When Prime Minister Muhyiddin Yassin announced a nationwide total lockdown in May to battle a surge in COVID-19 infections, Malaysia’s healthcare system was already in critical condition.

The country was struggling to contain a more recent outbreak of the coronavirus driven by more contagious variants, and worsened by gatherings ahead of Eid al-Fitr.

By the end of May, the country’s average daily cases per capita surpassed that of India as new single-day infections breached the 9,000 mark. Daily deaths had also peaked at 98 cases on May 29, with health chief Dr. Noor Hisham Abdullah calling it a “dark moment” for the nation.

Hospitals across the country, particularly in the Klang Valley, were running close to capacity as the influx of patient arrivals triggered a shortage of intensive care unit (ICU) beds and staff to provide adequate care for patients.

Healthcare workers in Kuala Lumpur had to turn patients away, given that COVID-19 care takes priority, while in the northern state of Kedah, doctors were left to decide who gets a chance to live due to the state’s limited number of ICU beds.

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Health officials resorted to unconventional measures to cope with the surge in COVID-19 cases and death, which included the deployment of military-built field ICUs and the utilization of shipping containers as makeshift morgues. Soon after, the nation went into “total lockdown.”

The first 14 days of the full lockdown brought new infections down to as low as 4,900 amid reduced testing in most states. As testing for the virus continued to drop in the weeks after, reports of new cases also decreased, albeit at a slower rate.

At this point, health experts warned of a rise in COVID-19 hospital admissions involving younger adults who were brought in critically ill with the disease.

Dr. Benedict Sim Lim Heng, an infectious disease consultant at Sungai Buloh Hospital – the country’s primary hospital for COVID-19 – said the majority of patients who required critical care were now aged between 40 and 60, with a significant number in their 20s and 30s.

“We are seeing young patients being brought in at the most advanced stage of the disease, people in their 30s and 40s being brought in and put on life support machines,” Sim said. “The situation has actually turned scarier. It is quite dire at times.”

As it turns out, the country’s COVID-19 situation was not getting any better and the misleading toll of confirmed cases had shifted the attention away from a rapidly evolving public health crisis.

In recent weeks, pictures and videos of overwhelmed hospitals in the Klang Valley have been shared online. One video showed at least a dozen patients on metal row chairs sharing oxygen supplies at the emergency department of Tuanku Ampuan Rahimah Hospital in Klang. Another showed bodies of COVID-19 victims being placed in a holding room as morgues overflowed.

Several hospitals have converted their parking lots into emergency units to accommodate more patients, stretching exhausted medical workers thin. Many healthcare workers are suffering from compassion fatigue due to the prolonged stress of dealing with COVID-19. Others who are reeling from burnout and exasperated by the lack of top-level support are calling it quits.

On July 10, Malaysia set a new record for the second consecutive day with 9,353 COVID-19 infections. Its total of more than 830,000 confirmed cases is the highest per million people in Southeast Asia – at least twice the caseload per capita in Indonesia – though lack of testing means that the number is vastly below the real toll.

By official count, over 6,100 people have now died from the coronavirus in Malaysia, of which 55 percent reported during the current “total lockdown” period. To put it simply, about 85 people with the coronavirus have died per day on average since the lockdown began on June 1.

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The brutal toll of the virus inside hospital ICUs, as told through stories and images shared anonymously by desperate frontline workers, show the extent of the havoc being wreaked in the country. Many are blaming the near collapse of the healthcare system on the government’s “half-baked” lockdown measures, which have only exacerbated infections.

The government’s decision to allow 18 manufacturing sectors to operate mainly at 60 percent capacity created favorable conditions for virus outbreaks at factories and workers’ dormitories. Workplace clusters have emerged as a key source of COVID-19 infection in Malaysia, with the bulk of the clusters identified linked to the industrial sector.

Insufficient testing has also resulted in early infections going undetected, especially among young adults, until they rapidly deteriorate. Public health experts and health advocates have long stressed the need for large-scale testing to run hand in hand with restriction orders.

Over the course of the lockdown period, the national positive rate (share of tests that returned positive for COVID-19) has remained above the World Health Organization (WHO)’s maximum 5 percent benchmark. This indicates that Malaysia is not testing enough people to contain the outbreak.

Opposition coalition Pakatan Harapan’s health committee recently declared the lockdown a complete failure, with movement restrictions unlikely to contain a fourth COVID-19 wave.

Foreign trade chambers have also voiced concerns about how the pandemic is being managed in Malaysia, while an army general said the country’s COVID-19 response lacked coordination and speed.

Many say the government has had misplaced priorities. As cases soared, Muhyiddin announced shifts in cabinet positions in a bid to ease tensions in the ruling coalition, ahead of the United Malays National Organization (UMNO)’s decision to withdraw support from his Perikatan Nasional (PN) coalition last week.

In the shift, Defense Minister Ismail Sabri Yaakob, UMNO’s most senior figure in cabinet, was made deputy prime minister. Foreign Minister Hishammuddin Hussein, another UMNO stalwart, has been promoted as Senior Minister for Foreign Affairs and will take over Ismail’s role as chief security officer.

The two UMNO lawmakers are part of a faction within the party that is more aligned towards Muhyiddin’s government. Another faction, headed by UMNO president Ahmad Zahid Hamidi, has resolved to break away from the PN coalition and is reportedly teaming up with Anwar Ibrahim’s Pakatan Harapan coalition to form a new government.

The country’s Attorney General Idris Harun has maintained that there are no “clear facts” that the premier has lost his majority. This means that Muhyiddin’s leadership still stands until it is proven otherwise in parliament, which will sit from July 26 for five days.

As COVID-19 continues to rage in Malaysia, anger towards the government is growing. For most Malaysians, whether Muhyiddin can survive this crisis after 15 months in power is less urgent than whether they can. As politicians bicker, Malaysians are left to fend for themselves.

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