EARLY signals of rising rates of Covid-19 infection should be taken seriously, and appropriate measures enforced to prevent a resurgence in the pandemic.
Stronger moves may have to be imposed, such as quickly closing schools when there are cases and delaying giving the green light to interstate movement ahead of and beyond Hari Raya, if necessary. Complacency is perilous.
A close look at the figures indicates that we are at a dangerous inflection point, where a wrong premature move in favour of lifting restrictions may send the number of new infections skyrocketing again.
Look at Chart 1, the graph of observed cases. The vertical bars, which represent the daily number of observed cases, show a definite uptrend in the last few days. This is accompanied by a rise in the infectivity rate (R), as shown in Chart 2.
Chart 1: are we at an inflection point for increased cases?
R, or sometimes given as R0 or RT, represents the number of other people infected by one Covid-19 patient. As R heads towards 0.8, there is an exponential decline in cases as fewer and fewer people get infected (the blue section in the graph). Similarly, as R heads towards 1.2, there is a rapid increase in cases as more and more people get infected, represented by the red section in the graph.
It is therefore extremely important to keep R at around the 0.8 level or lower when controlling the pandemic. This is done through social distancing and adherence to the standard operating procedures (SOPs), while simultaneously controlling movement and close interaction.
Relaxing any of these potentially increases R and an explosion in infections – an inflection point that will reverse the decline in cases and has the potential to substantially increase them, as shown in the region in red.
A look at Chart 2 now. The line in red shows that R, now at 0.94, is poised to set a new five-week high, pushing to breach 1.0 and go higher. The latest figures already indicate that for the last few days, new infections have been on an upward trend.
Chart 2: R is increasing
Note that a rising R is reflected immediately in a rise in the number of daily cases. Chart 3 already shows that while R for Malaysia is at 0.94, it is 1 or above for a number of states, including Penang, Kelantan, Kedah, Terengganu and Sarawak. The figure may increase further before it declines.
Chart 3: breakdown of R by state
The R value for states is calculated on a 14-day moving average, which means a rising trend will take longer to register. The R value for Malaysia as a whole uses a seven-day moving average.
It is useful to note that the rise in R came about two weeks after inter-district travel restrictions were lifted on March 5, indicating that there may be a correlation between rising cases and the lifting of travel curbs.
If R continues upward in the next few days, it portends more cases and a rapid increase in Covid-19 numbers unless steps are taken to tighten movement and/or SOPs, and increase enforcement.
On Sunday, Health Director-General Tan Sri Dr Noor Hisham Abdullah appealed to the public to abide by the SOPs, including restrictions on interstate travel, reminding that such travel was responsible for spreading Covid-19 to green states, or those without infections.
He is right to issue the warning. R is increasing, and we need to see whether it starts coming down in the next few days. If it does not, it indicates that more action needs to be taken as soon as possible.
There is a tendency to be lulled into complacency ahead of the vaccination programme, which is being rolled out in phases. That would be a mistake, because Covid-19 can increase in the interim and raise casualties. We have to be on constant guard even as vaccination takes place, and the process must be hurried along to reduce damage.
Right now, we need to be alert to prevent another needless resurgence of Covid-19, and if it means prolonging existing restrictions and imposing new ones, let it be done. Otherwise, future costs will be a lot heavier, as we have found out to our detriment before. – The Vibes, March 23, 2021
P. Gunasegaram believes in the old adage ‘prevention is better than cure’. He is executive director of advocacy organisation Sekhar Institute and editorial consultant of The Vibes