Covid-19 Vaccination Eases Care For Terminally Ill Patients: Expert

Covid-19 vaccination enables palliative care patients, who may be afraid of getting infected with coronavirus when they go to hospital, to seek early medical treatment, says Dr Richard Lim Boon Leong.

KUALA LUMPUR, May 6 — Giving Covid-19 vaccines to terminally ill patients will help improve their quality of life and improve access to palliative care, said a palliative medicine consultant.

Dr Richard Lim Boon Leong, the head of the palliative care unit at Selayang Hospital, emphasised that physicians should explain to family members of patients with terminal illness that Covid-19 vaccination can enable them to go out to get treatment without fearing coronavirus infection.

“There are some additional benefits beyond the fact that the typical benefits like preventing severe Covid-19 infections,” Dr Lim said in a webinar last month organised by the Institute for Clinical Research (ICR).

“What we have seen throughout the pandemic is that many patients who are unwell are actually frightened to come to hospital because they are afraid of getting Covid-19 infection from patients around there.

“So what they do, they avoid coming to hospital. They hold on to the symptoms until it is very late. So vaccination will reduce this burden and may enable easier access to care.”

Besides that Dr Lim also noted that vaccinating terminally ill patients will reduce the need for isolation, allowing family members to spend more time together.

“Vaccinating them also allows more freedom to spend the last months of life with better quality.”

Dr Lim defined terminally ill people as a group of patients who approach towards the end of life due to an incurable medical condition with an approximate life expectancy of less than six months.

When explaining the scope of palliative care, Dr Lim said that last year, 1,103 patients occupied the palliative care unit in Selayang Hospital, 66 per cent of whom were cancer patients.

“About two-third of our patients are with advanced cancer.”

One-third of patients in the public hospital’s palliative care unit were suffering from other terminal diseases such as end-stage renal failure (ESRF), chronic obstructive pulmonary disease (COPD), stroke, cardiac failure, and liver disease.

Last March, the Ministry of Health (MOH) prepared a list of priority groups for Covid-19 vaccination. The list includes terminally ill patients who suffer from auto-immune diseases, cancer patients, and people with chronic kidney disease or other diseases.

Vaccinating Elderly People Will Reduce Covid-19 Deaths

Dr Rizah Mazzuin Razali, a geriatrician and head of Geriatric Unit in Kuala Lumpur Hospital, pointed out that vaccinating elderly people will help to reduce Covid-19 deaths.

Based on a study that was published in the Lancet journal this year, in Germany, about 60 per cent of the high-risk population is expected to be infected with Covid-19 without vaccination, before herd immunity is achieved.

The research concluded that coronavirus vaccination could have prevented about 218,000 deaths, 99 per cent of which happened in high-risk groups.

The German study also stated that just by vaccinating 95 people in high-risk groups, one Covid-19 death can be prevented. But a total of 13,000 people must be vaccinated in the low-risk group to prevent one death.

Dr Rizah, who cited this study, said: “With the limitations in the amount of vaccines available, it is just logical to reserve the vaccines to those in high-risk people on a global scale and achieve the timely completion of vaccination campaigns so that we can prevent the vast majority of the deaths before the herd immunity is achieved.”

Dr Rizah also said that many Covid-19 deaths among the elderly worldwide had occured in nursing home facilities.

According to her, elderly care residents are more physically dependent, having cognitive and mental challenges as well as other chronic diseases.

“The first phase of the vaccination in many countries actually focused on nursing homes or long-term care facilities as they will be the first group of people who will see the benefits and potential side-effects.”

Medical conditions like diabetes, hypertension, cardiovascular disease, respiratory disease and dementia are diseases that are very synonymous to the elderly people and eventually increase the risk of severe illness from Covid-19 infection, Dr Rizah added.

Malaysia’s National Covid-19 Immunisation Programme (PICK) is currently in its second phase targeting 9.4 million people aged 60 and above, those with underlying health conditions, and people with disabilities. However, the government has yet to reveal how many senior citizens have been vaccinated.

As Covid-19 outbreaks surge in multiple states across Malaysia, coronavirus-related deaths and critical cases have been rising since last month. The country recorded 112 Covid-19 fatalities in the past week from April 28 to May 4.

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