PETALING JAYA: On Sept 5, a total of 336 Covid-19 deaths were reported, of which 107 were brought-in-dead (BID). A day earlier, there were 362 deaths with 104 BID cases.
With almost a third of cases being brought-in-dead, it has become a serious matter, with no sign of it abating.
Health minister Khairy Jamaluddin has promised to look into the cases, especially those in Category 1 and 2 that deteriorate quickly, while still at home or in quarantine.
A nationwide monthly high fatality was recorded in August – 7,640 Covid-related deaths, almost double the 3,854 cases in July.
For August alone, 1,577 cases or 20.6% were BID cases, and as of Aug 31, cumulative BID cases stood at 2,638, 15.8% of the total 16,664 Covid-19 fatalities, according to The Edge.
The number of BID cases is still high despite additional Covid-19 assessment centres set up and a virtual CAC to monitor those quarantined at home.
However, there is another BID problem: Non-Covid-19 brought-in-dead cases are also increasing.
No BID figures have been announced for non-Covid-19 cases but University Malaya Medical Centre (UMMC) emergency department physician Dr Khadijah Poh said that in the worst hit months, the number of BID cases with non-Covid-19 presentations also increased, although she did not have a breakdown of the data.
UMMC experienced an estimated 30% increase in both BID categories since December.
By June, the number doubled that of the pre-Covid-19 period. In July, the worst hit month, the department’s BID cases were six times more compared to the pre-Covid-19 figures, and with little improvement in August, she said.
What is worrying is that many cases in the last couple of months were not the usual elderly or those with comorbidities, the usual suspects of the pre-Covid-19 period.
A bigger percentage of them now were aged 40 to 50 and/or had no comorbidities and were mostly foreigners, said Khadijah.
While doctors fear that people are afraid to seek treatment as the healthcare system is bursting at its seams, deceased family members and friends had more to tell.
They said the poor response system, lack of facilities and delayed treatment led to unnecessary deaths.
A Kuala Lumpur resident who declined to be named said she tried calling for an ambulance from two hospitals in Johor for a friend on Covid-19 home quarantine who suddenly encountered breathing difficulties recently but no ambulance was available.
After many calls, someone in full protective clothing came in a car to pick her friend up but it was too late. She was pronounced dead on arrival at the hospital, she said.
The deceased was in her 40s, with no known medical conditions and had completed two Covid-19 jabs but it had been less than 14 days, she said.
Meanwhile, in a non-Covid-19 BID case, family members of the late Alan (not his real name), 61, are still in shock. He died after a routine gallstone removal procedure.
Alan’s brother, who wanted to be known only as “M”, said Alan had jaundice in the third week of July and a scan showed he had gallstones with biliary obstruction.
Before treatment at a private hospital, he was tested Covid-19 positive. He was sent to a Covid-19 public hospital but after two days, he was discharged and quarantined at home, said M.
“My brother was fine and was communicating and eating as usual. After testing negative for Covid-19 on the 11th day of quarantine, he went to the same public hospital for his gallstone removal procedure.
“He was discharged the same evening after a stent was inserted. The doctor said the jaundice should clear up in two days,” he said.
However, after midnight, Alan complained of severe pain and a cousin rushed him to a nearby private hospital. The doctor advised him to return to the public hospital where the procedure was done.
They reached the public hospital at 3am only to be told to try another public hospital. They left for the second public hospital but even at 1pm – some 10 hours later – there was still no bed for Alan.
After several calls, the frantic family members managed to admit him at the hospital where another procedure was done at 5pm, said the cousin.
The hospital discharged Alan but M said he was very weak, could hardly eat and needed a wheelchair.
Two days later, he had breathing difficulties and was readmitted to the same hospital and Alan’s wife was told to sign a document not to resuscitate him if his situation worsened. Alan died of sepsis shock and multiple organ failure shortly after.
M said the hospital doctor should have referred Alan to a private hospital for follow-up.
The health ministry had previously announced that it would refer non-Covid-19 cases to private hospitals.
Another issue the health minister needs to look at is the lack of medical care access for foreigners, especially undocumented workers, which could lead to BID cases.
A migrant workers’ rights advocate said many undocumented workers were turned away at vaccination centres because they could not register with MySejahtera.
“They are reluctant to register using the app because they fear that the data will be kept for future raids. They also avoid huge crowds because they are afraid of being detained,” she said.
Without medical care, they die outside of hospitals, leading to more BID cases.
The Covid-19 experience in the Klang Valley should be used to plan ahead for other states which are experiencing an overload of cases to minimise BID cases. There are lessons to be learnt from other countries, too.
And there are enough grieving families. - FMT
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