Comorbidities, no screening linked to virus deaths
KUALA LUMPUR: The majority of Covid-19 victims who were Brought In Dead (BID) to hospitals were those with comorbidities who were unaware that they had been infected as they were never tested.
The number of BID victims has been on the rise. Up to Tuesday, 1,131 out of 9,403 people who died of Covid-19 were BID. Health Minister Datuk Seri Dr Adham Baba said 755 of BID victims had comorbidities such as high blood pressure, diabetes, asthma, kidney disease and other chronic medical problems.
He said most of the BID victims were above 40 who did not know they had been infected. "Seventy-nine per cent of BID cases had never been screened for Covid-19 at any health facility. This means that they did not know they had Covid-19. "We also noticed that Category 1 (no symptoms) and 2 (mild symptoms) cases accounted for 80 to 90 per cent of cases."
He said BID cases were found among patients of all five categories of Covid-19.
"Data show some patients remained in Categories 1 and 2, but some patients slipped to Categories 3, 4 and 5 before they succumbed to the infection. The infection duration varies from one person to another," Dr Adham told the New Straits Times.
He said the contributing factors of transmission were close contacts, failure to get tested when there were signs of illness, delay in seeking treatment and patients not seeking treatment and testing despite symptoms.
"The overwhelmed medical transport services, for instance, and the limited number of ambulances available has also made it harder for patients to get the medical help they need in an emergency.
"Unfortunately, this logistics constraint has contributed to the rise in BID cases, especially in the Greater Klang Valley, where there has been a surge in infections."
Dr Adham said BID cases among those known to be infected were believed to be caused by patients providing incomplete contact details to the Health Ministry at screening centres.
"When the district health office wanted to check on the positive person, to set an appointment at the CAC (Covid-19 Assessment Centre) and wait for an admission bed, the patient could not be contacted because their details did not match.
"Either the information they provided was incomplete or incorrect, or some simply did not want to be admitted despite the deteriorating condition."
He said Covid-19 patients who were on home supervision must be closely monitored as their condition could deteriorate suddenly, resulting in more BID cases.
"The ministry takes the BID surge seriously and is in the midst of implementing several measures to reduce BID.
"Among them is the implementation of the virtual CAC in the Greater Klang Valley (Selangor, Kuala Lumpur, Putrajaya and Negri Sembilan) last month, where positive patients are monitored virtually to expedite diagnosis and management as well as to reduce congestion at the CACs."
Dr Adham said pulse oximeters were being issued to patients to help them monitor their health throughout the quarantine period at home.
"The Health Ministry is also strengthening the ambulance network to ensure prompt response to emergencies and has partnered with private medical practitioners to help with the home supervision of Covid-19 patients through the establishment of GP CACs and private CACs."
Dr Adham said there was evidence that vaccines would reduce the rate of hospitalisation among infected patients.
He said vaccines had been proven to reduce the severity of Covid-19 symptoms and significantly lessen risk of death.
"This can be seen through the experience of countries such as the United Kingdom, Israel and the United States, where hospital admissions due to Covid-19 infection and deaths related to the virus have shown vast improvement after 40 per cent of its population had been vaccinated.
"Therefore, we are expecting the same to happen here in Malaysia once we have reached the 40 per cent mark, " Dr Adham said.
He said once 40 per cent of Malaysia's 32 million population had been vaccinated, Covid-19 cases, especially those with severe symptoms, were expected to decrease.