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Last July 29, 2020, the Institute for Solidarity in Asia (ISA) initiated a discussion with hospital leaders from Visayas and Mindanao through the “Laban VisMin: Coping, Learning, and Rebuilding in the Health Sector” webinar, in partnership with Philstar.com. The struggle to contain the spread of the virus while administering to other health concerns of the community, they narrated, has been all too real for the frontliners of the health sector.
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Last July 29, 2020, the Institute for Solidarity in Asia (ISA) initiated a discussion with hospital leaders from Visayas and Mindanao through the “Laban VisMin: Coping, Learning, and Rebuilding in the Health Sector” webinar, in partnership with Philstar.com. The struggle to contain the spread of the virus while administering to other health concerns of the community, they narrated, has been all too real for the frontliners of the health sector.
Arriving at crisis mode
Before the pandemic struck, a sense of complacency was a shared feeling among the main respondents.
“We were sort of complacent because we [already] had existing isolation for emerging diseases. This was used before [for] SARS, H1N1. When we had the first infected COVID-19 case, we told ourselves, ‘this is it, this is real,’” recalled Dr. Ricardo Audan, OIC Medical Center Chief I of Southern Philippines Medical Center (SPMC).
Similar to SPMC, Davao Regional Medical Center (DRMC) has had previous experience with infectious cases. DRMC Medical Center Chief II Dr. Bryan Dalid narrated, “We [had] already been treating infectious cases day in and day out. I thought initially that they were enough to take care of COVID. However, during the month of February, we noticed that there was an increasing number of cases.”
When the gravity of the pandemic sunk in, it didn’t take long for the hospitals to adapt crisis mode and activate their respective Incident Command Systems. Preparations were immediately mobilized and contingency plans were established.
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Expanding like an accordion
Convening other hospital leaders from nearby healthcare facilities, they assigned which ones in their area, whether public or private, would accept COVID-19 cases and which would assume regular non-COVID services.
Coordination with local government units then led to SPMC, DRMC, Zamboanga City Medical Center (ZCMC), and Vicente Sotto Memorial Medical Center (VSMMC) to become COVID-19 referral hospitals tasked to handle moderate to severe cases.
Per SPMC’s Dr. Audan, “There was an apprehension with the pronouncement [at first]. But eventually we found it as something of a strategy to focus one hospital to admit COVID. The City Government [of Davao] also opened 11 Temporary Treatment and Monitoring Facilities to unload patients from SPMC.”
With this mandate on their laps, the next primary concern, according to ZCMC Incident Commander Dr. Giovanni Gimena, was that of space—where to place all these COVID-19 patients to ensure proper isolation.
“We have a building here catering to the [Out-Patient Department]. With the collaboration of Army engineers and engineers in the institution, we were able to create the 40-bed COVID referral facility,” said Dr. Gimena.
Likewise, Dr. Gerardo Aquino, VSMMC Medical Center Chief II, narrated how their hospital acted like an ‘accordion’, expanding its isolation facilities from 30 to 180 as more cases came in. Even then, VSMMC still catered to non-COVID cases as they were an end referral hospital in the area.
As for DRMC, its four isolation areas, which had been enough prior to the pandemic, also had to expand. They then converted a 30-bed private ward as well as an unused dorm into isolation areas. In addition, DRMC provided a dedicated Operating Room within the isolation area to minimize further contamination.
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In photo: Speakers and moderator discuss the experience of responding to COVID-19 from the frontlines.
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Providing supplies and support
Because of the scarcity of Personal Protective Equipment, many of the hospitals had to rationalize its use of supplies, relying on donations and even resorting to limiting its use for dealing with confirmed COVID-19 cases only.
In addition to the supply issues, manpower in the hospital was also equally difficult to sustain. Dr. Judy Ann Dumayas, Medical Center Chief I of Western Visayas Sanitarium (WVS), recalled how they initially encountered fear and resistance from staff who were naturally hesitant about getting assigned to the COVID-19 wards. Still, they answered the call for cooperation and contributed to the shared goal in this crisis.
In order to protect their healthcare workers, the hospitals rationalized the shifting schedule and made regular testing as well as dormitories available for the staff.
“Recently, we have [had] compulsory mass testing for all our workers. We test [nurses] every two weeks and we test our doctors weekly,” shared Dr. Aquino of VSMMC.
To further support the overall welfare of the staff, the hospitals provided avenues for mental health care.
“We give mental exercises and psychological aid for support, especially for nurses who are about to be deployed,” said Dr. Audan of SPMC.
As for ZCMC, the Psychiatric Department has also been made accessible for staff, patients, and their watchers.
While the pandemic has seemingly no end in sight, these hospitals are now looking towards establishing new and separate facilities for COVID and non-COVID cases, with help from local government units and national agencies. It may be a small step towards restoring hospital operations, but from all the learnings thus far, these hospitals know that it is one in the right direction.
“We need to identify an infectious center so that we will be ready for the next pandemic. Even after this, the testing will always be there. By the next pandemic, we will already have a template that will make us ready,” closed Dr. Aquino of VSMMC.
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View the full webinar on our Facebook page.
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