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PETALING JAYA: Malaysia’s Rt, an indicator of how fast Covid-19 is spreading, has risen with Health Director General Tan Sri Dr. Noor Hisham Abdullah recently tweeting his alarm. Last Sunday, the Malaysian Rt was at 1.58, while earlier this month it was at 0.72.
As of September 8, Sabah recorded a Rt of 3.72 while Kedah, 2.63.
Since then, this rate has dropped following measures taken by the ministry.
Last Sunday, it was 1.7 in Sabah and 1.58 in Kedah.
An indicator of how fast the virus is spreading, Rt shows the average number of people who contracted Covid-19 from an infectious person.
However, according to health experts, whether a country is safe from the threat of Covid-19 also depends on a number of other factors, such as health regulations from authorities and public compliance with these policies.
The epidemiologist at the Universiti Malaya, Dr. Awang Bulgiba Awang Mahmud, said that while the R-value was an important indicator of whether a country was safe from Covid-19, it was not the only one.
“Other indicators include the country’s ability to cope with the disease and the trend in the number of new and discharged cases compared to the number of new infections,” he said.
A value of Rt, the effective reproduction number, of less than 1.0 is a good sign.
While R0, or R-nothing, is the initial reproduction number of the virus at the beginning of the pandemic, Rt refers to the reproduction number at a given time.
“An Rt of less than 1.0 means that the number of people infected on average will decrease over time and if this situation persists, the disease will eventually disappear.
The R value is an estimated index for the entire country. “Any Rt above 1.0 means that the virus is spreading rapidly,” said Professor Awang.
An Rt of 1.0, he said, meant that a disease was endemic and would persist over time, such as dengue.
“If the causative organism mutates over time to become less virulent, then an endemic state will not cause too much trouble for the country as the disease would be relatively mild.
“If an effective vaccine is found (and) if enough people are vaccinated, the resulting herd immunity will reduce the number of people susceptible to the disease.
“We still do not have an effective vaccine for Covid-19. So we will have to reduce Rt through other means such as reducing the amount of contact through physical distancing or quarantine, maintaining personal hygiene and wearing face masks, ”he said.
Last week, Dr. Noor Hisham spoke about the need to strike a balance between protecting lives and livelihoods.
“We should not repeat another blockade as has been seen in other countries. Our Rt is alarming, ”he tweeted.
On September 8, he showed in a tweet how the Rt value had risen to 1.72, following the appearance of large groups in Sabah and Kedah. Just two weeks earlier, the Rt value was 0.72.
Professor of Epidemiology and Public Health Dr. Sanjay Rampal said that overall, the R0 value of the Covid-19 virus was estimated to be about 5.7 or 5.8.
This means that a person infected with Covid-19 could on average transmit the disease to five or six people if the virus is allowed to spread without any form of public health intervention.
“The infectivity of the virus depends on the agent of the virus and the environment.
“In our country, there are many public health interventions. With active case finding and contact tracking, the R value actually dropped to about 1.5 or 1.6.
“When there are interventions, such as physical distancing, we are reducing the likelihood that the infected person is spreading the disease,” he said.
Several factors, he added, affected the Rt value, such as the Covid-19 virus mutation and the intensity and compliance of public health interventions.
Malina Osman, a medical epidemiologist at Putra University Malaysia, said it was difficult to compare the R-value of Covid-19 with previous outbreaks of infectious diseases in the country, such as Severe Acute Respiratory Syndrome (SARS) in 2003 and Influenza A (H1N1). ) in 2009.
“In the local context, there is no documented evidence on the R-value for SARS and H1N1 as there were not many cases of both diseases in Malaysia at that time.
“However, studies conducted during the SARS outbreak with data from Hong Kong and Singapore showed that the R value ranged from 2.2 to 3.6. For H1N1, the R value documented in various studies ranged from 4.0 to 4.5, “he said.
While the Rt value was a good indicator of the transmissibility of the virus, Associate Professor Malina said care should be taken when interpreting the R value as it provides a generalized picture of an entire country.
“The R value is an estimated index for the entire country. Therefore, the value may be overestimated or underestimated for specific districts and areas.
“Counting the Rt value is a complex procedure. It depends on the type of transmission and the mathematical models used, the epidemiological data, the population structure and the intrinsic growth rate ”, he said.
Other factors, such as disease prevention policies and public compliance, were important in determining whether the virus remained a threat to the country, Associate Professor Malina said.
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