KUALA LUMPUR, July 12 — Teary health care workers described overwhelmed hospitals in the Klang Valley struggling to keep Covid-19 patients alive amid shortages of staff, oxygen supply, and medication.
Several anonymous medical frontliners, who shared their experiences via audio recordings with Projek #BangsaMalaysia, a community organisation, also claimed that Covid-19 cases and deaths are being under-reported.
One alleged that based on positive rates (share of tests that are positive), one in 10 people in Malaysia are infected with the coronavirus.
Another claimed that the Ministry of Health (MOH) does not include in its Covid-19 death tally patients with Covid-19 who died from another condition, or if Covid-19 patients died after 14 days’ isolation and had suffered from blood clots in the lungs, legs, heart attack, or stroke.
As of today, Malaysia officially recorded 844,870 Covid-19 cases, including 8,574 new infections in the past 24 hours. MOH reported 6,158 fatalities as of yesterday.
“You want to imagine what’s happening in Malaysia? We’re already in Italy 2020. We’re already in India 2021,” a frontliner said, referring to the Covid-19 surges that overwhelmed the health care systems in Italy in March last year and in India a few months ago.
One frontliner attributed the increase of Covid-19 fatalities in Malaysia to the lack of health care resources.
“You can see patients piling up outside EDs (emergency departments), patients holding up extension beds in wards, patients who are one tile away from each other, you think that we could hold the fort and keep going?”
Another described how Klang Valley hospitals are creating new intensive care unit (ICU) beds for critically ill Covid-19 patients in operating theatres and oncology wards, besides plans to convert outpatient clinics and consultation rooms to treat coronavirus cases.
The management of Hospital Tengku Ampuan Rahimah (HTAR) Klang said in a statement Saturday that it has converted a trainee doctors’ hostel and Daily Treatment Complex into Covid-19 treatment areas, after videos of Covid-19 patients sharing oxygen supply and being placed in close proximity in the emergency department in filthy conditions went viral.
“ICU beds are not just about opening one bed and putting the patient there. It’s a team and right now, we have people who aren’t trained to care for ICU patients but are forced to care for ICU patients,” a frontliner told Projek #BangsaMalaysia.
One problem that emerged in the current crisis is Covid-19 patients’ non-responsiveness to standard steroid treatment, tocilizumab, as they deteriorate with multi-organ failure immediately upon admission.
Even if patients do respond to treatment, they now tend to stay in ICU for a long time, sometimes even months.
“Last time, we had more elderlies. If they get very severe Covid, they have poor reserve, they won’t make it after a few days. But right now in our ICUs are young, fit patients. They kind of respond, but they really take a very, very long time to recover. So that’s why our ICUs are clogged up,” said one frontliner.
As of yesterday, MOH reported 961 Covid-19 cases in ICU. This figure refers to confirmed Covid-19 cases, excluding suspected or probable cases.
Another frontliner said that since early this year, increasing numbers of young adults and those without underlying health conditions in Malaysia are getting severe Covid-19 disease in Categories Four and Five. Entire families are losing their lives to the disease.
“I can only say if you think the ship is still sailing, I think it has sunk. If you think houses are not yet burning, it’s already burning.”Anonymous medical frontliner in the Klang Valley
Hospital beds, according to frontliners, have been prioritised for high-risk patients like the elderly since three to four months ago, while other Covid-19 patients “have to settle for plastic chairs”. Wards are full, while equipment like ventilators and oxygen canisters are insufficient. Major medications used to treat Covid-19 allegedly ran short since the past few weeks.
According to three frontliners:
“We are replacing oxygen canisters by the hour. Some patients might be required to share oxygen with five other patients.”
“The pressure, when we have a lot of patients using the oxygen, it cannot generate enough flow. There are some patients who may deserve to be intubated, but we cannot intubate because we have breached our capacity.”
“We have times when oxygen is not available, I have my nurses having to not only carry out nursing jobs, but they have to liaise with the members of transport who go and get the oxygen replaced every two hours because there’s only so much one canister of oxygen can do.”
The Covid-19 epidemic has also affected access to treatment for non-Covid patients who need ICU care, amid outbreaks in hospitals. A frontline medical worker in the paediatric department said a liver transplant for a baby may need to be postponed.
“I don’t know how to answer the parents — when is their child getting all these necessary procedures for them to carry on with life? So yeah we’re telling them, ‘We’re really trying our best to get the ICU backup for you, but we have an outbreak in the ICU. We couldn’t proceed with all these high-risk procedures and surgeries’.”
The frontline health care worker spoke of a Covid-19 outbreak at the oncology ward in her hospital, where all the patients tested positive for the virus and staff were infected as well, leading to the closure of the cancer treatment ward.
“Can you imagine in one night’s time, maybe half of the department is quarantined because of this outbreak? How are you going to arrange the workforce for the next day?”
Another frontliner criticised the injustice of contract medical officers who face the possibility of not being able to pursue specialisation training without permanent posts. One of them was allegedly given a 24-hour notice to transfer to another hospital to help with Covid-19 work.
“The fact that we’re still on contract, that we could just be without a job once this pandemic is over, it’s not a very positive thing to have on your mind when you step into work and see this horrific scene before you every day,” said a contract doctor.
The frontliners also advised Malaysians to get vaccinated and to avoid getting into accidents during the Covid-19 crisis because the chances of getting treatment would be low.
They criticised the government for not allowing them to speak publicly about the Covid-19 situation. MOH has issued several circulars reminding staff not to make any public statements on social media without approval from their superiors.
“Right now, every time we try to expose it, they will tell everyone in mass media that the situation is under control when we are like, hello, we are drowning here,” a frontliner told Projek #BangsaMalaysia.
HTAR management quoted MOH secretary-general Mohd Shafiq Abdullah yesterday as telling public servants “not to take pictures or record videos about the situation in health facilities for the purposes of seeking attention.”
One frontliner told Projek #BangsaMalaysia that the government should adopt Covid-19 public health strategies from New Zealand, Singapore, and Taiwan, countries that have managed to control their epidemics.
Taiwan yesterday reported 23 new local Covid-19 cases, local media reported, marking the 18th consecutive day with fewer than 100 daily infections.
“Try to get their strategy and try to implement it in Malaysia. If you know a certain strategy works and you don’t do it, ‘memang kerajaan pembunuh’.”