The World Health Organization (WHO) has initially categorised COVID-19 infection as a Public Health Emergency of International Concern (PHEIC) in late January 2020 and later on declared the outbreak as a pandemic on March 11, 2020. On February 4, 2020 the first Malaysian positive COVID-19 patients was detected. It was estimated through a thorough decision tree technique, cumulatively 22,000 positive patients were expected to be infected nationwide. At the current rate of disease detection, screening yield and clinical capacity in Malaysia, the identification of the positive patients will have to be continuously done until middle of May 2020. In addition, a prediction with the forecasted testing capacity was also conducted. In contrast with the earlier estimation, massive testing causes the number of positive patients to be saturated earlier, by the end of April 2020. Based on the projection, 346, 307 cumulative tests will be conducted with 225,100 cumulative positive cases will be identified. Of the numbers, the cumulative number of patients in care would be 17,631 with 705 cumulative number of admission to intensive care unit and 353 cumulative patients required for ventilator. The cumulative death and cumulative discharge are expected to be 394 and 6008 respectively. Currently, it is challenging for Malaysia to flatten the epidemic curve due to the constraints of healthcare resources. These challenges potentially highlight the need for realistic strategies with regard to the country’s capacity.

The sudden surge in the number of healthcare utilizations compels the hospital to plan for its future needs. Several time-series projections of Covid-19 were conducted to forecast the disease burden and resources utilization through simple predictive analytics. The projections revealed a rapid increase in the number of cases and patient in care at the hospital. It was estimated that the number of patients in care to range from 62 to 81 and 89 to 121 patients daily in the second and third phase of movement control order respectively. It was estimated that more than 100,000 plastic aprons, 80,000 sterile and non-sterile isolation gowns, 40,000 masks N95 and face shields, 30,000 gloves and nearly 17,000 bottles of hand sanitizers are needed until late May. Hence, a simple mathematical algorithm is a helpful tool to manage hospital resources during the pandemic.
COVID-19

Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.