By Steven Sim
GEORGETOWN, Malaysia--In the past one week, Penang embarked on an aggressive campaign to increase the capacity of our healthcare system through creating more ICUs and COVID-19 hospital beds, more quarantine and isolation facilities, getting more hands on the deck to support our frontliners and providing faster response time especially to COVID-19 patients in Penang.
While our COVID-19 cases are reducing, the daily numbers are still in the 4-digit region. Nonetheless, about 98 percent of our daily cases are Category 1 and 2 cases.
As such, I have stated at the onset of my appointment as the state-federal coordinator for COVID-19 management, that I will focus our efforts to ensure severe cases have access to medical treatment to save lives.
On Wednesday, a field hospital in Penang General Hospital (GH) was erected with 100 beds including 4 ICU beds. The whole set up process will take about 10 days and the field hospital is expected to be ready by this week.
Through the kind sponsorship of Yayasan Lee Chong Wei, we also managed to expand Bukit Mertajam Hospital to create space for another 32 beds.
An additional 100 Covid-19 beds were also added to Kompleks Masyarakat Penyayang and Penang GH outpatient department.
To free up more space in the government hospital for treating COVID-19 patients, the network of Penang private hospitals had agreed to accept 300 non-COVID-19 patients to their facilities.
With the help of the state government, the decanting exercise was executed smoothly last week.
Yesterday, a top Health Ministry official informed me that an extra 40 repurposed ICU beds will be created this week, with the aim of creating a total of 70 additional ICU beds in the next two weeks.
Once again, the goal here is to ensure patients have access to medical treatment in order to save lives.
Shift of thinking in quarantine strategy
At the beginning of September, the bed occupancy rate (BOR) for the Pusat Kuarantin dan Rawatan COVID-19 (PKRC) in Jawi was as low as 41.3 percent.
In view of the housing context in Penang, I requested Jabatan Kesihatan Negeri to change their approach on quarantine strategy.
COVID-19 patients who stay in smaller housing units such as low-medium cost housing, kampung houses, those with big households or staying with elderly at home, should be admitted to PKRC or encouraged to check-into isolation hotels.
This is to prevent further spread of the disease due to lack of quarantine space in their own homes.
From this shift of thinking, we see a marked increase in PKRC BOR to almost 60 percent by the end of last week.
On 21 September, another PKRC in Balik Pulau will be opened to cater for more patients.
There are also currently two isolation hotels in Penang, namely Vouk Hotel and Royale Chulan while a third one, MEI Hotel will start operating on 1 October.
For those undergoing home quarantine, Penang Care, a coalition of NGOs chaired by Phee Boon Poh, Penang state EXCO for Welfare, Caring Society and Environment, is providing telemedicine service on-demand to ensure home quarantine patients receive the necessary medical attention.
More hands on the deck
Pandemic management requires a whole-of-government and whole-of-society approach. We need more hands, or rather all hands, on the deck.
For this, state assemblymen from both the government and opposition blocks were invited to take part in the COVID-19 management committees in their respective districts.
I have also had engagement with them via Zoom to discuss issues faced in their respective constituencies and to update them on the work done so far.
A secretariat was set up with assemblymen from each district to work together with me in my role as the state-federal coordinator for COVID-19 management.
The members of the secretariat are: Azrul Mahathir (Bayan Lepas), Chris Lee Chun Kit (Pulau Tikus), Daniel Gooi Zi Sen (Pengkalan Kota), Heng Lee Lee (Berapit), Jason H'ng Mooi Lye (Jawi), Joseph Ng Soon Siang (Air Itam), Mohd Tuah Ismail (Pulau Betong), Mustafa Kamal Ahmad (Telok Ayer Tawar), Ong Ah Teong (Batu Lancang), Satees Muniandy (Bagan Dalam).
I have invited the State Opposition Leader to nominate an opposition ADUN to join our secretariat as well.
In the past one week, I have also engaged with representatives from the manufacturing industry (via Penang Manufacturing Industry Advisory Council, represented by Association of Malaysian Medical Industries (AMMI), Federation of Malaysian Manufacturers (FMM), Free Industrial Zone Penang, Companies’ Association (Frepenca) and Small and Medium Enterprises Association (Samenta) and Penang Strategic Investment Advisory Council) and the construction industry (via Real Estate Housing Developers Association (REHDA) and Master Builders Association, both Penang chapters) to discuss how to collectively reduce infections within their sectors.
Although cluster infections are only less than 30 percent of the total infections in Penang, the rest being sporadic infections, the industry players recognised the importance of their role to help the government to fight this pandemic.
Industry players from both sectors also expressed their commitment to support the vaccination drive for migrant workers.
Finally, over the past one week, the federal health ministry had redeployed 223 healthcare personnel to Penang to fill in various roles in the state.
This will definitely strengthen our medical frontliners to cope with the cases at hand.
Faster response time
One of the key challenges faced was the long response time at the COVID-19 Assessment Centre (CAC). Due to the escalating cases, our CACs were indeed overwhelmed.
I have often repeated the mantra: CAC is the first station in a patient's COVID-19 journey.
Hence response time must be prompt and seamless so that the patient can move on quickly to the next station for treatment and recuperation.
The additional personnel redeployed to Penang discussed in the previous section helped to increase work speed at the CAC.
The Penang state government also provided extra manpower to assist the CAC call centre to clear off backlog cases.
The good news is, the Health Ministry also decided to implement virtual CAC (vCAC) starting last Wednesday. This is a system similar to the one implemented in Klang Valley.
With vCAC, response time is substantially shortened because assessment can now be done virtually on a patient's Mysejahtera app without needing to be physically present at the CAC. With the quicker response time, patients and their family members can then focus on treatment and recuperation instead of fretting over bureaucratic processes.
Vaccination programme in full gear
Slightly more than a week after Penang allowed Malaysians to walk-in for vaccination at vaccination centres (PPV) in the state, last week on 17 September 2021, foreigners were allowed the same in four designated PPVs namely, Spice Convention Centre, Dewan Millenium, SP Arena, and Dewan Serbaguna Sungai Bakap.
It is clear that in this pandemic, no one is safe until everyone is safe. We need to ensure the vaccination of foreigners, migrant workers, refugees and even undocumented immigrants in our midst to fully cut off the Covid-19 infection chain.
Recently, Health Minister Khairy Jamaluddin announced that teenagers aged between 12-17 will be able to receive their vaccines soon, and the original plan was to vaccinate them in their respective schools.
Last week, I wrote to the minister to request him to allow walk-ins at existing PPVs for teenagers whose parents wish to have earlier vaccination for their children.
I hope a decision can be made soon on this.
Lesser cases, lower ICU BOR but we must continue to be on high alert after a week of intense operation and hard work on the part of the state and federal governments, Penang is beginning to witness a drop in daily cases.
Our ICU BOR is also reduced from beyond 100 percent at the beginning of September 2021 to 92.4 percent as of 20 September 2021. This is due to the combined factors of increased number of ICU beds and reduced number of admissions.
In other words, compared to last week, we have more medical facilities and our cases are reducing, both the mild and severe ones.
Yet, and this is a very big yet, it is not the time to relax our guard. We must continue to stay on high alert.
Our ICUs and hospitalisation rate, though reduced, are still high.
Our Brought-in-Dead (BID) cases are second in the country at 25 percent of our total COVID-19 deaths, we still have to ensure PKRCs have cleaner and better facilities, especially to cater for senior citizens, people with disabilities and pregnant mothers.
We are also working on expanding the telemedicine service for home quarantine patients in order to provide timely medical attention and prevent the sudden escalation of a patient's condition at home. This is crucial to prevent cases of BID.
Overall, we must continue to ensure a whole-of-government and whole-of-society approach to fight this pandemic together. I would like to thank the Chief Minister of Penang, Chow Kon Yeow and Health Minister Khairy Jamaluddin, for demonstrating how an all-party collaboration with aggressive actions based on science and facts can go a long way to deal with the COVID-19 pandemic.
*Steven Sim is the MP for Bukit Mertajam and the state-federal coordinator for COVID-19 management in Penang*
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