Malacca's only major govt hospital strained due to Covid-19 spike

 

Even with the best healthcare in the country, the Klang Valley has been struggling to cope with being the epicentre of the Covid-19 pandemic in Malaysia as well as with the rise of the Delta variant.

But in a small state like Malacca which only has one major government hospital, any spike in Covid-19 cases can have dire consequences on its healthcare system, what more with the threat of highly transmissible virus strains.

At the start of July, it was reported that the Malacca General Hospital (GH) had utilised 91 percent of its bed capacity, with 400 out of 444 beds at the hospital filled.

This led to the two smaller district hospitals in Malacca – the Alor Gajah Hospital and the Jasin Hospital – to start accepting Covid-19 patients as well as the creation of plans for a military field hospital to be set up.

But by mid-July, it was reported that Alor Gajah Hospital had 58 Covid-19 cases involving staff and patients. Around the same time, the setting up of the field hospital was announced to be postponed.

In the past seven days, Malacca recorded 3,692 new Covid-19 cases and 72 deaths.

Two sources working at the Malacca GH recently spoke to Malaysiakini on condition of anonymity due to the strict gag order barring Health Ministry staff from making unauthorised public comments. (Editor's note: Photo credit unrelated to sources.)

Both spoke about the alarming situation at the hospital’s Emergency Department, which has since been extended to a tarred road outside the department, with tents and portable beds set up.

“Actually, we are at the point of setting up even more new tents as we are talking to you now.

“But even with the (previous) extension, we are still in shortage. Patients are still sitting on chairs, on wheelchairs, and in very extreme conditions, I have witnessed patients sitting on the floor, it is true.

“We have no choice in view of the influx of patients in one shot. We are struggling to find beds or chairs for them," one of them said. 

“Very sadly, when they are sitting on the floor, they are nearby biohazard bins and other such things," the source added. 

The other estimated there are at least 30 to 50 patients stranded in the Emergency Department without beds every day, even with the best efforts of healthcare workers.

Sometimes, they said, that number can go up to over 80 patients and many of them need to wait for more than a day before they can get a bed.

“Some of them deteriorated while waiting in the Emergency Department,” they added.

The other source stressed that the patients are still able to receive timely treatment, albeit in a restrained state.

However, they warned that if Covid-19 cases continue to rise, the patients will have to wait longer before getting treated.

The hospital is also lacking in oxygen supply, with the Emergency Department only having six oxygen ports connected to the hospital’s centralised oxygen supply. One port can only be connected to one patient at a time.

Even with the help of oxygen tanks, the two sources said it is simply not enough.

“The oxygen pressure alarm has been ringing for the past one month due to low oxygen pressure (because) basically too many ill patients need high oxygen.

“The wall oxygen pressure in Melaka GH can’t cope with it, so some patients need to use oxygen tanks but if they are on ventilators or need high oxygen, it is not feasible to use oxygen tanks only,” said one source.

The other said one oxygen tank is supposed to be shared between two patients at most, but there are not enough tanks, so they had had to split one tank between three and four patients.

“With the lack of equipment, it is very real that doctors need to make decisions to intubate and save which patient.

“It is very clear we are choosing life and death for the patients,” they added.

Despite that, they said Malacca GH is still able to accept non-Covid-19 patients into the Emergency Department's green, yellow, and red zones. However, they said they do have a banner telling patients to go to the nearest health clinic if their situation is not critical.

Covid-19 wards in the hospital were also insufficient as more of them are being filled up with Covid-19 patients, said one source.

“Wards are almost full immediately when they open up (and) the Covid-19 wards are set up in a rush, with some of the partitions between patients’ cubicles and nursing counters not properly done,” they added.

Due to the full Covid-19 wards, patients sometimes have to stay at the Emergency Department for up to four days and most of those who require ventilation have little chance of getting a bed in the hospital’s Intensive Care Unit (ICU).

This is because beds in the ICU are very limited and they are “full all the time unless patients there pass away”.

“Hence, we have many patients who are ill and on high oxygen support or even ventilators who are being kept in the general Covid-19 ward, but of course the care is not comparable (to the ICU) due to the fewer manpower in the general Covid-19 ward,” they said.

It is not just about the lack of medical equipment and beds as the two sources said they are also exhausted due to lack of manpower.

“We are burnt out and exhausted. When we are burnt out and exhausted, the quality of our work is definitely going to be reduced especially when you have to rush to treat patients,” one source said.

The source also claimed that staff who have been in close contact with Covid-19 positive individuals were told they do not need to be screened or quarantined if they are asymptomatic, as they already do not have enough manpower.

Malaysiakini has contacted the Malacca GH director for a response to this matter.

Both sources said they do not foresee the situation easing up anytime soon. Instead, they believe it is only going to get worse as Covid-19 numbers continue to rise nationwide.  - Mkini