The COVID-19 third wave in Myanmar following the military coup

Background: COVID-19 seriously hit Myanmar between June and August 2021, a few months after the military coup, though the first and second waves in 2020 were managed effectively by the government. People in Myanmar experienced serious consequences of the COVID-19 pandemic precipitated by the disorganized health system under the military junta. This study aimed to analyse the situation of COVID-19 occurrence and death proportions during its third wave in Myanmar. Methods: An online survey was conducted using a Google form. People with the symptoms of COVID-19 and those who died from COVID-19 between June and August 2021 were eligible to participate. The Google form was extracted into an Excel datasheet and analysed using Stata v16.1. Results: Among the 29,171 participants, 76.7% were over 30 years old and 56.4% were female. A majority of participants were from highly populated regions: Yangon (17,220; 59%) (Business capital), Mandalay (3,740; 12.8%) and Sagaing (1,546; 5.3%). Participants sought health care from telegram/other online services (34%), home care by health care providers (22%), private clinics (13%) and public hospitals run under the military junta (5%). Overall, 15% of participants died, of which, 72% occurred at home and 17% at public hospitals. Significantly higher proportions of deaths were seen among participants over 60 years than other age groups and males (p<0.001). Death proportions at different weeks from June to August 2021 ranged from 12.4% to 17.3%, much higher than the military junta’s reports. Overall, 25% of participants received oxygen therapy. Conclusions: Death proportions in different weeks were consistently over 12%. The majority of participants received tele/online and home treatment services. Most deaths occurred at home. Findings indicated the high COVID-19 case fatality rates with limited access to public hospital care during the third wave. The data from this study suggest that the outcomes were adversely impacted by the military coup.