KUALA LUMPUR – A surge in Covid-19 cases in Sarawak, one of Malaysia’s most vaccinated states, is causing concern as the country prepares to transition to the disease being declared endemic at the end of next month.

Sarawak, which has fully vaccinated 87.9 per cent of its adult population, has emerged as the worst-hit state as infections begin to taper off in the country’s biggest urban centre, the Klang Valley, amid a massive nationwide vaccination campaign by the government.

The state in Borneo, home to over 2.6 million people, had one of the fastest vaccination rates at the onset of the vaccination programme as it was due to hold a legislative election in the middle of this year. The state polls have been postponed to early next year.

Sarawak recorded 3,118 daily cases on Thursday (Sept 9), 16 per cent of the 19,307 total cases reported nationwide.

“We are not sure what is driving the transmissions,” newly appointed Health Minister Khairy Jamaluddin said during a press briefing on Thursday.

He said that dealing with the situation in Sarawak would serve as a playbook for the other states as the country prepared to reopen the economy and live with Covid-19 while managing its healthcare system.

Mr Khairy said one possibility for the increased transmissions could be the waning effect of the vaccines. Sarawak’s high-risk elderly population had received both doses of a vaccine more than four months ago.

Malaysia on Wednesday hit a major milestone with 50.5 per cent of its 32.7 million population fully vaccinated.

At least 64.1 per cent of its population, including those fully inoculated, have received at least one dose of the Covid-19 vaccines.

Malaysia uses another yardstick in deciding when to slowly reopen its economy: by measuring the level of full vaccinations of only the adult population.

As at Wednesday, 70.5 per cent of adults have been fully inoculated.

The surge in Sarawak is worrying from another angle: more deaths among those who have been vaccinated have been reported in the state.

In the first week of this month, more than half of the deaths in Sarawak involved fully vaccinated individuals, the vast majority of them with comorbidities and above the age of 60.

Mr Khairy said in comparison, only 0.009 per cent of Malaysia’s fully vaccinated population had succumbed to the virus, with over 80 per cent of the victims over the age of 60 and having comorbidities.

Most economic activity is currently allowed in Sarawak, which is already in Phase 3.

Moving forward, the health ministry will start to use intensive care unit (ICU) bed usage and hospitalisation rates as barometers for the pandemic.

As at Wednesday, 82 per cent – or 1,575 Covid-19 ICU beds – are being used. And some 37.8 per cent of ventilators are currently being used for patients.

Ventilator use in Sarawak is the second-lowest in the country, but its ICU bed usage rate and hospitalisation rate have been creeping up over the past week. These now stand at 73 and 68 per cent, respectively.

Meanwhile, the Klang Valley region encompassing Kuala Lumpur, Putrajaya and Selangor, once the epicentre for Covid-19, will be moving to a more relaxed second phase of the country’s four-stage Covid-19 exit strategy starting on Friday, the government announced earlier this week.

As at Wednesday, 98.4 per cent of the Klang Valley’s adult population were fully vaccinated.

Mr Khairy expects the whole country to move to phase four, which is a total reopening of the economy, at the end October.

Malaysia currently has 248,676 active Covid-19 patients, with 83.7 per cent of them serving home quarantine. The rest are placed in designated quarantine facilities or in hospitals.

Malaysia has recorded 1.9 million cases and 19,163 Covid-19 deaths so far.