KUALA LUMPUR: Experts have warned that Sabah's healthcare system is at risk of being stretched to its limit in the next few weeks if the number Covid-19 cases continue to soar in the state.
They said the authorities needed to marshal all available resources towards stemming community transmission, which may hold the answer to averting a healthcare crisis in the state.
Epidemiologist Professor Datuk Dr Awang Bulgiba Awang Mahmud said the key to stopping the pandemic from overwhelming Sabah's healthcare facilities was to curb widespread community transmission.
"Using massive numbers (at least 100,000 to 200,000) of rapid test kit antigen, massive numbers of contact tracers and activating all quarantine facilities will be necessary (to curb the virus)," he told the New Straits Times.
He said medical reinforcements deployed from the peninsula to Sabah had fallen short of the intensive care units' demands.
"The number of critical cases is rising rapidly in Sabah and may overwhelm ICUs. Although more ventilators have been sent to Sabah, every ICU bed requires four nurses and equipment. As such, sending more ventilators is not enough."
He said Sarawak was too far away for Covid-19 patients to be easily relocated in the event Sabah's healthcare system became stretched.
He said the Rt (reproduction number of the virus at a given time) could not be used as the sole indicator to determine whether a healthcare system was strained.
"Epidemiologists do not just depend on a single number (the Rt) to monitor any outbreak or to decide on infection control measures. I suggest that we use an index which includes indicators, such as cases per capita, deaths per capita, test positivity rate, doubling/halving time, the ratio of new cases to discharges, percentage of beds occupied, locality-specific Rt, cluster-specific Rt, spatio-temporal correlation values, virus genotype and more, (as an indicator for the healthcare system)," he said.
Likewise, Universiti Putra Malaysia epidemiology and biostatistics expert Associate Professor Dr Malina Osman said: "Besides the infectivity rate, we can consider a healthcare system is strained when more health personnel become infected and when critical Covid-19 cases are increasing.
"Another important indicator is when there is a backlog of non-Covid-19 patients because other major healthcare facilities are forced to shut down temporarily."
She said Sabah had continuously recorded the highest number of cases, despite having an Rt of only 1.26 (as of Sept 30), which is lower than Selangor's Rt of 1.95, due to several reasons.
"Apart from the affected areas in Selangor having a higher population density, this may be because Sabah is experiencing a wider infection distribution.
"This may be partly due to the superspreader strain, D614G, that was detected at the Benteng LD cluster in Sabah. But, I think the wider infection distribution is more likely due to pre-Sabah state election activities."
While the spike in Covid-19 cases in Sabah could be attributed to increased testing abilities, Dr Malina said the figures could mean two things.
"If the standard operating procedures (SOPs) in Sabah are strictly complied with, then it reflects the effectiveness of our contact tracing and testing abilities. But if SOPs are 'questionable', then it is not a good sign."