Not suited to Covid-19 care

THE declaration of a state of emergency for the nation, and the consequent roping in of the private healthcare sector is of concern to many of us in the private healthcare sector.

We fully understand that the ongoing crisis in the country is a very serious one, and as Malay-sians we agree that there should be a concerted national effort to battle this Covid-19 pandemic and save the people. However, we appeal to the government and Health Ministry to consider the following points before the “takeover of private healthcare facilities” takes place.

The private healthcare sector has severe limitations in playing direct roles in treating Covid-19 cases. These are the reasons.

1. Most private hospitals are small, with the bigger ones having 200 to 300 beds, with only one hospital with 600 beds. This is no comparison to the thousands of beds in government facilities. The intensive care unit (ICU) capacity of smaller private hospitals is often only two to four, while the bigger ones may have up to a dozen at the most, compared with over 500 ICU beds in government hospitals.

2. Our staffing is a meagre few dozen specialists in the smaller ones up to the average private hospital and up to around 200 or more for a larger private centre, compared with several thousand doctors in a government facility.

The smaller hospitals may have two or three anaesthetists, and probably no intensivists while the larger private hospitals may have a dozen anaesthetists and one or two intensivists; a government hospital, on the other hand, would have an anaesthesia department with scores to hundreds of doctors.

In private hospitals, there are also no trainee doctors, no medical officers and no registrars to assist the anaesthetist or intensivist.

With regards to nurses and paramedical staff, some of our wards function with a bare dozen or so nurses so even if only a small number of them fall sick, it would cripple the wards. Technically, it will take only a few weeks before each private facility will be oversaturated and even crippled.

3. Our specialists are mostly in the high risk groups of ages above 60 and even if they do not succumb to Covid-19, the workload and stress may be enough to tip each one of them over.

These three factors alone – ie, capacity, staffing and age – would be enough to show that whatever “help” that could be gleaned from the private sector, it would just be a “little drop” in the face of the huge problem facing us.

We must not forget that apart from Covid-19 infections, which may have a mortality rate of just 1.6%, there are heart attacks, strokes, cancer, infections, acute trauma cases and other problems that can kill and cripple a larger percentage of sufferers if not treated. An influx of Covid-19 patients into private medical centres will result in compromising their ability to manage non-Covid-19 patients, who equally need medical care.

We therefore urge the government and Health Ministry to allow the private sector to continue to play this important role of looking after the rest of the population who need care too.

Most of us in the private medical sector have served in the public sector and have been involved in managing previous epidemics and critical cases, including HIV and the Nipah virus, and are used to serving our nation, even risking our lives.

We will continue to serve the nation to the best of our ability. However, we feel that being roped in to manage Covid-19 cases is not the answer due to these limitations.


Association of Specialists in Private Medical Practice Malaysia

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