The only reason to resort to a movement control order (MCO) is to buy time to protect the healthcare facility, to flatten the pandemic curve and allow a breather to our overstretched and exhausted healthcare workers.
All of the signatories in the open letter to the prime minister, and many more who reverted late to the call, will only agree to the MCO as a short circuit to rapidly dampen the spiralling numbers of Covid-19 cases, so as to prevent the healthcare services from being overwhelmed.
From the health ministry data that is available in the public domain, it suggests to us that our health facilities are not at their breaking point. The ventilator utilisation is only 3.4%, the Intensive Care beds utilisation is only 14% and it is only the general bed utilisation which is now breaching the 100% capacity.
One major Covid-19 hospital in the Klang Valley is presently nearly at full capacity. Category 1 and 2 cases occupy 40%-45% and 25%, respectively, of the bed space in the hospital. Imagine the number of empty beds that could rapidly be created by emptying 70% of the beds now occupied by the category 1 and 2 cases.
As a matter of fact, most of the developed nations practise home isolation of their asymptomatic and mild Covid-19 cases. It is a well established practice and the WHO has crafted a guideline for the management of patients in home isolation in March 2020 which has since been updated in August 2020.
Only in the past week or so has the health ministry begun to seriously consider this option. The ministry ought to immediately decongest their healthcare facilities of these cases through an efficient bed management process. Besides this, they should consider decanting all their non-Covid-19 cases to the nearby non-Covid-19 government and private hospitals.
This will allow the Covid-19 hospitals to focus on the care of the sickest patients, stages 3 to 5, and ensure the best outcomes. This will also relieve our health care providers, allow them some much required rest and also reduce the risk of being infected by the large volumes of Covid-19 patients presently in the hospitals.
Even the adviser to the prime minister similarly on BFM: “… I don’t agree that the health system is at a breaking point – it is easy to throw these words around. If you look at the situation in the UK, the US and all that, people, the health professionals, the health system, will find ways to cope…”
I think many of the experts in Putrajaya are either not aware or have never witnessed the battlegrounds in the Covid-19 hospitals, the healthcare centres or the low-risk quarantine centres. They seem to be unduly rigid with their policies and not pragmatic enough to modify and adjust according to the real world experience on ground zero.
Covid-19 is very much a rapidly evolving disease, and all of us, scientists, infectious disease and public health physicians included, are learning to cope with best, contemporary practices and not just sticking rigidly to textbook solutions. The WHO, with its line-up of top-notch advisers, has similarly erred and changed its position on multiple occasions.
In early April 2020, I similarly insisted on the practice of quarantine in isolation centres, implying that home isolation was a failure, but I have since changed my position.
Dr Theresa Tam, chief public health officer of Canada, said: “We have been criticised as public health professionals for changing our advice over time. We have been doing so because the science is evolving.”
I shudder to think how our health ministry would respond to the present situation in the UK, where the mutant coronavirus strain B 1.1.7 is reported to be 50%-70% more transmissible and causes 60,000 cases per day with 1,000 deaths as against our daily 2,500 daily cases.
Dr Musa Mohd Nordin is an FMT reader.
The views expressed are those of the writer and do not necessarily reflect those of MMKtT.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.