A medical frontliner at the Queen Elizabeth Hospital here said while the health community is excited to meet Khairy, they are just as eager for the minister to see the real situation on the ground for himself so he can help address the critical issues related to Covid-19.
The worker, who spoke on condition of anonymity, said the high number of patients dying from Covid-19 in Sabah is beginning to take a toll on the doctors and nurses at the hospital.
“It’s very demoralising to see most of our patients dying because at least half of the patients placed in the intensive care unit (ICU) here are expected to die despite the best care given,” the frontliner told FMT.
With record-high cases in August and daily infections remaining above the 2,000 mark, the frontliner described the situation in the state as “quite bad”.
The number of daily fatalities in the state hit a new record high yesterday with 55 deaths.
“Initially, we had 16 ICU beds in the hospital but over the past month another 34 ICU beds were added but with very little increment in manpower or staffing to complement that increase,” the frontliner said, adding that the Queen Elizabeth Hospital only accepts critical Covid-19 patients now.
To cope with the high admission rate into ICUs, the frontliner said the hospital rolled out a number of new policies.
“On the selection of patients, those aged 60 and above will not be considered for admission into the ICU. It is the same for undocumented migrants as well.
“Likewise for patients with multiple comorbidities, that is illnesses that don’t have a cure, like end-stage kidney failure and cancer, among others. They too, will not be admitted into the ICU.”
According to the frontliner, the hospital’s new policy is that such cases, which are referred to as “do not resuscitate” (DNR) patients, are instead admitted into normal wards and most of the time they will die there.
“We are looking at least 25 new patients every day that are being referred for intensive care therapy but all 50 ICU beds are occupied.
“So this creates a backlog in the emergency department, where these ICU patients are temporarily kept due to the insufficient beds,” the frontliner said, adding the waiting period is about five days before a patient can get a bed in the ICU.
The Covid-19 death toll in Sabah as of Sept 4 is 1,323, with 529 fatalities in August alone.
Sabah health director Dr Rose Nani Mudin, in responding to news reports on the insufficient ICU beds, had previously said the department was monitoring the situation.
She pointed out that the department had prepared repurposed beds and wards to treat critical patients outside the ICU.
On the admission criteria into the ICU, she said all patients regardless of their age will be assessed according to the triage approach, namely the stage of their infection, whether they needed ventilators because of lung failure, potential benefits from the use of ventilators, and availability of ventilators.
“In this time of crisis, patients with a higher recovery rate will be given priority but those needing oxygenation will still get treatment,” she said in a statement.
Unvaccinated patients
Meanwhile, healthcare workers have previously said that in an ideal world, doctors and nurses would prefer to treat everyone infected by Covid-19 but without adequate equipment as well human resources, that would just not be possible.
“We now realise that we can’t save everyone. The triage approach is good although it would still be difficult turning away patients from admission into the ICU.
“But it’s still very upsetting that the ones we try to save also die. This is because 100% of our patients in the ICU are either not vaccinated or have only received one dose of the vaccine.
“Unvaccinated individuals have very bad illnesses. So the important thing here is to push for complete vaccination, which will help us in the health sector,” the frontliner said, adding that the mortality rate is the highest among those not vaccinated.
“In fact, while vaccinated people can still get the virus, they never reach the ICU stage.”
On the issue of insufficient ventilators, the frontliner said the equipment availability was not the problem but rather the expertise to manage the ventilators and care for the patients.
“It is wrong to say ‘if we give you the ventilators you need, your problem will be solved’. There will be no point providing 100 ventilators without the proper resources, especially more qualified manpower.
“You need doctors and nurses who are properly trained in anaesthetics to care for the patients in ICU and you need anaesthetists to look after the ventilation support. So all of this is quite complex.”
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