Introduction
The COVID-19 pandemic has reshaped global health systems, revealing vulnerabilities in healthcare and public health infrastructure. While official COVID-19 death counts capture the immediate impact, excess mortality estimates uncover the pandemic’s broader effects, including indirect deaths caused by disrupted healthcare services and societal changes. This study examines global and regional excess mortality data and emphasises the role of Malaysia’s White Health Paper in preparing for future pandemics.
Global Excess Mortality Estimates
Globally, the World Health Organization (WHO) reported approximately 14.9 million excess deaths between January 2020 and December 2021, nearly three times the officially recorded COVID-19 deaths (World Health Organization, 2022). Similarly, the Institute for Health Metrics and Evaluation (IHME) estimated approximately 18.3 million excess deaths during the same period (Wang et al., 2022). These figures underscore the extensive direct and indirect impacts of the pandemic.
Regional Variations in Excess Mortality
Excess mortality varied significantly across regions. In Malaysia, a study in The Lancet Regional Health – Western Pacificreported an 8.5% increase in mortality from January 2020 to December 2021, reflecting indirect effects such as healthcare system disruptions and delayed treatments (The Lancet Regional Health – Western Pacific, 2022). In contrast, India reported a 20% increase in excess deaths, highlighting challenges in healthcare access and reporting (The Lancet, 2022). Other countries, such as Brazil and the United States, also faced substantial increases in excess mortality, further demonstrating regional disparities (Faust et al., 2021).
Indirect Effects of the Pandemic
Beyond direct COVID-19 fatalities, excess mortality includes deaths exacerbated by the pandemic. Delayed medical treatments due to overwhelmed healthcare systems led to increased deaths from chronic diseases, including cancer and cardiovascular conditions (Maringe et al., 2020). Mental health crises and substance abuse also contributed to rising mortality, particularly among younger populations (Faust et al., 2021).
The Role of Public Health Specialists and Policymakers in Malaysia
The pandemic has emphasised the importance of proactive public health leadership. In Malaysia, the White Health Paper provides a comprehensive framework for strengthening healthcare systems and preparing for future pandemics. Key recommendations include:
1. Strengthening Public Health Infrastructure
Investments in healthcare infrastructure and workforce capacity are critical. Public health specialists must advocate for equitable healthcare access and improved resource allocation.
2. Enhancing Surveillance and Data Systems
Surveillance systems must be upgraded to enable real-time detection and response. Leveraging digital health technologies, such as artificial intelligence and machine learning, is essential for improving data collection and analysis.
3. Developing Comprehensive Pandemic Preparedness Plans
Establishing a national pandemic preparedness plan that includes protocols for outbreak management, resource allocation, and community engagement is crucial. This plan should align with the White Health Paper’s strategic vision.
4. Community Engagement and Health Literacy
Public health specialists must prioritise health literacy and foster community participation in public health initiatives to ensure compliance during emergencies.
5. Sustained Investments in Health Systems
Policymakers must allocate adequate budgets for public health and encourage research in infectious diseases and healthcare innovation.
Conclusion
Excess mortality data highlight the devastating effects of the COVID-19 pandemic and the importance of strengthening healthcare systems to mitigate future public health crises. Public health specialists and policymakers in Malaysia must align their efforts with the White Health Paper’s recommendations to ensure preparedness and resilience. By addressing healthcare disparities, improving data systems, and fostering community engagement, Malaysia can build a robust framework for future pandemic responses.
References
Faust, J. S., Du, C., Mayes, K. D., et al. (2021). Mortality from drug overdoses, homicides, unintentional injuries, motor vehicle crashes, and suicides during the pandemic in the United States. JAMA, 326(1), 84–86. https://doi.org/10.1001/jama.2021.8012
Maringe, C., Spicer, J., Morris, M., et al. (2020). The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: A national, population-based, modelling study. The Lancet Oncology, 21(8), 1023–1034. https://doi.org/10.1016/S1470-2045(20)30388-0
The Lancet. (2022). Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020–21. The Lancet. Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02796-3/fulltext
The Lancet Regional Health – Western Pacific. (2022). Excess mortality in Malaysia during the COVID-19 pandemic. The Lancet Regional Health – Western Pacific. Retrieved from https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(22)00071-2/fulltext
Wang, H., Paulson, K. R., et al. (2022). Estimating global excess mortality associated with the COVID-19 pandemic. The Lancet, 399(10334), 1513–1536. https://doi.org/10.1016/S0140-6736(21)02796-3
World Health Organization. (2022). 14.9 million excess deaths were associated with the COVID-19 pandemic in 2020 and 2021. Retrieved from https://www.who.int/news/item/05-05-2022-14.9-million-excess-deaths-were-associated-with-the-covid-19-pandemic-in-2020-and-2021