A GROWING number of dead on arrival Covid-19 patients in hospitals have raised concerns of misdiagnosis, re-infection and healthcare access.

Doctors told The Malaysian Insight these are the the likely reasons many coronavirus patients have been brought in dead to the hospitals.

There were 103 DOA cases from March 1 until yesterday with 45 such cases in the first 18 days of this month alone.

The increasing numbers also reflect the spike in the daily Covid-19 cases and death toll.

Associate Prof Dr Tan Toh Leong, an emergency physician at the Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia Hospital’s emergency department, said the test results of these patients could have yielded a false negative, leaving them outside of the infected person list.

He said there was also a possibility that it was an infectious variant that could not be detected using regular RT-PCR tests on these people.

Such variants, which could be doing the rounds, require mutation specific primers, he said.

“It is the same RT-PCR test but it uses a different primer. We don’t do that in routine checks,” Tan said in explaining why unknown variants are not captured in such tests.

“Last year the virus was still an ‘amateur’ but currently it has adapted to the human body,” he said.

Tan said viruses tend to evolve and can sometimes stay in the host’s body without being detected for a long time.

“They evolve into a new strain and make themselves adaptable to the body. When they replicate, they become less likely to be detected, leaving the patient without any symptoms,” he said.

“Although there are no symptoms, their deadly elements might still be functioning, and that is when sudden death happens.”

He said re-infection could be another cause of death, especially among young patients.

“Being reinfected for the second time will be worse than the first and the third time might spell doom,” he said, adding that the high number of sporadic cases might also mean that there are positive cases which are going undetected.

Tan said anther reason for DOA cases could be the patients were unable to get treatment on time due to strained medical resources.

He added that it was important for Malaysia to prevent cross-infection, to avert the formation of new local strains which could be resistant to the current vaccines and lead to further spike in cases.

Director-general of health Dr Noor Hisham Abdullah recently tweeted there were 45 DOA cases from May 1 to May 18 alone.

On May 18, eight DOA cases were reported, five of them in Selangor.

Noor Hisham previously warned that DOA cases were on the rise in the Klang Valley, adding that all the bodies were swabbed for Covid-19.

Meanwhile, virologist Dr Chee Hui Yee from the Faculty of Medicine and Health Sciences at Universiti Putra Malaysia said some patients may not know how to check their health during home quarantine, leading to their deaths.

“Those in home quarantine should check their oxygen levels regularly,” she said, encouraging those in quarantine to buy an oximeter.

“If the oxygen level falls below 95%, they need to quickly call the Covid-19 assessment centre for advice and arrange for admission,” Chee said.

She added that there was also a possibility that some people may not be aware that they are infected as they did not test for Covid-19, which could also lead to sudden deaths.

Malaysia yesterday recorded 6,493 fresh Covid-19 cases for a caseload of 498,795. Fifty died of the virus yesterday, bringing the death toll to 2,149. – May 21, 2021.