KUALA LUMPUR, Sept 20 — Sarawak medical experts are deeply concerned about the rapid spread of the Delta coronavirus variant in the highly vaccinated state that is causing soaring hospitalisations.
Hospital beds for Covid-19 patients in Sarawak are near capacity at 94 per cent while intensive care units (ICU) are 87 per cent full, as severe coronavirus cases continue rising. Daily new infections in the country’s largest state surged nearly 900 per cent from 329 cases mid-July to 3,284 cases yesterday, based on seven-day averages.
Dr Chua Hock Hin, a consultant infectious disease physician at Sarawak General Hospital (SGH) in Kuching, compared Delta, which American health authorities say is as contagious as chickenpox, to eight-time Olympic champion sprinter Usain Bolt who is known as the fastest man alive.
“We’re always chasing this Delta variant — it is way faster,” Dr Chua told a webinar last September 9 titled “Living with Covid-19 Endemic” that was organised by the Society of Private Medical Practitioners Sarawak. CodeBlue obtained a video recording of the virtual meeting.
The infectious disease doctor noted that about 70 per cent to 80 per cent of family members of a person infected with Covid-19 also test positive for the virus.
He said Sarawak is seeing not just an increase of Covid-19 infections in fully vaccinated people, but also rising severe breakthrough cases.
“A lot of our patients, about 70 per cent of those who are admitted, are actually fully vaccinated,” Dr Chua said.
“When we look at their Ct (cycle threshold) value of their virus between those fully vaccinated and not vaccinated, it’s not much difference. When you see Ct value in the teens, meaning 10 to 20, you know that this person most likely is infected with Delta variant.”
Ct values obtained in Rt-PCR tests for Covid-19 indicate the amount of virus present in a sample. A study in China found that people infected with Delta had viral loads — a measure of the density of viral particles in the body — up to 1,260 times higher than individuals infected with the original coronavirus strain in 2020, Nature reported last July.
Dr Chua’s observations about fully vaccinated Covid-19 cases carrying similar virus levels as unvaccinated people match findings on Delta in the United States and United Kingdom published last month. Sarawak has fully vaccinated about 65 per cent of its total population with two doses to date.
Prime Minister Ismail Sabri Yaakob yesterday formally announced a booster programme that would offer third jabs to high-risk individuals — like the elderly with comorbidities and immunocompromised individuals — once 80 per cent of the country’s adult population has been fully vaccinated. Health Minister Khairy Jamaluddin targeted an early October rollout and said senior citizens — with conditions like heart problems, diabetes, and hypertension — comprised most of Covid-19 deaths and critical cases, but did not release data on serious breakthrough infections.
At the same September 9 webinar, both Sarawak state health department Dr Mohamed Sapian Mohamed and Sarawak Covid-19 Vaccine Advisory Group (Scovag) chairman Dr Andrew Kiyu expressed concern about the spread of Delta from the southern region, where Kuching is located, to the middle and northern parts of the country’s largest and rural state.
Dr Sapian said Sarawak’s University Malaysia Sarawak (Unimas) sequences far more Covid-19 samples to identify variants, compared to the Institute for Medical Research (IMR) under the federal Ministry of Health (MOH) that does genomic sequencing for the rest of the country.
Unimas’ Institute of Health and Community Medicine (IHCM) director Prof Dr David Perera said last Monday that all 303 infections with variants of concern reported on August 31, of 307 positive cases, were Delta. This 99 per cent rate of Delta marked an increase from 82 per cent reported by IHCM on August 2. Delta comprised 100 per cent of samples tested in Kuching, Serian, Samarahan, Sri Aman, Betong, Sarikei, Mukah, Miri, and Limbang.
SGH’s Dr Chua said most people getting infected with Covid-19 in Sarawak now are those with underlying medical conditions who need to seek medical care or undergo surgery.
He pointed out, for example, that many haemodialysis patients, which number about 3,000 in Sarawak, did not turn up infected during the first and second waves of the Covid-19 epidemic, but even fully vaccinated patients are now starting to turn up with coronavirus infection.
“People with medical illness, surgical illness that need medical attention at usual time are now increasingly vulnerable to Covid-19 because Delta variant is spreading very, very rampantly because it’s very transmissible.”
Dr Chua also said SGH is admitting an increasing number of patients with serious conditions like heart failure, fluid overload due to chronic kidney disease, pulmonary fibrosis (lung disease), stroke with aspiration pneumonia (complication after stroke), and diabetic ketoacidosis (serious diabetes complication), who also happen to be infected with coronavirus and hence are categorised in the severe Categories Four and Five of Covid-19.
“These are the increasing number of patients that we are seeing, which is in tandem with the high vaccination rate that we are seeing,” he said.
He noted that some of these patients were previously treated in private hospitals for their non-Covid conditions, but they would be transferred to public hospitals upon testing positive for Covid-19.
“So you can see there is a big problem in this group of patients and in this era which probably needs to be addressed in the process of opening up.”