PETALING JAYA: The infectivity rate (R0), which has been rising, has to be closely monitored to prevent a spike in Covid-19 cases, say public health experts.
They say the infections should be within an acceptable range so that the healthcare system is not overburdened even as the country enters the endemic stage.
Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said the current situation must be monitored closely even though vaccination coverage among adults is now more than 95%.
Some adults could be at risk of being infected as their immunity levels could be reduced three to six months after their inoculation, depending on the type of vaccine, she said.
“With current active cases still over 60,000 and the infectivity rate on the rise, inevitably more and more cases will be reported. I have been informed informally that the number of admissions among paediatric patients who have not been vaccinated has increased,” she said when contacted yesterday.
Even in an endemic phase, Dr Malina said the number of cases should be within an acceptable range that the healthcare system can handle.
“The cases should be low, and in my opinion, should not exceed three digits nationwide,” she said.
The R0 nationwide has been trending down from late July but it has been inching up since Oct 20. For the most part of October, the R0 had hovered between 0.86 and 0.88.
As at Nov 11, the R0 rose to 1.0, five weeks after interstate travel was allowed. It has now increased to 1.05 as at Nov 13. The last time the country’s R0 was above 1 was on Aug 31.
The R0 is a measure of virus transmission, or number of new infections generated by each case. An R0 rate of 1, for example, means that on average, each infected person will infect one other person they come into contact with.
Hospital admissions nationwide in the past seven days have also increased by 7%, according to data on the Health Ministry’s CovidNow portal.
The highest increase was seen in Kuala Lumpur with 133%, followed by Melaka (48%), Putrajaya (35%), and Perak (20%). Selangor saw an increase of 7% while Penang fell by 4%.
In view of the current situation, Dr Malina said all efforts to curb infections must continue.
“We hope that the booster dose will be taken by those who are being advised to do so, and the coverage of the vaccine will also be further increased,” she added.
Universiti Malaya’s Department of Social and Preventive Medicine Prof Dr Moy Foong Ming said unless the R0 was monitored, it might come to a stage where the infectivity rate would rise until it becomes difficult to control.
“If the R0 is 1, that means the total infections will not be reduced when 100 patients infect another 100 people. The daily cases can only be reduced if the R0 is less than 1,” she said.
Although the vaccination rates for adults and adolescents were high, she said that there was the possibility of breakthrough infections.
“The waning effect of the vaccines is another aspect that the Health Ministry needs to monitor, especially among the elderly and those with comorbidities,” she added.
The rate of fully vaccinated adults and adolescents currently stand at 95.2% and 79.6%, respectively.
Dr Moy said in an endemic phase, cases should reach a baseline value where the healthcare system and workers were not overburdened, hospital beds and ICUs (intensive care units) were not swamped, and non-Covid 19 patients were able to have their appointments or surgeries scheduled in the optimal time and not be delayed.
Healthcare services such as screening, health promotion and education of the community should also be able to be conducted as scheduled.
As such, she urged the public to not let their guard down and to continue adhering to the standard operating procedure.
“The cases can only go down further when our rakyat internalise the SOP and not be complacent. The most important SOP is to wear a mask when in public places, avoid crowded and poorly ventilated places, keep your physical distance and sanitise your hands, plus being vaccinated.
“For the elderly or high-risk groups, they should go for it when the booster dose is offered to them as breakthrough infections can happen especially among these groups.
“We need all these layers of protection in order to further bring down cases,” she said, adding that people should not abuse the privileges that they are enjoying now.
Health Minister Khairy Jamaluddin tweeted a reminder to the public, saying they should keep their face masks on and avoid crowded places.
Senior citizens should also get their booster jabs when it’s available to them, he added.