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Experts Believe Malaysia Is Not Testing Enough People For Covid-19

Experts Believe Malaysia Is Not Testing Enough People For Covid-19

Tasneem Nazari

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Local health experts believe the Ministry of Health (MoH) is under-testing for Covid-19.

While the number of positive Covid-19 cases in Malaysia may have spiked in the last two weeks since the implementation of the movement control order (MCO), the number of new cases per day have been averaging between 100 and 200.

Experts agree that the country should be recording a higher number of positive cases with increased testing.

(Credit: Ministry of Health)

Speaking to Malay Mail, Malaysia Medical Gazette managing editor Dr Khoo Yoong Khean explains that this is easily seen when we look at the number of tests done per million of the population rather than just the total number of tests.

In 2019, Malaysia’s population is estimated to be at 32.6 million.

According to the MoH, Malaysia did 39,663 tests. That’s around 1,255 tests per million people. South Korea is doing 6,500 tests per million people and Singapore is doing 6,800 tests per million people.

Dr Khoo Yoong Khean via Malay Mail

According to him, the higher number of positive cases don’t show the true picture of the outbreak. Instead, it’s better to refer to the number of deaths and/or the number of ICU cases.

Senior consultant paediatrician Datuk Dr Amar-Singh HSS agrees that the better way to determine the severity of Covid-19 in Malaysia is by looking at the number of deaths.

Covid-19 statistics in Malaysia as of 1 April. (Credit: Ministry of Health)

Assuming 1% of all patients die (a very conservative number), Dr Amar said 1% means for every one death, there are 100 positive cases. Therefore, 37 deaths mean that there are 3,700 positive cases.

How many do we have now? We have 2,626 cases. But you see, 3,700 cases based on the number of deaths is not today’s number; it is a number from four weeks ago.

Datuk Dr Amar-Singh HSS via Malay Mail

He points out that the incubation period of Covid-19 is about 10 days or two weeks before symptoms start to show. Then the patient is admitted, placed on a ventilator or in the ICU before they pass away.

In this sense, 3,700 positive cases was Malaysia’s epidemic size three to four weeks ago. Today, the number would be much higher, especially if you consider the fact that some cases are asymptomatic. Based on the United States Centers for Disease Control and Prevention, as many as 25% of people infected with Covid-19 may not show symptoms.

The actual mortality rate for Covid-19 is currently 1.4% in Malaysia and 3.4% globally.

This is also the reason why mass testing is so important.

According to Dr Amar, mass testing does not have to include the society at large. However, at the moment, MoH is only testing PUIs with symptoms.

Mass testing means we test everybody who has come into contact with a positive case. Now we’re only testing symptomatic individuals.

Datuk Dr Amar-Singh HSS via Malay Mail
Health Ministry personnel screen the homeless for Covid-19 before sending them to transit centres during the MCO. (Credit: Malay Mail)

Unfortunately, even if we wanted to, Malaysia does not have the capability to mass test at the moment. We are limited by general resources like manpower and labs.

In addition, local production of test kits is low and done primarily in the Institute of Medical Research. Global production of test kits was also low at the beginning of the outbreak and any kits made in China, South Korea and Taiwan were reasonably kept for domestic use and not exported.

Countries like South Korea also have large-scale drive-through testing, making it very tough for Malaysia to match their numbers. 

In the end, we can only work within our limits.


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