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Friday, May 22, 2020

With Covid-19, neither the hospital nor Parliament is safe



We know how badly the Covid-19 pandemic is affecting us: people are dying, we are facing lockdowns and an increasing number of workers are losing their jobs. But would any doctor have ever thought that he or she would one day tell a patient that the hospital is not a safe place?
This is exactly what happened to an 84-year-old man who had a fall resulting in a slight fracture of the pelvis. His doctor told him he’d live longer staying at home than being admitted to a hospital ward.
I was talking to a friend, who is 86, on the phone yesterday when he related this incident. He said his cousin fell in the bathroom of his home and was taken to a private hospital where, after an x-ray, he was told there was a fracture on his pelvis but that it did not require surgery.
The cousin was told that with the Covid-19 pandemic, even hospitals were not safe, especially for vulnerable people like him. Most of those who are dying of Covid-19 are above 60 or who already have major health problems.
He would be most safe in his own home, the doctor told the cousin. So within a few hours, he was back home with the necessary medicine.
Who would have thought a private hospital would not want to let a patient stay a few nights so that it could make more money, or perhaps even perform the surgery to make even more money?
The gentleman whom I was speaking to has a regular doctor’s appointment next month at another hospital for a heart-related problem. He has been advised by several doctors whom he knows to postpone the appointment to a later date.
Again this is because there will be many people seeking treatment, and many others visiting patients, at the hospital. Who knows if someone among them has the SARS-coV-2 virus, especially since some of those infected are asymptomatic?
I suppose the fear is justified as even staff of hospitals – such as the Women and Children’s Hospital in Likas and the Keningau Hospital, both in Sabah – have been infected.
On April 23, health director-general Dr Noor Hisham Abdullah said 325 medical workers from his ministry had tested positive for Covid-19, but added that none of the cases was due to contact with Covid-19 patients at healthcare facilities.
But then again, it is a myth that hospitals are very safe, a myth that the pandemic is likely to explode in Malaysia.
Even before the pandemic, the World Health Organization had revealed that the occurrence of “adverse events” due to unsafe care at hospitals was likely one of the 10 leading causes of death and disability in the world.
It estimates that each year, about 134 million such “adverse events” occur in hospitals in low-and-middle-income countries alone due to unsafe care, causing 2.6 million deaths.
WHO says as many as four in 10 patients in the world are “harmed in primary and outpatient health care” and that 80% of the harm is preventable. “The most detrimental errors are related to diagnosis, prescription and the use of medicine,” it adds.
But don’t, for a moment, assume that this does not happen in developed countries where there are better facilities and better-trained medical staff. WHO estimates that one in every 10 patients in high-income countries is harmed while receiving hospital care and that 50% of these are preventable.
Most Malaysians may not be aware of the danger lurking in clinics and hospitals because this is not a part of public discourse. I wonder if any of our academics in public universities has conducted a study on the number of people dying due to “adverse events” in Malaysian hospitals. If not, I hope somebody does so.
With the invisible SARS-coV-2 virus, the situation would be even worse.
In the UK, up to a fifth of those with Covid-19 in several hospitals contracted the disease while already being treated there for other health-related issues, according to a May 17 report in The Guardian.
So, the decision of the doctor to send my friend’s cousin home is sound.
But it is not just the hospital that is unsafe in Malaysia. Even Parliament has been deemed unsafe by the government and that is why, it said, the first meeting of the third term of the 14th Parliament on May 18 had to be shortened, with the only business being the opening address of the Yang di-Pertuan Agong.
The 222 MPs were told that due to the danger posed by Covid-19, the debates would take place when Parliament meets next, from July 13 to Aug 27.
Of course, many Malaysians think political considerations were also at play in the decision to disallow any debate on the king’s address or to discuss any other matter.
Everyone knows that former prime minister Dr Mahathir Mohamad, who lost a tussle for power with Muhyiddin Yassin, had given notice he’d move a no-confidence motion against the latter in Parliament.
Even if the motion had not been placed high enough on the order of the day list to be debated, Mahathir and other opposition MPs would have brought up the question of whether Muhyiddin had majority support of the MPs to remain as prime minister during the debate on the king’s speech.
That is perhaps why even the debate on the king’s speech was postponed to the next meeting of Parliament in July. It affords Muhyiddin time to get as many MPs as possible on his side.
But it was clear on Monday that Muhyiddin had more support than Mahathir, based on the seating at the Dewan Rakyat – there were 114 MPs on his side of the house. Later, however, one of them, Sri Aman MP Masir Kujat, clarified that he was still with the opposition and that he had been wrongly seated with the government backbenchers.
That still gives Muhyiddin’s loose coalition, Perikatan Nasional, 113 seats to the opposition’s 108, with Selangau MP Baru Bian as the sole independent. That’s dangerously thin for PN.
We don’t know how the voting would have gone if the motion of no-confidence against Muhyiddin had been taken on May 18 but it appears PN felt it was unsafe to test it in Parliament, at least for now. It seems then that for the PN, Parliament may be doubly unsafe. - FMT

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