Covid-19: What the experts say to expect

By Xavier Kong

This is the second part of a series of articles on Covid-19.

A report from research house JP Morgan claims that Malaysia should expect to see a milder development of Covid-19, with a lower mortality rate as well. With a mortality ratio of about 0.94%, compared to the global average of 4.4%, Malaysia is looking to be in a better place.

The report by MW Kim and Ling Wang of JP Morgan also notes that Malaysia sees a higher test per million capita of 482, which is between four and 81 times higher than our Asean counterparts, and also higher than several countries in the European Union.

“It suggests that the country has relatively better positioning to contain the virus diffusion process,” said the duo.

The second contributing factor is the strong efforts to slow the infection curve development, namely the Movement Control Order (MCO), which Kim and Wang lauded as decisive. Other strong efforts include the restricted entry for foreigners and restrictions on Malaysians travelling abroad, the closure of schools and colleges, the bans on gatherings, and the shutdown of non-essential businesses.

The third factor is actually the high number of critical care beds available in Malaysia, which the duo note “looks sufficient to manage mortality risk.”

“Given that only about 10% of total infection generally need intensive care beds compared to the forecasted total infection at peak, we think that the country has the capacity to absorb future hospital demand to a large degree,” added Kim and Wang.

However, the duo also expressed concerns that Malaysia could be looking at the epidemic entering the curve acceleration stage locally, based on the doubling, almost tripling of infections observed over the past few days. Still, they expect this to ebb within two weeks, with a forecasted peak of infection in the middle of April at about 6,300 cases.

Kim and Wang also noted that the findings of a Covid-19 demographic study by the US Centers for Disease Control (CDC) reveal that severe illness leading to hospitalisation, including ICU admission and death, can occur in adults of any age. This, they said, is consistent with the research house’s view that Covid-19 can infect a substantial number of young adults as well.

“We see Malaysia’s decisive policy action in the last week as justified by the rapid
recent increase in infections. We believe the government’s actions are proving effective in curbing the spread and intensity of the epidemic. Mortality rates in Malaysia are low, and Malaysia’s aggressive testing strategy, ‘test per million capita’, far exceeds Asean peers and even several European nations,” said the duo, adding that this strategy could result in higher reported infection numbers, but added to their confidence of milder development and mortality.

“The recent limitations on movement should also help to slow the spread, and border controls should subdue secondary spread of the epidemic,” they added.

The US situation

Over in the US, the numbers at the time of writing read 54,935 confirmed cases, with 379 recoveries and 784 deaths, with a report by Ferguson et al from the Imperial College of London stating that the global impact of Covid-19 has been profound, and that “the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic.”

Through epidemiological modelling and in the absence of a Covid-19 vaccine, the study looked at the projected impact of non-pharmaceutical interventions, with the conclusion that multiple forms of such interventions needed to be combined to have a substantial impact on transmission.

According to the simulation of Ferguson et al, a peak in mortality is likely to occur after three months should there be no control measures or changes in individual behaviour, with 81% of the population infected over the course of the epidemic.

“From an uncontrolled epidemic, we predict critical care bed capacity would be exceeded as early as the second week in April,” said the report.

At this time, nine states in the US are currently on lockdown, with other states taking social distancing measures.

The Nobel approach

Michael Levitt, a Nobel laureate and Stanford biophysicist, believes that the warnings of many epidemiologists that warn of months, or even years, of massive social disruption and millions of deaths are false.

“What we need is to control the panic,” he said. In the grand scheme, “we’re going to be fine.”

He noted that the data simply does not support such a doomsday scenario, especially in areas where reasonable social distancing measures are in place. However, he also placed himself solidly in the camp of those calling for strong measures to fight the outbreak.

“The social-distancing mandates are critical, particularly the ban on large gatherings, because the virus is so new that the population has no immunity to it, and a vaccine is still many months away. This is not the time to go out drinking with your buddies,” he said.

This is followed by the announcement by Prime Minister Tan Sri Muhyiddin Yassin, on March 25, where he announced an extension on the MCO by a further 14 days to end on April 14, instead of the initial March 31. He urged Malaysians to be “physically and mentally prepared” to face a longer MCO period, especially if the MCO needs to be extended further past April 14.

What’s the sum total from all these? So far we are doing well in terms of keeping the pandemic under control. But we are not out of the woods yet, and we need to remain ever vigilant and continue with the partial lockdown. Not to do so would be reckless.

Other countries may not be so lucky. They may have passed the point at which the pandemic can be controlled. We need to see what happens there. There will be consequences for them and we won’t be totally insulated.

But the continued shutdown of many services and businesses will take its toll on the economy and we will have to do what we can to mitigate the effects.

Other parts in this series of articles:

Part 1: Covid-19: Softening the blow

Part 3: Covid-19 hits economy really fast and hard

Part 4: Covid-19: How the government should stimulate the economy

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