Almost Half Of Sabah Covid-19 Patients Very Sick

The 43% proportion of Sabah’s Covid-19 patients who are sick enough to require hospitalisation is more than triple the 12% of Malaysia’s overall Covid-19 cases back in early April who were in the third to fifth stages of disease.

KUALA LUMPUR, Oct 14 — Four in 10 coronavirus patients placed in some form of facility in Sabah are ill enough to be hospitalised, according to Ministry of Health (MOH) statistics, amid soaring Covid-19 infections in the state.

Health director-general Dr Noor Hisham Abdullah revealed today a 71 per cent occupancy rate of 1,018 beds across nine Covid-19 hospitals in Sabah as of yesterday, which amounts to 723 hospitalised Covid-19 patients.

Covid-19 patients in Sabah in stages 3 to 5 of disease are admitted to hospital. Stage 3 refers to people with Covid-19 who suffer from pneumonia, but do not need supplemental oxygen; Stage 4 patients have pneumonia and need supplemental oxygen; while Stage 5 patients need ventilator support.

Dr Noor Hisham also stated a 23 per cent occupancy rate of 4,161 beds across 19 low-risk quarantine and treatment centres in Sabah, which amounts to 957 Covid-19 patients. People infected with coronavirus who either do not have symptoms (Stage 1) or show mild symptoms (Stage 2) are placed in these facilities.

This means that 43 per cent, or 723 of 1,680 Covid-19 patients in Sabah government facilities, were hospitalised as of yesterday, with moderate to severe disease, while 57 per cent had either mild or no symptoms.

The Health DG also told a virtual press conference that coronavirus patients occupied 57 per cent of 110 intensive care unit (ICU) beds across nine Covid-19 hospitals in Sabah as of yesterday, which equates to 63 Covid-19 patients. Yesterday, 101 Covid-19 patients on ICU were reported nationwide.

Covid-19 patients in Sabah are using 30 per cent of 180 ventilators, according to Dr Noor Hisham. (It is unclear why there is a discrepancy between the number of Covid-19 patients in Sabah on ventilator, presumably 54 people, and the number of coronavirus patients nationwide on ventilator at 32, as stated in MOH’s Covid-19 report yesterday).

The 43 per cent proportion of Sabah’s Covid-19 patients who are sick enough to require hospitalisation is 3.6 times higher than the 12 per cent of Malaysia’s overall Covid-19 cases back in early April who were in the third to fifth stages of disease.

MOH statistics confirm anecdotal reports from doctors on the frontlines across Sabah, who told CodeBlue that hospital beds were full of sick Covid-19 patients, as medical frontliners struggle with what they described as understaffed hospitals and working continuously for more than 24 hours due to coworkers contracting the coronavirus.

Sabah’s public health care system appears to face a real risk of being overrun with sick Covid-19 patients, as hundreds of infected people enter the system every day. Out of the 660 new Covid-19 cases reported nationwide today, 429 were in Sabah.

Yesterday, 443 Covid-19 cases were reported in Sabah, preceded by October 12 with 291 cases, 488 cases (October 11), 277 cases (October 10), 274 cases (October 9), and 271 cases (October 8). In just one week from October 8 to 14, a total of 2,473 locally transmitted Covid-19 cases were reported in Sabah.

Four Covid-19 deaths were reported in Sabah today, preceded by yesterday with four fatalities, two deaths (October 12), two deaths (October 11), three deaths (October 10), six deaths (October 9), and five deaths (October 8). Just three of the 26 coronavirus victims reported in the span of a week in Sabah were foreigners (MOH’s October 8 report did not state the nationality of the five victims). These Sabah deaths also represented Malaysia’s total Covid-19 casualties over the past week as no fatalities were recorded in other states.

Dr Noor Hisham also revealed coronavirus patients’ high occupancy rates of beds reserved for them in most of the nine Covid-19 hospitals in Sabah as of October 13, ranging from a high of 95 per cent to a low of 25 per cent:

Sabah HospitalCovid-19 bed occupancy rateNumber of Covid-19 patientsNumber of beds reserved for Covid-19 patientsTotal beds (including for non-Covid patients)
Likas Women and Children’s Hospital (Kota Kinabalu)95%105110642
Tawau Hospital83%178214413
Queen Elizabeth Hospital (Kota Kinabalu)73%237324684
Lahad Datu Hospital70%92131226
Hospital Duchess of Kent Sandakan54%87164389
Keningau Hospital51%1835212
Kudat Hospital50%12152
Kota Marudu Hospital25%312109
Semporna Hospital25%2870

(There is a slight discrepancy between the number of hospital beds reserved for Covid-19 patients in Sabah — the number of such beds Dr Noor Hisham listed for each hospital totals 1,000, although he had stated verbally earlier there were 1,018 hospital beds for Covid-19 patients in Sabah, with a 71 per cent occupancy rate).

Dr Noor Hisham said MOH was looking at adding two more ICU beds for the district hospital of Semporna — the worst-hit district in Sabah with 763 local Covid-19 cases reported within the past 14 days as of yesterday — in a day or two.

Doctors have told CodeBlue that Covid-19 patients are transported from Semporna to Tawau Hospital for further treatment, but even Tawau Hospital is reportedly overwhelmed with Semporna patients. Tawau recorded 447 local Covid-19 cases within the past fortnight as of yesterday.

Dr Noor Hisham also said today that Sabah has recorded an increase of Covid-19 patients being discharged from hospital, with 350 discharged yesterday.

He did not offer an explanation at his virtual press conference on why such a high proportion of Covid-19 cases in Sabah developed moderate to severe disease that required hospitalisation.

Sabahans may generally suffer poor health, as Sabah is the poorest state in the country. According to a Khazanah Research Institute report on malnutrition in Malaysia, which cited MOH’s National Health and Morbidity Survey 2016, Sabah had the sixth-highest rate of underweight children below five years old at 15.2 per cent. Almost a quarter of children below five in Sabah, or 23.5 per cent, were stunted.

A 2008 study published in The Lancet found that “lower birthweight and undernutrition in childhood were risk factors for high glucose concentrations, blood pressure, and harmful lipid profiles once adult body-mass index and height were adjusted for”.

It is also possible that impoverished Sabahans who earn daily wages from informal work may be reluctant to get tested for Covid-19 when they develop mild symptoms, due to fear of losing income from a 14-day quarantine or hospitalisation, and only get admitted to hospital when they’re at a severe stage of the disease, leading to poorer outcomes.

Main Covid-19 Highlights

MOH reported 660 new Covid-19 cases nationwide today, including 654 local transmissions. This has pushed up the active Covid-19 cases in the country to 5,768. A total of 108 Covid-19 patients are being treated in ICU, including 35 on ventilator support.

Sabah recorded the highest proportion of Covid-19 cases reported today at 65 per cent (or 429 cases); followed by Kedah with 113 cases (17.1 per cent), of which 109 came from the Tembok cluster in the Alor Star Prison; and the Klang Valley with 76 cases (68 in Selangor, seven in Kuala Lumpur, and one in Putrajaya), forming 11.5 per cent of total new cases today.

Four deaths from Covid-19 were reported today, all in Sabah. One new Covid-19 cluster was reported today, the Kencana cluster, comprising 17 cases across Selangor (Hulu Langat, Petaling, Klang and Gombak), Kuala Lumpur (Cheras), and Johor (Johor Baru, Batu Pahat, and Pontian). The index case for the cluster (Patient 13,805) was identified from a symptomatic screening on October 7 and admitted to Sungai Buloh Hospital.

As of today, 52 districts in Malaysia are yellow zones, reporting 40 local Covid-19 cases and below reported within the past fortnight, while 19 districts are red as they have reported 41 local Covid-19 cases and above within the past 14 days.

“The Ministry of Health has taken various actions, such as active case detection, continuing surveillance activities at sentinel clinics and hospitals, cleaning and disinfection activities, and increasing testing, tracking, isolation, and treatment,” Dr Noor Hisham said in his written statement.

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