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