PETALING JAYA: Workplaces and detention centres were the source of 35% of all Covid-19 cases over the past two months, making them the top clusters as the country battles a high tide of infections.
The Health Ministry reported 158,789 Covid-19 cases in a 60-day period from Dec 7 last year to Feb 4 this year.
The Star did an analysis of the daily figures from this period and found that 29.2% (46,411 cases) were linked to clusters detected from targeted worker screenings at factories, construction sites, security companies and other workplaces.
Clusters that emerged due to screenings at prisons, lockups and immigration detention centres comprised 6.1% (9,618 cases).
Other types of clusters, which include those linked to inter-state travel, family and social gatherings, made up a combined 8.1% (12,827 cases).
The remaining infections – which were not attributed to clusters – were from close contact screenings, and other types of screenings, as well as imported cases.
For context, Dec 7 last year was when inter-district and interstate travel restrictions were lifted.
Covid-19 screening for prisoners, those under remand and other detainees, had been stepped up a few months earlier.
It was then announced that screenings would be mandatory for foreign workers, in stages, from Jan 1 onwards this year.
A steady rise in daily cases subsequently led to the reimposition of the movement control order on Jan 13.
Universiti Malaya epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud said that workers' living conditions and adherence to SOPs at work must be looked into to address the spike in workplace infections.
"We need to look into whether SOPs are being adhered to in the workplace, like where they eat and rest, and whether their living conditions are a factor in causing spread," he said.
He also acknowledged that the enforcement of the amended Workers' Minimum Standards of Housing and Amenities Act 1900 (Act 446) to improve worker's living condition will take time due to the economic downturn, which will make it difficult to stem the rampant spread of Covid-19 infection.
"In the short term, we will need to do repeated testing followed by prompt isolation of infected cases of migrant workers despite the cost.
"In the long term, we have no choice but to improve workers’ living conditions," he said.
Apart from clusters, Dr Awang Bulgiba said more attention should be given to the threat posed by unlinked or sporadic transmissions.
Unlinked or sporadic transmissions refer to newly diagnosed cases that cannot be linked to any previous cluster.
Dr Awang Bulgiba said he noticed a rising trend since September last year in the number of infections unlinked to any cluster.
"Now, the unlinked cases have probably resulted in so many other infections that we are having outbreaks in healthcare facilities and care homes which are unrelated to existing clusters," he said.
He added that asymptomatic transmission – in which a person is infected but shows no symptoms – was another cause for concern.
Dr Awang Bulgiba said a publication last month by the Journal of the American Medical Association found that transmissions from asymptomatic individuals were estimated to account for more than half of all transmissions.
"I have maintained from the outset of the pandemic that asymptomatic infections probably outnumber symptomatic infections although there were people who disagreed with me.
"Now the infection is well and truly entrenched in the community and this is spreading asymptomatically," he added.
Dr Awang Bulgiba said more testing is needed, and not only to trace new and active infections.
“We need repeated seroprevalence surveys to determine the level of past and current Covid-19 infections in the country.
“This is likely to reveal a much higher infection rate than what has been discovered with the current testing strategies used,” he said.
Citing an example, Dr Awang Bulgiba said that when China’s researchers did a seroprevalence study in several locations, the number of infections found were much higher than the number of cases that were reported in the actual outbreak.
On Sunday (Feb 7) Health Minister Datuk Seri Dr Adham Baba said that 6,414,565 Covid-19 tests has been done throughout last year until Feb 5.
Of the total, 3,332,554 were RT-PCR (Reverse Transcription Polymerase Chain Reaction) tests.
He said that for this year, 1,188,284 RT-PCR tests had been carried out as well as 1,893,727 RTK-Ag (Rapid Test Kit Antigen) tests.
Dr Adham said the numbers showed that government was giving attention to RTK Antigen and RT-PCR tests in order to detect cases.
Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said mass testing is needed for economic activities in the country to fully resume safely.
Mass testing, she said, should include college or varsity students, those in charge of inmates and nurseries, frontliners, as well as other high-risk industries or job settings.
"We hope the government will proceed with certain mechanisms to reduce the price of screening tests so that more screening can be done.
"If companies have the appropriate budget, are able to get affordable prices for screening tests and properly enforce standard operating procedures, Covid-19 screenings can be made mandatory," she said.