Malaysia Considers Palliating Covid-19 Patients If Epidemic Worsens

Dr Adham Baba also acknowledges that more ICU beds for Covid-19 cases have been created at the expense of non-Covid patients, reducing the latter’s chances of getting critical care.

KUALA LUMPUR, May 25 — Severe Covid-19 cases may be transferred from critical to end-of-life care if the coronavirus crisis worsens in Malaysia, Health Minister Dr Adham Baba said today.

He, however, did not explain how such decisions would be made, as bed occupancy rate in Covid-19 intensive care units (ICU) reached 94 per cent nationwide amid a surging epidemic that shows no signs of slowing.

Malaysia today reported a daily record high of 7,289 Covid-19 cases, leading to a total of 46,468 fresh infections recorded in just the past week alone.  

“Even though we don’t deny the possibility to palliate patients if situation gets worse, we are maximising our efforts to optimise our resources by getting more personnel which are experts to conduct service at ICU level and ventilator level, using modified standard and level of care to enable us to provide appropriate treatment to all,” Dr Adham said in a joint press conference with Covid-19 Vaccine Coordinating Minister Khairy Jamaluddin today.

Dr Adham was answering CodeBlue’s question on which hospitals have already begun triaging critical coronavirus patients. Covid-19 ICU bed utilisation in the Klang Valley was over-capacity at 113 per cent as of May 21, according to the Ministry of Health (MOH). 

The bed occupancy rate of Covid-19 ICU beds was 317 per cent in Kajang Hospital, Banting Hospital (200 per cent), Serdang Hospital (172 per cent), Tuanku Ampuan Rahimah Hospital (117 per cent), Ampang Hospital (113 per cent), and Sungai Buloh Hospital (111 per cent).

Dr Adham, who agreed with the possibility, said: “Our hospitals are trying our best to provide an appropriate level of care to all patients, including non-Covid patients. The management of each patient is made based on the clinical judgment which is in the best interest of the patient.”

CodeBlue also asked the minister to spell out the number of critical non-Covid cases that have been stepped down from ICU units to make way for Covid-19 cases. 

MOH’s data showed that as of May 21, Serdang Hospital for example had 55 suspected, probable or confirmed Covid-19 cases requiring intensive care, but the facility only had 52 total ICU beds for both Covid and non-Covid cases, including 32 designated for Covid-19 patients.

Dr Adham said MOH has added 479 ICU beds for Covid-19 patients, leading to a total of 1,059 beds nationwide today from 580 in early April this year. These additional Covid-19 ICU beds were created by repurposing general beds.

“The mechanism is repurposed or converting ordinary to critical care wards through allocating more existing ICU beds for Covid-19 care at the expense of non-Covid patients,” the minister acknowledged.

“At the moment, 66 per cent of total ICU beds in Covid-19 hospitals have been allocated for Covid-19 patients, thus reducing the chance of non-Covid patients to receive critical care.

“Nonetheless, the stepped down care is for those patients showing recovery from acute critical cases, thus creating more beds for new cases requiring critical care. The utilisation of these Covid-19 ICU beds is currently at 94 per cent.”

Last month, CodeBlue reported that the Sibu Hospital in Sarawak was forced to step down severely sick Covid-19 patients with poor prognosis from critical care to accommodate new cases in its full ICU.

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