SitRep: Malaysia

As of this writing, Malaysia reports 4,119 positive cases, 65 deaths, and 1,487 recoveries. Malaysia reported its first positive COVID-19 infection on January 25, 2020. Over the following few weeks, cases increased by only several per day, all of which were Chinese nationals. In early February, Malaysia recorded its first local infections, with 29 cases reported on February 29. 

And then there was Tabligh jamaat.

To date, 1,591 cases can be tied to the Tabligh jamaat religious gathering at Jamek Mosque in Seri Petaling, Kuala Lumpur. From February 27-March 1, an estimated 12,000-16,000 attendees met in close quarters and shared meals. Over 620 individuals in Malaysia tested positive from attending the event, and cases in Brunei (most of its 73 cases), Thailand (10), Singapore (5), and Cambodia (22) can be traced to Tabligh as well. March 17 brought the country’s first deaths, a 60-year-old priest and a 34-year-old Tabligh participant. By March 20, positive cases rose to 1,030, including 15 infected medical workers. March 23 marked 14 cumulative deaths. March 29 was the highest day of fatalities, with 9.

After the Tabligh cluster came to light on March 14, 2020, the authorities announced a Movement Control Order (MCO) on March 16. The order’s six restrictions, in effect until March 31 and later extended to April 14, include no mass gatherings—including religious, athletic, social, and cultural—and businesses must close, except necessities including markets and convenience stores; those returning from abroad must undergo a health check and self-quarantine for 14 days; tourists and foreigners are forbidden from entering the country; schools must close and extracurricular activities are cancelled; government and private premises must close, except for those on a list of essential services, including utilities, postal services, broadcasting, banking, health, prisons, food supply.

After the MCO was put in place, the authorities also increased COVID-19 testing, focusing on symptomatic cases. Malaysia’s testing rate is 1,255 per 1 million people, compared with South Korea at 6,500 and Singapore at 6,800. Experts recommend increasing the testing rate and expanding who qualifies for a test to include those who come in contact with positive cases. In addition, testing should focus on healthcare professionals, services providers such as delivery personnel and cashiers, and those living in areas with large outbreaks. Malaysia has 46 labs capable of testing. As of March 31, the testing capacity was 11,750 per day, and the authorities expressed a target of 16,500 per day using PCR kits. Malaysia is attempting to create test kits domestically, as well as purchase them from abroad.

There are signs that the general public is not taking the MCO seriously, including allegations of patients intentionally concealing symptoms and travel histories. Some participants in the Tabligh were reluctant to come forward, and authorities have spent a great deal of effort to track them, but doctors report that others are uncooperative as well. With the Tabligh cluster already spreading to the fifth generation, the third wave of the outbreak, community infections, may be next. Indigenous communities have begun blocking their village entrances in anticipation of the third wave, reportedly forgoing government food assistance in their isolation attempts.

Two economic stimulus packages have been announced, one by interim Prime Minister Mahathir Mohamad on February 27, and the second on March 27 by the new Prime Minister Muhyiddin Yassin. The first package of RM 20 billion (U.S. $4.6 billion) focuses on businesses, including those hardest hit by regional travel restrictions and small and mid-sized businesses. But the March 27 stimulus of RM 230 billion is a signal that the government took the Tabligh cluster and its impact seriously. This “Caring for the People” stimulus package provides RM 128 billion in one-off cash payments to households and individuals, to be disbursed in April and May, discounted utility bills, and deferments on rental payments and retirement contributions. The total economic stimulus of RM 250 billion represents 15.5% of Malaysia’s GDP and is equivalent to 84.2% of the original 2020 budget.

What is clear from this trajectory is that better information dissemination to the public regarding virus prevention measures, early testing, and banning mass gatherings could have gone a long way to prevent the severity of the situation in Malaysia. Tabligh attendees claim neither they nor the public were sufficiently alarmed at the end of February. However, the extreme precautions and sobering experiences of other countries, particularly those in Asia, should have sounded the alarm. Since then, however, the authorities quickly took action to try to contain the outbreak. Still, if the population does not continue to observe the MCO or the MCO is lifted on April 14, the outbreak may become out of control.

Policy Recommendations for Malaysia:

  1. Increase testing, including those who are asymptomatic but have had contact with positive cases, to understand the true extent of the outbreak. 
  2. Ensure adequate medical facilities, testing equipment, protective gear, and personnel for continued or increased outbreak, and procure supplies from abroad where necessary. 
  3. Require quarantines of households with confirmed or suspected cases.
  4. Improve tracking procedures and oversight of quarantine compliance.  
  5. Ensure vulnerable populations have access to information, food supplies, and medicine.
  6. Extend the MCO as long as necessary, and improve public messaging about the extent and severity of the outbreak, including virus prevention measures.

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