We are absorbing a torrent of Covid-19 information that is vague, non-evidenced, of low research value, transient, developing and changing.
If it is for individual consumption, well and fine. But for medical practitioners and administrators, it can be a disaster waiting to happen if the knowledge is not processed and verified.
This is because SARS-Cov-2 is a virus unknown previously to the human body and cannot react accordingly, is infectious, fatal and can be present in asymptomatic individuals. Thus, it is a little-known enemy.
Medical practitioners need to get more organised knowledge or information through some form of grouping for discussion and research by topics, disciplines, interests, subspecialities, medical societies, etc, and focus on our prioritised end-point needs. This would be more productive and useful not only for any individual doctor or healthcare worker but also our disciplines and workplace.
If we expect all organised knowledge on Covid-19 to come only from one line of information, I think there can be disadvantages and a waste of human capital of the medical fraternity during this much-needed period.
Even at medical university level or hospital level, this concept of organising, processing and verification of knowledge should prevail. Of course, there should be vigorous regulation and direction within the framework of the health ministry and the medical universities as well.
The health director-general and state directors are doing an excellent job administratively but we cannot just rely on Putrajaya alone in the creation of knowledge about Covid-19. In fact, it should come from all doctors and specialists, including paramedics in the public and private medical sectors and especially from medical universities.
So, what can each one of us do? What Covid-19 research questions does one have? What issues do we need to clear up? If it is done in a better organised and streamlined way, then it would be clearer, faster, more useful and productive.
This could help as everyone at any point or level of the learning curve could really understand the issues. We should harness this pool of medical minds at all levels. I think the most practical way is to split it into state-level.
I am suggesting the setting up of a Covid-19 medical information centre.
Vertical information and directives from the health ministry can be strengthened by horizontal input of information and knowledge that can lead to a better understanding of the issues at hand. Hospital administrators will find the knowledge and information useful, and some of the best practices in fighting Covid-19 can be shared by medical authorities and the public.
I have discussed my opinion with four medical deans or former deans. A Covid-19 medical information centre is needed right now – to prevent a museum built over dead bodies. We have to work at great speed, otherwise all will be lost.
If, at normal times, we go for medical knowledge at the top of the pyramid for evidence-based medicine, Covid-19 does not allow us to do so anymore. To me, even anecdotal or subclinical knowledge based on clear and sound logic can be used until further, better evidence prevails.
SARS-Co-2 has destroyed our pyramid of clinical evidence medicine. All medical practitioners have to be well-equipped in knowledge and, at the same time, be preemptive and anticipatory. Otherwise, Covid-19 will strike us in the face.
The formulation of directives at the director-general level is, of course, most difficult. But to leave it to him alone (despite his machinery and advisers) is not the best option while we just do the minimum individually. We have to come out of our own cocoons and selfishness and do our best and contribute at various levels (self/department/specialty/professional society, etc).
This is not the time for self-glory. From what I can see, manpower and logistics are not the main hindrances. What is needed is sincerity and hard work and also to understand the higher objectives and leave personal interest and egoism aside. There has never been in medical history a time when we have to think bigger and smarter, anticipatory and strategic, and stay cool and focused as what Covid-19 demands of us now.
Unless there is a good understanding of the situation – putting our medical manpower to the best use, and balancing between the needs and demands to ensure we can act correctly in the first instance – then we will have to spend more time to flatten the Covid-19 curve at the cost of more lives.
I propose that my idea and suggestions be taken up at individual, hospital and department levels in Kelantan at least. I hope Kelantan can be a working model for other states to follow. And to my dear comrades in Kelantan, let’s work together and get organised.
We have only one chance to end this. We are the last bastion of defence and we cannot fall. All specialties and hospitals need information, organised and crystallised. This will give us the best chance to defeat Covid-19.
Dr Mohamad Hamzah is the medical director of KPJ Perdana Specialist Hospital Kota Bharu, Kelantan.
The views expressed are those of the author and do not necessarily reflect those of FMT.
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