Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 28 March 2021

Malaysia Situation summary  As of 28 March 2021, there have been a total of 341 944 confirmed cases of COVID-19 in Malaysia. In the past seven days, 8904 new cases have been reported – a 4.0% decrease compared to the previous week. In the past seven days, 22 new deaths have been reported, bringing the total number of COVID-19 deaths in Malaysia to 1255. As of 28 March, the national real-time reproductive number (Rt) was estimated at 0.94 (95% confidence interval [CI]: 0.93–0.96).  Most states have reported a continued decline in cases, including the four states reporting the highest numbers of cases (i.e. Selangor, Sarawak, Johor and Penang). Kelantan and Pahang had notably higher numbers of cases compared to the previous week.  While the number of reported cases continued to decline, albeit at a slower rate, there was a slight increase in the number of severe cases requiring intensive care and ventilator support. The number of deaths reported remained about the same, with 22 deaths reported in the past seven days. The proportion of cases reported as unlinked to existing clusters appears to have plateaued at around 21–22.5%, a moderate indicator of potential widespread community transmission. There has been a decline in new clusters reported, but of those detected, the majority are still related to workplaces.  Overall, data from the Google Mobility Report have indicated that nationwide population movement is on the rise. Thus, continued vigilance and adherence to public health and social measures are important despite the observed declining trend in cases reported. Upcoming events related to religious and social traditions, including the month of Ramadan, Eid and Easter celebrations, warrant some caution, especially regarding the operation of daily food bazaars for the breaking of the fast.  The risks of importation of cases from other countries continue to be managed through effective point-of-entry control measures, including testing and quarantine protocols. Nonetheless, continued vigilance is important considering the potential introduction of SARS-CoV-2 variants of concern and the high numbers of cases currently being reported by several neighbouring countries. There is a need to improve the capacity for genomic sequencing for surveillance of new variants. Unofficial border crossings may pose some risks of importation of COVID-19 cases.  The National Immunization Programme is currently in Phase 1, prioritizing front-line workers and targeting 500 000 people to be vaccinated by April 2021. As of 28 March, 25.8% of the target population under Phase 1 have received their second dose of COVID-19 vaccines. Presently, the Pfizer-BioNTech and Sinovac vaccines are being used in the national immunization efforts.  With regards to movement control orders (MCOs), Sabah (except select subdistricts), Perlis, Kedah (except select subdistricts), Perak, Pahang, Teregganu, Negeri Sembilan (except Seremban), Malacca, Federal Territory (FT) of Labuan and FT Putrajaya have been placed under a recovery movement control order (RMCO) until 31 March. Penang, Kelantan, Selangor, FT Kuala Lumpur and Johor have been placed under a conditional movement control order (CMCO) until 31 March. Sarawak has been placed under CMCO until 12 April.

Upcoming events and priorities  The Ministry of Higher Education has established 24-hour operation rooms in higher learning institutions across Malaysia. The centres will serve to collect information and provide feedback regarding COVID-19. The centres were set up under the Ministry’s Risk Management Plan to safeguard the welfare and safety of students in local higher learning institutions.

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1 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 28 March 2021

National transmission assessment

National transmission stage assessment: Stage 3 (low confidence) – Large-scale community transmission1 Week 12 (22–28 March 2021)

The total number of cases reported in the past seven days (8904) decreased by about 4.0% compared to the previous week, suggesting a slower rate of decrease compared to previous weeks. On average, 48 125 tests were conducted per day, with a positivity rate of 2.64%. Daily reported cases remain above 1000, averaging at 1272 cases daily. Of the newly reported cases, 69 (0.8%) were imported, and 8835 (98.2%) were locally transmitted. The states of Selangor, Sarawak, Johor and Penang reported the greatest numbers of new cases, although fewer compared to the previous week. In Sarawak, where cases were previously localized to two or three districts, the geographical spread of cases was more prominent, and the state-level proportion of unlinked cases has increased to 23.1%. While overall most cases are linked to existing clusters, 2004 (22.5%) cases were reported as unlinked at the time of reporting, a slight increase from the previous week. Clusters remain mostly linked to workplaces. While the number of reported cases is showing signs of a potential plateau, there has been a slight increase in the number of severe cases reported. Nationwide, 169 cases required intensive care on 28 March, compared to 154 the previous week, and of them, 76 required ventilator support (compared to 65 the previous week). The number of deaths has remained about the same, with 23 deaths this week.

EPI Update Tests Cases Deaths ICU COVID-19 8904 Data reported for 336 874 22 31.8% New cases in the EPI week ending Tests in the Deaths in the ICU utilization rate past 7 days 28 March 2021 past 7 days past 7 days (-2.5%) (-2.7%) (-4%) (% difference (-4.3%) compared to the previous 7 days) 7 521 383 341 944 1255 531 Cumulative tests Cumulative cases Cumulative ICU beds for COVID-19 deaths patients (including 4.55% private hospitals) Positivity rate 0.37% Case fatality rate

Imported 69 2004 381 n/a Active clusters Active clusters with cases and (0.8%) (22.5%) more than three clusters Imported cases in the Cases in the past 7 generations past 7 days days with no link

1 The transmission stage assessment is made based on three sets of indicators relating to i) trends in cases (including confirmed cases and positivity rates); ii) severe illness (including ICU admissions, mortality and severe acute respiratory illnesses case reporting); and iii) sources of infection (including the proportion of local/imported cases, unlinked cases and clusters). Having more than 25% of locally acquired infections unlinked to known clusters is one of the main signals (but not the only indicator) for large-scale community transmission (Stage 3). 2 of 3

2 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 28 March 2021

Epidemiology Fig 1. Daily reported COVID-19 cases, Malaysia, as of 28 March 2021

Table 1: Active cases and real-time reproductive number (Rt) estimates by state, as of 28 March 2021 State Active casesa Rt estimate 95% CI Selangor 5581 0.85 0.83–0.87 Sarawak 2847 1.10 1.07–1.14 Johor 1795 0.92 0.88–0.97 Penang 1626 1.02 0.97–1.06 FT Kuala Lumpur 1114 0.93 0.87–0.98 Sabah 709 0.94 0.87–1.01 Kelantan 665 1.19 1.10–1.27 Perak 376 0.71 0.66–0.78 Kedah 372 1.08 0.99–1.18 Negeri Sembilan 367 0.87 0.79–0.95 Pahang 248 1.30 1.15–1.46 Malacca 244 1.10 0.99–1.23 Terengganu 142 0.78 0.67–0.89 FT Labuan 39 1.31 0.97–1.70 FT Putrajaya 34 1.00 0.70–1.36 Perlis 1 - - a This state-level reporting is on a rolling 14-day basis, from 15 to 28 March 2021, and excludes imported cases. Source: MOH Malaysia.

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3 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 28 March 2021

Clusters  Of the 1347 clusters identified in Malaysia, 381 are currently active. A total of 50 new clusters were identified in the past week. A total of 85 clusters have been declared closed.  Between 1 January and 25 March 2021, a total of 41 clusters were detected in educational or sub- educational sectors. Of those, 15 (36.6%) were recorded in higher education institutions, followed by 11 (26.8%) in secondary schools, 10 (24.4%) in primary schools or preschools and 5 (12.2%) in religious education centres. In total, 2228 COVID-19 cases were detected in educational clusters. Of those, 1058 (47.5%) cases were recorded in higher education clusters, followed by 631 (28.3) cases in secondary school clusters, 419 (18.8%) cases in primary or preschool clusters and 120 (5.4%) cases in other educational sectors.  A spike in cases detected on 28 March in Sarawak has been linked to a detention centre cluster in the Serian district. Another spike in cases was reported on 28 March in Johor and has been linked to a new detention centre cluster and close contact screening.  As of 28 March, a total of 972 342 non-Malaysians have been screened, of which 125 370 (12.9%) tested positive. Among them, 124 579 (99.4%) cases were locally transmitted, and 791 (0.6%) were imported. To date, 146 deaths have been reported among non-Malaysians, making up to 11.6% of total deaths. The proportion of fatal cases (PFC) was 0.12% among non-citizens, compared to 0.51% PFC among Malaysians.

Strategic approach

Non-pharmaceutical interventions (NPI)  Effective 27 March, Sarawak authorities will permit the reopening of spas, reflexology centres, foot massage centres and karaoke establishments. All premises must obtain prior approval from the Divisional Disaster Management Committee. Additionally, Ramadan bazaars will be allowed to operate in the state from 12 April to 12 May 2021. All employees must undergo RT-PCR tests and obtain a negative result before beginning operations.  Kelantan religious authorities have announced that adults aged 70 years and above will be permitted to perform Friday prayers in mosques located in the state. Congregation sizes will be limited to 50 people at any one time. Daily prayers and religious lessons in mosques will likewise be permitted, subject to venue capacity.  Sarawak authorities have made it compulsory for all funeral-related social gatherings to be reported to the nearest district office prior to implementation. All attendees must comply with the standard operating procedures set by authorities.

Table 3: Movement control orders currently being implemented State Location Type of MCO Effective dates Sabah Kampung Lebak Moyoh, Kota Belud EMCO 26 March to 8 April Kampung Siasai Tamu, Kota Belud Sarawak State-wide CMCO Extended to 12 April Kampung Batu Gong, Kecil Siburan EMCO 27 March to 9 April Kampung Chupak, Kecil Siburan Pahang Taman Guru, Jalan Gambang, Kuantan ECMO 27 March to 9 April Kelantan Rohaniah Care Centre, Integrasi EMCO 29 March to 11 April Ikhwan School, Kampung Gong Kulim, Semerak, Pasir Puteh Johor Immigration Detention Depot, KDN EMCO 28 March to 10 April Setia Tropika Complex, Johor Bahru Immigration Detention Depot, Immigration Department, Sultan Iskandar Building, Johor Bahru Perak Tapah Prison, Batang Padang EMCO Extended to 12 April 4 of 3

4 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 28 March 2021

Vaccines  As of 28 March, a total of 580 765 COVID-19 vaccine doses have been administered across Malaysia. A total of 129 110 individuals have received both vaccine doses. That comprises 25.8% of the target 500 000 vaccinated individuals under Phase 1.  FT Labuan has completed Phase 1 vaccination (two doses) of all front-line workers in the territory.  Government authorities have announced that more groups will be included in Phase 2 of the national COVID-19 vaccination programme. These groups include front-line workers in crucial economic sectors, such as manufacturing, construction, aviation, oil and gas, and front-facing economic sectors. Also to be included are Malaysians residing in Johor who have to commute daily to Singapore and have already signed up for vaccination on the national contact tracing application, MySejahtera.

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