KUALA LUMPUR, June 22 — The nearly 500 ambulances that the Health Ministry is procuring are not all categorised as “negative pressure ambulances”, the ministry said today.
In explaining the June 19 reported remarks of Health Minister Datuk Seri Dr Adham Baba, the ministry said the minister’s remarks on the procurement of ambulances had been misunderstood and misinterpreted.
“In that statement, it was not stated that all the 500 ambulances are of the ‘Negative Pressure Ambulance’ as has been misunderstood and reported by certain quarters,” the ministry’s secretary-general said in a brief statement today, but did not go on to specify how many of the ambulances being procured were of the negative pressure type.
The ministry said it viewed negative pressure ambulance features as being needed to fight the Covid-19 pandemic currently and in the future, noting that such ambulances have a negative pressure system, HEPA filters and UV lamps for patients with infectious diseases especially those that are airborne.
The ministry said it had on June 17 advertised its offer of tenders to procure 490 ambulances together with medical equipment for the use of hospitals and clinics nationwide.
Following the news report on the health minister’s comments on procurement of ambulances, politicians and healthcare workers had criticised the ambulance procurement plans.
Yesterday, Opposition coalition Pakatan Harapan’s health committee with 12 signatories had questioned the plan which was said to cost RM300 million, asking for justification on spending such a sum on 500 negative pressure ambulances and what was the data to show its necessity.
Among other things, the PH politicians had said the money would be better spent if used to take in more volunteers for the national Covid-19 immunisation programme and increasing Covid-19 testing
They had also said such a budget could instead be used to speed up Covid-19 vaccination such as by increasing vaccination centres, increasing mobile vaccination clinics, increasing drive-through vaccination centres.
They had also urged the health minister to explain the urgency to offer the tender for 500 ambulances and whether it had received Cabinet approval, while also asking if it would be through open tender and which company had successfully won the procurement tender.
Today, the Academy of Medicine Malaysia’s College of Anaesthesiologists, Malaysian Society of Anaesthesiologists and the Malaysian Society of Intensive Care issued a joint statement to question the reported minister’s remarks on the purported plans to purchase 500 negative pressure ambulances to transport Covid-19 machines.
They stressed the need for clear data to justify the use of negative pressure ambulances in matters such as whether it has been shown to reduce Covid-19 infections and whether existing ambulance services have caused more patients and more healthcare workers to be infected with Covid-19.
The three organisations also highlighted that any touted benefits of negative pressure ambulances in preventing Covid-19 patients from spreading Covid-19 infection to healthcare workers during ambulance transfers would be negligible, as all healthcare workers wear appropriate personal protective equipment during such transfers and the destinations that the patients are transferred to are not necessarily negative pressured areas.
The three societies instead recommended measures in the US for transporting Covid-19 patients which include wearing PPE, patients to be kept separated from others like the drivers as much as possible, using air conditioning units on non-recirculating settings, using exhaust fans to maximise air changes in driver and patient compartments, and family members not riding in the transport vehicle.
While saying that they have yet to come across the role of negative pressure ambulances in any recommendations or guidelines except for a publication from Hubei, China which reported of a decline in Covid-19 cases there with the availability of negative pressure ambulances, they noted that it is believed that there were multiple factors instead of just the ambulances which led to the successful containment of Covid-19 cases there.
Stressing on prudent spending, the three societies said they believe negative pressure ambulances pose no benefit in managing Covid-19 cases, and that such ambulances does not improve outcome but would result in large sums of money being spent.
“Apart from the cost of a negative pressure ambulance, which is estimated to be between RM500,000 and RM600,000, there are also costs incurred with regular maintenance of the HEPA filters.
“The expenditure to change the HEPA filters is anticipated to be about RM3,000 to RM5,000 per
ambulance per month. Furthermore, the worst-case scenario is to have these ambulances suboptimally or underperforming due to lack of funds to maintain them,” the three societies said.
The three societies said one immediate solution to address the Health Ministry’s lack of ambulances is to engage private ambulances and non-governmental organisations with ambulance services to help in patient transfers for a fee, with the healthcare workers involved required to wear PPEs and to have been vaccinated to reduce Covid-19 transmission risk.
The three societies also recommend the immediate recruitment of junior doctors and nurses who have just graduated and converting all contract posts to permanent posts, in order to ease the workload and stress by the Covid-19 health frontliners.
“Any surplus budget would best be spent investing in our young doctors and nurses. They have been and will be our last line of defence so that the care of the Covid-19 patients can be
continued optimally,” the societies.