Yesterday (24 March) a journalist asked me the questions below:
1) Some compared the severity of COVID-19 outbreak with Italy, what do you think about the similarities and differences between the two countries?
2) What lessons can Malaysia learn from the Italy situation?
A week ago or so, I also saw some people sharing an infographic showing that Malaysia could be stepping towards Italy. So I did some analysis , to show you why this is (so far) not the case. See my analysis below:
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On 21st February, Italy has 20 cases confirmed (17 new cases), that was the starting point of the collapse. I treat that fateful day as their case D1.
On 1st March (D10), finally the Italian Council of Ministers came out with nationwide measures to contain the outbreak. Italy was assigned into three areas according to level of security: 1) Red Zone: the whole population is in quarantine (lockdown); 2) Yellow Zone: ‘social distancing’ (social and sports events suspended, schools and many public places shut down); 3) The rest: safety and prevention measures in public places. That day Italy had 1694 accumulative cases, 34 deaths. That was the picture just 10 days after.
Malaysia’s second wave came about on 27th February. That day had 2 new cases after 11 days of absence of positive detection, brought to accumulative 24 cases. 10 days later, on 7th March, the accumulative cases were 93, nothing as serious as Italy. In fact, 27 days later, the total case number is 1624, still lower than the figure in Italy on the D10.
Malaysia’s outbreak situation got worsen on 15th March (D18), from that day onwards the new cases coming in per day are reported in 3 digits (so far). But our government decisively and quickly declared on 16th March (D19) that 2 days later, 18th March (D21), Malaysia will have a nationwide Movement Control Order (MCO) imposed. The total case number was 790 when going into the first day of MCO.
In fact, the first day when the Health Department Director General (DG) Noor Hisham mentioned about the Tabligh event at Sri Petaling was 11th March (which this cluster so far forms the largest, currently 986 patients). One week later, the government already took action to impose the MCO, that should be seen or considered as prudence. It is most probably because the Ministry of Health had already been notified knowing that the Tagbligh cluster COVID-19 positive persons had returned home and probably brought back the virus to their own communities in each and every state.
But for Italy, the new cases after the tough measures implemented in 1st March, at first the increase rate was in a couple of hundreds, one week later (8th March) the increase was in 4 digits daily, until today. In Malaysia, after a week the nation under MCO, the highest peak was on D6 (212 new cases). Thus after one week of certain degree of lockdown/movement restriction, the total cases in Italy grew 3.5x but in Malaysia only 2.1x. (Referring to the figure graphics) So, when Malaysia is compared with Italy, there is still a very big gap, whether in terms of disease transmission speed or number of cases (in fact, the whole dynamic of disease transmission). This shows that Malaysian health authorities are actually doing superior job at containing the disease spread (although it is not without challenges, requiring full cooperation from the residents).
The out-of-control situation in Italy, I am afraid that it is a case study that every country in the world are now looking into, because there are many lessons to be learned. I once read an article said, a country’s disease control measures, are closely associated with the social and culture, politics and economics, as well as history and heritage of the local communities and the whole country. Probably some notice, before the disease transmission has lost control, wearing a face mask in the western world in public was not an encouraged behaviour, instead the person would be discriminated. The people in the society has their own mindset and logic, eg. those who are sick should stay home and not coming out (wearing a mask), healthy persons do not need to wear one. We should know the fact that the western world in general enjoy their personal liberty, do not like or resist the top-down authoritarian approach in limiting their freedom. It is a difficult issue, how the government and authority should devise a sensible policy and measures at the same time trying to communicate and persuade the people about the cause.
Another lesson to be learned, is that when Italy first enforced the lockdown order, there were still many did not obey, eg. going out to park playing with kids as usual. The public awareness about disease prevention is low, the government has to reflect and review if their own communication and action strategies are ineffective? At least Italian language in Italy is more prevalent and widely understood, Malaysia has multiple ethnics as well as a large size of migrant population from diverse nationalities, if Malaysia only uses the national language Malay, communication might not be effective enough in disseminating the important information to the ground.
Ministries and departments have to coordinate their efforts, reach consensus, be cooperative and streamline their actions and commands, then only the public would not be confused, (consequently ) panic and fearful. This COVID-19 outbreak is not just public health issue but involves management of a host of other-related issues concerning socioeconomics, culture and religion sensitivity, politics, etc.
My special concerns are for the vulnerable groups such as low-income families and refugees during this period. Without income for 2 weeks, how are they going to ensure their whole family has enough food and basic supplies? This is a huge social challenge. The government and civil society organisations, at this crucial time, should show solidarity towards those who need help more than others, we should do our bits to reach out and help these people.
