Effectively assessing the COVID-19 pandemic situation in Myanmar is hard to do under Military junta control. Official figures and anecdotal accounts indicate the Myanmar people are struggling to control the spread of the pandemic, and this has as much to do with treatment mismanagement as lack of health personnel and resources.

As of going to press, Myanmar’s COVID-19 related deaths hit a total of over 15,000, according to the Ministry of Health and Sports.

The Myanmar health ministry claims they have registered 383,514 confirmed COVID-19 cases, said to be from 3.4 million people tested over the last 18 months.

But care is needed when considering case numbers given that they rely on the PCR Test, which is reportedly losing credibility as a method to assess who has COVID-19.

UNTREATED PATIENTS

The country’s struggle to tackle the health threat has been compounded by the military coup, according to critics, who claim the junta has failed to allocate resources effectively and has tended to favour government administration-related patients rather than the general public. In addition, many health workers quit or have temporarily stopped working in accordance with the Civil Disobedience Movement (CDM), a movement that has seen many civil servants go on strike.

All this has been catastrophic for health care in Myanmar. The country’s health service was limited at best before the military coup and the stress put on it by the arrival of the COVID-19 pandemic last year.

Tallying the COVID-19 case and death numbers appears to remain problematic due to the continued use of PCR Tests and the lack of clarity over what people have actually been dying of.

WHAT ARE PEOPLE DYING OF?

As one health ministry official clarified during the earlier bout of cases in 2020, most people who die registered as COVID-19 actually die of other conditions or diseases – hence the description given by the health authorities, namely “COVID-19 related”, rather than saying the person died of COVID-19.

So, what are people dying of? At least on an anecdotal level, there appears to be a rush to obtain oxygen cylinders which would appear to indicate that the patients are having problems breathing and this would indicate that they could be suffering from COVID-19, given the generally accepted guidance on the virus’s symptoms.

At this stage, the need for oxygen cylinders in Myanmar remains acute, indicating most patients are not receiving early care in the form of the right treatment protocols and antiviral medicine.

For many with COVID-19 symptoms in Myanmar, the situation is dire because of the security situation and the limited health facilities operating.

It is not surprising, given these circumstances, that a significant number of people are treated too late, or fail to get treatment, and die.

TEST NOT FIT FOR PURPOSE

But what is unclear is the veracity of the actual COVID-19 tally in terms of case numbers and death numbers. These numbers could be artificially inflated, if the claims of doctors and lawyers around the world challenging the pandemic narrative are anything to go by – and the changes in approach by the authorities in the USA.

America’s Centers for Disease Control and Prevention (CDC) recently announced they would end the use of the PCR Test at the end of the year – the test used around the world to assess whether a person has COVID-19 or not.

The CDC has already effectively admitted that the test was being misused. In January, the CDC downgraded their recommendation for the cycle threshold used in the test. According to some health professionals, the PCR Test is typically misused coming up with a large percentage of “false positives” due to is being run at a high cycle threshold – the cycle threshold commonly used with the test around the world.

Health professionals and lawyers have been alleging that governments and health authorities are being fraudulent in their use of the PCR Test, both in terms of how it is used – including testing healthy individuals – but also in terms of the alleged inflated numbers.

Instead of carrying out normal health protocol where the focus is on people with symptoms, mass testing has been carried out in an unprecedented drive to test the general population.

Health professionals calling out the alleged fraud claim the COVID-19 figures are heavily overinflated because the PCR Test is being misused.

CORRECT TREATMENT?

A growing number of health professionals around the world have raised concerns over how the pandemic has been handled and the use of appropriate treatment.

As one group of doctors in the UK noted, the harm caused by COVID-19 and the health authority’s response to it should have meant that advances in prophylaxis and therapeutics for COVID-19 were embraced. However, evidence on successful treatments has been ignored or even actively suppressed. For example, a study in Oxford published in February 2021 demonstrated that inhaled Budesonide could reduce hospitalisations by 90 percent in low risk patients and a publication in April 2021 showed that recovery was faster for high risk patients too. However, this important intervention has not been promoted.

Dr Tess Lawrie, of the Evidence Based Medical Consultancy in Bath, presented a thorough analysis of the prophylactic and therapeutic benefits of Ivermectin to the UK government in January 2021. More than 24 randomised trials with 3,400 people have demonstrated a 79-91 percent reduction in infections and a

27-81 percent reduction in deaths with Ivermectin. Many doctors around the world have reported success in using this drug in the treatment of COVID-19.

Naturally, many doctors are understandably cautious about possible over-interpretation of the available data for the drugs mentioned and other treatments, although it is to be noted that no such caution seems to have been applied in relation to the treatment of data around the government’s interventions, such as the effectiveness of lockdowns or masks when used in support of the agenda involved with COVID-19.

The crux here may be that early treatment could reduce the risk of requiring hospitalisation and such health protocols alter the entire view held by many professionals and lay people alike about the threat posed by COVID-19, and therefore the risk vs benefit ratio for vaccination, especially in younger groups.

STRUGGLING FOR AIR

The controversy over the COVID-19 tally, however, is likely to be of little interest to Myanmar patients, many of them elderly, who are struggling to breathe and may be suffering from the virus.

The rush for oxygen, as Mizzima Weekly has reported before, would appear to indicate that people could be suffering from “end-stage” COVID-19 – in other words, they have not had early treatment and for whatever reason have waited until their condition worsened before they sought help.

There are a range of health treatment protocols including the use of antivirals and vitamins that are being used with success by doctors around the world to help manage the pandemic.

But in Myanmar, the health system has broken down. And this means they are not getting the right treatment due to a lack of doctors and the correct medicine. Despite the fear surrounding the virus, the survival rate for those properly treated is high, with figures quoted above 99 percent. But this would only appear to apply in the Western world or in countries or regions where doctors understand how to treat patients – as seen recently in some regions of India.

Myanmar clearly needs a major overhaul of its COVID-19 treatment protocols. But given the ongoing crisis under the Military junta, it would appear that this is unlikely to be brought in.

Controversy around the testing and COVID-19 numbers should not detract from the challenge – people in Myanmar are dying of COVID-19 because they are not receiving the treatment they need.

Jan Raphael is a pseudonym for a writer who covers Asian and world affairs.

Mizzima is not responsible for the views expressed in this article.