Covid-19 death rate shows up years of ICU neglect

 

Senior consultant paediatrician Dr Amar Singh says doctors had for years asked for more ICUs to be set up but this was not done. (Bernama pic)

From Loh Foon Fong

The Covid-19 death rate is at a frightening level with about 200 deaths a day being reported. Doctors fear this could be because many people seek treatment too late or do not seek treatment at all.

Some patients are afraid to get tested for fear of ending up in a huge quarantine centre.

A lack of workers has also led to limited and delayed contact tracing, with those infected even being unaware that they were close contacts of someone infected.

“We can save a lot more people if they get tested and treated earlier,” said a doctor who did not want to be identified.

“If patients seek medical attention only when they are very ill, they risk developing complications and staying in the hospital for a long time, using up a lot of resources, which others need.”

However, even when they do get tested, there is a problem with medical care. Many have complained that their loved ones were left unattended or did not get urgent care fast enough.

With daily new infection cases reported at more than five figures recently, public hospitals have been running short of beds in intensive care units and patients have to be put in normal wards and emergency departments where they do not get the high level of care they need.

Ventilators, oxygen support and certain medicines are also in short supply, doctors say.

The health system has not been able to cope with the massive influx of Covid-19 patients and doctors have had to make the painful – and ruthless – decision of who lives and who dies.

The situation has become so dire that one doctor said, “Humans are treated with little dignity.”

Several doctors point out that the pandemic has exposed the years of an understaffed and underfunded weak public health infrastructure, with the highly infectious Delta variant of the coronavirus making things even worse.

Senior consultant paediatrician Dr Amar Singh, in an interview with activist Nathaniel Tan on Aug 7, said doctors had for years asked for more ICUs to be set up but this was not done.

“Even without Covid-19, we struggled to find ICU beds. Many patients were ventilated in the general wards because there were no ICU beds for them,” said Ipoh-based Amar, who has retired from civil service.

While the situation in the Klang Valley has not stabilised, there has been a steep rise in the number of patients needing ICU beds in Perak, Kedah and Sabah since the end of June, leading to overruns, he said.

“Sabah has reached the crisis level it experienced last year,” he said.

There was also a concern for Penang, which had 20 ICU beds and has since repurposed 60 since many cannot afford treatment in private hospitals.

Amar said it had taken one year to reach the total figure of 100,000 Covid-19 cases, but now, that number is reached within six days.

He said the government should increase Covid-19 testing and share detailed and real-time data with experts for them to support the health ministry by analysing the data and strategising plans to arrest the situation.

Can more be done to save lives?

The head of the Greater Klang Valley Special Task Force, Dr Chong Chee Kheong, said more beds are being added every day but in light of the high daily Covid-19 cases, there is a constant need for beds and the equipment that comes with them.

He said the ministry now has its own micro plant to supply oxygen to its hospitals to overcome the short supply.

“We expect to see a reduction of cases in the Greater Klang Valley area in three to four weeks,” he said in an interview.

Asked what other support was needed, Chong said the task force had met with state governments and assemblymen and they had agreed in principle to mobilise their own machinery to attend to the needs of those under home quarantine.

He urged those tested Covid-19 positive to link up to the MySejahtera app and be monitored by the virtual Covid-19 Assessment Centre (CAC) or by a community health clinic or by a GP.

A source said that following the setting up of the task force, fewer patients were turned away and oxygen supply capacity had started improving.

The army has also assisted in supplying oxygen in the Klang Valley and buses and vans were added to make up for the lack of ambulances to ferry patients to CACs or hospitals, he said.

Klang MP Charles Santiago said health minister Dr Adham Baba had gone to the Hospital Tengku Ampuan Rahimah Klang to help sort out the hospital’s needs recently but he hoped more specialists and nurses could be deployed there.

In early August, Mercy Malaysia built a field hospital with 100 beds and the bed situation was slightly better, he said.

Santiago urged big corporations, especially pharmaceutical companies that had made huge profits during this pandemic, to support the needs of overburdened public hospitals.

Support is also needed from the whole government. The National Security Council (MKN) should stop easing restrictions for the fully vaccinated for at least another month even if the situation in the Greater Klang Valley improves after more people are vaccinated.

Instead, it should strategise how the government can meet the needs of the colossal number of Covid-19 patients.

Above all, the government should share more detailed statistics and work with state governments and others with expertise to plan for a more strategic handling of the pandemic and at a more localised level.

A lot more people can be saved if the whole of government and society work together. A lot of public messaging is needed to urge people to get themselves tested and treated early.

Then, they can minimise the risk of ending up in the ICU, and denying others in need. Maybe the death rate will then come down. - FMT

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.