be willing to have locations based EMCO.
For the general public, the unknowns are
- Will your residential area be subjected to EMCO? I am sure that if there are more than a dozen cases within your residential areas over a short period of time, you can expect an EMCO. You don't have control. The only control you have is to get your provisions ready.
- How safe are you when going out? When the number of cases in a particular zone is very low, you can ignore the SOP eg wearing mask, social distancing without any real danger. But when the cases are on the rise and especially since we know that there are many asymptomatic cases, you ignore the SOP at your peril. So avoid going out and if you have to, imagine everyone is a potential case. My favourite story of everyone being a zombie is now more relevant than ever
I don't think there will be exponential growth...more likely expect some EMCO
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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.
