KUALA LUMPUR, Oct 28 – Covid-19 was the leading cause of death in Malaysia last year, contributing to more than half of maternal deaths and killing one in five people under the age of 40, according to data released by the Department of Statistics Malaysia (DOSM).
While it is not surprising for Covid-19 to overtake ischaemic heart disease as the principal cause of death during the surge of Malaysia’s epidemic in 2021, the Ministry of Health (MOH) has never previously highlighted high coronavirus fatalities among pregnant women or young adults in their 20s and 30s.
Covid killed 31,063 people in Malaysia in 2021, nearly 20 per cent of the 157,251 medically-certified deaths recorded last year, beating ischaemic heart disease at 13.7 per cent, pneumonia (11.1 per cent), cerebrovascular diseases – conditions that affect blood flow and the blood vessels in the brain – at 6.5 per cent, and transport accidents (1.9 per cent).
This occurred despite annual increases in deaths due to ischaemic heart disease from 18,526 in 2020 to 21,485 in 2021, and from pneumonia and cerebrovascular diseases which also increased from 12,424 and 9,105 in 2020 to 17,503 and 10,181 respectively in 2021.
Transport accidents were the fifth leading cause of death in Malaysia last year, even though most of the country was under some form of lockdown for most of 2021 due to Covid-19.
Though Malaysia began rolling out Covid-19 vaccines in early 2021, the country’s vaccination rate was slow in the first few months due to insufficient supply, with uptake only increasing in June last year. The Delta variant also swept the nation in 2021, which led to a rise in Covid deaths in several states as hospital intensive care units run at over-capacity.
A study on Covid-19 deaths in Malaysia found that unvaccinated individuals had a mortality rate 43.2 times higher than people fully vaccinated with Pfizer, and 12.5 times higher than people who obtained Sinovac.
Maternal deaths attributed to Covid-19 accounted for 57.3 per cent of maternal mortality last year, which more than doubled from 117 deaths in 2020 to 300 deaths in 2021. The maternal mortality ratio rose from 24.8 per 100,000 live births to 68.2 per 100,000 live births over the same period.
Other causes for maternal deaths last year include obstetric embolism at 6.7 per cent, postpartum haemorrhage (5.7 per cent), ectopic pregnancy (3.3 per cent), and gestational hypertension (pregnancy-induced) with proteinuria or high levels of protein in urine (2.3 per cent).
Obstetric embolism refers to a serious condition when the amniotic fluid or foetal materials enter the mother’s bloodstream. Ectopic pregnancy is when a fertilised egg implants and grows outside the main cavity of the uterus.
Covid was also the principal cause of death for people aged between 15 and 40 years at 21.3 per cent out of 17,953 deaths recorded for the age group in 2021, exceeding transport accidents (11 per cent), pneumonia (7.3 per cent), ischaemic heart diseases (6.7 per cent) and cerebrovascular diseases (3.6 per cent).
The virus was also the leading cause of death for people aged 41 to 59 years at 23.4 per cent, and for people aged 60 years and older at 18.5 per cent out of 52,282 and 150,219 total deaths recorded in the respective age groups last year.
It is unclear why a bigger percentage of younger people aged 41 to 49 years (23.4 per cent) and those aged 15 to 40 years (21.3 per cent) died from Covid-19, compared to senior citizens aged 60 years and over (18.5 per cent).
Overall, more men (57 per cent) died from Covid-19 than women among the 31,063 people who succumbed to the virus in Malaysia.
Covid was also the principal cause of death for major ethnic groups in Malaysia with Indians having the highest death rate from Covid at 19.5 per cent, followed by other bumiputera (18.5 per cent), Malays (17.9 per cent), and Chinese (16.3 per cent).
Nine states recorded Covid-19 infection as the principal cause of death in 2021, except for Kedah, Kelantan, Pahang, Perak, Perlis and Terengganu. These states reported ischaemic heart disease as the principal cause of death. Only Putrajaya recorded pneumonia as the principal cause of death at 12.4 per cent.
Malaysia has the highest cumulative Covid deaths per capita among Asean countries at 1,085.9 Covid deaths per million people, as of October 26. In second place, Indonesia has so far reported 578.99 Covid deaths per million people, according to Our World in Data.
Across Asia, Malaysia’s cumulative deaths per capita also far exceeds India’s 375.82 Covid deaths per million people. Hong Kong, however, has a higher cumulative death rate at 1,381 Covid deaths per million people.
Elsewhere, countries such as the United States, the United Kingdom, and Italy to date have recorded cumulative deaths of over 3,000 Covid deaths per million people.