When COVID-19 cases nearly doubled on March 14—skyrocketing from 64 a day before to 111—President Rodrigo Duterte responded by placing Luzon on Enhanced Community Quarantine, restricting land, air, and sea travel; suspending mass transport facilities; and prohibiting mass gatherings, among other enforced guidelines.
Responding to the severity of the pandemic, the Department of Health (DOH) ordered one million sets of personal protective equipment (PPE) from China, accredited 30 COVID-19 testing facilities across the country, and initiated measures to ensure uninterrupted treatment for immunocompromised patients—those with a weakened immune system.
Despite these measures, health institutions have been overwhelmed by the surge of COVID-19 cases as well as suspected infections. This led to hospitals such as Chinese General Hospital and Medical Center and De Los Santos Medical Center releasing public announcements stating that they no longer had the capacity to accept COVID-19 patients.
Beyond the lack of necessary medical equipment, health workers struggle to maintain their physical and mental composure amid the elevating tension that continues to grip the country.
“Work in the hospital gets challenging every time. Every time we enter the [facility] feels like the first time to handle [suspected] and [probable COVID-19 cases],” shares Dr. Ma. Veronica Regalado-Magsino, an anesthesiologist at San Juan de Dios Hospital in Pasay City and at Dr. Jose Fabella Memorial Hospital in Manila.
Administering anesthesia for various medical procedures, Regalado-Magsino routinely works in operating rooms, emergency rooms, and the intensive care unit. There, especially recently, she has seen no shortage of patients with respiratory complications—for some, even the smallest breath of air can be a painful undertaking. With damaged lungs, such individuals usually need tracheal intubation, a procedure where a breathing tube is inserted into the trachea or windpipe to open up one’s airways and provide a supply of oxygen from a ventilator. Prior to intubation, however, anesthesiologists like Regalado-Magsino play a crucial role: muscle relaxants need to be administered to the critically ill due to the risk of potential circulatory failure and hypoxemia, or low oxygen levels in the blood.
And while their importance in saving lives has never been more pronounced, serving as a healthcare provider amid the COVID-19 pandemic is arguably one of the most dangerous professions. Apart from facing the highest risk of infection, medical frontliners continue to be plagued by physical exhaustion, mental and emotional burdens, and a lingering fear that they may contract the virus and transmit it to their families.
“[As much] as we would like to help the patients…we [may] have to isolate ourselves lest we may also be carriers, not only to our co-workers but to our families as well,” Regalado-Magsino furthers.
Despite this, she assures that health professionals have all been trained to handle different types of cases and have been following strict protocols—including proper wearing and removal of PPE, wearing a mask at all times, and regular hand sanitation within the hospital’s premises.
The physician also states that the initial shortage of hospital equipment has been addressed thanks to ongoing support from the government and private sector. On top of this, she mentions that they have received alternative medical resources in the form of reusable aerosol boxes that can help minimize exposure to aerosols, or liquid droplets suspended in the air, when medical personnel intubate patients.
Underequipped and unprotected
While hospitals in Metro Manila have been receiving continued support, health centers outside the National Capital Region struggle with limited resources. “There is definitely [a] shortage of PPE in our institution. We rely mainly on donations from [local government units] and private organizations,” discloses Dr. Trina Regalado, a general surgery resident from Batangas Medical Center.
Aside from an immediate shortage of medical supplies, there is also a concern on the limitations of facilities, she adds, as none of their operating rooms are equipped with negative pressure ventilation systems, which are essential for preventing harmful airborne pathogens—disease-causing agents—from escaping the room.
The glaring shortage of manpower has also limited the hospital’s operating capacity. From an initial three teams, Regalado and her colleagues have been regrouped to five teams, shrinking the number of medical residents per team. This was implemented to “limit the number of residents, just in case someone in [the] team gets infected and shows symptoms,” she explains. Furthermore, they have been working 24-hour shifts twice a week to minimize exposure to suspect and probable COVID-19 patients.
On a larger scale, however, the medical resident voices concern toward other hospital patients who require immediate surgery, expressing, “Besides potentially getting infected, we fear not being able to operate on patients scheduled for elective surgeries, especially cancer patients…The number of operations [that we could perform] were limited, requiring us to operate only on emergency, life-threatening cases.”
Due to the surging number of suspect and probable cases, she also discloses that their department has had to limit admissions for other patients “since surgery wards and private rooms were converted to COVID-19 wards.” The extensive ramifications that the pandemic continues to deal on most, if not all, medical institutions in the country pervade considerably beyond the COVID-19 cases alone.
A unified front
In the fight against COVID-19, reports surfaced on medical personnel, hospitals, and other frontliners feeling “left out” by the Philippine government’s pandemic response. As of May 8, the country had the highest rate globally of medical professional fatalities at 3.88 percent, according to Andrei Martin Diamante, a data analyst at EnergyAustralia. Afflicted health workers also make up more than 10 percent of the total COVID-19 cases nationwide.
While many countries around the world have eased back to normalcy, some countries such as Japan and China are experiencing their second wave of COVID-19 infections. Quarantine measures in the Philippines have also recently been stepped down.
It is clear that the crisis is far from over.
The DOH must pour their “efforts and resources into COVID hospitals”, Regalado urges. In addition, she recommends that the government hasten the accreditation process and build more testing centers to “render better chances in containing the infection.” Although the total testing capacity of licensed laboratories had been reported to be around 12,000 tests per day, recent data has shown that the actual number of tests conducted daily fails to reach this mark consistently.
Regalado-Magsino, meanwhile, adds that public officials must “consider the state of the poor” in formulating policies. Moreover, any decisions made and programs implemented ought to be “for the betterment of the country and not only [the government’s] own lives”, she emphasizes.
“Full and immediate” support for medical workers are what these health professionals appeal for as they continue to fight at the frontlines.