Malaysia transitioning to endemic stage of the pandemic

“The ‘Transition to Endemic’ phase is an exit strategy to enable all of us to return to almost normal life after two years of struggling with COVID-19,” he told a press conference, according to Bernama.

In addition to accepting vaccinated overseas travellers without quarantine, the new stage will see the end of limits to business operating hours, worker capacity based on vaccination status, and mass gatherings. But wearing masks in public places will still be compulsory.

He added that the new phase would be temporary as the nation prepared to enter the endemic phase, the timing of which is subject to an official decision by the World Health Organization (WHO).

The country is confident it can move into a transitional stage thanks to high vaccination rates, the arrival of new COVID-19 antiviral medicines, and a sturdy national testing policy, Tan Sri Dr Noor Hisham Abdullah, Malaysia’s Director General of Health, told Global Health Asia-Pacific. He added it was hard to say when COVID-19 could be declared endemic as it was continuously evolving, thus warranting a cautious approach.

Endemicity is a state where an infectious disease is regularly occurring but doesn’t require emergency measures to keep it at bay as it doesn’t usually lead to steep surges in cases. That doesn’t mean endemic COVID-19 will stop making people sick and causing death, but the hope is that it will be easier to deal with to the point where countries can lift all the restrictions while still containing its spread.

Malaysia’s latest move to end the pandemic is a logical next step considering how the Southeast Asian nation withstood the recent wave of COVID-19. While it saw thousands of new COVID-19 cases in February and March, the number of deaths and intensive care cases rose less sharply compared to the more lethal wave that hit the country in the summer of 2021.

Data from the Malaysian Ministry of Health show that daily cases from mid-February to the end of March fluctuated between roughly 15,000 and 30,000, with the average seven-day mortality rate moving from about 30 to almost 90, while the number of patients entering intensive care units (ICU) fluctuated between about 170 and 400. But despite the lower daily cases in August 2021, which oscillated between 15,000 and 20,000, the country saw much higher death and intensive care usage rates, with the average seven-day mortality rate climbing to between 250 and up to more than 300, while the average number of ICU patients with COVID-19 hovered between 1,400 and 1,600.

Despite the ongoing high number of daily cases, Malaysia is recording fewer patients requiring ICU or dying from COVID-19 due to the success of its vaccination programme and various public health measures like masking, maintaining physical distance, and other restrictions to contain the spread of COVID-19, according to Dr Noor Hisham.

He stressed that, despite the improved conditions, vaccination and public health measures would still have a role to play given that COVID-19 cases could surge again due to new variants and the relaxation of public health measures, something that is beginning to happen in Europe and which Malaysia needs to take into account as well.

Since the outbreak of the pandemic in 2020, the Director General of Health has earned the trust of many Malaysians due to his common-sense approach and regular public briefings that have made him the most recognisable public face in the nation’s fight against the pandemic.

Hailed as one of the country’s most competent healthcare leaders, Dr Noor Hisham likes to caution the public against lowering its guard in the face of COVID-19, and new waves of the disease have proven him right.

“We’re still fighting a war,” he told the New Straits Times back in August 2020, when the country was still recording daily COVID-19 cases in single digits. “Now our problem is when the numbers go down, people let down their guard. You see, when we succeed, it breeds complacency and that in turn can breed failure. It’s a vicious circle. We want to do prevention; now the onus is on the public to comply.”

For his contribution to containing the spread of COVID-19 in Malaysia, Dr Noor Hisham received the Lifetime Achievement Award from Global Health Asia-Pacific last December. At the awards ceremony, he highlighted that the key lesson to learn from the pandemic was that both the public and private healthcare sectors should work in synergy to tackle health crises. This meant recognising the assistance offered by private providers to care for non-urgent cases, such as elective surgeries, and implementing the national COVID-19 vaccination programme. “We need to come together as one to make the impossible possible,” he said.