Why Are More Young People Dying At Home From Covid-19?

By Ashswita Ravindran |

Among the 38 BID cases from Covid-19 reported from Feb 1-24 this year, about 21% were below the age of 40, while 58% were younger than 60.

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KUALA LUMPUR, Feb 26 — In the first 24 days of February alone, eight of 38 brought-in-dead (BID) Covid-19 cases in Malaysia were younger than 40, while more than half of them were below the age of 60.

Between February 1 and February 24, there were 38 BID Covid-19 cases reported, comprising 32.8 per cent of a total of 116 BID cases since the coronavirus pandemic hit the country in January last year. Brought in dead means the victims died before they could seek medical treatment.

Among the 38 BID cases reported this month, as of February 24, eight of them (21.1 per cent) were below the age of 40, while 22 of them (57.9 per cent) were aged below 60.

The youngest BID case this month, as of February 24, was reported on February 22, a 17-year-old male foreigner who was BID in Johor. The boy did not have any comorbidities. Meanwhile, on February 7, an 18-year-old girl with underlying bronchial asthma was BID to Selayang Hospital.

Across 10 months from March 31, 2020 to January 31, 2021, it was reported that nine of the BID Covid-19 cases were aged below 40, while 33 were below the age of 60, compared to just slightly lower figures in the first 24 days of this February alone.

Since the beginning of the pandemic until February 24 this year, 55 out of 115 BID cases in Malaysia, or 47 per cent, were reported among those below the age of 60, while 17 cases were those below the age of 40. The age group with the highest number of reported BID cases was those aged between 61 and 65 years (21 cases).

People aged above 60 are believed to be more vulnerable to severe disease and death from Covid-19. It is unclear why a large proportion of BID victims in Malaysia are younger.

So far, as of February 24, 2021, there have been 116 BID cases since the first BID case reported on March 31, 2020, comprising 10.7 per cent (1,088) of the overall 1,088 deaths due to Covid-19 in Malaysia.

As compared to last year which only had 36 BID cases, this year, Malaysia recorded 80 BID cases, 42 in the month of January, and 38 in the month of February (up to February 24).

Overall as of February 24, the highest number of BID cases were reported in Sabah (59), followed by Klang Valley (35), and Sarawak, Penang, and Pahang each with four cases respectively.

However, in the month of February alone, it was noted that 44.7 per cent (17) of the BID cases were reported in Klang Valley.

Klang Valley reported 17 BID cases in January and February each. Last year, Klang Valley only had two BID cases, but this year it rose to 33 cases. Klang Valley is known for its well-equipped and good health care facilities with many tertiary hospitals. Hence, it is unclear why patients take a longer time to seek treatment in these facilities.

The BID cases in Sabah have been showing a decline in trend from 22 cases in January 2021 to 11 cases in February this year.

Infectious disease expert and former Health deputy director-general Dr Christopher Lee told CodeBlue that the increase in BID cases is an area of concern.

“The substantial numbers seen suggests that the current system has to be improved. To do this, these cases should undergo review to look for the contributing factors leading to the outcome, which presumably is being done,” Dr Lee said.

“Clearly, the triaging system for home quarantine as well as the patient helpline needs to be bolstered.

“On paper this has been addressed by the introduction of the Covid-19 Assesment Centre (CAC) but review needs to be done (to) ensure that it is working well on the ground,” Dr Lee added.

CAC was recently set up by the Ministry of Health (MOH) on January 25 to handle Covid-19 cases undergoing home monitoring. CAC identifies positive Covid-19 cases who require to be hospitalised as well as those who are suitable for home quarantine.

It is unclear why the Covid-19 cases were BID to the hospital. MOH, in its publicly available reports, does not state if these cases tested positive after their death, or if they were patients on home quarantine who did not seek immediate treatment when their conditions deteriorated.

Although the home quarantine system is in place and regular monitoring is reportedly being done by health care workers on these patients, it is unknown why the patients are deteriorating at home and later on brought dead to the hospital.

Update on March 4: CodeBlue had mistakenly missed out on one BID case that was reported on February 13. The case was a 56-year-old male who was brought-in-dead in Selangor. A total of 38 BID cases were reported in the month of February as of February 24, and not 37 as initially reported by CodeBlue.

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