We need strategy to manage Covid-19 cases in non-Covid hospitals

 

There is an increasing number of severe Covid-19 cases presented to government hospitals in Selangor now, at least since the last two-three weeks, and stuck in a non-Covid-19 hospital for days.

Additionally, there are currently 10 Covid-19 patients on ventilators in the wards in some Hospitals. They cannot be transferred to Hospital Sungai Buloh as the ICU is full.

Hospital Sungai Buloh used to take in any suspected Covid patients. At that time, the guidelines said any patient with RTK positive (rapid test) would be admitted.

Now symptomatic, severely ill, close contacts from known clusters, with obvious chest X-ray changes and RTK positive, are sometimes turned away and have to wait for a positive PCR swab test before being considered for transfer to Hospital Sungai Buloh. That PCR test alone will easily take 24 hours or more. And then, more days could be spent waiting if there are no ICU beds available.

While we understand that Hospital Sungai Buloh is trying its best and unable to accept more cases, what is next for these patients?

Usually, patients with multiple medical problems like diabetes and end-stage renal failure need specialised care. Yet, they are now often stuck in the emergency department or an ordinary ward on ventilators.

If these patients are not admitted to a Covid hospital or an ICU, they are deprived of proper treatment, monitoring and appropriate care. Then, of course, our death rates will surely increase.

It is worse when there is covid infection outbreak cluster in the ward or ICU, and the ward or ICU is on lockdown. No further patients can be admitted to that ICU or ward until a quarantine of 10-14 days is completed.

These are some suggestions on what can be done to mitigate these problems:

1. More Covid hospitals must be opened in Selangor.

2. Separate well equipped and manned critical care Covid wards should be set up in more hybrid hospitals to cope with the increasing number of Covid-19 patients in this third wave.

3. We need a clear strategy on how to cope with the increasing number of very ill Stage 4 and 5 Covid-19 patients in various hospitals when these cases can not be transferred to a Covid-19 designated hospital.

We need advanced planning, clear guidelines and support from health experts and our leaders to solve this problem.

4. Hospitals need more financial support for equipment, new wards, and extra manpower.

5. Private hospitals, owned by government-linked companies, should consider opening their doors, with compassion and goodwill, to help the government cope with this huge increase in cases.

It is not acceptable for private hospitals to prioritise profit and refuse to treat Covid-19 positive patients in their facilities and be afraid that taking in such cases would turn away other patients.

After all, there are more beds in private hospitals than government facilities in Klang Valley. We are fighting a disaster now, and we need everyone to contribute and sacrifice. We need to work together, public and private hospitals.

Selangor Hospitals are in crisis and breaking at its seams.

We need a state-level policy and systems solution formulated in anticipation of these problems before it worsens even further.

Let us do better to improve the delivery of critical care to prevent and reduce further Covid-19 deaths together. Fast. - Mkini

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The views expressed here are those of the author/contributor and do not necessarily represent the views of MMKtT.