The news yesterday that private hospitals in Malaysia may no longer accept patients because they have reached full “Covid-19 occupancy” is worrying.
Association of Private Hospitals Malaysia president Dr Kuljit Singh said hospitals were constrained both by the number of beds and ICU facilities that could accommodate Covid-19 patients and the availability of specialists and nurses.
Already Covid-19 designated public hospitals are straining under the weight of the cases being handled. The number of infections appears to be rising again, with cases breaching the 3,000 mark two days in a row yesterday.
Yesterday there were 3,332 new Covid-19 cases in Malaysia, bringing the total so far to 404,925. There were also 15 deaths, taking the total number of deaths due to Covid-19 to 1,492.
Will we face a similar situation to that of India? I hope not, but we have to be prepared.
What can we learn from the current heart-wrenching Covid-19 situation in India?
On April 29, India reported another global record of daily infections – 379,257 cases. It took the overall cases in India to 18,376,524. The death toll in the 24 hours preceding yesterday morning was 3,645. The total number of deaths due to the disease stood at 204,832 yesterday.
The case fatality rate stood at 1.11% while 15,086,878 people have recovered from Covid-19 infections.
I’m sure many of you have seen video clips of the suffering in India, especially in Mumbai and Delhi, on television and social media. Some of these have been heart-breaking.
I’d like to write about the situation and lessons we can learn by looking at some of the stories that have emerged from India.
A teacher, Devendra, 38, drove 1,400km from his village in Jharkhand to Noida, about 18km from Delhi, on April 24 to deliver oxygen desperately needed by his friend Ranjan Aggarwal, who was in hospital suffering from Covid-19.
Doctors at the hospital had earlier told the family of Aggarwal that they had run out of oxygen, as the hospital was flooded with patients. They might be able to do something if the family could get some oxygen and so they reached out to Devendra who sourced a cylinder from an oxygen plant.
The lesson for the authorities: Ensure we have all necessary equipment and medical supplies ready and make preparations to have them available at a minute’s notice if the need arises. Our health authorities should contact their counterparts in India to learn how to prepare ourselves if a similar situation were to strike Malaysia.
Narayan Dabhalkar, 85, was admitted to the Indira Gandhi government hospital in Nagpur on April 22 after his oxygen level began dipping. He was fortunate to get a bed in the casualty ward but after seeing a woman pleading with doctors to get her 40-year-old husband admitted, he left for home, saying they could give the bed to that man.
According to media reports, Dabhalkar, a member of the controversial NGO Rashtriya Swayamsevak Sangh or RSS, told doctors, “I am 85. I have lived my life. Saving the life of a young man is more important. Their children are young… please give my bed to them.”
He was told his condition was not stable and treatment at the hospital was necessary but he left. Three days later, Dabhalkar died at his home.
The lesson for our authorities: Ensure there are adequate beds in our hospitals. The government should immediately take measures to turn spaces elsewhere into wards at a moment’s notice if the need arises. Military hospitals, for instance, must be on standby. Perhaps they should look into the possibility of converting train coaches into temporary wards as is being done in India. The Indian railways ministry is converting 4,000 train coaches into what it calls “Covid-19 facilities” equipped with 64,000 beds in total. As of April 28, it had handed 169 such coaches to the various states in India.
On April 25, a nurse at the district hospital in Rampur, Uttar Pradesh, asked a doctor to issue a death certificate. Reports say they started arguing and the nurse slapped the doctor. He retaliated. The whole incident was caught on video.
They later said they were under a lot of stress due to the catastrophic situation at their hospital and that was the reason they lost control of themselves.
The lesson for our authorities: Ensure doctors and nurses get some rest. They need proper sleep too. Medical staff should not be so stressed that they turn on each other or become careless. Arrangements must be made to increase the number of medical staff – perhaps by drawing on senior students and nurses at teaching hospitals and universities. Those with little experience can handle the less serious work, such as testing.
On April 27, there was chaos at a major Mumbai vaccine centre as stocks had run out. Hundreds of people, mostly the elderly, had to be turned away. The same scenario played out in several other vaccination centres.
Many of those who had come to the centres to find them closed or be turned away, complained that the least the authorities could have done was to inform them by phone.
Lesson for the authorities: Ensure there are enough doses at vaccine centres. Don’t be lulled into relaxing because the vaccination take-up is slow. If there is a large spike in cases, there may be a rush to get vaccinated, so be prepared.
One of the reasons given for the sudden spike in cases in India leading to fear and frenzy is the presence of new variants of the virus. India, medical experts there said, was slow to understand or act on the variants being reported in other nations.
What is Malaysia doing about this?
Another reason is the large asymptomatic population – estimated to be between 80% and 85% by medical experts. It was also found that the long waiting period for results after testing had encouraged many asymptomatic people to violate standard operating procedures and spread the virus.
What is Malaysia doing about this?
Yet another reason – and probably the most important – was the complacency of the government and the public that the disease had been brought under control following a dip and plateauing of cases between last December and early March. The increasing number of people being vaccinated also served to lull them into complacency resulting in many people failing to observe SOPs such as wearing masks and maintaining physical distance.
Massive election rallies and religious and cultural functions, in addition to indoor events such as social gatherings and weddings which were attended by large numbers of people – and where physical distancing was thrown to the winds – all contributed to the current Covid-19 crisis faced by India.
The lesson for all of us: Don’t let your guard down; don’t be complacent. Gatherings should be limited to a manageable number of people and contact tracing should be intensified.
Which is why I fail to understand the decision to allow pasar malams to operate. I have seen pictures and videos of the crowds and I wonder why the authorities haven’t put in place better safeguards. Many in the crowds in the videos I saw were not following SOPs.
SOPs must be strictly followed as that is the only way to keep ourselves safe for now. Those who have been vaccinated should not feel they are safe as the vaccine is but one of several measures to protect ourselves. Physical distancing and wearing masks are our best bet for now.
All of us have to cooperate with the health authorities and follow the SOPs. The enforcement authorities, for their part, should show common sense when implementing the SOPs and other rules. And there should be no double standards.
While we need to be concerned and careful about how we behave in the face of the spreading disease, we need not be overfearful as this story from India tells us:
A 106-year-old man, Mohan Patel, was found to be critical but because of overcrowding at hospitals, he had to return home and have his treatment supervised by a doctor from the hospital. According to news reports, the native of Bhandarpur village in Madhya Pradesh followed all the instructions of his doctor – especially about remaining in self-isolation – and recovered. You can say he had a never-say-die spirit.
And here’s another story for those with family or friends in critical condition:
Usha Nigam, 62, a retired bank manager in Madya Pradesh, was admitted to hospital with 95% of her lungs infected. The family was told her chances of survival were almost nil but after 80 days on oxygen and 50 days in the intensive care unit, she made an amazing recovery.
How? She didn’t give up hope and started eating food that would boost her immunity. According to reports, her family provided solid support, even celebrating family occasions such as birthdays with her to keep her spirits up. They too had a never-say-die spirit.
The views expressed are those of the writer and do not necessarily reflect those of FMT.
CLICK HERE FOR THE LATEST DATA ON THE COVID-19 SITUATION IN MALAYSIA