No Covid-19 patient should be brought in dead

 

The Malaysian Health Coalition is concerned with the increasing number of Covid-19 patients brought-in-dead (BID) to hospitals. As of May 31, Malaysia recorded 2,796 Covid-19 deaths in Malaysia. 293 out of the total (approximately 10 percent) are patients who were BID. These deaths reflect possible systemic failures and must be taken seriously.

We urge the following:

1. Research the possible issues leading to BID

The government must conduct relevant research to determine the exact reasons and causes for the high number of Covid-19 patients BID. Genomic testing will help us understand if there are more virulent variants in Malaysia. Granular data from this research should be made public for awareness and analysis.

Systemic barriers like lack of physical access to healthcare facilities or lack of education on Covid-19 symptoms should be identified and addressed, especially in Sabah which makes up 29 percent of all BID cases. If issues of distrust in science, health professionals, or the government are identified, then long-term solutions should be implemented.

The media must provide easy-to-understand information for the rakyat to take Covid-19 seriously, especially for those undergoing home quarantine.

2. Strict assessment and better monitoring of home quarantine patients

In theory, all patients diagnosed with Covid-19 are currently directed to Covid-19 Assessment Centers (CACs), where doctors decide if they can undergo home quarantine or must be admitted to a hospital or low-risk quarantine centre.

The delay between diagnosis and quarantine decisions should be reduced. Decisions on home quarantines must strictly adhere to Health Ministry guidelines on Covid-19 management, without exceptions or double standards.

Home quarantine patients and their caregivers should be properly educated on the self-monitoring of symptoms, and to report red flag symptoms immediately.

There must be a robust system for District Health Offices to promptly check on patients who report red flag symptoms to evaluate whether hospital admissions are necessary. Private sector general practitioners should be included in the monitoring of home quarantine patients, including providing home visits if necessary.

3. Increase testing capacity

Since many Covid-19 patients do not have symptoms and can rapidly deteriorate, it is possible that many of them were BID because they did not realise they were positive for Covid-19 until it was too late.

Increasing testing capacity (whether targeted or mass) will accurately identify more of those who are positive with Covid-19. Rapid antigen tests can be used for rapid assessments, while the PCR test can be used for those requiring admission. This will allow us to correctly triage and optimally manage all Covid-19 cases.

The share of positive rates for Covid-19 tests in Malaysia has consistently been above five percent, which means that Malaysia is under-testing. Therefore, increasing testing will increase the chances of detecting all Covid-19 patients, not just symptomatic patients only.

The increasing numbers of Covid-19 patients who were BID may reflect underlying systemic failures. We urge the government to implement short-term recommendations to reduce the number of Covid-19 patients BID while delivering long-term strategies to increase access, trust, and health literacy among all Malaysians. - Mkini

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The MALAYSIAN HEALTH COALITION (MHC) is a coalition of over 50 organisations and individuals representing health professionals in Malaysia. Find a list of members here.

The views expressed here are those of the author/contributor and do not necessarily represent the views of MMKtT.