Severely Ill Covid-19 Patients Stuck In Non-Covid Hospital

By Kanmani Batumalai | 14 January 2021

At Serdang Hospital, two to six gravely ill Covid-19 patients were waiting daily in the isolation room in the emergency department the past one week.

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KUALA LUMPUR, Jan 14 — Severely sick Covid-19 patients are allegedly awaiting days to be transferred from a non-Covid hospital to Sungai Buloh Hospital, risking worse outcomes and even death.

An anonymous source working at a hospital in Selangor told CodeBlue that sick Covid-19 patients are only accepted by Sungai Buloh Hospital, Selangor’s only Covid-19 treatment hospital, if they test positive with the gold standard RT-PCR.

According to the source, Sungai Buloh Hospital used to take in any suspected Covid-19 patients initially, before hospital guidelines were changed to admit any patient who tested positive for coronavirus with the antigen rapid test kit (RTK).

“Now, symptomatic, severely ill, close contacts from known clusters, with obvious chest X-ray changes, and RTK-positive are sometimes being turned away and have to wait for swab PCR positive to be considered for transfer to Hospital Sungai Buloh,” the anonymous source claimed.

The source pointed out that by the time the patient waits for his or her RT-PCR test result, which takes at least 24 hours or more, the patient will then have to wait for several more days due to the lack of intensive care unit (ICU) beds in Sungai Buloh Hospital.

“There is an increasing number of severe Covid-19 cases presenting to government hospitals in Selangor now, at least since the last two to three weeks, and stuck in non-Covid-19 hospitals for days,” the source told CodeBlue.

The public hospital worker added that there are 10 to 12 Covid-19 patients on ventilators in the wards of Serdang Hospital alone, who cannot be transferred to Sungai Buloh Hospital with a full ICU.

According to the person, at Serdang Hospital, two to six severely ill Covid-19 patients were waiting daily in the isolation room in the emergency department the past one week, besides the 10 to 20 coronavirus patients with pneumonia waiting a day in the normal wards to be transferred to Sungai Buloh Hospital. These are in addition to the 10 to 12 Covid-19 patients on ventilator support in the wards of the non-Covid-19 treatment hospital.

The anonymous source said that severely sick Covid-19 patients usually have multiple co-morbidities like diabetes and end-stage renal failure that require specialised care. However, more often than not, these patients are stuck either in the emergency department or an ordinary ward with ventilator support.

“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.”

An analysis found that 69.2 per cent of Malaysia’s total Covid-19 fatalities last year had at least one underlying medical condition. The most common comorbidity seen was hypertension (52 per cent), diabetes mellitus (38 per cent), ischaemic heart disease/ heart disease (16 per cent), chronic kidney disease (14 per cent) and dyslipidemia (12 per cent).

The source also added that things get worse when there is a Covid-19 outbreak in the ICU or a ward, causing the entire ICU to be locked down. This simply means no patients can be admitted until 10 to 14 days of quarantine is completed.

Dr Suresh Kumar, the head of medicine and infectious disease consultant from Sungai Buloh Hospital, yesterday acknowledged a delay in admitting severely sick Covid-19 patients due to a surge of such cases over the past two weeks in that hospital, but denied that Sungai Buloh turned away patients.

Serdang Hospital refused to comment on the issue when CodeBlue contacted the director’s office. A staff from the director’s office stated that the hospital is required to carry out an investigation before coming up with an official statement.

“We have to discuss with the director. All are busy at the moment,” the staff told CodeBlue.

Besides that, CodeBlue contacted the Covid-19 response team in Sungai Buloh Hospital to confirm the claims made by the anonymous source.

When asked if ICU units are full in Sungai Buloh Hospital, Dr Mustapha Kamal from the hospital’s Covid-19 response unit, said: “Full.”

Dr Mustapha, who did not comment on the alleged refusal of sick Covid-19 patients, said Sungai Buloh Hospital admits ill Covid-19 patients based on the hospital’s capacity.

“We try our very best to accept. Sungai Buloh Hospital usually tries to cater Class Three to Five,” Dr Mustapha told CodeBlue. “Usually, we try our best to accept cases from all over Selangor. Especially the very ill ones.”

Covid-19 patients are categorised based on five clinical stages — Stage 1 is asymptomatic, Stage 2 is symptomatic without pneumonia, Stage 3 refers to pneumonia without hypoxia, Stage 4 patients have pneumonia with hypoxia; while Stage 5 patients are critically ill with multi-organ involvement. Hypoxia is a condition when tissues of the body don’t receive sufficient oxygen supply, necessitating supplemental oxygen for the patient.

Dr Mustapha also noted that the Stage Four and Five patients in Sungai Buloh Hospital’s ICU increased by at least 20 to 25 per cent in the past one month.

“This time, [Covid-19] wave is very bad,” Dr Mustapha added.

According to Dr Suresh, the number of Stage Four and Five Covid-19 patients in Sungai Buloh Hospital, who required admission to ICU, increased exponentially from 2.76 per cent on November 2 last year to 15.49 per cent on January 11 this year.

Health director-general Dr Noor Hisham Abdullah, in a press conference yesterday, said Sungai Buloh Hospital was short of manpower and that 41 coronavirus patients were on ventilator support in non-Covid hospitals. He added Sungai Buloh Hospital’s ICU beds could be increased from 60 to 110 or 120 if the facility obtained more human resources.

He said the Health Ministry was working with private hospitals to take in Covid-19 patients, as well as non-coronavirus cases like cancer or semi-emergency cases.

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