PIN37 Projection of Covid-19 Based on Decision Tree Analysis: WE Have NOT Won but WE Have NOT Lost the WAR!

Abstract

The World Health Organization has initially categorised COVID-19 infection as a Public Health Emergency of International Concern 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 decision tree technique, that cumulatively 22,000 positive patients were expected nationwide through four main known big clusters reported. At the current rate of disease detection, screening yield and clinical capacity, the identification of the positive patients will have to be continuously done until middle of May 2020. Another prediction with the forecasted testing capacity with massive screening program, was made through similar decision tree technique with several parameters included. The parameters included are R0, Rt of COVID-19, numbers of daily test conducted, positive yield of the test, rate and trend of intensive care admissions, treated and death. In contrast to the estimation with current rate, massive screening program caused 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 and 225,100 cumulative positive cases will be identified through the screening initiatives. 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 especially if the movement control order (MCO) is not successful due to the constraints in healthcare resources. These challenges potentially highlight the need for realistic strategies with regard to the country’s capacity, which may include extending the MCO and implementing bigger scale of screening and treatment program.