KUALA LUMPUR, March 11 – The Covid-19 pandemic likely claimed 48,100 lives in Malaysia, 1.5 times higher than 31,500 deaths officially reported by the end of 2021, new research shows.
The Covid-19 excess mortality team from the Institute for Health Metrics and Evaluation (IHME) at the United States’ Washington University aimed to estimate excess mortality from the Covid-19 pandemic in 191 countries from January 1, 2020 to December 31, 2021 to identify the true death toll of the pandemic beyond reported fatalities due to Covid-19 alone.
Excess mortality refers to how many more people died from any cause (or all-cause mortality) than would be expected based on historical trends before the Covid-19 pandemic.
“The difference between excess mortality and reported Covid-19 deaths might be a function of underdiagnosis due to insufficient testing, reporting challenges, or higher than expected mortality from other diseases due to pandemic-related changes in behaviours or reduced access to health care or other essential services,” researchers concluded.
The peer-reviewed study published in medical journal The Lancet yesterday estimated 48,100 excess deaths in Malaysia, 1.5 times higher and 16,600 more than the 31,500 casualties officially due to Covid-19 by December 31 last year.
Researchers estimated 81.4 excess deaths per 100,000 people in Malaysia, higher than the 53.3 reported Covid-19 deaths per 100,000 population, with a 1.53 ratio between the excess mortality rate and the reported Covid-19 mortality rate.
Malaysia’s estimated excess mortality rate and estimated excess deaths not tied to population size were fourth highest and fifth highest in Asean respectively.
Indonesia recorded the highest estimated excess mortality rate at 140.7 per 100,000 people, followed by Myanmar (100.9), the Philippines (82.9), Malaysia (81.4), Cambodia (52.5), Vietnam (37), Laos (34.7), Thailand (24.9), Brunei (15.8), and Singapore with a negative value at -15.8.
In terms of cumulative excess deaths, Indonesia came in first at 736,000 estimated excess deaths, followed by the Philippines (184,000), Myanmar (101,000), Vietnam (72,300), Malaysia (48,100), Thailand (35,200), Cambodia (17,500), Laos (4,640), and Singapore with a negative value at -1,770.
Estimated excess mortality rates were unavailable for the Asean region, as Malaysia, Cambodia, Indonesia, Laos, Myanmar, the Philippines, Thailand, and Vietnam were listed under Southeast Asia, while Singapore and Brunei were listed in the high-income Asia Pacific.
The study estimated that 18.2 million people died globally because of the Covid-19 pandemic in the last two years, as measured by excess mortality, three times higher than the official record of 5.94 million deaths due to Covid-19.
Researchers attributed a “substantial fraction” of the 12.3 million more excess deaths versus reported Covid-19 fatalities to Covid-19 infection, but pointed out that this fraction likely varied by location.
At the regional level, the number of excess deaths due to the Covid-19 pandemic was highest in south Asia, north Africa and the Middle East, and eastern Europe.
Besides Singapore, negative excess mortality rates were estimated in Iceland, Australia, New Zealand, and Taiwan, which means reported deaths from all causes that occurred during the pandemic in these countries were lower than expected mortality. The IHME study attributed this to strict pandemic lockdown measures that reduced exposure to risk of death from certain diseases and injuries.
“The full magnitude of the Covid-19 pandemic has been much greater in 2020 and 2021 than is indicated by reported deaths due to Covid-19, with Covid-19 potentially being a leading cause of mortality in 2020 and 2021,” said researchers.
They added that further research is needed to distinguish the proportion of excess deaths that were directly caused by coronavirus infection.
Infectious disease consultant Dr Benedict Sim Lim Heng from Sungai Buloh Hospital said in April 2021 that Covid-19 patients who died post-recovery — either from complications due to lengthy hospitalisation or from persistent effects of the disease — are not officially classified as Covid-19 deaths.
Note: The headline was amended from “Covid Deaths” to “Covid-Related Deaths” to clarify that excess deaths estimated in Malaysia do not necessarily mean deaths “due to” Covid-19 as some may include deaths “with” Covid-19.