A doctor’s perspective on Covid deaths

Many people have died and are dying in Malaysia during this Covid pandemic, especially during the Delta Variant surge in the Greater Klang Valley. There are many factors that have contributed to this sad turn of events. I shall touch on two of these factors.

There is a systemic issue. Managing many, many patients went beyond many hospitals’ already increased capacity. Even though we had prepared to manage a big influx of patients, and were ramping up to manage more and more, it was just not enough, not quick enough. Not enough hands, not enough equipment, not enough monitoring ability, and even not enough space.

One reason many died is that many came in very ill, and we just did not have the capacity to manage such a huge number of very ill patients. Then another group deteriorated very fast, and we all tried our very best, and yet did not have the capacity to manage all of them as well. Many were saved, and yet many died.

The ICUs were full. The ward had many ventilated patients. Many ventilated patients remained in emergency departments for days. All beyond our capacity. This disease is too vicious.

It comes back as a nightmare to me, even while I am awake. We could not add any more of the ill patients to the designated space. We could not move the very ill patients to the designated resuscitation room as it was just too crowded. We had no space even to move.

It is very sad to see so many dying. Such a painful, heart-wrenching tragedy. I remember faces, names, ages. I remember talking to family members, seeing them make their last video calls. I remember too those whose families we could not contact. Those who had nobody in their last moments.

When we had given them the maximum we could do, gave them all we had, many still went downhill. And then we had to let them go. This was very traumatic.

Through it all, hospitals and state authorities worked very hard to improve and offer better care for patients. There has been much teamwork and cooperation. Many NGOs and public groups have come forward to help. And now the system is much improved.

Another reason people died is that they were not protected. More people who were not vaccinated have died and are dying. It took a long time to finally procure enough vaccines and offer them to everyone in Malaysia. A system has been set up. Priority groups have been outlined, and vaccinations have been rolled out.

A very important fact is vaccination is voluntary. Everyone has to take their own initiative to register, ask, go, and get the vaccine. Vaccination is promoted widely, and anyone who desires to be vaccinated can, and will be offered vaccination. Yet, we are not able to vaccinate everyone fast enough. Many appointments were given far too late.

There has been much concern that vulnerable groups get priority. Many hospitals are vaccine centres and have worked hard to ensure vaccination targets were met. Vaccine registration counters have been opened at hospital lobbies with walk-in registration for patients or those with allergies. Many other initiatives to ramp up vaccination rates have been implemented in Selangor and KL and other parts of the country. More effort is still needed.

Even though we have a system set up to assign appointments, if you think you are very vulnerable and need to be prioritised urgently, both you and the group you belong to often have to agitate and seek to be prioritised. This has worked before to ensure needs are met. The police force and teachers are examples of groups who have been prioritised after they spoke up. We all need to speak up and advocate for each other to ensure all are vaccinated fast and the system improves.

There is a growing surge of the Delta Variant in many states outside the Greater Klang Valley. Let us all work together to prevent more Covid Deaths. We do not need a blame game. It benefits no one. Many great lessons have been learnt in Greater Klang Valley, from ramping up FTTISV (Find, Test, Trace, Isolate, Support and Vaccinate), to how crucial is enhanced public-private cooperation, to urgently preparing more capacity to manage very many ill patients, and the need for many more ICUs.

Let us take action to protect and save each other through mutual goodwill.

Dr Cecilia Anthonysamy.
17th August 2021

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