operate during that period. it was extended indefinitely, as the severe and continued spread of the virus led to malaysia's healthcare system capacity being reached in some regions. on 15 june, prime minister muhyiddin yassin introduced a four-phase national recovery plan (nrp) to help the country emerge from the covid-19 pandemic and its economic fallout. 2022 on 3 january 2022, sarawak and kelantan moved to phase 4 according to national recovery plan (nrp), ending movement restrictions in malaysia. on 1 april 2022, malaysia will move to the endemic phase. all international borders will be reopened and the mask mandate removed for outdoor spaces except for crowded areas and indoor spaces. on 1 may 2022, people will be able to enter public premises regardless of their vaccination status, except those who have tested positive for covid-19 or unvaccinated travellers undergoing quarantine. malaysia will also remove pre-flight and on-arrival testing requirements for fully vaccinated travellers and those who have just recovered from covid-19. masks will remain mandatory for indoor activities and on public transport. emergency powers on 25 october 2020, the yang di-pertuan agong sultan abdullah of pahang rejected prime minister muhyiddin's request for him to declare a state of emergency in response to a spike in covid-19 cases throughout malaysia. on 16 december, prime minister muhyiddin invoked a state of emergency to stop by-elections scheduled to be held in the bugaya constituency of sabah and the gerik constituency in perak scheduled for january 2021. the yang di-pertuan agong abdullah had assented to the request to impose the states of emergency within these two electorates in response to a third wave of infections, which had risen to a total of 86,000 cases and 422 deaths by 16 december. on 12 january 2021, king abdullah of pahang declared a national state of emergency until at least 1 august 2021 to curb the spread of covid-19 and in response to a political crisis involving prime minister muhyiddin's perikatan nasional government. under this state of emergency, parliament and elections were suspended while the malaysian government was empowered to introduce laws without approval. on 26 july, the minister in the prime minister's department of parliament and law, takiyuddin hassan, announced that the emergency ordinance and its subsequent rules and guidelines had been revoked on 21 july by the federal government. however, when questioned by the opposition on whether the yang di-pertuan agong's consent was given for the revocation, their calls were not answered by the government. bans on mass gathering events immediately after the spikes of the cases related to the sri petaling tabligh event, prime minister muhyiddin yassin announced that religious, social and sports mass gatherings must be cancelled or postponed until 30 april 2020. however, the end date for the ban on mass gathering events are subject to revision depending on the situation of the outbreak. in addition, registrar of societies (ros) bans all parties registered with ros from organising any meeting and activities until 30 june 2020. on 4 february 2021, senior minister ismail sabri yaakob announced that chinese new year family reunion dinners would only be allowed at their residences among family members from the same household. these "standard operating procedures" were criticised by several politicians and public figures including deputy national unity minister ti lian ker and member of parliament ong kian ming as "culturally insensitive" and unnecessary. the national unity ministry subsequently allowed chinese new year family reunions of 15 family members living within a 10 km radius that did not involve interstate or inter-district travel. disinformation some people have been arrested for allegedly spreading false information about the covid-19 pandemic. as of may 17, 2020, police and the malaysian communication and multimedia commission (mcmc) have opened 265 investigations on covid-19-related fake news. a total of 30 people have been charged, 11 were served with a warning notice and 18 others pleaded guilty. on 11 march 2021, the government announced the emergency (essential powers) (no.2) ordinance 2021, which states that those who spread "fake news" "by any means, with intent to cause, or which is likely to cause fear or alarm to the public" could face a fine of rm100,000 or three years imprisonment or both. medical responses the medical response and preparedness for the outbreak in malaysia are overseen by director-general of health noor hisham abdullah under the health ministry of four successive governments. preparations to stockpile equipment, detect and monitor cases, and treat covid-19 patients were reported to have been initiated as early as 6 january 2020, following a world health organization (who) report on a late-december 2019 outbreak of "pneumonia of unknown cause" in the city of wuhan in hubei, china. face masks on 23 july 2020, senior minister ismail sabri yaakob announced that it will be compulsory for people to wear face masks in public spaces such as markets and public transportation from 1 august, with violators facing a rm1,000 (us$235) fine. on 27 april 2022, the malaysian government confirmed that it would lift face mask requirements for outdoor settings from early may 2022. on 7 september 2022, health minister khairy jamaluddin announced that face masks would be optional for most indoor spaces excluding health facilities such as hospitals, clinics, nursing homes and public transportation. testing and treatment centres on 5 january 2020, the national crisis preparedness and response centre (cprc) under the ministry of health malaysia began operation. by early february 2020, 57 hospitals were reported to provide screening services for coronavirus, while among them, 26 government hospitals are responsible for the confirmation of coronavirus and the suspected patients. with the rapid increase of infections, a further total of 409 sites across the country have been gazetted by the federal government as quarantine zones for coronavirus patients comprising public universities, community colleges, technical institutes, former national service (plkn) camps, training centres, polytechnics and hotels owned by federal ministries, departments, agencies and statutory bodies. as of 2 may 2020, 5,484 beds at 40 hospitals, 3,873 beds (in addition to 2,100 beds on standby) at 26 hospital extension centres/low-risk covid-19 centres, 422 icu beds, and 1,059 ventilators have been allocated for covid-19 patients. based on the january 29 circular from the malaysia ministry of health, foreigners in malaysia would not have to pay for covid-19 testing or outpatient treatment at government hospitals. this announcement was reiterated by the director-general of health dr noor hisham abdullah on march 23, 2020, when asked to clarify a statement made by the prime minister that foreigners would have to pay for covid-19 testing. on 8 april 2020, a consortium of associated laboratories in malaysia comprising gribbles pathology, quantum diagnostics and clinipath malaysia launched the country's largest covid-19 collection and testing programme to increase testing capacity. malaysian public universities have also been providing research and scientific capacity with 10 diagnostic laboratories at public higher learning institutions in the country nationwide have been called as part of a joint initiative by the higher education and science, technology and innovation ministries to help the health ministry in conducting coronavirus tests daily. despite further capabilities to conduct more tests, the health ministry had stated that the country is yet to find its suitable rapid test kits to solve the increasing backlog of pending result cases along with the revelation that the existing supply of coronavirus reagents test kits could only last for another week which causing the health ministry to source from other countries including singapore. as a response, the federation of chinese associations malaysia (hua zong) has called on the federal government to ensure sufficient coronavirus test kit reagents for the country especially among malaysia's eastern states of sabah and sarawak which are reportedly struggling to source test kit reagents. the solidarity trial, launched by who to research and compare the safety and effectiveness of treatment protocols which included chloroquine, hydroxychloroquine, interferon-beta, lopinavir/ritonavir and remdesivir, would be conducted in nine government hospitals across the country. on 3 july 2020, minister of health adham baba announced that both malaysian citizens and foreign nationals travelling to malaysia would be required to pay fees when undergoing covid-19 tests under the prevention and control of infectious diseases (fee for coronavirus diseases 2019 (covid-19) detection test) regulations 2020, which came into effect on 29 june. on 24 december 2020, malaysian senior minister ismail sabri yaakob confirmed that the national security council would require the compulsory screening of all foreign workers from 1 january 2021 so that action can be taken against employers who refuse to have their workers tested. by 16 may 2021, health director-general noor hisham abdullah confirmed that intensive care unit (icu) occupancy rates at hospitals in kuala lumpur, selangor, penang, sarawak, kedah, and perak had reached 80% due to the covid-19 pandemic. some hospitals have used up all their icu beds to treat covid-19 patients. as a result, malaysian authorities have been forced to deploy military-built hospitals and field hospitals. the health ministry has been forced to postpone elective surgery operations while semi-emergencies have been transferred out of covid-19 hospitals. by 15 july 2021, hotels were being converted into quarantine and treatment centres for low-risk covid-19 patients due to a rapid increase in nationwide cases placing a strain on the country's hospitals. hospitals across the country particularly the klang valley were also forced to turn away patients due to a shortage of intensive care unit beds and staff to adequately care for the patients. health workers and medical professionals have reported experiencing "burnout" and compassion fatigue. the surge in cases throughout 2021 has been attributed to the government's less stringent lockdown measures and an earlier decision to allow 18 manufacturing sectors to reopen under 60% capacity, creating favourable conditions for virus outbreaks in factories and workers' dormitories. on 26 july 2021, thousands of junior doctors working on contracts went on an ethical strike to protest against the government system of absorbing medical officers into permanent positions within the country's healthcare which were implemented in 2016 and also harsh working conditions including 36-hour shifts. the strike was organised anonymously after the junior doctors' grievances were not resolved. striking doctors dressed in black marched out of several hospitals including kuala lumpur hospital and sungai buloh hospital. director-general of health noor hisham abdullah urged doctors not to join the strike while police in kl confirmed they would investigate some of the organisers. the strike campaign amidst reports of overcrowding and unsanitary conditions at quarantine centres. bbc news also reported that undertakers and funeral workers were overwhelmed with requests to bury patients, many of whom had died at home. vaccination efforts main article: covid-19 vaccination in malaysia between november 2020 and january 2021, the malaysian government entered into agreements with several governments, international organizations, and companies including the chinese government, astrazeneca, covax, pfizer, pharmaniaga berhad and duopharma to procure various covid-19 vaccine stocks for the country. in late january 2021, a covid-19 vaccine developed by the chinese academy of medical sciences' institute of medical biology became the first covid-19 vaccine trial in malaysia. in early february 2021, the science, technology and innovation minister khairy jamaluddin was appointed as the coordinating minister for the immunization program. the covid-19 vaccine supply access guarantee special committee (jkjav) was also established to facilitate the procurement of covid-19 vaccine supplies for the country. on 11 february, the special committee on ensuring access to covid-19 vaccine supply announced that covid-19 vaccines would be distributed freely to both citizens and resident foreigners. the government also launched a twelve-month immunization program between 24 february 2021 and february 2022, with prime minister muhyiddin yassin being the first individual in malaysia to receive the covid-19 vaccine when it was broadcast live nationwide. in early september 2021, minister of international trade and industry mohamed azmin ali announced that malaysia would start treating the covid-19 pandemic as an endemic disease from late october 2021 due to a high vaccination rate. anti-viral pills on 2 october 2021, health minister khairy jamaluddin confirmed that the malaysian government was negotiating with merck & co to procure stocks of its antiviral molnupiravir pills for treating covid-19. travel and border control policies travel restrictions prohibition dated 7 february 2020 in sabah.prohibition dated 1 february 2020 in sarawak.temporary prohibition released by the state secretary of the government of sabah and sarawak disaster management committee of the government of sarawak. under the movement control order put in