Outpatient Visits Dropped By Seven Million In 2020 Amid Pandemic

Colorectal cancer screenings dropped by over 50% from more than 13,000 screenings in Oct 2019 to fewer than 6,000 in Jan 2020, says MOH’s deputy director for NCDs.

KUALA LUMPUR, Oct 20 — Outpatient visits to public health clinics were down by 17.5 per cent, or 6.94 million, from 39,618,638 visits in 2019 to 32,678,125 visits in 2020, according to the latest Ministry of Health (MOH) data.

MOH deputy director for non-communicable diseases (NCDs) Dr Feisul Idzwan Mustapha said similar declines were seen for other services at public hospitals, including rehabilitation and screening, though no exact figures were provided.

He said screenings for colorectal cancer, for example, declined by over 50 per cent from a peak of more than 13,000 screenings in around October of 2019, to fewer than 6,000 in January 2020 following the country’s initial Covid-19 outbreak. 

“The MOH is trying to bring the figures (for screening) back up, and as you can see in colorectal cancer, there is an increasing trend by the end of 2020. The coronavirus has not only affected screenings for colorectal cancer but other cancers as well. Many civil societies who do community testing for cancer were also hindered from their work,” Dr Feisul told an online media briefing on healthy dietary and NCDs on October 8.

Dr Feisul said many follow-up treatments — including for diabetes and heart diseases – were initially deferred to the Movement Control Order (MCO), but are now delayed due to ongoing fears of contracting the virus at health facilities.

“These patients know they are at risk but they are worried about getting infected with Covid-19 and this makes it difficult for follow-up care,” he said.

MOH has since taken several steps to address these setbacks by setting up virtual clinics, facilitating the supply of medicines for repeat prescriptions through postage, and setting up an online appointment booking system to reduce in-person waiting time at clinics.

Slide comparing Covid-19 mortality risks for NCD patients and non-NCD patients. Picture from Dr Feisul Idzwan Mustapha’s presentation at the online media briefing on health dietary and non-communicable diseases (NCDs) on October 8, 2021.

Meanwhile, Dr Feisul pointed out that individuals with NCDs were more likely to die of Covid-19 by 3.7 times than those without NCDs, while among those who have been fully vaccinated, Covid-19 deaths with NCDs are 7.3 times more likely to occur compared to non-NCDs.

He said the burden of NCDs in Malaysia continues to rise, with one in five adults likely to be diabetic, one in three adults likely to have hypertension, and two in five adults having high cholesterol levels.

MOH science officer for nutrition Nur Liana Abdul Latif, in her presentation on healthy diets, said many severe Covid-19 cases that resulted in intensive care treatment and deaths had comorbidities. Those who are obese are seven times likelier to get severe Covid-19 disease.

The MOH is doubling down on its “suku suku separuh” (quarter quarter half) campaign, which promotes dividing food portions on a plate into a quarter for meat or fish, a quarter for grains and nuts, and half for fruits and vegetables. Malaysia is preparing to shift to treating Covid-19 as an endemic disease that is expected to persist.

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