ABSTRACT
Introduction: In March 2020, Malaysia initiated the first Movement Control Order (MCO) to curb the spread of COVID-19 infections. While healthcare services remained operational, fears of contracting COVID-19 may have impacted health seeking behaviours and healthcare access. A survey was conducted to investigate how the first MCO impacted actions of individuals experiencing upper respiratory tract infection versus other symptoms, routine follow-up visits, and refill prescription practices. Method(s): A cross-sectional survey among adult Malaysians was conducted from November to December 2020. A selfadministered questionnaire was developed, validated, and disseminated on social media and communication platforms. Result(s): 3001 participants responded to the survey. 486 (16.0%) of them reported being unwell during the MCO. Regardless of symptoms, actions taken to seek medical care were similar. The most common action on average was visiting a medical doctor (55.0%), followed by self-medicating at home (38.0%). 588 participants had a scheduled appointment for their medical condition during the MCO. 253 of them had their appointments affected by the lockdown, for examples, 85.0% postponed, 12% cancelled, 9.0% referred. Only 42.3% of these affected participants saw a doctor within 3 months after the first MCO. Out of 487 participants who regularly collected medications from the pharmacy, 69.0% had a prescription refill appointment during the lockdown. Only 15.0% of them did not collect their medications on the scheduled date. Conclusion(s): The first MCO did not severely affect health seeking behaviour and prescription refill practices. However, there are concerns over timely access to follow-up appointments due to extensive rescheduling and backlogs triggered by the pandemic.
ABSTRACT
Introduction: Elective surgeries were suspended during the national lockdown implemented in March 2020 to curb the spread of the COVID-19 pandemic. Our study aimed to assess the impact of COVID-19 pandemic on national cataract surgical rates. Method(s): We conducted an interrupted time series analysis of cataract surgeries from 2017 to 2021 in Malaysia to evaluate the change in cataract surgical rates before and after the lockdown. Incidence rate ratios were estimated using a seasonally adjusted Poisson regression model. Stratified analyses were performed to establish whether the effect of the lockdown varied by COVID- 19 status of the hospital, sex, and age groups. Result(s): The mean monthly cataract surgical rates before lockdown was 14.1 per 100,000 population with an underlying trend of a 1.0% increase per month. The lockdown was associated with an abrupt 54.0% reduction in monthly rates (95%CI: 0.36-0.60;p<0.001). In May 2020, we observed a gradual recovery in the rates with a peak at 13.8 per 100,000 population in September 2020 although it has not rebounded to its pre-lockdown rate in December 2021. There was no evidence that the effect of the lockdown differed by COVID-status of the hospital, sex, or age groups. Conclusion(s): The initial lockdown period in March 2020 was associated with an immediate reduction in cataract surgical rates to nearly half of its baseline rate. Although cataract surgical rates have marginally trended upward after restrictions were eased, efforts should be taken to restore the delivery of cataract services to its pre-pandemic level to mitigate the negative effects caused by service disruption.