PETALING JAYA: With brought-in-dead (BID) Covid-19 cases accounting for some 30% of the daily death toll since early this month, health experts call for a better home monitoring policy with adequate support service to patients.
Malaysian Public Health Physicians’ Association president Datuk Dr Zainal Ariffin Omar said that more data on the BID cases should also be released and analysed for the policy to work and help find solutions to lower BID cases.
“BID cases account for about 30% of the total deaths in September. The Health Ministry should provide more details, like gender, age, location, economic status, vaccine status and probable comorbidities.
“The relevant data will help us find out the reason and associated factors, so that targetted efforts can be implemented to lower the BID cases,” he said yesterday.
To improve the home care support system, he called for home-care patients, especially those in the B40 group, to be given the appropriate tools to look after themselves.
“The MOH should first evaluate the patients’ risks. Once verified as Covid-19 positive, patients should receive a support pack that contains the necessary tools and manuals so that they can monitor themselves better.
“These include a clear and easy-to-understand manual, an oximeter, a thermometer, a blood pressure checker, a guide on how to update the MySejahtera app, helpdesk and referral info and some basic medicines,” he said.
Dr Zainal Ariffin said that other factors that led to more BID cases were due to patients’ inadequate knowledge and skills about home monitoring and clinical outcomes.
“Others included lateness in seeking further treatment, a wait-and-see attitude, no access to transport, hospitalisation cost and citizenship issues,” he said.
Health Minister Khairy Jamaluddin said on Sept 9 that about 86% of the BID cases in August died without undergoing any medical observation.
He said the ministry would find out why these deaths were not under any medical supervision so that better advice can be given to the public to either get tested or seek treatment once they have an onset of symptoms.
Dr Zainal Ariffin noted that MOH should also make hospital admission compulsory for Covid-19 patients with certain risk factors, such as comorbidities, or those who hail from a lower socio-economic level and have poor access to hospitals.
“For home-care patients, there should be regular visits or monitoring from MOH staff, who probably need to have their tasks rescheduled.
“To make this happen, the ministry can rope in non-governmental organisations, private general practitioners and community support groups,” he said, adding that such an effort must be effectively taught and promoted to the people.
Malaysian Medical Association (MMA) president Dr Koh Kar Chai also agreed that more BID data is necessary because “every BID case is a case of concern” and the high numbers of late are alarming.
“A breakdown of the cases into age groups, comorbidities, locations, economic backgrounds, vaccination status and why the cases were not referred or taken to hospital at Stage Three will definitely help.
“We can better understand and formulate measures to reduce, if not, to prevent BID cases,” he said.
From MMA’s liaison with the health authority, Dr Koh noted that the ministry had initiated measures to manage this problem by enhancing the monitoring of patients on home quarantine.
“Apart from the Covid-19 virtual assessment centres (CAC) with reporting done via MySejahtera, follow-ups are being done by the CACs run by the state health departments.
“GPs (general practitioners) have also been roped in at the CAC, where they conduct follow up on patients under Categories One and Two before referring them to hospitals if the need arises,” he said.
In the long term, he said awareness campaigns on vaccination must continue to avoid any BID cases due to vaccine hesitancy without a valid medical reason.