LAUSR

Dengue fever is a vector-borne disease that threatens onethird of the world’s population. Malaysia is one of the dengue-endemic countries with outbreaks occurring in a cyclical pattern with different predominant serotypes.1,2 There should be an increase in dengue cases in 2020 and 2021. However, the number of cases reduced dramatically in 2020 (90 304) and 2021 (26 365) compared to the year 2019 (130 101), which coincided with the COVID-19 pandemic.3 The Malaysian government implemented a nationwide lockdown under the movement control order (MCO) on March 18, 2020, with different strategies and regulations had been introduced. The MCO measures included banning the public from going out and attending gatherings and travel restrictions. Academic institutions, public premises, and private premises were all closed.4 The conditional MCO (CMCO) started on May 4, 2020, when most economic sectors resumed operation under strict standard operating procedures (SOPs), and interstate traveling was allowed.4 Then, the recovery MCO (RMCO) took over with further relaxing of control measures such as the resumption of religious activities, reopening of entertainment, wellness and educational centers, with certain restrictions.4 Reinstatement of MCO to different states (MCO by states) according to the COVID-19 cases was reimposed from January 11, 2021. However, many nonessential sectors remained open.4 This was then replaced with a nationwide total lockdown (FMCO) on June 1, 2021 until June 27, with control measures of similar stringency as the initial MCO but with certain relaxations, such as 40% of office attendance being allowed.4 On June 28, 2021, Malaysia entered a 4-phase national recovery plan (NRP) with further relaxation of SOPs according to the phases.4 This study aims to establish the relationship between dengue and COVID-19 and evaluate the effect of each stage of the MCO on dengue cases.