key: cord-290429-0d34abdo authors: Elengoe, Asita title: COVID-19 Outbreak in Malaysia date: 2020-06-17 journal: Osong Public Health Res Perspect DOI: 10.24171/j.phrp.2020.11.3.08 sha: doc_id: 290429 cord_uid: 0d34abdo In 2020 a significant threat to public health emerged. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic outbreak emerged in December 2019 from Wuhan City, Hubei Province, China and spread to the rest of the world. This disease was named COVID-19 by World Health Organization. To date (17(th) April 2020) a total of 2,230,439 cases of COVID-19; 150,810 cases of deaths and 564,210 recovered cases have been reported worldwide. In this review the SARS-CoV-2 morphology, pathogenic mechanism, similarities and differences between SARS-CoV and Middle East Respiratory Syndrome and severe acute respiratory syndrome, transmission mode, diagnosis, treatment, and preventive measures were investigated. The outbreak of COVID-19 from a Malaysian perspective was explored and mental health care during the COVID-19 outbreak was explored. To date, there is no vaccine or no specific treatment for COVID-19. Therefore, preventive measures are very important to prevent and control the rapid spread of the SARS-CoV-2 virus. Preparedness should be a priority for future pandemic outbreaks. A continuous occurrence of an unknown acute respiratory tract infection was reported in Wuhan City, Hubei Province, China, since 12 th December 2019, originating from the Hunan South China Seafood Market [1] . On the 7 th January 2020, Chinese scientists isolated the unknown viral sample from an infected person and sequenced its genome using the next gene sequencing tool. They reported that the virus had 96.3% genetic similarity with a Yunnan bat coronavirus RaTG13 and 70% homology with severe acute respiratory syndrome coronavirus (SARS-CoV) [2] . On the 12 th January 2020, the World Health Organization (WHO) announced the cause of this epidemic outbreak was a novel coronavirus discovered in 2019 (2019-nCoV) or SARS-CoV-2 and named the disease coronavirus disease 2019 (COVID-19) [3] . However, the answer to the origin of SARS-CoV-2 remains to be determined. The SARS-CoV-2 spread rapidly to other countries including South Korea, Taiwan, Thailand, Singapore, Japan, Italy, Iran, Spain, USA, UK and was classified by the WHO as a pandemic on 12 th March 2020 [3] . As of the 17 th April 2020, there are a total of 2,230,439 cases of COVID-19; 150,810 cases of deaths and 564,210 recovered cases have been reported throughout the world [4] . The USA has had the highest number of cases of COVID-19 (686,431) and number of deaths (35, 578) [4] . There have been 58,179 USA patients who have recovered from COVID-19 [4] . On the 17 th April 2020, a total of 8,861 new cases and 961 new deaths were reported in USA [4] . The number of cases has increased exponentially in USA, Italy, Spain, UK, Turkey, and Russia. This article describes COVID-19 and its outbreak in Malaysia. The SARS-CoV-2 is a beta coronavirus, which is a large, spherical, enveloped, non-segmented positive-sense, singlestranded RNA virus genome of about 30 kb [5] . It consists of 4 main structural proteins which are spike glycoprotein (S), membrane (M), envelope (E) and nucleocapsid (N) proteins [6] . SARS-CoV-2 uses its spike to inhibit the activity of neutralizing antibodies. Neutralizing antibodies are mainly involved in preventing viral particles from interacting with the host cell to infect cells. S protein contains S1 and S2 domains and the interaction between the S1 domain of SARS-CoV-2 with a specific host cell receptor called Angiotensin Converting [16] . However, there are some infected individuals who do not develop any symptoms and do not feel unwell. These people are called asymptomatic carriers. The people who are highly vulnerable to COVID-19 are the elderly, young children, pregnant ladies, and people with chronic diseases such as hypertension, diabetes, heart problems, kidney and liver diseases, in addition to immuno-compromised people including patients with cancer, HIV, auto-immune disorders, and smokers. To date, there is no vaccine or specific antiviral therapy confirmed by the WHO to be effective against COVID-19. However, there are a number of medicines which could potentially be repurposed to treat COVID-19 (Table 2) As of the 17 th April 2020, there were 5,251 COVID-19 cases Hospital (Sabah) [21] ]. where 39 people were identified as COVID-19 positive [44] . The MOH to date has reported 29 virus clusters throughout Malaysia. There were 69 COVID-19 positive cases reported by the MOH on 17 th April 2020 [21] and this was the first time that the number of cases was less than 100 since the 14 th March 2020. 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