More Malaysians Died Late 2019. Did Covid-19 Come Here Earlier?

By Kanmani Batumalai | 05 June 2020

Preliminary research shows 1,412 more deaths in the last quarter of 2019 among people aged 60 years and older in Malaysia, compared to the 2016-2018 historical average in the same period.

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KUALA LUMPUR, June 5 — Malaysia experienced 1,015 more deaths from October to December 2019 than the historical average in the same period from 2016 to 2018, statistics showed.

Dr Ng Chiu Wan, a public health medicine specialist from the Department of Social and Preventive Medicine, University Malaya, also revealed in preliminary research that 1,412 more deaths occurred in the last quarter of 2019 among people aged 60 years and older in Malaysia, compared to the average total mortality from all causes in that age group during the same period in the years 2016 till 2018.

The first Covid-19 case in Malaysia was only confirmed on January 25. South China Morning Post reported that the first case of a person in China with Covid-19 contracted the coronavirus as early as November 17. Malaysia suspended entry to Chinese nationals from Hubei province and its provincial capital, Wuhan, on January 27.

All-cause mortality from October to December 2019, compared to the same period in 3-year average (2016-2018), by age groups. in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

“Are there truly more deaths among the elders, or can this be explained by more elders last year and this year and therefore, there were just more counts of deaths?” Dr Ng told a public webinar titled “The Flip Side of Covid-19 Pandemic” last month.

“If there were more deaths, what did they die of? The question that we want to answer is — did they die of some respiratory problems? Did they die of Covid, undetected, undiagnosed?

Dr Ng Chiu Wan, public health medicine specialist, Department of Social and Preventive Medicine, University Malaya

“Why were there more deaths from October to December last year? Is it true that perhaps these were not Covid deaths, they were deaths from flu for instance, or was there Covid in Malaysia undetected?” she added.

She said her early findings have paved the way for many other questions to be raised, with the next phase of research exploring answers for these queries.

All-cause mortality from October to December 2019, and from November to December 2019, compared to the same period in 3-year average (2016-2018) in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

The elderly and those with underlying medical conditions are believed to be more vulnerable to developing severe disease from Covid-19. The median age among Malaysia’s 115 Covid-19 victims is 64 years.

Dr Ng’s early findings raise questions on whether Malaysia may have been unintentionally under-reporting deaths from Covid-19, like what was found in several countries that reported “excess deaths” during the pandemic, or a higher number of people who died than expected based on historical trends.

Covid-19 fatalities in Malaysia are officially recorded in hospitals when a patient succumbs to the virus. As of June 4, the Ministry of Health (MOH) has screened 14,285 residents, caretakers, and staff in 385 old folks’ homes, out of which only 0.2 per cent, or 26 people, tested positive for Covid-19. The majority of these Covid-19 patients at 85 per cent, or 22 people, did not display symptoms.

All-cause mortality from October-December 2019, and January-March 10, 2020, compared to the same periods in 3-year historical average, by age group in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

This year, from January until March 10, Malaysia reported only two extra deaths compared to the average count of deaths from all causes in the same period from 2017 to 2019.

Data dissection also showed that from January till March 10 this year, there was not much difference in the number of reported deaths among people aged below 20 compared to the average total deaths in this age group in the same period of the last three years, said Dr Ng, referring to similar trends between 2020 and the historical average from 2017 to 2019.

When quantified, those aged below 20 in Malaysia had lower mortality rates from January until March 10 this year, with 225 fewer deaths than the historical average in the same period for the last three years.

All-cause mortality from January to March 10, 2020, compared to the same period in 3-year average (2017-2019), by age groups in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

However, 461 more deaths occurred among those aged 60 and older from January till March 10 this year, compared to the average mortality in this age group in the same period in the years 2017 to 2019.

Malaysia recorded the first two deaths from the coronavirus on March 17.

All-cause mortality (60 years and older) from January to March 10, 2020, compared to the same period in 3-year average (2017-2019) in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

“During the start of cases in Malaysia from the 25th January, unlike the graph that we saw in Financial Times, there is no spike in death counts,” Dr Ng said.

Financial Times estimated that more than 50 per cent of deaths from all causes occurred in 14 countries in March and April 2020, compared to the same time period between 2015 and 2019. The financial paper also indicated the possibility of the world under-reporting the Covid-19 mortality rate.

“What we do see is that roughly a week before the 18th of March 2020, the start of MCO (Movement Control Order), there was a drastic, very steep drop in the number of daily deaths reported to the Department of Statistics and National Registration Department,” Dr Ng said.

All-cause mortality from January to March 2020, compared to the same period in 3-year average (2017-2019) in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

She noted that 1,105 fewer deaths occurred this year from January until March 18, compared to the average number of deaths in the same period from 2017 until 2019. This contrasted with two extra deaths in the country from January to March 10, compared to the historical average for the past three years.

After one month of the MCO, the government made an announcement last April 19 on permitting delayed registration of new births and deaths up to 90 days from the date the MCO ends.

This might have caused the reduction in the recorded number of deaths in the country from March 10 to 18 this year, Dr Ng theorised.

All-cause mortality from January to March 10, 2020, and January to March 18, 2020, compared to the same periods in 3-year average (2017-2019), in Malaysia. Graphic from Dr Ng Chiu Wan presented at “The Flip Side of Covid-19 Pandemic” webinar on May 13, 2020.

In the year 2017 and 2018, pneumonia and chronic lower respiratory diseases remained among the top five principal causes of deaths in Malaysia.

Covid-19 shares the symptoms like pneumonia such as shortness of breath, cough, or fever. The coronavirus also causes severe pneumonia in lungs.

The New York Times reported that at least 87,000 more people have died during the Covid-19 pandemic than official coronavirus death counts, according to its review of mortality data in 14 countries.

The data shows that, in the pandemic weeks in March and April this year, many of those countries had a surge in deaths that exceeded the numbers declared as official Covid-19 deaths.

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