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: The residential addresses of 3054 notified CHIKV cases in 2009-2010 were georeferenced onto a base map of Sarawak with spatial data of rivers and roads using R software. The spatiotemporal spread was determined and clusters were detected using the space-time scan statistic with SaTScan.
RESULTS: Overall CHIKV incidence was 127 per 100 000 population (range, 0-1125 within districts). The average speed of spread was 70.1 km/wk, with a peak of 228 cases/wk and the basic reproduction number (R0) was 3.1. The highest age-specific incidence rate was 228 per 100 000 in adults aged 50-54 y. Significantly more cases (79.4%) lived in rural areas compared with the general population (46.2%, p<0.0001). Five CHIKV clusters were detected. Likely spread was mostly by road, but a fifth of rural cases were spread by river travel.
CONCLUSIONS: CHIKV initially spread quickly in rural areas mainly via roads, with lesser involvement of urban areas. Delayed spread occurred via river networks to more isolated areas in the rural interior. Understanding the patterns and timings of arboviral outbreak spread may allow targeted vector control measures at key transport hubs or in large transport vehicles.