KUALA LUMPUR, Jan 10 — Existing medical facilities in the country will be overwhelmed if Covid-19 cases spike in March to an estimated 8,000 cases a day, several medical experts polled by Malay Mail have warned.
In order to help contain the infections, they suggested that the federal government set up more quarantine centres in each state, and work closely with the state agencies to better reach the masses who are in need of urgent care.
“If public hospitals continue to be overwhelmed with cases of Covid-19, asymptomatic or mild cases of Covid-19 will have to be sent to quarantine centres or quarantine at home while cases with severe symptoms will be warded in hospitals.
“In fact, the government is already considering home quarantine as an option. But if we reach 5,000 to 8,000 cases a day, hospitals may still be overwhelmed,” said Malaysian Medical Association (MMA) president Prof Datuk Dr M. Subramaniam.
“Over time, the continual high number of cases can put a strain on our healthcare system. Already, many healthcare workers are suffering from fatigue and high levels of stress with the high patient load and it is affecting their mental health,” he added.
Health director-general Tan Sri Dr Noor Hisham had recently said that according to prediction models, cases will hit 8,000 per day if the basic reproduction number (R-nought or R0) of the virus infection increases to 1.2.
Using the Susceptible-Exposed-Infective-Recovered (SEIR) epidemiological prediction models, he said the current scenario’s infection rate is at 1.1, meaning daily cases would hit 3,000 which is what happened on Thursday when Malaysia recorded 3,027 cases, a new daily high.
According to local think tank Social and Economic Research Initiative (Seri) chief executive Dr Helmy Haja Mydin, cases will increase as screenings and tracing activities get more aggressive in the coming weeks.
The respiratory health specialist said the more important thing to look at is to identify who needs care at medical centres and who can stay at home.
“Key worries will be the availability of intensive care unit beds and ventilators (which are limited) as well as the increasing mental and physical fatigue of our healthcare workers,” Dr Helmy told Malay Mail.
“Mortality rates will rise if there are insufficient facilities, and let’s not forget the displacement effect on other non-Covid-19 cases.”
With regards to the displacement effect, Dr Helmy was alluding to patients who may need urgent medical care but are sidelined due to the lack of doctors, operating rooms and medical facilities as all attention is being given to Covid-19.
“So these people don’t get timely reviews,” he added.
In late December, Dr Noor Hisham said the occupancy rate in government hospitals nationwide is currently at 81 per cent and 58 per cent occupancy at the Covid-19 Quarantine and Low-risk Treatment Centres (PKRC).
However, he said the Health Ministry is considering letting people diagnosed with Covid-19 to spend their quarantine at home instead.
Dr Noor Hisham had said that it would be subject to several factors, including the size of the house and the ability of officials to monitor the patient’s health progress.
Dr Subramaniam agreed with that assessment but said authorities will still need to prepare more quarantine centres.
“It must be noted also that not all mild or asymptomatic cases of Covid-19 are suitable for home quarantine. Other factors such as the size of the house home, number of occupants and other risk factors need to be taken into consideration.
“The government will need to still prepare with arrangements to increase quarantine centres in every state. State governments should play a more active role in supporting the health ministry with these needs,” he added.
To that effect, Dr Arvinder Singh, medical officer for the Institute of Clinical Research Malaysia who works and helps with Covid-19 cases, said the key players in the event cases double or triple are the state governments.
When contacted, he said the state governments are the ones who are closer to the people in their respective states and the central government as well as MOH will not be able to micro-manage the whole country’s Covid-19 spread.
He suggested that in order to mitigate the situation, the establishment of local task forces to go and find and meet those who are most vulnerable and in need of medical attention, especially in rural areas and places with a high density of foreigners, is desperately needed.
“There may be a useful need to develop state task forces to help with mitigation, however, this will require the support from MOH especially in terms of resources and data.
“Mitigation can mean many things like managing resources and managing vaccines when they arrive. Where do we vaccinate first, how do we transport the vaccines? Who to screen? Where are the main places where there are many people who live in very congested areas?
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“I also agree we need more quarantine centres and to give an example, in Ipoh many hotels are closing down as the tourism industry nose dives. It would be a good idea to use these unoccupied hotels as quarantine centres which will also bring back some jobs for those working in the industry,” said Dr Arvinder.
“All you need is a doctor and several nurses on-site to make sure compliance and to check on the quarantine and after 10 days they can go home. That way those who are asymptomatic will not infect others around them, especially older people who are easily stricken by the virus.”
All three experts agreed there is a need for early detection and with more screenings and tracing activities, cases are bound to increase.
However, the experts reminded all Malaysian’s to be more disciplined and vigilant in following the SOPs.
“The virus is already in the community and it is now up to us to stop the spread.
“Although vaccinations will largely help with this, we still need to be vigilant. The virus hates our compliance — so why not irritate and kill it with our good behaviour?” said Dr Arvinder.
Malaysia has had 542 deaths and 133,559 case cases thus far with the number set to increase in the coming months.
The government is mulling stricter SOPs for several sectors and will make the announcement tomorrow.
