KUALA LUMPUR, March 16 – The National Disaster Management Agency’s (NADMA) funeral assistance programme has not been extended to the next-of-kin of those who died from long Covid, Kubang Pasu MP Amiruddin Hamzah said.
Amiruddin said families of long Covid victims have trouble applying for the Covid funeral aid programme, which provides a one-off RM5,000 assistance to family members of Covid-19 victims, as victims’ death certificates do not state Covid-19 as the cause of death.
“There are long Covid patients who do die after recovering from Covid-19 — they go back home, they have (long Covid) symptoms, they are readmitted into the hospital, and they die.
“But the death certificate states reasons like ‘renal failure’ as the cause of death with no other indication that points to long Covid or the initial Covid that the patient had earlier,” Amiruddin said, in his question to Deputy Health Minister Dr Noor Azmi Ghazali, during the latter’s winding-up speech at the Dewan Rakyat today.
“I was told previously, in response to my earlier question on the matter, that if there is indication from the hospital that the victims’ death is tied to Covid, the families will be considered for assistance (by NADMA),” added Amiruddin, a Pejuang MP.
Dr Noor Azmi responded to Amiruddin’s statement by saying that hospitals cannot determine the cause of death in an arbitrary way. He said medical doctors at hospitals would have carried out a diagnosis on the cause of death based on tests and the kinds of treatment given to the victim.
“On whether the cause of death can be linked to Covid so that financial assistance can be given to the victim’s family, you may have to refer this to NADMA; and if the death can be attributed to Covid, there will be parties to determine the cause.
“So, if the cause of death was stated as ‘renal failure’, I’m sure they have done all the tests necessary to conclude that the death was due to renal failure,” Dr Noor Azmi said, to which Amiruddin once again stressed was “initially attributed to Covid” and then long Covid.
A peer-reviewed study published in medical journal The Lancet last week 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.
The Covid-19 excess mortality team from the Institute for Health Metrics and Evaluation (IHME) at Washington University in the United States 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.
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.
Unlike Malaysia that appears to have restrictive classifications of Covid-19 deaths, based on Dr Noor Azmi’s comments in Parliament, Belgium has taken an “inclusive” approach to Covid-19 mortality reporting, according to IHME’s paper.
Belgium’s ratio between excess deaths and reported Covid-19 deaths is close to 1 in the IHME model, indicating that most of Belgium’s excess mortality is accounted for as Covid-19 deaths.
“Covid-19 mortality was strongly correlated with excess all-cause mortality in Belgium. The excess mortality was a key indicator in the Covid-19 epidemic to validate that the epidemiological reporting of Covid-19-related mortality was correctly conducted during the epidemic,” said Sciencano, a public Belgian health institute, in a report on Covid-19 mortality surveillance in Belgium from March 2020 to February 14, 2021.
For all Covid-19 cases, Belgium includes death in its Covid-19 mortality surveillance, “unless there was a clear alternative cause of death that could not be linked to Covid-19”, for example trauma. “There must have been no period of complete recovery between the illness and death.”
Infectious disease experts Dr Christopher Lee and Dr Benedict Lim previously noted that Covid-19 deaths in Malaysia may be higher than officially reported, as many patients have died after hospital discharge due to Covid-19 complications.
The CovidNow team previously told CodeBlue that they would respond to the IHME model that estimated some 48,000 excess deaths in Malaysia.