FROM THE FRONT LINES: MALAYSIA

Preparing for a storm that was already here

By Dr. Pui Li Wong

Dr. Pui Li Wong
Dr. Pui Li Wong

I am an Infectious Diseases physician helping in hospital preparedness and managing COVID-19 patients in Kuala Lumpur, Malaysia.

At the end of December 2019, the world heard about the cases in China, and everyone hoped that it would go no further. Malaysia saw its first case on January 25th, 2020, and our hospital at the end of February. You could say we had months to prepare for this, but I don’t think any of us could predict the speed as to which we would have to scale up our services and preparedness, while keeping everyone safe.

We went from having 4 beds for COVID-19 patients at the end of February, to 80 beds for patients in 3 weeks. This doesn’t even take into account the numbers our Emergency Medicine counterparts were seeing at screening.

This meant transferring our patients to other wards, cutting down significantly on outpatient clinics and elective surgeries, without compromising their care. We had to make sure all staff were trained and safe to care for these patients, whether they were doctors, nurses, or cleaners. Protocols had to be agreed on, in place, understood, and implemented in a very short amount of time.

At the same time, anxiety and fear was rife not only in the community, but even amongst healthcare professionals. Navigating through this was a minefield, which was emotionally exhausting and at times heartbreaking, as these are the same people who will need to be confident in caring for our patients. Educating healthcare workers to use personal protective equipment rationally and responsibly was deemed as endangering their lives and their families. Gaining their trust and preparing them mentally for this task was not easy given how quickly the outbreak escalated.

This was a stark contrast to the wards caring for those affected by the COVID-19 infections. The attitudes and mood of healthcare workers caring directly for patients were calm, and there was a sense of comradery and banter. Teams were made up of not just medical doctors, but doctors of other specialties were helping too. Communities were sending us food and resources to ensure that we were taken care of and donating protective equipment to us. The movement control order that was implemented (local lockdown) has helped us to flatten the curve and helped our services to cope.

Thanks to all the effort, sleepless nights, missed family occasions and sacrifices my colleagues have made, for the first time in months, I can now take a deep breath, and just be with my family while the sun is still up.

Dr. Pui Li Wong is a D43 Fellow in an HIV and mental health research and training program in the Asia-Pacific region. She is an Infectious Diseases physician at the University of Malaya Medical Centre in Malaysia. She is keen to understand the influence and impact of mental health and aging on people living with HIV, and how this affects their engagement into care.

D43TW011302 (Sohn, Wainberg): CHIMERA (Capacity development for HIv and MEntal health Research in Asia)