I was interviewed by Malaysiakini prior to the MCO 2.0 lockdown
https://www.malaysiakini.com/news/558220
Published
Modified 9 Jan 2021, 12:41 pm
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Speaking to Malaysiakini, health economist Lim Chee Han agreed with the use of a targeted MCO to contain red zones - areas that have recorded 41 or more infections over the past 14 days.
The Third World Network public health researcher explained how restricting movement could break the chain of community transmissions.
This, in turn, can help lessen the strain on the healthcare system - said to be on the verge of a breakdown.
“Reducing the number of people going out would certainly mean reducing people’s interaction, and hence the probability of contracting the virus [...]
“The government can focus on the 64 red zone districts first and definitely reimpose restrictions on cross-state or cross-district movement.
“This is so the Health Ministry can have fewer worries about the probability of residents in red zones spreading the virus further and be able to focus on reducing local transmissions,” he said.
Restrictions on interstate and interdistrict travel were lifted on Dec 7. Interstate travel and social activities like sports have since led to at least 14 new Covid-19 clusters.
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Read the full response I gave to the journalist below.
Many indicators point that the situation is getting out of hands for MOH to handle the 3rd wave pandemic, they are all at unprecedented record numbers by 7 Jan 2021: daily confirmed cases (3027), active cases (25221), infected districts (in the past 14 days) (121 or 80.7%), red zone districts (64 or 42.7%), clusters (254) and non-clustered cases (1507 or 50%). (Refer to the figures below)
Many of these indicators the trends are already showing upward trajectory since first week of December, the prognosis is not looking good. Since Dec 7, inter-district and state restrictions are also lifted, that was probably the main factor contributing to the virus being spread around the nation – about 30 more districts reported cases in the past 14 days as of Jan 7, compared to Dec 7. On Jan 7, with the fall of Hulu Perak, Kangar (Perlis) and Langkawi (Kedah) become the only two districts on the west coast of Peninsular which do not have any cases in recent 2 weeks.
To the MOH, what concerns them is the capacity to accommodate more confirmed patients in certain states or districts, as well as ability to do contact tracing and testing to curb new case load. The stress and pressure are unevenly distributed, for example, in Klang Valley, 4 districts have seen over 1000 cases in recent 2 weeks (Klang alone has 3536!), whereas the most populated district (Kinta) in the neighbouring state Perak has only 147. DG Hisham has said it right, the government has to consider measures to reduce the disease burden, expansion of healthcare capacity will never be able to catch up with the worsening pace of pandemic caseload.
Public should be made understood that, the virus follows the patient/carrier wherever they go, thus reducing the number of people going out would certainly mean reducing people’s interaction and hence the probability of contracting the virus. Therefore, it makes sense for the government to impose movement restrictions depending on the level of severity of disease transmission in recent period in certain locality (district or state).
Despite many in public are now calling for the reintroduction of the MCO lockdown measures for the entire nation like the first one in March 2020, I agree with DG Hisham that is not necessary for now. The government can focus on the 64 red zone districts first, definitely the government should re-impose restriction on cross-state or cross-district movement, so that the MOH could have less worry about the probability that residents in the red zone spread the virus further, instead focusing on calming down the transmission in local community.
It is quite understandable that the government wants to minimise the damage of the MCO measures to the economy as much as possible, so to balance the ‘lives and livelihoods’. While people should be still allowed to go out to work if the nature of the work requires them to do so, the government should consider re-impose travel restriction on non-essential activities or restrict the number of persons in car. The ultimate objective should be reducing the number of people (‘the crowd’) out there hence the possibility of physical interaction and disease transmission.
Since this would not reduce the disease transmission as much as the first phase of MCO back in March 2020, it will certainly take longer time to suppress the case growth, but at least the government is at better position to control and contain the disease while permitting most economy activities continue to run. However, the government should also learn from past mistake for lifting the movement restriction in red zones too early in December, resulting the touristic places and rural kampong folks exposed to COVID-19 risks.
The current 3rd wave pandemic is averagely at least 7 times worse than the height of 2nd wave pandemic back in March 2020 (when comparing the average daily cases between these two groups: 154 vs 1085). Therefore it is not difficult to imagine why the MOH can feel the strain now even though they are much organized and prepared than before.
Cumulative and average daily cases
Note that the active cases and local infection cases were actually reduced at the beginning of December, this shows that the initial CMCO did work to contain and suppress the disease transmission. The premature uplift of the cross-district and cross-state movement measures is probably the main factor we see the surge of cases later on.
Trend of Daily Confirmed , active and local infection cases
This is also true for the frontline state such as Selangor at the district level.
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Klang is the worst hit district for the 3rd wave of pandemic, look at its ups and downs.
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Districts with local infections & Red zone districts (in the past 14 days) (total=150 districts/areas)
Significantly higher number of non-cluster cases shows the bad prognosis going forward, as more cases with unknown sources, it means that the local transmission is more prevalent and the situation is less controlled. This number would have immediate future implications to forming the new clusters.
Active Clusters and non-cluster cases
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