Adham: 28% Of Malaysia’s Covid-19 Deaths Happened Before Treatment Sought

Sabah comprised 54% of Malaysia’s 300 Covid-19 deaths as of Nov 10.

KUALA LUMPUR, Nov 24 — More than a quarter of Covid-19 victims in Malaysia died before they sought treatment at medical facilities, according to Health Minister Dr Adham Baba.

The health minister said 84 fatalities, or 28 per cent of 300 official Covid-19 deaths recorded as of November 10, occurred before they arrived at health facilities for treatment. The remaining 216 victims had received treatment at Ministry of Health (MOH) facilities.

Among the 300 Covid-19 fatalities as of November 10, there were 162 Covid-19 deaths in Sabah, 29 in Kuala Lumpur, 22 in Johor, 19 in Sarawak, 18 in Selangor, and the remaining 50 fatalities in other states.

Dr Adham noted that the 300 Covid-19 deaths reported as of November 10 was equivalent to a 0.71 per cent case fatality rate in Malaysia.

“If a comparison is made with the neighboring countries in Southeast Asia, this fatality rate is relatively low, compared to Indonesia (3.33 per cent), Vietnam (2.88 per cent), Thailand (1.56 per cent), Brunei (2.02 per cent) and Singapore (0.05 per cent),” Dr Adham said in a written Parliament reply to Sarikei MP Wong Ling Biu on November 12.

Covid-19 mortality statistics in Malaysia as of November 22, 2020. Picture from the Ministry of Health.

The Institute for Clinical Research (ICR) under the National Institutes of Health released an infographic yesterday on 335 Covid-19 deaths out of 54,775 positive cases as of November 22, resulting in a 0.6 per cent case fatality rate.

Males still comprised the majority of Covid-19 fatalities at 65 per cent, compared to females at 35 per cent. Nearly two-thirds, or 64 per cent, of Covid-19 deaths in Malaysia involved people aged 60 years and above.

The proportion of fatalities reduced according to younger age groups: 20 per cent for the 50 to 59 age group; 7.2 per cent for the 40 to 49 age group; 4.5 per cent for the 30 to 39 age group; and 3.9 per cent for people aged below 30. ICR did not release death statistics according to specific age groups below 30 years.

The Sabah state government said a total of 3,030 babies and children below 12 years old had contracted Covid-19 in Sabah as of November 19, but did not reveal fatalities in this age group. Two infants and two children aged below 15 in Sabah have died from Covid-19.

ICR said 87 per cent of Covid-19 deaths were reported to have at least one underlying health condition. High blood pressure was the most common underlying condition at 61.4 per cent of Covid-19 fatalities, followed by diabetes (41.3 per cent) and heart disease (24.1 per cent).

Malaysia has reported 337 Covid-19 deaths as of yesterday.

Most Covid-19 Victims Sought Treatment At Critical Stage

Covid-19 patients are categorised based on five clinical stages — Stage 1 is non-symptomatic, Stage 2 is mild, Stage 3 refers to people with Covid-19 who suffer from pneumonia, but do not need supplemental oxygen; Stage 4 patients have pneumonia and need supplemental oxygen; while Stage 5 patients need ventilator support.

“The majority of death cases received treatment in hospital at the critical stage, with 54.63 per cent at Stage 4 and 26.85 per cent critical at Stage 5.

“The main cause of death is severe pneumonia, a severe lung infection which involved failure of other organs, comprising 260 Covid-19 deaths (89.66 per cent) from the total deaths, followed by acute heart illness which involved 19 cases (6.55 per cent ), and the rest of the deaths involved other causes such as cancer,” Dr Adham said in his November 12 parliamentary reply.

Sarikei MP Wong had asked MOH to state the core causes which contribute to Covid-19 deaths in the country.

Dr Adham stated that age factors, like patients aged 50 years and above, patients who have comorbidities, especially high blood pressure, diabetes and other chronic diseases, as well as the critical clinical level of the patient when seeking treatment are the risk factors that contribute to Covid-19 deaths in the country.

Sabah’s Covid-19 Capacity

At the same time, Tenom MP Noorita Sual also asked MOH to state the efforts of the ministry under the new Perikatan Nasional government to overcome the shortage of staff and facilities in Sabah, especially during the third wave of Covid-19.

“Through the action plan for Covid-19 management, MOH increased the capacity of beds in Covid-19 hospitals, quarantine and low- risk centres, ICU beds, ventilators, capacity of lab tests and human resources,” Dr Adham told Noorita in a November 12 written parliament reply.

According to MOH, so far, Sabah has nine Covid-19 hospitals and 26 quarantine and low- risk centres. The total number of beds in hospitals as well as quarantine and low- risk centres have been increased by more than 14 times to 5,756.

“The rate of bed usage at now is at 39 per cent. The total intensive care unit (ICU) beds in Sabah is 127 units, where the usage rate is at 78 per cent, compared to 60 units of beds with seven per cent usage rate in early September this year.

“In order to accommodate the increasing rate of bed usage in ICU, a few clinical areas in Sabah hospitals have been modified to treat critical Covid-19 patients. So far, 193 ventilators have been prepared with 37 per cent of usage rate.”

MOH has also collaborated with private health care facilities to outsource patients to private hospitals in order to ensure continuity of services and treatment for non-Covid-19 cases. A total of six MOH hospitals in Sabah have outsourced medical services across 12 disciplines as follows:

  • Paediatric Cardiology
  • Paediatric Surgery
  • Vascular Surgery
  • Gynaecology
  • Hepatobiliary Surgery
  • Orthopedic
  • Urology
  • Cardiology
  • Radiology
  • Ophthalmology
  • Cardiothoracic Surgery
  • Neurosurgery

“A few private hospitals have been identified to conduct 1,833 operations and surgical procedures. So far, 30 radiology cases, three neuro operations, and four cardiology cases have been referred to receive treatment.

“The Medan Hospital in Tawau was built in Tawau Sports Complex with 100 beds on October 16. This hospital was built with the collaboration of MOH and the Malaysian Armed Forces with the aim to help Tawau Hospital in treating non-Covid-19 patients, especially emergency surgeries, paediatric, and obstetrics and gynaecology cases,” said Dr Adham.

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