Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

Malaysia Situation summary  As of 20 December 2020, there have been a total of 93 309 confirmed cases of COVID-19 in Malaysia.  In the past seven days, 9834 new cases have been reported, an 8.8% decrease compared to the previous week. o Of the new cases reported, only 42 (0.4%) were imported.  In the past seven days, 22 new deaths have been reported. This brings the total number of COVID-19 deaths in Malaysia to 437. The case fatality rate (CFR) is now 0.45%.  As of 18 December, the Ministry of Health (MOH) reports that Malaysia has a cumulative total of 1771 cases among health-care workers. o An estimated 1359 (76.7%) cases were recorded in the current third wave of the pandemic. o The increase in COVID-19 cases among health-care workers in the Klang Valley is believed to be linked to the increased number of cases in the community.  A recent outbreak among patients and health-care workers has been reported at Klang Hospital (HTAR), . o As of 17 December, at least 50 staff and some patients have tested positive for COVID-19. o All patients had been hospitalized at HTAR for non-COVID-19-related illnesses and had tested negative upon admission. o The source of transmission is currently being investigated. However, state health officials speculate that the rise in cases is likely due to the hospital’s location in a COVID-19 red zone and the treatment of a large number of severe acute respiratory infection (SARI) patients.  As of 20 December, a total of 195 104 non-Malaysian have been tested, and 19.2% (37 419 cases) have tested positive. Of these, 98.7 % (36 935 cases) were locally transmitted, and 1.3% (483 cases) were imported. To date, 74 deaths have been reported among non-Malaysians. Over the past seven days, 31.3% positive cases out of samples (5177/16553) tested among non-Malaysians.

Upcoming events and priorities  The Joint Committee of People’s Well-Being has agreed to address the issue of prison overcrowding with a proposal to reduce the total capacity of inmates in national prisons.  The government has announced that it will allow COVID-19 treatment and vaccine costs for parents to be tax-deductible under medical, special needs and parental care expenses. Under this directive, individuals can claim up to RM 8000 in income tax relief. Taxpayers can also claim RM 1000 in income tax relief for COVID-19 vaccination for themselves, spouses and children.

National transmission assessment

At the national level, Malaysia remains in Stage 2, localized community transmission. The number of cases reported remains high at 9834 new cases in the past week, albeit a slight decrease (-8.8%) from the previous week, and there is further geographical spread of cases detected. A total of 9792 cases (99.6% of total) were locally transmitted. There were 22 COVID-19 deaths in the past week. On average, 112 people were receiving care in intensive care units daily, and of these, 55 per day were on ventilator support. Selangor and FT are the two states/federal territories with the greatest number of new cases reported. In the week ending 20 December, Selangor reported 3418 cases (34.8% of total), and WP Kuala Lumpur reported 2111 new cases (21.5% of total). Most cases are linked to existing clusters, particularly those related to workplaces and worker groups or prisons. However, 22.9% of cases were reported as unlinked at the time of reporting,

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1 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

including 1210 unlinked cases reported in Selangor. The number of cases in six states and federal territories (FT) – Selangor, , , , FT Kuala Lumpur and FT – remains high due to the expansion of COVID-19 screening among foreign employees. Overall testing has increased slightly, with an average of 23 012 tests conducted per day in the past week. Extensions to the conditional movement control order (CMCO) have been announced for selected states and districts. Meanwhile, , , , , and , and the federal territories of Labuan and have been put under a recovery movement control order.

EPI Update Tests Cases Deaths ICU COVID-19 9834 Data reported for 161 096 22 23.2% New cases in the EPI week ending Tests in the Deaths in the ICU utilization rate past 7 days 20 December past 7 days past 7 days (+0.9%) (+4.8%) (-8.8%) 2020 (-33.3%) (% difference compared to the

previous 7 days) 3 101 878 93 309 437 500 Cumulative tests Cumulative cases Cumulative ICU beds for COVID-19 3.01% deaths patients Positivity rate 0.5% Case fatality rate

Imported 42 2251 199 NA Active clusters Active clusters with cases and (0.4%) (22.9%) more than three clusters Imported cases in the Cases in the past 7 generations past 7 days days with no link

Epidemiology Fig 1. Daily reported COVID-19 cases, Malaysia, as of 20 December 2020

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2 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

Of the 22 new deaths reported in the past seven days, 14 (63.6%) were recorded in Sabah. Seven (31.8%) were women, and six (27.3%) cases were non-Malaysians.

Table 1: Active cases by state, as of 20 December 2020  Sabah 3940  N Sembilan 1369  1247  Terengganu 35  Selangor 8025  791  Malacca 149  46  Penang 612  FT Labuan 135  Sarawak 4  Pahang 447  198  FT Kuala Lumpur 3088  FT Putrajaya 23  Perlis 0 This state-level reporting is on a rolling 14-day basis, from 7 to 20 December 2020, and excludes imported cases.

Clusters  Of the 443 clusters identified in Malaysia, 199 are currently active.  Nationwide, 27 new clusters were identified last week. Of these, 15 were at workplaces including construction sites.  In the past seven days, 19 clusters have been declared closed.

Table 2: New clusters reported in the week ending 20 December 2020

Cluster name State Total Date first Notes cases reported Solar Ria Selangor 37 14  Sepang, Kuala Selangor, Gombak, Petaling, December Hulu Langat  Index case (#73 366): pre-departure screening on 7 December Senu Setia FT Kuala 26 14  Lumpur December  Index case (#83 123): pre-departure screening on 13 December Puncak Selangor 85 16  Kuala Selangor, Klang Galaksi December  Targeted workplace screening (warehouse) from 14 December Bukit Punai Sabah 9 16  Kota Kinabalu December  Index case (#79 023): hospital admittance screening on 11 December Tapak Bina FT Kuala 48 16  Lembah Pantai Permai Lumpur December  Targeted workplace screening (construction site) from 16 December Tapak Bina FT Kuala 17 16  Matahari Lumpur December  Targeted workplace screening (construction site) from 12 December Tapak Bina FT Kuala 8 16  Lembah Pantai, Cheras, Kepong Laut Lumpur December  Targeted workplace screening (construction site) from 3 December Cahaya Johor 32 16  Johor Bahru, Kota Tinggi, Pontian Mahsuri December  Index case (#75 224): symptomatic screening on 8 December Seri Tasik Perak 7 16  Perak Tengah, Kinta December  Index case (#67 913): pre-surgical screening on 2 December Inten Pahang 9 16  December 3 of 3

3 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

 Index case (#78 487): symptomatic screening on 10 December Jalan Rusa FT Kuala 129 17  Cheras Lumpur December  Community screening (housing estate) from early December Tapak Bina FT Kuala 17 17  Lembah Pantai Pasifik Lumpur December  Workplace screening (construction site) on 12 December Maringkan Sabah 11 17  Telupid, Ranau December  Index case (#70 580): symptomatic screening on 5 December Tapak Bina Selangor 20 18  Sepang Lebuh December  Workplace screening (construction site) from 15 December Sugud Sabah 26 18  Penampang, Papar December  Index case (#60 068): symptomatic screening on 26 November Tapak Bina FT Kuala 12 18  Lembah Pantai Jalan Tengah Lumpur December  Workplace screening (construction site) from 3 December Persiaran Negeri 21 18  Seremban Heights Sembilan December  Index case (#84 673): symptomatic screening on 14 December Tembok Johor 69 18  Kluang Gajah December  Index case (#87 833): symptomatic screening on 16 December Utama Rini Johor 23 18  Johor Bahru, Kulai, Pontian December  Index case (#80 177): symptomatic screening on 11 December Tapak Bina Selangor 49 19  Petaling Jalan Zuhrah December  Workplace screening (construction site) from 14 December Keris Sabah 41 19  Kota Kinabalu, Tuaran Residence December  Index case (#80 664): symptomatic screening on 12 December Jalan Timah Johor 49 19  Johor Bahru, Kulai December  Index case (#90 535): symptomatic screening on 18 December Brumas Sabah 17 19  Kalabakan December  Index case (#74 561): self-screening on 8 December Long Panji Kelantan 11 19  Kota Bharu, Machang December  Index case (#86 605): symptomatic screening on 15 December Tapak Bina FT Kuala 147 20  Kepong Metropolis Lumpur December  Workplace screening (construction site) from 14 December Estate Maju Sabah 28 20  Kota Kinabalu, Putatan, Tuaran December  Index case (#74 498): symptomatic screening on 8 December Batu 39 Johor 28 20  Pontian December  Index case (#90 568): targeted workplace screening on 18 December

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4 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

Cases among health-care workers Figures 2 and 3 show the breakdown of reported cases among health-care workers, according to the source of infection and health-care profession, respectively.

 As of 18 December, the MOH reports that Malaysia has a cumulative total of 1771 cases among health-care workers. o A total of 1697 health-care officers are currently undergoing home surveillance orders. o Hospitals in the Klang Valley that have reported cases among health-care workers include: Hospital Tengku Ampuan Rahimah (HTAR), Klang (54); Hospital Serdang (29); Hospital Sungai Buloh (15); Hospital Kuala Lumpur (10); Hospital Ampang (5); and Hospital Selayang (4).

Figure 2: Distribution of health-care worker cases, by Figure 3: Distribution of health-care worker cases, source of infection, n = 1771 as of 18 Dec 2020 by profession, n = 1771 as of 18 Dec 2020

Strategic approach

Non-pharmaceutical interventions (NPI)  Effective 14 December, Malaysians returning from overseas will be required to undergo a compulsory quarantine for only 10 days at dedicated facilities. They will be tested for COVID-19 on the eighth day of isolation and released on the 10th day if the results return negative. They will then be required to wear a wristband and continue their quarantine at home until the 14th day. o Sarawak: Non-Sarawak residents and foreign nationals entering the state from overseas will need to undergo 10 days of quarantine and screening at the point of entry. A negative test result will only be valid for three days prior to entry into Sarawak. Travellers must continue with home quarantine until the 14th day.  Several measures are being put in place to interrupt transmission in work places and prisons and to prevent spread to and from the community. These include: o The Housing and Local Government Ministry has released new standard operating procedures (SOPs) for construction firms applying to build temporary on-site housing for workers. o COVID-19 screening are being expanded in workplaces, prisons and other places of detention. Effective 1 January 2021, COVID-19 screening will be made mandatory for foreign workers across Malaysia. o Under the new CMCO directives, the government has issued a work from home directive for workers in management and supervisory roles. Such directive limits the time, duration and number of supervisory-level workers allowed at work sites. Face-to-face meetings for official businesses are permited, at 50% attendance of the room’s capacity and subject to

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5 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

physical distancing measures. All workers are required to register with the MySejahtera contact tracing app upon entry onto the work premises. o Prisons and detention centre settings that report a high number of COVID-19 cases have been placed under Enhanced Movement Control Orders (EMCO). Before entry into prisons, detainees are required to be tested for COVID-19. Furthermore, all physical reunion sessions between inmates and their families in conjunction with the upcoming Christmas celebrations have been replaced with virtual Skype sessions or telephone calls.  The government has announced that Christmas visits will be limited to private gatherings of not more than 20 people at any one time on 25 December in conditional movement control order (CMCO) areas. In places under enhanced movement control order (EMCO), only household gatherings will be permitted. Landed properties will be limited to a maximum of 20 people. Church prayer sessions will be permitted in CMCO and recovery movement control order (RMCO) areas at limited times. Churches in green, yellow and orange zones are limited to 300 people, depending on the premises, while those located in red zones cannot have more than 30 worshippers at any one time.  Selected tourism and cultural sectors in areas under CMCO will be allowed to reopen beginning 19 December. The number of attendees and visitors will be limited to 50% of the premises’ space, and physical distancing will apply. o Local tournaments will be allowed with a maximum seating capacity of 10% or 4000 spectators. Individual and team sports activities for the purposes of training, games and matches (indoor and outdoor) are allowed without spectators in CMCO areas.  Pahang o Effective between 18 to 31 December, all government departments in Kuantan district are not permitted to hold public programmes to limit the risk of COVID-19 transmission in the district.  Sabah o Members from the same household will now be permitted to dine-in and share a table at eateries, subject to safe distancing measures. o Sabahans returning from Brunei Darussalam will no longer be required to serve a mandatory quarantine upon entry if they present a negative COVID-19 test (RT-PCR or rapid test kit-antigen) taken no more three days before arrival into Sabah.  Kelantan o State Islamic authorities will permit obligatory prayers, Friday prayers and activities to be held in mosques and prayer halls effective 21 December.  Malacca o Eateries across the state are allowed to operate until 2:00 daily.  Members of Parliament under home surveillance orders may attend Parliament upon receiving permission from the Health Director-General and following strict protective measures, such as wearing full personal protective equipment while in the building.

Table 3: Movement control orders currently being implemented State Location Type of MCO Effective dates Perak Yamaha factory workers’ hostel EMCO Until 21 December Depot tahanan imigresen Langkap EMCO Extended to 31 December Kinta, Teja & Mukim Changkat Jong Ipoh, Hulu CMCO Extended to 31 December Chemor, Hulu Kinta district Sabah Kampung Desa Bajau, Lahad Datu EMCO Extended to 29 December Kampung Dasar Baru, Lahad Datu State-wide CMCO Extended to 31 December Selangor State-wide (except Sabak Bernam, Hulu CMCO Extended to 31 December Selangor, Kuala Selangor) 6 of 3

6 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 20 December 2020

FT Kuala Lumpur Territory-wide CMCO Extended to 31 December Negeri Sembilan Seremban CMCO Extended to 31 December Port Dickson Seremban prison and quarters EMCO Extended to 31 December Johor Batu Pahat CMCO Extended to 31 December Kulai Kluang Prison and quarters EMCO 19 to 31 December Penang Mukim 12 CMCO Extended to 31 December Mukim 13

Surveillance and testing  Between 1 and 14 December, 17 000 foreign workers have participated in mass COVID-19 screening activities. o Of the total, 555 (3.3%) have tested positive for COVID-19. o An estimated 663 factories and 652 clinics have participated in this exercise.  Fishmongers, other vendors and workers at the Pasar Sentral Urban Transformation Centre (UTC) in FT Labuan will undergo COVID-19 screening following the detection of the Hujung Pasir cluster.  The Selangor task force and IMAM Response and Relief Team (Imaret) are cooperating to conduct a community testing programme in hot zones within Meru, Klang. Testing will primarily focus on factories with high rates of COVID-19 infections and the surrounding communities. Testing will be conducted with rapid test kits-antigen.  WHO is working with the Institute of Medical Research Malaysia (IMR) to conduct external quality assessment (EQA) for COVID-19 testing. Presently, the EQA programme for sub-national COVID-19 testing is ongoing with 20 participating laboratories.

Health-care capacity  Foreign nationals linked to the Genting and Kuala clusters and displaying mild symptoms have been treated at the COVID-19 Quarantine and Low-Risk Treatment Centre at the Pahang Sports Complex (Sukpa) and the Malaysia Agro Exposition Park Serdang (MAEPS) in Selangor. As of 20 December, Sukpa has ended its operations. All cases have recovered and were allowed to return home.  The MAEPS 2.0 is expected to be ready by 25 December. Authorities have announced that the centre will have a maximum of 10 000 COVID-19 beds and will be utilized in three phases. Phase one will ready 3000 beds, phase two will have 3300 beds and phase three will have 3700 beds.  Johor has opened three COVID-19 Quarantine and Low-risk Treatment Centres in the state.

Risk communication and community engagement  The Selangor COVID-19 Task Force has advised the public to postpone travelling to their hometowns.  The federal government has clarified that wearing face masks is only compulsory in crowded public places. Wearing face masks is mandatory in crowded markets, buses and train services. Furthermore, those who only wear face shields without a mask will be fined for violating COVID-19 measures.  Following reports of COVID-19 cases among health-care workers, the MOH has urged all health-care workers in both the public and private sector to strictly follow SOPs. The public has been advised to limit their visits to hospitals for essential purposes only.  The MOH has made it clear that no COVID-19 transmission has been reported at temporary flood evacuation centres. However, authorities are urging all members of the public to strictly adhere to COVID-19 measures put in place at such locations.  A subcommittee on communications under the Special Committee on COVID-19 Vaccine Supply Access Guarantee has been formed to draft strategic communications plans to present accurate COVID-19 facts and information to the public. Moreover, the subcommittee has identified various categories of the public’s level of confidence with a COVID-19 vaccine, including anti-vaccine minority groups. Therefore, the government is implementing proactive communication strategies to explain the importance of taking a COVID-19 vaccine clearly. 7 of 3

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