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History, Sacrifice & Significance

FMS SABAH RISES TO CHALLENGE

Dr Suraihan Bt Sulaiman | KK

Dr Mohamad Ariff Fahmi B Ahmad Zawawi | KK Merotai Besar

“Its impossible”, said pride. “It’s risky”, said experience. “It’s pointless”, said reason. “Give it a try”, whispered the heart. –unknown quote-

“New studies had shown that there is a risk of developing long Covid in patients infected with Covid-19. Therefore, we need to follow up these patients. However, due to our specialize clinics are closed, we would like to ask help from the Primary Care team to follow up them and to discuss with respective specialties should any post Covid complications rises in these patients”

The 3rd wave of pandemic Covid-19 hits Sabah first in early October 2020 and the positive cases keep escalating day by day which also means the discharged cases each day were escalating; thanks to our modern healthcare services. The burden brought by this pandemic is insurmountable to everyone. For Primary Care team, we already facing a wide range of challenges from screening, tracing, managing active cases in Low Risk Covid-19 Quarantine and Treatment Centers (PKRC), as well as Person Under Investigations (PUI) in the quarantine centres. As more evidence emerged, literatures on long Covid or post Covid complications are being published and became a huge concern to the healthcare professionals and also the public. After several discussions and in depth considerations between the ID Physician, Family Physician, and Public Health Physician; finally we decided to take up the challenge in following up patients who have been infected with Covid-19 in Primary Care or health clinics.

However, at that time, there was lack of guidelines or consensus to guide us on what to look for and what should we assess during those follow ups. How long should we follow up? How frequent? What parameters should we used to monitor? and many more questions run through our minds but none can provide a concrete answer as the evidence were still scattered and scarce. Taking the challenge thrown by our respective Sabah State Health Director, Datuk Dr Christina Rundi; a team consist of 10 Family Medicine Specialists (FMS) lead by Dr Zaiton Bt Yahya, Head of Sabah FMS, was formed and started to brainstorm using available evidences collected and formulate it as a guide for the Primary Care healthcare workers when following up the post Covid patients.

Taking the challenge thrown by our respective Sabah State Health Director, Datuk Dr Christina Rundi; a team consist of 10 Family Medicine Specialists (FMS) lead by Dr Zaiton Bt Yahya, Head of Sabah FMS, was formed and started to brainstorm using available evidences collected and formulate it as a guide for the Primary Care healthcare workers when following up the post Covid patients.

We started with smoothing out the process of transitioning post Covid-19 patients to Primary Care by developing a standardized flow chart for step down care, referral letter, and clerking sheets used during follow up. Prior to official launching, a virtual meet up with all FMS in Sabah was conducted to value their opinions and amendments were made based on their constructive and beneficial comments.

Moving forward, we decided to focus on developing recommendations based on 6 domains which were Respiratory, Cardiovascular, Neurology, Psychology, Rehabilitation, and Geriatric. For each of these domains, 1 external expert reviewer was invited to offer their expert opinions. Since not much information on the post-COVID complications in the obstetric and paediatric domain, we decided to exclude those topics for the time being. The Post-COVID-19 Follow Up Recommendations for Primary Care was officially launch on 30th November 2020 through circulation of its PDF version through WhatsApp group and since then it has been a great help to many healthcare workers as well as managers caring for the sick person in the community.

A famous quote ‘when the going gets tough, the tough get going’ is best describe the perseverance of Family Medicine Specialists in Sabah in facing the challenges slammed by this pandemic. We are honoured and blessed to have great team members in the development group of this recommendations. Thank you and may Allah blessed us with abundance of blessings from the deeds and sacrifices.

“There will be obstacles,

There will be doubters,

There will be mistakes,

But with hard work,

There are no limits.”

-Michael Phelps–

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