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

Background: COVID-19 has disrupted health system of many countries, particularly worse in those resource limited settings including Myanmar. First and second waves in Myanmar during 2020 were effectively managed by the government. However, the momentum was disrupted due to the military coup in early 2021. 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-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 high with limited access to public hospital care during the third wave.  The data suggests that COVID-19 third wave severely hit Myanmar, with adverse outcome fueled by the military coup. However, the online Telehealth clinics operated by Ministry of Health, Myanmar National Unity Government, offered the alternative accessible solution for the certain population within the country.