Thursday, August 13, 2020

Philippine doctor cry out for relief, urge return to stricter quarantine

Aug 02. 2020
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By Inquirer

MANILA, Philippines — The country’s medical community on Saturday said the health-care system was being overwhelmed by the continued spike in the number of COVID-19 cases, particularly in the national capital and its surrounding areas, and urged the government to impose a strict lockdown on Mega Manila for at least two weeks this month.

In response, President Rodrigo Duterte directed the government body tasked with managing the administration’s response to the pandemic to immediately act on the concerns raised by more than 60 medical societies in the Philippines in a letter sent to him on Saturday, according to presidential spokesperson Harry Roque.

“Our health-care workers are falling ill as they take care of patients, responding to the call of duty while battling the fear and anxiety COVID-19 brings. Our health-care workers are burnt out with the seemingly endless number of patients trooping to our hospitals for emergency care and admission,” said Dr. Jose Santiago Jr., president of the Philippine Medical Association (PMA), reading their letter to Mr. Duterte in an online news conference.

“We are waging a losing battle against COVID-19, and we need to draw up a consolidated, definitive plan of action … We propose the two-week ECQ (enhanced community quarantine) be used as ‘time out’ to refine our pandemic control strategies,” the letter said.

Roque said the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF) would discuss the suggestion to place Mega Manila under ECQ for two weeks.

Mega Manila includes the National Capital Region, Central Luzon, Calabarzon (Cavite, Laguna, Batangas, Rizal and Quezon) and Mimaropa (Mindoro, Marinduque, Romblon and Palawan).

Executive Secretary Salvador Medialdea did not wait for the IATF’s action and on Saturday night called a meeting of key Cabinet members and other officials involved in the pandemic response “to address the concerns of the medical community.”

Prior to this, National Task Force Against COVID-19 chief implementer Carlito Galvez Jr. and several senior officials met with representatives of PMA, Philippine Nurses Association and Philippine Association of Medical Technologists to discuss the issues they raised.

The recommendations following Medialdea’s meeting will be submitted “for the President’s review,” Roque said.

A shift to ECQ means the closure of all but essential businesses and the suspension of public transportation.

Everyone would be under home quarantine and the movement of people would be restricted to accessing essential goods and services, and to going to work in only a few offices or establishments that are permitted by the government.

 

The government imposed ECQ from March 16 to May 15 in Metro Manila and the rest of Luzon. This was followed by the modified ECQ until June 30 and the more relaxed general community quarantine (GCQ) for the whole of July, which was extended to Aug. 15.

Santiago said that PMA wasn’t among those consulted by the administration on whether quarantine measures for the first two weeks of August should be loosened, tightened or maintained.

New record set

Since June 1, daily COVID-19 cases had exponentially grown, reaching more than 4,000 on Friday. The capital region has consistently accounted for at least half of the daily cases.

For the third straight day, the country again broke its record as 4,963 new COVID-19 cases were recorded on Saturday, pushing the national tally to 98,232, of which 30,928 remain active.

The Department of Health (DOH) said Metro Manila accounted for 54 percent, or 2,667, of the latest cases. It was followed by Cavite, with 405, Cebu (355), Laguna (324) and Rizal (252).

The DOH said that 80 percent of the new cases, or 3,981, were infections that occurred within the last 14 days. Metro Manila also accounted for most of these cases (2,087), followed by Calabarzon (959) and Central Visayas (223).

Sought for an explanation for the record number of new cases since Thursday, DOH said that it couldn’t say for certain if this may have been caused by laboratory issues, such as backlogs.

Risk of collapse

The number of patients who have recovered rose to 65,265 with the recovery of 93. The death toll increased to 2,039 after 17 more succumbed to the severe respiratory disease.

The medical groups acknowledged that going back to the strict lockdown was a “complex decision,” considering that millions had lost their jobs due to the pandemic.

“[But] let us remember that we need healthy people to reinvigorate our economy. The current crisis necessitates putting prime importance on effective solutions addressing the health problems at hand,” their statement said.

Dr. Maricar Limpin, vice president of the Philippine College of Physicians, warned that if the administration did not heed their call, it would risk a collapse of the health system.

“Let us remember that our hospitals are our last defense in protecting the health of Filipinos,” Limpin said. “Listen to us because we are the ones attending to the sick. Let us not let our last line of defense fall.”

As of Thursday, the DOH recorded a total 4,823 health workers infected with the coronavirus and 38 have died.

To ensure the health system can properly treat and manage the newly infected amid the surge in cases, DOH earlier said that mild and asymptomatic patients should be put in quarantines so hospital beds could be reserved for the severely and critically ill. It also mandated that 20 percent of beds be set aside for COVID-19 cases in private hospitals, while at least 30 percent should be allocated in public health facilities.

Proposed measures

Santiago said that even if hospitals had the physical capacity to expand, they couldn’t because there were not enough health workers to look after patients.

“There are available beds, but if you don’t have nurses who would man the COVID-19 wards, that’s the challenge. That’s why we cannot expand even if we want to,” Santiago said.

Santiago said hospitals were optimizing the work schedule of their health personnel “to conserve manpower and ensure they are able to rest to remove the fatigue factor.”

Health Undersecretary Maria Rosario Vergeire earlier said there were not enough applicants for medical front line jobs. Of 9,365 available jobs, only 6,510 have so far been filled, and 40 percent of these health workers were deployed to government hospitals.

Aid packages

Once Metro Manila is placed back on strict lockdown, the medical community suggests that measures be taken to resolve such problems as the inadequate number of hospital personnel, the failures in tracing and isolating cases, transportation and workplace safety, and public compliance with self-protection.

Cash aid packages should also be readied for those whose livelihood would be affected by the proposed “timeout for the health sector.” 

“All we’re asking for is two weeks. We have to break the chain of transmission,” Santiago said.

Earlier on Saturday, Roque said the strict lockdown “has served its purpose” and the government would intensify “other strategies” to contain the contagion.

He said the government would continue to impose localized lockdowns, increase the allocation of hospital beds for COVID-19 patients, and hire more health workers.

“The Palace understands the delicate balancing act between public health and the economic health of the nation given that Metro Manila and Calabarzon (Cavite, Laguna, Batangas, Rizal and Quezon) make up 67 percent of our economy,” Roque said.

He said community quarantine would have to be complemented with the allocation of beds for COVID-19 patients to scale up hospital capacity, and the hiring of more doctors, nurses and other medical personnel.

In addition, the authorities would impose strict localized lockdowns and place barangays with a high number of cases under ECQ, Roque said.

Local governments would also be made to strictly impose minimum health standards, implement massive targeted testing, conduct intensified tracing, quarantine close contacts and isolate confirmed cases, he added.

Listen to ‘real soldiers’

Sen. Francis Pangilinan said the government should listen to the health workers “because they are the real soldiers in this pandemic.”

Sen. Panfilo Lacson said Malacañang should “seriously consider” the health workers’ request.

“Putting human lives above all considerations is a no-brainer, given the choice,” Lacson said.

Sen. Sonny Angara warned that if doctors and the medical system were overwhelmed, “then the whole system and government strategy will surely be affected.”

Sen. Richard Gordon said the medical groups’ suggestions should be studied.

“To me, life is more important, and it would be hard to lose our doctors,” he said in an interview with dwIZ radio.

But Sen. Cynthia Villar disagreed with health workers’ request.

“They should do their job well. We cannot close down the economy because if people won’t die of COVID, they will die of hunger,” she said also on dwIZ.

The country has to live with COVID-19, and if the economy suffers, more people would lose their jobs and go hungry, Villar said.

—With a report from Inquirer Research

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