Subjects and methods: This short communication reviews articles and government announcements related to containment measures and the Movement Control Order of Malaysia, and graphically presents data pertinent to Covid-19 in Malaysia in order to show the relationship between fluctuations in Covid-19 cases and movement control.
Results: At the onset of the Covid-19 outbreak, Malaysia had initiated travel restrictions and quarantine; but with a persistent increase in new Covid-19 cases, the Movement Control Order was finally rolled out on 18 March 2020, requiring closure of all businesses except those providing essential services and items. Enforcement of the order was tightened progressively, resulting in significant improvement of compliance, while other interventions such as tracking of potential contacts and medical screening were underway, and the media continued to provide updates and general advices. The numbers of new and active Covid-19 cases started showing evident downtrends from mid-April, thus indicating the effectiveness of movement control and its compliance.
Conclusion: The article provides insight into crucial factors contributing to the success of movement control to effectively contain Covid-19, and highlights the need to prevent future upsurge through continuous monitoring and enforcement.
METHODS: An Excel-based budget impact model was constructed to assess dialysis-associated costs when changing dialysis modalities between PD and ICHD. The model incorporates the current modality distribution and accounts for Malaysian government dialysis payments and erythropoiesis-stimulating agent costs. Epidemiological data including dialysis prevalence, incidence, mortality, and transplant rates from the Malaysian renal registry reports were used to estimate the dialysis patient population for the next 5 years. The baseline scenario assumed a stable distribution of PD (8%) and ICHD (92%) over 5 years. Alternative scenarios included the prevalence of PD increasing by 2.5%, 5.0%, and 7.5% or decreasing 1% yearly over 5 years. All four scenarios were accompanied with commensurate changes in ICHD.
RESULTS: Under the current best available cost information, an increase in the prevalent PD population from 8% in 2014 to 18%, 28%, or 38% in 2018 is predicted to result in 5-year cumulative savings of Ringgit Malaysia (RM) 7.98 million, RM15.96 million, and RM23.93 million, respectively, for the Malaysian government. If the prevalent PD population were to decrease from 8% in 2014 to 4.0% by 2018, the total expenditure for dialysis treatments would increase by RM3.19 million over the next 5 years.
CONCLUSIONS: Under the current cost information associated with PD and HD paid by the Malaysian government, increasing the proportion of patients on PD could potentially reduce dialysis-associated costs in Malaysia.