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

Malaysia Situation summary  As of 6 September 2020, there have been a total of 9397 confirmed cases of COVID-19 in Malaysia, including 128 deaths.  In the past seven days, 63 new cases have been reported, a decrease of 4 cases compared to the previous week.  Two (2) new deaths were reported in the past seven days. Both cases had a history of comorbidities and were linked to the Tawar cluster. The case fatality rate has increased to 1.4%.  Of the 63 cases reported in the past seven days, 31 (49.2%) were imported.  On 6 September, the Ministry of Health (MOH) reported that 1 case had been detected among travellers under the Malaysia–Singapore Periodic Commuting Arrangement (PCA). Thus far, no cases have been reported under the Reciprocal Green Lane (RGL) scheme.  Of the 14 active clusters, five reported new cases in the past seven days: o Tawar cluster (): 78 total cases, and 7 new cases reported in the past seven days. o Bunga cluster (): 6 total cases. The cluster was first reported on 31 August with an imported index case. o Benteng (LD) cluster (): 16 total cases. The cluster was first reported on 1 September at the Lahad Datu District Police Headquarters lock-up. Of the 16 cases, 10 were non-Malaysians. o MV Glen cluster (): 3 total cases. The cluster was first reported on 30 August. All cases remain active. o Telaga cluster (Kedah): 9 total cases. The cluster was first reported on 30 August. All cases remain active and some involve health-care workers at the Sultanah Bahiyah Hospital. o Semenyih 2 Immigration Detention Center (DTI) cluster: 3 total cases. The cluster was first reported on 4 September. All cases remain active and involve two Malaysian immigration officers and a foreign detainee. Upcoming events and priorities  The Recovery Movement Control Order (Recovery MCO), which was originally scheduled to end on 31 August, has been extended to 31 December 2020.  The MOH has expressed concern that imported cases in Malaysia may increase during the coming winter season, as respiratory tract infections are more commonly reported in winter compared to other seasons. Moreover, the COVID-19 reproductive number in Malaysia has increased from 0.74 (26 August) to 1.0 (31 August), based on estimates generated by the Malaysian National Institutes of Health. Imported cases in Malaysia contributed to this increase. Therefore, the MOH is advocating for further strengthening of national borders.  The MOH is working with the Immigration Department and relevant authorities to tighten the country’s borders and prevent illegal entry. Furthermore, following the detection of cases among immigration depot detainees, the MOH has cautioned front-line workers to remain vigilant when handling suspected COVID-19 cases. National transmission assessment

At the national level, Malaysia remains in Stage 2, localized community transmission. Thirty-two (50.8%) of the 63 cases reported in the past seven days were locally transmitted. Only six (9.5%) of the new locally transmitted cases in the past seven days were unlinked. The Recovery Movement Control Order, which was originally scheduled to end on 31 August, has been extended to 31 December 2020. The Government is currently exploring the options and conditions on re-opening international borders

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

with selected nations, with particular focus on using appropriate criteria for assessing risk and strategies for testing requirements and quarantine upon entry.

Epi Update Tests Cases Deaths ICU COVID-19 Data reported for 74 527 63 2 1.4% epi week ending Tests in the New cases in the Deaths in the ICU utilization rate 6 September past 7 days past 7 days past 7 days (0%) 2020 (11.0%) (-6.0%) (100.0%) (% difference compared to the previous 7 days) 1 307 454 9 397 128 442 Cumulative tests Cumulative cases Cumulative ICU beds for COVID-19 0.72% deaths patients Positivity rate 1.4% Case fatality rate Imported 31 (49.2%) 6 (9.5%) 14 0 cases and Imported cases in the Cases in the past 7 Active clusters Active clusters with clusters past 7 days days with no link more than three generations

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

Epidemiology Fig 1. Daily reported COVID-19 cases and movement control measures, Malaysia, as of 6 September 2020

Movement Control Order Recovery Movement Control Order

Mortality  The latest death reported was on 1 September 2020. The case (#9174) was an 80-year-old Malaysian woman with a history of lung cancer and hypertension. She was reported to be a case linked to the Tawar cluster on 15 August. She developed a fever and cough on 6 August and was admitted to a medical centre. She was transferred to Pulau Pinang Hospital on 14 August when she tested positive for COVID-19. Her condition deteriorated due to cancer-related complications, and she required ventilator support from 24 August.  Another death was reported on 31 August. The case (#9124) was a 62-year-old Malaysian man with a history of diabetes and hypertension. He was reported to be a case linked to the Tawar cluster on 13 August. He first developed a cough on 11 August and was admitted to Sultanah Bahiyah Hospital (Kedah) on 13 August. His health condition deteriorated, and he required ventilator support from 19 August.

Geographical distribution  The states with active cases as of 6 September are (6), Kedah (23), Sabah (15), (1), (1), (1), Melaka (2), and Selangor (6). This state-level reporting is on a rolling 14-day basis, from 24 August to 6 September 2020, and excludes imported cases.  On 2 September, the MOH declared and Penang free of COVID-19. This declaration followed the designation of Segamat, Barat Daya and Timur Laut as green zones without clusters or cases. However, the MOH cautions the public against complacency. As of 6 September, Penang has reverted to being a yellow zone following one active case in Timur Laut.

Clusters  Of the 108 clusters identified in Malaysia, 14 are currently active. Three new clusters were identified in the last week. These were:

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

o Bunga cluster: The cluster was first reported on 31 August in Negeri Sembilan. The cluster originated from a ship in Port Dickson with travel history from the Port of Singapore. As of 3 September, a total of six cases have been detected. A total of 34 crew members working on the ship were screened on 28 August during the ship sign-in and sign-off process. As of 3 September, 55 individuals have been screened. The six confirmed cases involve three Malaysians and three non-Malaysians. All cases were not symptomatic and were initially quarantined at a hotel in Selangor. o Benteng LD cluster: The cluster was reported on 1 September at the Lahad Datu District Police Headquarters lock-up in Sabah. Following the screening on 6 September, a total of 776 individuals have been tested. As of 6 September, there have been 16 confirmed cases. Of the confirmed cases, 10 involve non-Malaysians. They are all asymptomatic. The source of infection is under investigation. Cases linked to this cluster have also been detected in Prison. Further investigations by the MOH have shown that a lock-up detainee (case #9351) reported on 1 September had been a prisoner at Tawau Prison. This follows after it was found that four cases reported in Tawau Prison had previously been at the Lahad Datu District Police Headquarters. As a result, as of 6 September, 420 individuals have been screened in Lahad Datu, while 356 individuals have been screened in Tawau. o Semenyih 2 DTI cluster: The cluster was first reported on 4 September at the immigration detention depot (DTI) in Selangor. The index case (#9302) was a non-national detainee who was screened before deportation and tested positive on 27 August. The second (#9382) and third (#9384) cases linked to the cluster were immigration officers who had accompanied the index case to the clinic. As of 4 September, a total of 269 people have been screened. Cases have been detected in Selangor and Negeri Sembilan. Screenings have been performed on 134 detainees, 129 staff at the depot, and six family members of depot staff.  The MOH reports that three cases linked to the Tawar cluster were positive for the D614G mutation. However, the MOH has been unable to detect any epidemiological link between the Tawar and PUI Sivagangga cluster.  In the past seven days, six clusters have been declared closed. These are the Kuching Engineering, PUI Melbourne, Satok, Sentosa, Mambong and Bukit Tiram clusters.

Strategic approach

Non-pharmaceutical interventions (NPI)  The Targeted Enhanced Movement Control Order (TEMCO) implemented in Aman Jaya, Kedah will be enforced until 10 September. As of 31 August, 12 533 individuals out of an estimated 22 360 total residents have been screened.  The Government has announced that starting from 7 September, it will impose an entry ban on citizens of countries that have recorded more than 150 000 cases. This directive affects long-term pass holders such as expatriate workers, students and permanent residents.  From 1 September, all non-Sarawakian workers in the oil and gas industry entering Sarawak will be required to undergo a mandatory 14-day quarantine. The sign-on process will require a mandatory quarantine period. The sign-off process will require workers to undergo quarantine and get tested on the second day; if they test negative, they will not be required to complete the remaining quarantine days.  Sabah will now bar entry of any travellers from states with active COVID-19 clusters in the country.  Penang has cancelled all year-end activities and celebrations because of the national COVID-19 situation.  Following the emergence of a new cluster in an immigration detention depot (Semenyih 2 DTI) and a case reported involving a foreign detainee held at the Beranang temporary detention centre, the MOH has urged front-line workers to take preventive measures whenever handling confirmed and suspected COVID-19 cases.

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

 Following reports of a COVID-19-positive case among travellers under the PCA, travellers under the scheme will no longer be permitted to quarantine at home. They will instead be required to serve their mandatory quarantine periods at designated centres.

Risk communication and community engagement  A global survey conducted by Ipsos from 24 July to 7 August found that Malaysia ranked among the top six countries with the highest interest in getting a COVID-19 vaccine. The survey, titled Global Attitudes on a COVID-19 Vaccine, was conducted across 27 countries. The survey also found that while only 35% of Malaysians are resolute in getting vaccinated against COVID-19, an estimated 48% of Malaysians believe that a vaccine would be available for them before the end of 2020. Among those Malaysians who reported an unwillingness to be vaccinated against COVID-19, 48% expressed worry about vaccine side-effects, while 36% felt they were not sufficiently at risk of COVID-19. A limitation to the survey was that only 500 Malaysians were sampled, and the surveyed population comprised members of a more urban, educated and affluent community than the general population.  The Malaysian Trades Union Congress (MTUC) stated that no significant moves had been taken by employers to improve the poor living conditions of foreign workers. The employers were given a three-month grace period to affect changes following the amendments to the Worker’s Minimum Standards of Housing and Amenities Act 1990.  The Raja of Perlis has chided the state’s mosque management committees for failing to ensure full compliance with the standard operating procedures among congregants.  The Sarawak Disaster Management Committee (SDMC) has advised children aged 12 years and below to refrain from entering night markets.

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