Frontline Handling of the COVID-19 Pandemic: A Call for…

It has been 4 months and healthcare workers start to burn out. Many healthcare workers get sick, and no life is worth one million pesos. We are not superheroes. We are not immune to the virus. As a matter of fact, many healthcare workers (like nurses) opt to resign because of the risks in their lives without proper compensation. Yes, it is our duty to take care of the sick, but we have lives and families of our own to protect. When we get infected, it should not be always blamed on breech in PPE protocols. Are PPEs provided appropriate and of good quality? We have been reusing, extending use, or improvising PPEs. Many private hospitals are on the verge of bankruptcy.

In some provinces, there are only one or two IDS specialists, in others, none. We have felt the surge of cases the past month and believe me when I say that lately patients are more critical and we see more morbidities and mortalities even among the young ones, and sometimes even among our colleagues in the medical field. Aside from managing COVID patients, we continuously monitor the implementation of Infection Prevention and Control measures in our institutions, we coordinate patients to the Regional and City Health Surveillance Units, and we attend to numerous meetings with the hospital administration on how to better cater to our COVID patients. The Infectious Diseases Specialists, just like all frontliners, are spread out too thin. This is not just about physical exhaustion; it also takes a toll on our emotional and psychological wellness. But let me affirm our commitment to serve as health care workers. We are one with the country in the fight against COVID-19.

We call for the solidarity of all stakeholders and the cooperation of each and every Filipino. This war against COVID is not just in the hospital level; it starts in each one of us, in each household, and in each community. Therefore, we appeal to the public to strictly adhere to preventive measures such as physical distancing, hand hygiene, and wearing of masks and face shields. Cliché as it seems but prevention is key to saving lives.

• We urge local government units for intensified community interventions such as contact tracing and better referral systems. It is sad to see sick individuals, but it is tragic to see dying families.
• As the Department of Health reports that 99% of 52,406 active cases are asymptomatic and mild, we request for expansion of community quarantine facilities for these patients to better allocate hospital beds to severe and critical patients.
• In terms of utilization of COVID-19 beds, it has been reported that only 50% of COVID-19 beds are occupied yet major hospitals declared full capacity. We wonder why admissible patients hospital-hop and have nowhere to go. We plead for a better system to identify which hospitals have vacancies to properly direct and coordinate patients to them. There might be beds available but no nurses to take care of these patients.
• Let us not forget our non-COVID patients, those with chronic diseases such as cancer, diabetes, heart diseases, TB, HIV, to name a few. These patients have to be seen by doctors as well. We recommend allotting a safe space for them in each and every institution. Public health programs for TB, HIV and vaccination have taken a back seat. These programs should resume activities to prevent additional catastrophic disease outbreaks.
• We implore for an increased supply of proper personal protective equipment and hospital supplies (such as high flow nasal cannula and mechanical ventilators), access to drugs including investigational drugs, and more health workers.
• There is a high rate of resignation among nurses due to workload, inadequate rest, fear of getting COVID-19, difficulty in transportation and inadequate pay among others. More countries are hiring nurses from the Philippines and these countries have relaxed their requirements for hiring. I believe that our nurses want to serve our country and we should take care of them. The welfare of all frontliners should be prioritized. Proper compensation and provision for housing should be provided. Acceptable nurse to patient ratio must be identified and practiced in order to provide quality patient care.
• In order to serve our patients better and to sustain the operations of private hospitals, we request Philhealth for detailed guidelines on the memorandum (Philhealth Circular No. 2020-0009 “Benefit packages for inpatient care of probable and confirmed COVID-19 developing severe illness/outcomes”) and expansion of the COVID case rates.

Now more than ever, the Philippine Society for Microbiology and Infectious Diseases, together with the Philippine College of Physicians, remain committed to serving the Filipino people especially during this public health emergency of international concern. We remain dedicated to saving lives and reducing the burden of infectious diseases in the country. We urgently need health care reform for better health in the community.