Health experts call for stricter enforcement of second MCO

PETALING JAYA: The success in containing the pandemic and reducing the number of cases very much depends on stricter enforcement of the movement control order, say health experts.

Prof Dr Moy Foong Ming, from Universiti Malaya’s Department of Social and Preventive Medicine, said while the current restrictions appeared to be stringent, implementing them was a different matter.

“On paper, the current MCO is strict, but there is inadequate and inconsistent enforcement.

“The most distinct example of inadequate enforcement is that physical distancing is not enforced in markets or grocery stores, ” she said.

She estimates that Malaysia would need at least six weeks to see the R value, which is the infectivity rate, decline and stabilise.

“The first two weeks will not have much improvement as the infections already happened the two weeks before MCO.

“The next two weeks may show some improvement if the MCO is strictly enforced. However, the MCO is not the solution. It is just to buy time for the government to improve and be better prepared to manage the pandemic, ” she said.

Epidemiologist Datuk Prof Dr Awang Bulgiba Awang Mahmud of Universiti Malaya said it was difficult to determine whether the second round of MCO was sufficient to prevent Covid-19 infections from rising further.

“It is difficult to make a good prediction at this point in time for three reasons. Firstly, the high positivity rate of more than 8% indicates inadequate testing.

“The high number of unlinked cases indicates widespread community transmission.

“Thirdly, the granular data for this third wave has also not been made available for an independent group of experts to analyse, ” he said.

According to John Hopkins University, Malaysia’s test positivity rate based on its seven-day moving average is about 8%, which means that out of all the Covid-19 tests conducted, about 8% are detected to be positive.

A higher test positivity rate suggests that more Covid-19 tests should be carried out, as there are many cases that remain undetected in the community.

The World Health Organisation recommends that this test positivity rate should remain below 5% for at least two weeks before governments consider relaxing restrictions.

As such, Dr Awang Bulgiba said the numbers in Malaysia were likely to be under-reported, and with new procedures for Category 1 and 2 patients to undergo home quarantine, there would be more positive cases that would remain unknown.

“Looking at the restrictions introduced this time around, MCO 2.0 is not as strict, so the contact rate is going to be higher, which will make it more difficult to control transmission.

“It will take up to 12 weeks to see a sustained decline in new infections, but looking at the recent numbers, this means a long and difficult road ahead and I am not even sure whether 12 weeks is enough, ” he said.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah said the current MCO was not stringent enough.

“There is still a lot of movement and overcrowding in public places. Though it will be difficult, we do not have a choice but to close more places until the situation comes under control, ” he said.

However, Universiti Malaya professor of epidemiology and public health Prof Dr Sanjay Rampal said the second round of MCO had been more systematic and standardised than the first one imposed in March last year.

“The stricter standard operating procedure compared to the conditional MCO and the recovery MCO is appropriate, given the higher risk of community transmission.

“However, we must be patient as the MCO takes one to two weeks to substantially bring down the transmission due to the range of incubation period, ” he said.

He added that as Malaysia started to concentrate its testing on symptomatic cases, those diagnosed might require higher utilisation of healthcare services.