We note the comments made by the Health DG and efforts by MOH in curbing this pandemic in Sabah. However, MMA feels there is more that can be done to mitigate the situation in Sabah.
The information from the ground in Sabah with regards to bed occupancy at hospitals and quarantine centers as well as ICU bed utilisation, especially in the red zones, do not correspond to the figures presented during the daily press conference by MOH.
This discrepancy is likely due to the fact that the statistics presented is an average for all the facilities in Sabah.
We urge MOH to present the statistics based on the individual hospitals and quarantine centres used in treatment of Covid-19 in Sabah to prevent giving a false sense of security amidst the alarming condition in the red zones.
Higher bed occupancy at hospitals and quarantine centres and ICU bed usage in red zones reaching the brim may be masked by a reduced usage in other centres.
Presenting the statistics by using an average percentage for the entire state provides a false sense of security and dampens the urgency of the situation.
ICU beds available at a hospital in another district or different part of Sabah may not be a practical solution to be utilised, as it is not easy to transport a critically ill Covid-19 patient on breathing assist device to another health facility, without putting the patient and many others along the way at risk.
If indeed certain hospitals and quarantine centers are utilised up to 90 per cent or more compared to the rest, MOH should look at increasing the availability of resources and infrastructure at these centers. Emergency funds should be utilised to recruit more quarantine centres in the red zones to accommodate the increased demand. Hotels that have closed down or not occupied in these areas should be leased for this purpose.
Sabah Local Government and Housing Minister, Datuk Seri Masidi Manjun was reported saying 99.5 per cent of the beds in Sabah have been filled on 22 October. This is in vast contrast to the numbers presented by MOH recently.
There are also reports from Sabah that mention there is a delay in transporting patients who tested positive during screening from home to treatment centers. The inadequacy of transport vehicles further challenged by the geography and recent floods in certain regions in Sabah are told to be responsible for this.
The federal government and MOH should also look at pooling and mobilisation of its resources and medical equipment for use in Sabah. There are many other medical equipment needed, besides the ventilators that are frequently highlighted in the media.
With the expansion of beds in existing health facilities for treatment of Stage 4 and 5 Covid-19 patients, the requirement of medical equipment like syringe pumps, vital signs monitoring devices, and many other ancillary items is skyrocketing.
We have been told that with the recent increase in use of High Flow Nasal Cannula in the treatment of Covid-19, there is increased aerosolisation and thus a resultant increase in the need for powered air-purifying respirators (PAPRs) to be used by all staff and doctors monitoring these patients in the wards.
MMA suggests for MOH to pool these items that were procured during the first and second waves in other parts of the country and mobilise them to be sent to Sabah immediately for use during this outbreak and use the emergency funds to purchase other equipment and machines required which are not available. These items can then be mobilised back to other states as the needs arise once the outbreak in Sabah is controlled.
Another strategy to relieve the workload of the government health clinics and green (non-critical) zones at emergency departments would be to outsource the green zone patients and follow up of stable NCDs (non-communicable diseases) to the hundreds of general practitioners all over Sabah for a nominal fee and devise a mechanism for follow up medications prescribed to be still obtained from the government pharmacies. This will allow the government health clinics to pool their existing manpower for Covid-19 screening.
Another option is to recruit general practitioners in the vicinity to help with Covid-19 screening for a nominal fee. MMA feels the army of government trained general practitioners with fully equipped clinic facilities in Sabah are not being utilised, despite the increasing workload in government health clinics. The public and the private sector in health care needs to work together especially during times like this.
MMA, via MMA Foundation and MMA Sabah, has commenced the MMA Sabah COVID-19 Fund on the 15th of October to provide aid to tackle the Covid-19 crisis in Sabah. We are doing our best to assist MOH to increase the testing capacity and procure the medical equipment as needed. The first batch items are currently being purchased with the funds collected and these will be delivered to the Sabah state health department.
MMA’s Sabah Covid-19 Fund has also channeled medical equipment worth nearly RM1.2 million to the Sabah State Health Department to date from various corporate sponsors, including a batch of 36 High Flow Nasal Cannula expected to be delivered in the next few days. MMA wishes to express its deep gratitude to all generous donors.
Dr Subramaniam Muniandy is president of the Malaysian Medical Association.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.