Don’t Ignore Critical Non-Covid Patients: Anaesthesiology, Intensivist Groups

By CodeBlue | 18 January 2021

Critically sick non-Covid patients should be treated in private hospitals, so that public hospitals can concentrate on managing Covid-19 patients.

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KUALA LUMPUR, Jan 18 — Seriously ill non-Covid-19 patients should not be sidelined amid the ongoing Covid-19 crisis, anaesthesiologist, critical care physician, and intensivist groups said.

The Malaysian Society of Anaesthesiologists, the College of Anaesthesiologists, Academy of Medicine of Malaysia (AMM), and the Malaysian Society of Intensive Care, in a joint statement, pointed out that the management of critically ill non-Covid-19 cases and semi-urgent non-Covid-19 cases is affected, while the country’s focus is currently on managing Covid-19 patients.

“Many factors contribute to this, such as diminishing intensive care unit (ICU) beds, ward beds, and availability of resources to manage them,” the anaesthesiologist, critical care physician and intensivist groups said.

“It is hoped that care for some of these groups of patients can be handled at the private hospitals so that the public hospitals will be able to concentrate on managing Covid-19 patients.”

During the first and second wave of Covid-19 in Malaysia, many non-Covid-19 patients such as cancer patients had their treatment delayed, while many elective surgeries were also postponed in public hospitals to accommodate for Covid-19 patients.

The anaesthesiologist, critical care physician, and intensivist groups said that they stand united to care for Covid-19 patients in both public and private hospitals.

While discussions are ongoing between the Ministry of Health (MOH) and the Association of Private Hospitals Malaysia (APHM) in roping in private hospitals to manage Covid-19 cases, the doctors in their statement said that there should be a balanced view on this approach.

The anaesthesiologists, critical care physicians, and intensivists said that private hospitals have to prepare to manage Covid-19 patients requiring ICU care.

“Private practitioners are already dealing with more patients who are presenting with severe acute respiratory illness (SARI) in the emergency department and requiring intubation. These patients are subsequently found to be positive for Covid-19 infection.

“Their medical care continues while ICU beds are sourced out in the public hospitals. The previous ease at which intensive care beds are made available is no longer a reality,” the doctors said.

MOH has asked private hospitals to prepare to treat stage five Covid-19 patients who also require ventilation and ICU care. APHM president Dr Kuljit Singh however said that not all private hospitals can manage stage five patients as not all private hospitals are equipped for it in terms of airflow, sanitation etc.

The anaesthesiologist, critical care physician, and intensivist groups also pointed out that most private hospitals have already established their own Covid-19 Task Force team in aniticapiton of the rising cases and the likelihood of their involvement in managing Covid-19 cases.

“We applaud these initiatives and encourage hospitals to be in touch with our societies and colleges for guidance if required. Support is available in the form of management protocols of the Covid-19 patient, webinars or standard operating procedures,” the medical groups said.

Meanwhile, for smaller private hospitals, the medical groups said that cross-referrals to other private hospitals for further management should also be considered.

The doctors also said that they will lend their expertise in resource coordination, close monitoring practices, infection control procedure, and management of difficult intensive care patients.

“Collectively, as a fraternity, it is our view that we will stand in close collaboration with the MOH and the APHM to the best of our intent and abilities taking into account the resources that are at our disposal within the hospitals that we are attached to.”

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