Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 21 March 2021 Malaysia Situation summary As of 21 March 2021, there have been 333 040 confirmed cases of COVID-19 in Malaysia. In the past seven days, 9277 new cases have been reported – a 10.0% decrease compared to the previous week. Of the newly reported cases, only 52 (0.6%) were imported. Twenty-three new deaths have been reported, bringing the total number of COVID-19 deaths in Malaysia to 1233. As of 21 March, the national real-time reproductive number (Rt) was estimated at 0.94 (95% confidence interval [CI]: 0.92–0.96). The number of new COVID-19 cases reported in Malaysia decreased again in the week ending 21 March 2021, albeit at a slower rate compared to previous weeks. Daily reported cases remain above 1000, averaging around 1325 cases daily. There has been a gradual decline in severe cases requiring intensive care and ventilator support. The number of deaths reported has also declined, with 23 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%, 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. While indicators show a promising trend of decreasing transmission, multisource and event-based surveillance of risks warns of rising population mobility trends and lack of adherence to public health and social measures. 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 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 high numbers of cases currently being reported among several neighbouring countries. There is a need to improve the capacity for genomic sequencing for surveillance of local transmission. Unofficial border crossings may pose some risks. The National Immunization Programme is currently in Phase 1, prioritizing front-line workers and targeting 500 000 people to be vaccinated by April 2021. Upcoming events and priorities On 17 March 2021, the Prime Minister launched the Safe@Work initiative to enable COVID-19 close contacts to continue working according to a new protocol known as the Safe Work Bubble. Under the Bubble, all close contacts will be placed in hostels away from other colleagues and may continue to work until their COVID-19 test results are made known. Company management will be responsible for creating such bubbles and ensuring all COVID-19 measures are strictly followed. The government is finalizing standard operating procedures (SOPs) for the upcoming Ramadan and Aidilfitri celebrations. Ramadan is from 13 April to 13 May 2021. Authorities have announced that the compound fines issued for COVID-19 SOP violators will be recommended at RM 1500. Fines may be issued to those who fail to wear a face mask, practise physical distancing or check in manually or via the MySejahtera application. As of 21 March 2021, a total of 428 710 COVID-19 vaccine doses have been administered across Malaysia. From that, a total of 16 368 individuals have received both vaccine doses. That comprises 3.3% of the target 500 000 vaccinated individuals under Phase 1. The Ministry of Health has clarified that those who have received their second COVID-19 dose will be issued a COVID-19 vaccination badge and a digital certificate that can be downloaded on the national contact tracing application, MySejahtera. 1 of 3 1 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 21 March 2021 National transmission assessment National transmission stage assessment: Stage 3 (low confidence) – Large-scale community transmission1 Week 11 (15–21 March 2021) The number of new COVID-19 cases reported in Malaysia decreased in the week ending 21 March 2021, with 9277 new cases reported (10% decline from the previous week), despite an increase in the number of tests conducted. On average, 49 462 tests were conducted per day, with a low positivity rate of 2.68%. Daily reported cases remain above 1000, averaging at 1325 cases daily. The majority of cases were locally acquired (99.4%). Selangor reported the highest number of new cases in the past week (2902), but in a decreasing trend and decreased proportion of unlinked cases (19.3%). On the other hand, Penang reported an increase in the number of new cases (1205) and a relatively high proportion of unlinked cases (35.3%). In Sarawak, although the number of reported cases increased (1797), the proportion of unlinked cases was relatively low (15.1%). Nationwide, 154 cases required intensive care (2.5% decrease) on 21 March, and of these, 65 required ventilator support (8.5% decrease). The number of deaths reported also declined, with 23 deaths reported in the past seven days. The proportion of cases reported as unlinked to existing clusters appears to have plateaued, at 21.8% over the past seven days. There has been a decline in new clusters reported, but of those detected, the majority are still related to workplaces. EPI Update Tests Cases Deaths ICU COVID-19 9277 Data reported for 346 233 23 29.0% New cases in the EPI week ending Tests in the Deaths in the ICU utilization rate past 7 days 21 March 2021 past 7 days past 7 days (-2.5%) (+13.3%) (-10.0%) (% difference (-43.9%) compared to the previous 7 days) 7 184 509 333 040 1233 531 Cumulative tests Cumulative cases Cumulative ICU beds for COVID-19 deaths patients (including 4.64% private hospitals) Positivity rate 0.37% Case fatality rate Imported 52 2018 416 n/a Active clusters Active clusters with cases and (0.6%) (21.8%) 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 21 March 2021 Epidemiology Fig 1. Daily reported COVID-19 cases, Malaysia, as of 21 March 2021 Table 1: Active cases and real-time reproductive number (Rt) estimates by state, as of 21 March 2021 State Active casesa Rt estimate 95% CI Selangor 7115 0.87 0.85–0.89 Sarawak 2804 1.03 1.00–1.07 Johor 1978 0.80 0.77–0.84 Penang 1677 1.09 1.04–1.13 FT Kuala Lumpur 1284 0.91 0.86–0.96 Sabah 765 0.85 0.79–0.91 Perak 505 0.75 0.70–0.80 Negeri Sembilan 445 0.68 0.63–0.74 Kelantan 395 1.00 0.92–1.10 Kedah 257 1.13 1.02–1.25 Terengganu 213 1.09 0.96–1.22 Malacca 122 1.06 0.93–1.20 Pahang 78 0.73 0.59–0.89 FT Putrajaya 26 0.85 0.56–1.20 FT Labuan 14 0.74 0.42–1.14 Perlis 5 0.89 0.71–1.08 a This state-level reporting is on a rolling 14-day basis, from 8 to 21 March 2021, and excludes imported cases. Source: MOH Malaysia. 3 of 3 3 Malaysia Coronavirus Disease 2019 (COVID-19) Situation Report Weekly report for the week ending 21 March 2021 Clusters Of the 1297 clusters identified in Malaysia, 416 are currently active. A total of 60 new clusters were identified in the past week. A total of 68 clusters have been declared closed. As of 21 March, a total of 952 586 non-Malaysians have been screened, of which 122 906 (12.9%) tested positive. Among them, 122 145 (99.4%) cases were locally transmitted, and 761 (0.6%) were imported. To date, 144 deaths have been reported among non-Malaysians, making up 11.7% of total deaths. The proportion of fatal cases was 0.12% among non-citizens, compared to 0.52% among Malaysians. Authorities have reported that between 1 January and 21 March 2021, a total of 3170 cases linked to inter-state travel had been detected. The three states with the highest number of cases linked to inter-state travel were Kedah (714 cases), Perak (582 cases) and Negeri Sembilan (370 cases). Strategic approach Non-pharmaceutical interventions (NPI) Effective 1 April 2021, spectators will be permitted to attend sports events at permitted venues or stadiums. In CMCO areas, only 10% of the maximum capacity or 2000 spectators will be permitted entry. In areas placed under RMCO, only 25% of the maximum capacity or 8000 spectators will be permitted entry at any one time. Inter-district travel is permitted in all states and territories, except Sabah and Sarawak. Inter- state travel is not permitted. The National Security Council has announced that food and commercial bazaars will be permitted to operate across Malaysia for the upcoming Ramadan and Eid celebrations.