MCO Best Chance To Flatten Epidemic Curve

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KUALA LUMPUR (Bernama) — COVID-19 is an infectious disease caused by a coronavirus 2 (SARS-CoV-2 ) that was first identified in Wuhan, China in 2019. The World Health Organisation (WHO) declared the outbreak a Public Health Emergency of International Concern on Jan 30, 2020, and six weeks later a pandemic.

The spread of the virus is relentless with evidence of local transmission in many countries across all six WHO regions.

SARS-CoV-2 was first isolated in Malaysia on Jan 25 and our experience with previous outbreaks led to a swift action plan that began with the initial strategy of containment.

However, following a spike in cases related to a local religious gathering, a Movement Control Order (MCO) was imposed on March 18. Further actions by our National Security Council will depend on the success of all the measures implemented thus far.

How should we respond in a viral pandemic? There are a few options, each has its positives and drawbacks. There is an easy (or suicidal) approach where the virus is allowed to infect the population and then bank on the development of herd immunity remotely assuming this Ribonucleic Acid (RNA) virus does not mutate.

However, there will be untold misery: for an infection of 60 percent of the population of Malaysia with a conservative one percent mortality rate, the number of deaths will be colossal, the health system as we know it will collapse, and the world after it will turn ugly.

The shallow advantage here is that we get no disruption to our daily routines; in short, this is utter madness.

Another option is to mitigate via measures such as widespread testing, case identification and subsequent isolation, contact tracing and social distancing with the hope that the epidemic curve would flatten enough, but a seminal paper from the Imperial College COVID-19 Response Team shows that this is far from adequate (unless strict adherence to the path of Singapore or South Korea).

Otherwise, there will still be a deluge of cases overwhelming the current healthcare capacity with significant mortality.

A more draconian approach is a suppression strategy, coupled with our existing public health measures (testing, identification, contact tracing and isolation) and social distancing, which present the best chance for Malaysia to contain COVID-19 cases at any given time in relation to the capacity of our healthcare infrastructure and staff, and mitigate death and its related health sequelae.

Our MCO introduced under the Prevention and Control of Infectious Diseases Act 1988 and the Police Act 1967 is one such measure.

This strategy if judiciously implemented will achieve the following: reduce the number of new COVID -19 cases and therefore death, relieve the pressure on our healthcare system and professionals, and not least buy time for us to prepare for the next peak if any and for a vaccine or treatment to be ready.

Although our MCO is dissimilar to a total lockdown seen in China or Italy, it shares many similar features, perhaps ours is a partial lockdown or a forced social distancing order.

It compels people to stay at home, adopt social distancing and limit movements and ban travel to flatten the curve.

This method is undoubtedly ruthless on the people due to the restriction on movement for many legitimate reasons and potentially devastating to our economy, but given our local nuances, it has the best chance to flatten the curve.

Therefore, it is vital that we as Malaysians ensure the MCO that started on March 18 works.

This is achieved by strict adherence to its six core items of implementation because the consequences of failure are more profound as alluded to above.

Furthermore, failure also means the need for the MCO to be further extended and a more stringent implementation order.

This prospect will ruin an already strained economy and prolong the discomfort caused by movement restriction and our life will take a longer time to return to the new normal.

The threat of COVID-19 is so real, this is the time for us to come together to make this work for our future and the future of Malaysia.

This article was originally published by BERNAMA at

Prof Dr Mohammed Fauzi Abdul Rani

Prof Dr Mohammed Fauzi Abdul Rani

Consultant In Chest and General Medicine

Dr Gary Lee Chin Keong

Dr Gary Lee Chin Keong

Consultant Cardiologist & Electrophysiologist