The Epidemiology of COVID-19 in Malaysia

Abstract

Background: COVID-19 has rapidly spread across the globe. Critical to the control of COVID-19 is the characterisation of its epidemiology. Despite this, there has been a paucity of evidence from many parts of the world, including Malaysia. We aim to describe the epidemiology of COVID-19 in Malaysia to inform prevention and control policies better. Methods: Malaysian COVID-19 data was extracted from 16 March 2020 up to 31 May 2021. We estimated the following epidemiological indicators: 7-day incidence rates, 7-day mortality rates, case fatality rates, test positive ratios, testing rates and the time-varying reproduction number (Rt). Findings: Between 16 March 2020 and 31 May 2021, Malaysia has reported 571,901 cases and 2,796 deaths. Malaysia's average 7-day incidence rate was 26 • 6 reported infections per 10 0,0 0 0 population (95% CI: 17 • 8, 38 • 1). The average test positive ratio and testing rate were 4 • 3% (95% CI: 1 • 6, 10 • 2) and 0 • 8 tests per 1,0 0 0 population (95% CI: < 0 • 1, 3 • 7), respectively. The case fatality rates (CFR) was 0 • 6% (95% CI: < 0 • 1, 3 • 7). Among the 2,796 cases who died, 87 • 3% were ≥ 50 years. Interpretation: The public health response was successful in the suppression of COVID-19 transmission or the first half of 2020. However, a state election and outbreaks in institutionalised populations have been the catalyst for more significant community propagation. This rising community transmission has continued in 2021, leading to increased incidence and strained healthcare systems. Calibrating NPI based on epidemiological indicators remain critical for us to live with the virus. (243 words) Funding: This study is part of the COVID-19 Epidemiological Analysis and Strategies (CEASe) Project with funding from the Ministry of Science, Technology and Innovation (UM.0 0 0 0245/HGA.GV).

COVID-19: What we need from epidemiology to help informed policies

“…In The Lancet Regional Health - Western Pacific , Jayaraj and colleagues provide a comprehensive view of the COVID-19 situation in Malaysia for the past year by describing its spatiotemporal patterns based on various epidemiological indicators: time-varying reproduction number (Rt), incidence rate, mortality rate, case fatality rate, test positive ratio, and testing rate, providing. [2] The article also demonstrates the characteristics of COVID-19 associated mortalities in Malaysia, which is similar to other existing studies showing vulnerable groups are mainly elderly and patients with co-morbidities. [3] Reporting single indicator alone will not suffice as it does not help in gauging the real outbreak situation.…”

Assessing the Spatiotemporal Spread Pattern of the COVID-19 Pandemic in Malaysia

“…The second and third peaks of Moran's I values were in mid-September and end of October to early November, 2020, which also preceding a surge of COVID-19 cases of the third wave of COVID-19 in Malaysia. These values informed the spatial dynamics of the initial outbreak, in addition to the incidence rate and time-varying reproduction number (25).…”

“…The few studies available were limited to analysis of spatiotemporal pattern of cases using monthly (22) or biweekly data at district level (23). Other studies examined state-level variations in cases and their interactions with air pollutant concentrations (24), or described epidemiological indicators by subregion (25). Spatiotemporal pattern analysis of disease transmission is vital in measuring the spatial dynamics of the epidemic for monitoring its occurrence, intensity, and direction of transmissibility.…”

Using Andersen’s model of health care utilization to assess factors associated with COVID-19 testing among adults in nine low-and middle-income countries: an online survey

“…The higher rate of COVID-19 positive diagnosis in Bangladesh may be explained by a higher prevalence of COVID-19 pandemic in Bangladesh (15.1%) [ 12 ], and the reluctance of people to get tested for COVID-19, when they have no or only moderate COVID-19 symptoms [ 34 ]. The lower rate of COVID-19 positive diagnosis in Malaysia may be attributed to a lower average test positive ratio and testing rate (4.3% and 0.8 tests per 1000 population) [ 11 ]. In Thailand the low rate of COVID-19 positive diagnosis may be attributed to a low prevalence of COVID-19 infection (7.5% among hospital patients) [ 13 ], and a low-test positive ratio (1.3, January–March 2021) [ 35 ], and a high compliance to COVID-19 preventive measures in Thailand [ 36 ].…”

“…In nationwide COVID-19 seroprevalence surveys in Brazil the prevalence was 1.9% in May 2020 and 3.1% in June 2020 [ 10 ]. In Malaysia, between 16 March 2020 and 31 May 2021, Malaysia’s average 7-day incidence rate was 26.6 reported infections per 100,000 population, and the average test positive ratio and testing rate were 4.3% and 0.8 tests per 1000 population [ 11 ]. In a cross-sectional online survey in 2020 in Bangladesh, 315 (15.1%) of 2080 individuals reported to have experienced a COVID-19 infection [ 12 ], and in a retrospective cohort study of adult hospitalized patients in 2020 in Thailand, 107 (7.5%) of 1409 patients were COVID-19 infected [ 13 ].…”