A Malaysia Airlines hostess (R) wearing a protective face mask checks the temperature of a Chinese passenger before she boards a flight to Beijing at the Kuala Lumpur International Airport in Kuala Lumpur on February 14, 2020. Photo: AFP/Nicolas Asfouri

KUALA LUMPUR – A sudden spike in coronavirus infections has triggered alarm in Malaysia, with the Muslim-majority country now reporting the highest number of Covid-19 cases in Southeast Asia.

The country experienced its biggest single-day jump in infections on March 15, with 190 new cases. That number rose again on March 16 (Monday) with 125 more infections, bringing the national total to 553.

Until now, Malaysia had a relatively low number of coronavirus cases and appeared to have well-managed the situation through selective travel restrictions and a transparent response that earned World Health Organization (WHO) praise.  

The rapid surge in new infections follows a tumultuous and unexpected shift in political power in Putrajaya, which saw the country operate for two weeks without a Cabinet or a health minister.

For Prime Minister Muhyiddin Yassin’s weeks-old government, the widening outbreak is proving to be a baptism of fire.

“Covid-19 represents the new government’s first, biggest and most visible test of competence,” said Khor Swee Kheng, a health systems specialist and a former frontline doctor at a public hospital in Malaysia during the 2009 H1N1 swine flu outbreak. “Any failures, perceived or real, will further affect the legitimacy of this government.”

When the new premier was sworn-in on March 1, Malaysia had only 29 Covid-19 cases. As the outbreak widened, Muhyiddin delivered a special address on March 13, where he announced measures to postpone all mass assemblies until April 30 to confront a “second wave” of infections that he warned would threaten economic growth.

Malaysian leader Muhyiddin Yassin at the Prime Minister’s Office in Putrajaya, March 9, 2020. Photo: AFP/Mohd Rasfan

“Up until today, there is an increase of new Covid-19 positive cases following the detection of two main clusters that mostly involve Malaysians,” said Muhyiddin, 72, in his speech. “With the current trend, this outbreak is estimated to continue for a period that is quite long. It will not be over in the near future.” 

The nation’s first fully locally transmitted cluster has been linked to “Patient 26”, who came forward earlier this month and identified himself as Hisham Hamdan, a top official at Malaysia’s sovereign wealth fund Khazanah.

According to the Ministry of Health (MoH), he had been in close contact with at least 21 confirmed cases.

The second cluster spread from a gathering of Islamic missionaries at a religious event held on the outskirts of Kuala Lumpur from February 27 to March 1, which saw an estimated 16,000 attendees including foreigners from around the region. 

Newly-recorded cases in neighboring Singapore, Brunei and Indonesia are also linked to the event.

Cases have spread across the country as an estimated 14,500 Malaysian event participants have since returned to their home states. Some 90 people from Brunei attended, where cases have soared from zero to 50 in less than a week. The sultanate barred its citizens from exiting the country on March 15 in an effort to contain the Covid-19 spread.

Though Muhyiddin has declared all international conferences, sporting events and mass social and religious gatherings either canceled or postponed, it is not clear whether smaller-scale religious congregations will continue to be held in mosques and other places of worship.

Zulkifli Mohamad, the country’s new religious affairs minister, allowed Muslim Friday prayers to proceed in the Federal Territories on March 13 despite the worsening outbreak, but said prayers can be carried out at home if the situation worsens. Attending Friday prayers is a compulsory religious obligation for Muslim men.

Malaysian Muslims attend prayers on the eve of the first day of the Islamic fasting month of Ramadan at National Mosque in Kuala Lumpur on June 5, 2016. Photo: AFP/Aiman Arshad

Only the northern state of Perlis directed Muslims not to perform Friday prayers in the state’s mosque in response to the MoH’s recommendation to avoid mass gatherings. Islam is incorporated into the administration of each Malaysian state; constitutional monarchs or rulers determine Islamic law guidelines for their states.

The federal government can, however, order closures of mosques or the cancellation of Friday prayers to prevent the spread of infectious diseases, said constitutional lawyer Lim Wei Jiet.

“Primacy must be given to federal law if there is an overlap of jurisdiction. If state muftis or state governments don’t agree, the federal government prevails,” he said.

“However, I believe that because it is a sensitive matter which may involve the input of state rulers, the federal government is not taking such drastic action and is merely paying an advisory role thus far. For the moment, each state can issue their own guidelines for Friday prayers.”

A state fatwa committee in Negeri Sembilan, a coastal state south of Kuala Lumpur, has since followed suit by declaring all mosques and suraus closed between March 17 to 26 following the spike in Covid-19 cases.

Health experts have called for a halt on religious congregations as part of “social distancing” measures to contain the outbreak.

In neighboring Singapore, mosques islandwide have been closed until at least March 26, with Friday prayers cancelled for the first time in the city-state’s history.

When Malaysia’s previous Cabinet was dissolved on February 24 after then-premier Mahathir Mohamad resigned in the midst of a tussle for political power, the country was left without a health minister.

People wearing protective face mask waiting to crosss the road in Kuala Lumpur, Malaysia on March 14, 2020. Photo: AFP Forum via EyePress Newswire/FL Wong

Malaysians were agog as an attempted parliamentary coup, now known as the “Sheraton Move”, unfolded a day earlier. As political chaos ensued throughout late February and early March, the Covid-19 outbreak significantly advanced its spread around the globe, with cases proliferating in South Korea, Italy and Iran.

Khor remarked that the MoH’s performance during the country’s political limbo, led by Director General of Health Noor Hisham Abdullah, “did not miss a beat” despite an expected rise in cases.

The health systems specialist said the MoH and newly-appointed Health Minister Adham Baba must now lead “an all-of-society response” to combat the outbreak.

“Dr. Adham Baba is trained as a general practitioner and has experience setting up and managing a chain of primary care clinics, which should help him in this new portfolio,” said Khor. “It remains possible for Malaysia to ‘flatten the curve’ and spread out the patient numbers over a longer time period.”

However, Asia Times spoke with another Malaysian health specialist who was less sanguine about both the government and health system’s readiness to handle a worsening outbreak.

“There are two issues we’re facing right now. One, the change in government. We have a whole new Cabinet and a new health minister who doesn’t know the ropes at all. They’ve just come in and are in a very, very tight spot and are scared to make drastic decisions,” said the specialist, who requested anonymity.

“The second thing is, we are not ready as a community and as a health service. Protective equipment is an issue. The private sector is also concerned with a lack of masks and the personal risks of infection.”

A woman leaving a pharmacy in Kuala Lumpur, Malaysia, on Jan 30, 2020. Photo: AFP via EPA

The specialist said further drastic social distancing measures, including the closure of schools, religious congregations and certain non-essential businesses, are required to prevent a wider national emergency.

“Many are not ready to face this epidemic as we have been lulled into thinking things are under control. But we are already getting community spread extensively, and if we don’t go for broke right now, we are headed for a wildfire Italy-style epidemic in two weeks’ time,” the specialist said, expressing a view echoed by other medical experts in the country.

The Malaysian Health Coalition, a group of local medical experts representing seven professional societies, urged authorities on March 16 to implement firm measures, including social distancing, to curb the spread of coronavirus to avoid overwhelming the health system.

“We’ve never invested in an intensive care capacity as much as we need to, although there have been rather pleas from many of us,” said the specialist, who noted that Malaysia has fewer than 1,000 intensive care unit (ICU) beds in public hospitals nationwide, many of which are usually already occupied by ill patients.

“We’re not going to be able to manage the intensive care when it comes. We’re just not ready to handle this.”