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Convert selected private hospitals into dedicated Covid-19 centers

SO far, we are not doing badly at all in our struggle to contain the deadly coronavirus disease 2019 (Covid-19) pandemic that has plunged the world into a health crisis, which is likely to push the global economy into a recession never seen before.

Based on information midday Saturday, our country of 105 million has had 307 cases and 19 deaths. Just to put these figures in context, confirmed number of cases in South Korea is 8,897; Malaysia, 1,183; Japan, 1,054; Indonesia, 450; and Thailand, 411. A figure that could also put the Covid-19 situation in context is that in the 2012 dengue outbreak, there were 271,480 dengue cases, 1,107 of those infected dying of it.

We are certainly not over the hump, but I’m convinced that with the “enhanced community quarantine” — the stay-at-home order in the entirety of Luzon and the ban on travel to and from metropolitan Manila — we’re starting to contain this terrible pandemic.

What is needed now is intensified contact tracing to quarantine those who had even remotely been in contact with a confirmed case. We should have locked down the entire country starting March. An old friend and comrade, Aileen Baviera, was fatally infected with Covid-19 after attending a conference in Paris last March 5.

The biggest risk we face is a sudden and then sustained increase over the next two weeks of cases as happened in Italy, Spain and now in the United States. The deluge of cases in those countries engulfed their medical facilities. This, among other things, resulted in the steep fall of quarantine protocols in their hospital emergency rooms and intensive care units (ICUs), in turn creating more carriers, sadly even infecting the physicians and nurses themselves.

Thanks to social media, I came across the excellent suggestion of Dr. Ramy Roxas, former professor of University of the Philippines-Philippine General Hospital (PGH) and Chief of Surgery of The Medical City, for the government to have a more organized strategy in dealing with Covid-19 patients. I publish his suggestion verbatim, which he titled “A call to nationalize selected private hospitals in Metro Manila as Covid-19 centers.” It reads:

“Hi, guys, I’m putting these ideas across, hopefully to generate movement in both public and private sectors. This was triggered by a report that Spain also had to nationalize private hospitals in the light of their Covid-19 crisis.

“The move to designate the Philippine General Hospital, Lung Center of the Philippines and the Dr. Jose N. Rodriguez Memorial Hospital as Covid-19 centers is misdirected and may only exacerbate this crisis.

“The intensive care unit of PGH is under renovation, Rodriguez Memorial is underdeveloped and the Lung Center is reluctant to expose its existing patients with lung cancer and TB (tuberculosis) to Covid-19 patients.

“In short, all three hospitals are neither ideal nor ready to become Covid-19 centers.

“It will be difficult to segregate Covid-19 patients from the thousands of non-Covid patients at PGH who require just as important medical care, being the most highly sub-specialized government hospital in the country.

“Which hospitals in Manila will be able to take over this volume? From what we have experienced so far, it is very difficult for one hospital to serve both Covid-19 and non-Covid patients. Aside from the risk of cross-contamination, the care of Covid-19 patients takes a huge toll on health manpower and resources (among others, quarantine facilities, personal protective equipment and respirators).

“At present, the most number of Covid-19 patients admitted for care are in private hospitals, overwhelming their capacity and forcing them to shut down many non-Covid services.

“These private hospitals have the best ICUs, emergency rooms and infectious disease facilities and staff in the country. They also have a lot of vacant beds and spaces now, as they have been forced to shut down non-Covid services. They are therefore in the best position to become Covid-19 centers.

“These hospitals are already seeing large volumes of persons under monitoring, persons under investigation and confirmed cases — and it will be difficult to transfer these patients out to any other facility. Certainly wealthier patients may not want to transfer to government facilities.

“The financial losses to these private hospitals and their patients will be substantial. Their consultants are not salaried and are also therefore vulnerable to the economic consequences of this catastrophe.

“Given this dire scenario, the only viable strategy is for the Philippine government to temporarily nationalize and take over these large private hospitals under the following conditions:

– Service only Covid-19 patients, whether PUMs (persons under monitoring), PUIs (persons under investigation) or confirmed

– Designate their staff to serve as full-time Covid-19 teams, with appropriate rest and quarantine, if need be

– Provide full financial support and reimbursement for these hospitals

– Expand their current capabilities by providing them with additional manpower, PPEs (personal protective equipment), respirators, etc., possibly from the other hospitals

– Put their health workforce on salary their health and provide lodging and quarantine facilities for them… Ensure optimal protection for them at all times, as well as psychosocial support

– Provide free services for all Covid-19 patients, irrespective of severity or economic status

– Keep other hospitals Covid- free, allowing them to provide services just as important for other types of patients

“This is a national emergency. We cannot delay our response again. I can think of no better strategy, before this contagion engulfs all hospitals.

“Strong government leadership and decisiveness is imperative!”

This is such a “doable” proposal, what with President Rodrigo Duterte’s persuasive powers. Out of the 40 hospitals treating the 300 or so Covid-19 patients, only 11 have been treating more than half of the pandemic’s victims. These are the ideal hospitals with the best facilities and with trained medical staff that can be fast converted into facilities dedicated to treating Covid-19 patients.

The President would need to summon to a Malacañang meeting just six people to plead with them to help the country overcome this terrible pandemic. These are Manuel V. Pangilinan, chief executive of First Pacific Co. Ltd., which owns five of these hospitals (Cardinal Santos, Makati Medical, Manila Doctors, Asian Hospital and de los Santos); Lucio Tan, who owns the University of the East Ramon Magsaysay Memorial Medical Center; taipan Federico Dy of Security Bank who heads the board of the two St. Luke’s hospitals; and the head of the Philippine Dominican Order that owns the University of Santo Tomas Hospital. (As of my deadline, I am unable to determine who owns Medical City, which has 33 Covid-19 patients, and the Chinese General Hospital, which has seven.)

Having just these 11 hospitals treat Covid-19 patients would also make this task so organized. It will also ensure that the virus doesn’t get out of the 40 hospitals that are treating the victims.

Email: tiglao.manilatimes@gmail.com
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