KUALA LUMPUR, April 26 — Sarawak General Hospital’s (SGH) Covid-19 intensive care unit (ICU) and wards are now full, restricting the Kuching facility to moderate and severe coronavirus cases as stabilised patients are transferred out.
A medical officer from SGH, a hybrid hospital which also treats non-coronavirus cases, told CodeBlue that all seven beds for Covid-19 patients in ICU are currently filled, while five beds for severe acute respiratory infection (SARI) cases in the intensive care ward will be converted into Covid-19 beds.
“We are in the process of converting all to Covid-19 beds. So it will soon be a total of 12,” the anonymous source told CodeBlue on April 21.
“We used to have 18 Covid-19 ICU beds during the previous wave, but it’s very unlikely that we will go back to that as we do not have enough staff to cope with our temporary ICUs for non-Covid or SARI patients.”
The anonymous source also mentioned that some Covid-19 patients in the ward, who are on oxygen therapy such as high-flow nasal cannula (HFNC), are still awaiting ICU beds.
“We need to prioritise the ill ones with multiorgan involvement or difficult ventilation. Currently, of our seven patients in Covid-19 ICU, two are intubated and five are on HFNC.”
Sarawak’s State Disaster Management Committee’s (SDMC) Covid-19 report yesterday stated that SGH is treating seven Covid-19 patients in its ICU, including two intubated. SGH currently manages the second highest number of Covid-19 ICU cases in Sarawak, behind Sibu’s 29.
Another anonymous medical officer from SGH said that hundreds of new Covid-19 cases are being admitted into Sarawak’s main public hospital daily, with hundreds of recovered patients discharged a day.
“Our admission team and wards are overwhelmed with patients. We would try our best to clear up beds in wards for new admissions every day by sending relatively more stable patients to other wards to continue their isolation process,” the doctor told CodeBlue.
“I think everyone is trying our very best and we try to make room for new patients every day even though our wards are full. We try to make empty beds by sending old patients to other settings because what choice do we have?”Anonymous Sarawak General Hospital doctor
The anonymous source said that if the condition of Covid-19 patients shifted to non-hospital settings deteriorates or if they develop warning signs, then they will be transferred back to the general hospital again.
SGH has several settings to cater to Covid-19 patients based on the severity of their illness. After being reviewed by an infectious diseases team, Covid-19 patients will be triaged according to the presence of symptoms, seriousness of disease, and underlying health conditions.
“In settings like Anjung Kasih or Kolej Sains Kesihatan Bersekutu (KSKB), we will put more stable patients. We only keep ill or high-risk patients in the general hospital,” the doctor said.
The anonymous source also mentioned that intubated Covid-19 patients will be placed in the Covid-19 ICU or the infectious disease ward, whereas ill patients on oxygen supplementation or high-flow nasal cannula will be put in the female medical ward. Covid-19 patients on oxygen support are considered to be in stage four of their disease, the second-worst category, as they suffer from pneumonia with hypoxia (lack of oxygen).
More stable Covid-19 patients will be admitted into the male medical ward.
“When they think patients are stable enough to step down care, then they will be transferred to Anjung Kasih and KSKB,” said the SGH doctor.
It is to be noted that Anjung Kasih is a hostel-like facility situated within the SGH compound, whereas KSKB is located outside the public hospital.
A third anonymous SGH medical officer, however, maintained that SGH is still able to manage the surge of Covid-19 cases.
“Sibu is overwhelmed, Kuching side still can keep our heads above water. What happens after Raya and Gawai is anyone’s guess,” the source told CodeBlue.
CodeBlue reported last Friday that Sibu Hospital’s 30-bed ICU has similarly hit full capacity, forcing the government facility to step down critical Covid-19 patients with poor prognosis from intensive care after 28 days when they are no longer infectious. According to SDMC’s report, there were 29 Covid-19 ICU patients in Sibu Hospital as of yesterday, out of 47 across Sarawak. Sibu also currently has 17 intubated Covid-19 patients out of 25 statewide.
CodeBlue could not reach the directors of Sarawak state health department and SGH for comment at the time of writing. CodeBlue is keeping the identities of the three interviewed SGH medical officers anonymous, as government doctors are not allowed to speak publicly without permission from top Ministry of Health (MOH) officials.
According to SDMC’s official Covid-19 report, Sarawak’s state capital of Kuching reported a total of 1,122 new Covid-19 cases in the past fortnight as of April 25. Kuching is in the third rank in Sarawak in reporting the highest number of new Covid-19 infections, behind Bintulu’s 1,601 new infections and followed by Sibu’s 1,325 new cases in the same period.
Sarawak is one of the new epicentres in Malaysia’s Covid-19 epidemic, as the country’s largest state reported 7,913 new coronavirus infections from April 12 to 25, comprising about a quarter of 32,086 infections nationwide.