Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 11 April 2021

Malaysia Situation summary  As of 11 April, there have been a total of 360 856 confirmed cases of COVID-19 in Malaysia. In the past seven days, 9897 new cases have been reported – a 9.8% increase compared to the previous week. In the past seven days, 41 new deaths have been reported, bringing the total number of COVID-19 deaths in Malaysia to 1329.  More states (nine out of 16 states) have reported an increase in new COVID-19 cases in the past week. Selangor and contributed the highest number of new local cases in the past week, with 2574 cases and 2439 cases respectively. The number of cases continued to climb in Sarawak, and the state recorded its highest number of daily new cases at 555 on 9 April. In Penang, although the total number of cases in the past week has declined slightly, the concentration of active cases in the state is the highest in the country at about 126 active cases1 per 100,000 population. In Kelantan, the number of new local cases have more than doubled from the previous week.  While the number of reported cases appears to have increased by 9.8% compared to the previous week, there was a slight decrease in the number of critically ill cases requiring intensive care and ventilator support. The number of deaths increased by 24.2% from the previous week, with 41 deaths reported in the past seven days.  Several signals warn of the risk of a COVID-19 resurgence: o As of 11 April, the estimated national effective reproductive number (Rt) was 1.06 (95% confidence interval [CI]: 1.04–1.08). An Rt value of 1 and above indicates the potential for continued transmission of SARS-CoV-2 and a resurgence of cases. o Overall, data from the Google Mobility Report suggest that nationwide population movement is on the rise. o Upcoming events related to religious and social traditions, including the month of Ramadan and Eid celebrations, warrant some caution, especially regarding the operation of daily food bazaars for breaking the fast.  Continued vigilance and adherence to public health and social measures are important o The risks of importation of cases from other regions 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 countries from around the region.  The National Immunization Programme is currently still in Phase 1, prioritizing and targeting 647 398 front-line workers to be vaccinated. As of 11 April, 61.2% of the target population under Phase 1 have completed the full COVID-19 vaccination regime.

Upcoming events and priorities  Authorities across Malaysia have announced new standard operating procedures for the upcoming Ramadhan celebrations. Breaking fast and buffet events will be permitted with varying capacity limits depending on movement control orders (MCOs). Furthermore, the Ministry of Health (MOH) has reminded the public to limit non-essential travel and continue following COVID-19 measures.  The Sarawak Disaster Management Committee has announced new regulations for domestic and international travellers into the state. Further information can be found here.  The Ministry of Tourism, Arts and Culture (MOTAC) has announced that authorities are refining the standard operating procedures for international travel for Malaysian citizens. Updated regulations are expected to be announced soon.

1 Calculated with state-level reporting on a 14-day rolling basis of active cases, excluding imported cases. Source: MOH Malaysia and Department of Statistics Malaysia. 1 of 3

1 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 11 April 2021

National transmission assessment

National transmission stage assessment: Stage 3 (low confidence) – Large-scale community transmission2 Week 14 (5–11 April 2021)

The total number of cases reported in the past seven days (9897) increased by 9.8% compared to the previous week, signalling an increase in the number of daily new cases recorded. On average, 49 281 tests were conducted per day, with a low positivity rate of 2.87%. Daily reported cases remain above 1000, averaging 1414 cases daily. Of the newly reported cases, 96 (1%) were imported, and 9801 (99%) were locally transmitted. Most states are signalling an increase in the number of new COVID-19 cases. The states of Selangor and Sarawak reported the greatest numbers of new cases. Kelantan recorded more than double the number of new local cases in the past week (694) compared to the previous week (325). There has been a slight decrease in the number of new clusters reported (54) compared to the previous week (58), but of those detected, the majority are still related to workplaces. The number of cases not linked to existing clusters has increased to 2407 (24.3% of total cases). Clusters remain mostly linked to workplaces. While the number of reported cases is showing signs of an increase, there has been a very slight decrease (1.6%) in the number of severe cases reported. Nationwide, 183 cases required intensive care on 11 April, compared to 186 the previous week, and of these, 81 required ventilator support (compared to 94 the previous week). The number of deaths has increased, with 41 deaths this week (compared to 33 the previous week).

EPI Update Tests Cases Deaths ICU COVID-19 9897 Data reported for 344 968 41 33.9% New cases in the EPI week ending Tests in the Deaths in the ICU utilization rate past 7 days 11 April 2021 past 7 days past 7 days (-1.6%) (+1.9%) (+9.8%) (% difference (+24.2%) compared to the previous 7 days) 8 204 996 360 856 1329 540 Cumulative tests Cumulative cases Cumulative ICU beds for COVID-19 deaths patients (including 4.40% private hospitals) Positivity rate 0.37% Case fatality rate

Imported 96 2407 343 n/a Active clusters Active clusters with cases and (1.0%) (24.3%) more than three clusters Imported cases in the Cases in the past 7 generations past 7 days days with no link

2 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 11 April 2021

Epidemiology Fig 1. Daily reported COVID-19 cases, Malaysia, as of 11 April 2021

Table 1: Active cases and real-time reproductive number (Rt) estimates by state, as of 11 April 2021 State Active casesa Active cases/100,000 Rt estimate 95% CI Selangor 4951 76.06 1.02 0.99–1.05 Sarawak 3697 118.43 1.08 1.04–1.11 Penang 2223 125.79 0.96 0.92–1.00 Johor 1284 33.07 0.88 0.84–0.93 Sabah 1158 28.96 1.21 1.14–1.28 FT Kuala Lumpur 1064 82.08 1.05 0.99–1.11 Kelantan 899 47.18 1.15 1.08–1.23 Perak 763 29.69 1.07 1.01–1.15 Kedah 318 14.42 1.06 0.97–1.16 Negeri Sembilan 295 25.86 1.00 0.90–1.10 Pahang 274 16.09 0.96 0.86–1.07 Malacca 162 17.33 1.08 0.96–1.21 Terengganu 142 13.17 1.56 1.33–1.80 FT Labuan 81 81.57 1.05 0.85–1.27 FT Putrajaya 73 70.33 1.34 1.08–1.63 Perlis 0 - - - a This state-level reporting is on a rolling 14-day basis, from 29 March to 11 April 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 11 April 2021

Age distribution of COVID-19 cases  Between 1 January and 6 April 2021, COVID-19 incidence in Malaysia was reported to be highest among adults aged 20–29 years (1217 cases per 100 000 population). This age group was followed by adults aged 30–39 years (1184 cases per 100 000), 40–49 years (736 cases per 100 000) and 50–59 years (540 cases per 100 000). The lowest incidence was recorded in children between 0 and 9 years (274 cases per 100 000).  Overall, between 1 January to 6 April 2021, Malaysia has recorded a COVID-19 incidence of 702 cases per 100 000 population.

Clusters  Of the 1459 clusters identified in Malaysia since the start of the pandemic, 343 are currently active. A total of 54 new clusters were identified in the past week compared to 58 new clusters in the previous week. A total of 70 clusters were declared closed in the past week.  As of 11 April, a total of 1 002 857 non-Malaysians have been screened, of which 130 063 (13%) tested positive. Among them, 129 168 (99.3%) cases were locally transmitted, and 895 (0.7%) were imported. To date, 152 deaths have been reported among non-Malaysians, making up 11.4% of total deaths. The proportion of fatal cases (PFC) was 0.12% among non-citizens, compared to 0.51% PFC among Malaysians.

Health-care capacity  A total of 63 hospitals, including three university hospitals, have been allocated to treat COVID-19 patients. Hospital bed capacity includes: o 6775 COVID-19 beds o 540 COVID-19 beds in intensive care units.  The Sultan Muhammad IV Stadium in Kelantan will be converted into a COVID-19 Low-Risk Quarantine and Treatment Centre.

Testing and surveillance  From 5 to 18 April 2021, all individuals travelling into or through , Sarawak will be required to present a negative RT-PCR test result for permission to enter. The test must be taken within three days prior to entry. Those who frequently travel into Bintulu or who travel for essential services will be given a relaxation on this directive, and their swab tests results will be valid for two weeks.

Strategic approach

Non-pharmaceutical interventions (NPI)  The Sarawak Disaster Management Committee has released updated guidelines for all travellers entering the state. All non-Sarawakians and non-Malaysian travellers who have resided in Malaysia for more than 15 consecutive days will be required to seek approval from authorities prior to entry. Travellers will be required to undergo a 14-day quarantine at designated centres. Travellers entering with approval and for essential purposes will not be required to serve a quarantine period if their stay is limited to no more than three days and two nights in Sarawak. Native Sarawak residents travelling internationally into the state will be allowed to transit through FT Kuala Lumpur and quarantine at the first point of entry in the state. Non-Sarawakians travelling internationally will be quarantined at the first point of entry in FT Kuala Lumpur.  The Sarawak Disaster Management Committee has released standard operating procedures for breaking-of-fast events hosted in restaurants, halls, hotels and food premises. Organizers of such events are required to inform local authorities and their respective divisional disaster management committees prior to the ceremony. Only 50% of the venue capacity or 300 people are allowed at each event at any one time.

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4 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 11 April 2021

 Sabah authorities have released detailed standard operating procedures for the implementation of the movement control orders (MCOs) in Tawau and Keningau districts. New directives permit entry into the affected districts for essential services only. Furthermore, only 30% of the employees from the management group of essential services companies are allowed to work in the office at any one time. Social activities and official government programmes are prohibited from being held in either district. Only two individuals are permitted to travel in one vehicle at any one time.  Effective 6 April, all village heads in Sarawak will be required to notify their respective district offices prior to holding social gatherings in their villages.  The Prisons Department now permits visitations through prior appointments. Visitors must be aged 12 years and above and must strictly follow the released guidelines.  Kelantan authorities will permit prayers to be held in mosques and prayer halls throughout the state during Ramadhan. Prayers will be permitted to the maximum venue capacity, but congregants must practice physical distancing at all times. Religious talks will not be permitted during terawih prayers but will be permitted after morning and Asar prayers. All Ramadhan bazaars and official government events in Kelantan have been cancelled.  Perak state authorities will permit the operation of Ramadhan bazaars, while monitoring compliance to standard operating procedures.  Selangor authorities will allow terawih prayers to be held in mosques and prayers halls. Congregants will be required to bring their own prayer mats, undergo temperature screening, register through MySejahtera upon entering the mosque and wear a face mask at all times.

Table 3: Movement control orders currently being implemented State Location Type of MCO Effective dates Pahang Kampung Juara, Tioman island EMCO Extended to 20 April Taman Mentiga Jaya, Pekan EMCO 9–22 April Taman Perdana, Pekan Perkampungan Peramu Jaya 3, Pekan Taman Sepekan Makmur, Pekan Kampung Pulau Serai, Pekan Sabah Kampung Murni C, Nabawah EMCO 7–20 April Industrial Training Institute (ILP), EMCO 10–23 April Taman Permata, Taman Seri Labuk, Sandakan Kampung Gayang, Tuaran Taman Sri Bukit Tawau, Tawau EMCO 12–25 April Taman Cahaya, Tawau Jalan Tengku Osman, Tawau Tawau Fire and Rescue Department quarters, Tawau Bandar Sri Indah, Tawau Jalan Mesra, Tawau Kampung Titingan, Tawau Taman Golden Hill, Tawau Lahad Datu district MCO 11–24 April Kampung Muhibbah Raya, Tawau EMCO Kampung Bukit Belacon, Segama, Lahad Datu Terengganu Kampung Belaoh, Mukim Hulu Besut EMCO 7–20 April Kampung PPRT Beloah Baru, Mukim Hulu Besut Kampung Keruak, Mukim Hulu Besut Kampung Pak Sik, Hulu Besut EMCO 12–20 April Felcra Keruak, Hulu Besut 5 of 3

5 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 11 April 2021

Sarawak State-wide CMCO Extended to 26 April Kampung , , Serian EMCO Extended to 23 April Kampung Serpan Laut, Asajaya, EMCO 8–21 April Samarahan Prison and staff quarters, Sri Aman Sungai Passin, Matu EMCO 12–25 April Nine longhouses in Sungai Duan, EMCO 11–24 April Mukah Polytechnic Kampung Menuang Baru, Perak Tapah Prison EMCO Extended to 26 April

Vaccines  As of 11 April, a total of 979 794 COVID-19 vaccine doses have been administered across Malaysia. From that, a total of 395 891 individuals have received both vaccine doses. That comprises 61.2% of the target 647 398 vaccinated individuals under Phase 1.  Phase 2 of the National Immunisation Program is scheduled to begin from 19 April across eight states and territories (Kedah, Malacca, Pahang, Penang, Sabah, Sarawak, Terengganu and FT Labuan). Phase 2 immunization efforts will begin a few days after 19 April in the remaining states. Phase 2 vaccination will target those aged 60 years and above, people with disabilities and those with co- morbidities. Around 55 000 high-risk teachers are also expected to be included.  The COVID-19 Immunisation Task Force (CITF) has stated that MySejahtera users will be required to confirm their attendance for the COVID-19 vaccine appointment within 48 hours of receiving their notification. Failing this, the vaccination appointment will be automatically cancelled and rescheduled for a later date.

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