Home Death Trend during MCO in Taiping

Introduction There are two methods for cause of death certification based on the place of occurrence of the death. Death in hospitals is certified by physicians as medically-certified deaths and death at home are certified by local police station as non-medically certified deaths. Excess community deaths from non-Covid causes had been seen across Europe during the pandemic.

Objective This study aimed to demonstrate the trend of home death in the district of Taiping, Perak during the Movement Control Order (MCO) 1 period which was from March to April 2020.

Methodology Retrospective cross sectional study. Data for home death was obtained from the Taiping Police Department. Data for total number of admission during MCO1 obtained from the Hospital Record Office.

Results The average bed occupancy rate (BOR) for this hospital in 2019 was 75%. The BOR was 78% in the month of February 2020, but reduced to 68% and 58% in March and April respectively. Death occurring at home seen increased from 69 cases, 86 cases to 100 cases in the month of February, March and April 2020 respectively. 60% of the cause of death recorded from death at home was “sakit tua” (died due to old age).

Conclusion As BOR decrease, the number of home death increased during MCO 1. There are many ways to look at this and definitely warrant more than “sakit tua” as a cause of death. It may be related to collateral damage of the lockdown or sick people are too scared to go to hospital during MCO. Verbal autopsy (VA) can be applied to increase the accuracy of COD but are subjected to recall bias unless it is done as soon as a home death is reported. Currently, VA is conducted by trained medical personnel. We proposed that training of non-medical personnel is needed for a more accurate COD for death occurring at home, especially during the time of pandemic in the future.