MANILA — Some hospital staff in Dr. Jose Fabella Memorial Medical Center in Manila have become anxious over the supposed rising number of COVID-19 infections inside the medical facility, which they blamed on the alleged lax implementation of health protocols on patients.
“Irma” (not her real name), an employee of the national maternity hospital for almost 10 years now, alleged that patients were easily admitted even without a swab test result.
Irma said many hospital staff, and even patients, are now contracting the virus. Incoming patients, she said, would lie about their condition, swab test results, or symptoms when being interviewed at the triage.
“Asymptomatic, tapos na-admit sa delivery room or sa labor room. Nahalo sa ibang pasyente, although naka-face mask, face shield. Pero kung masyadong marami ang pasyente, ilan lang naman ang bed sa labor room, tapos sa recovery room din," Irma told ABS-CBN News.
(They are asymptomatic. Then they got admitted to the delivery or labor rooms, along with other patients, although they are wearing face masks and shields. But the patients are overwhelming, as we only have limited beds in the labor room, and in the recovery room.)
"Minsan, 2 in a bed. So mga after 2 or 3 days, kung normal ang delivery, mapapauwi agad yung pasyente. And then paglabas nung result, positive pala sila. Unfortunately, nagkalat na sila sa ward,” she added.
(Sometimes, 2 people share a bed. So after 2 or 3 days, the patient is discharged if it's normal delivery. Then, the test result comes out, indicating the patient is positive. Unfortunately, the virus has already spread in the ward.)
Irma pointed out that infected patients expose others in the same room to the virus.
“Siyempre, may mga mothers din na hindi rin naman natin mapipigilan na minsan nagtatanggal ng mask, nagtatanggal ng face shield, lalo na kapag sila-sila na lang. So, nagkakahawahan din sila, lalo na kung sama-sama dun yung mga na-expose pala dun sa COVID na nag-a-antay lang ng swab,” she said.
(Some mothers remove their masks or shields, especially when they are just by themselves. So spreading the virus is possible, most especially if among them are those who were already exposed to COVID but are just awaiting their swab test results.)
Irma said the hospital's policy requiring mandatory swab test or RT-PCR certification from incoming patients has been relaxed.
Those who will claim to be 100 percent healthy can go straight to either the labor, operating or delivery room, and will be mixed with other patients.
The untested patient’s companions, although they only stay outside, can also approach the hospital staff for their concerns, exposing them to more danger, she said.
Irma cited their 2 recent COVID-19 cases involving those who stayed in the regular patients' ward.
“Mayroon kaming isa (patient) for this month. Tapos last month, meron ding isa. Pareho silang nasa normal delivery ward… Ang protocol kasi, once na may nag-positive sa ward, lahat ng close contact should be separated or isolated. And then properly swabbed or quarantined,” she said.
(We had a patient this month and last month. They were in the normal delivery ward. Their close contacts should have been separated or isolated as per hospital protocols.)
Irma also complained about the lack of separate room where they can wear or remove their personal protective equipment.
“Ang problem lang sa isolation area na 'to - oo, may separation sila, may plastic separation each bed, pero yung proper doffing and donning. So paano ka magsusuot ng PPE kung wala kang separate area for that, na dapat merong maliit na area man lang?” she said.
(The isolation area has a plastic separation each bed, but it does not have a proper doffing and donning area. How can you wear your PPE then? We should have a separate area.)
“Since COVID ay pwede siyang mag-transmit via aerosol, kung wala kaming proper place for doffing (removing of PPE) and donning (putting of PPE), pwede kaming magkalat ng infection dun sa mga dadaan kung saan kami nagtanggal ng PPE.”
(If we do not have a proper place for doffing and donning PPE, we can spread the virus to everyone who would pass by where we remove our PPE.)
Irma suspects those patients were among the spreaders in hospital wards, their community, and even inside their homes.
She doubted whether the hospital was able to report these patients to their respective barangays.
“Rene,” another staff of the hospital working for over 20 years now, echoed Irma's sentiments.
According to Rene, as of April 20, their hospital has recorded 22 new COVID-19 cases, 11 of which are patients, while 11 are members of the hospital staff.
“Ang nangyayari kasi, 'pag nandudun na (hospital), diretso na lang akyat. Hindi na hinihingan ng swab test. Kaya halo-halo na lang dun… Ang isyu kasi is yung paghahalo ng mga (COVID) suspect sa OR-DR (operating room-delivery room) na hindi naman isolation room… Sa DR, may isang kwarto doon na para lang dun sa suspect," said Rene.
(What happens when you are in the hospital is you can directly go upstairs without swab tests. That's why everybody can just be mixed with individuals who may have COVID-19.)
"Minsan kasi... nangyayari wala nang paglalagyan. Sama na lang s'ya sa kama. Dun na rin tabi-tabi sila nung mga pasyente na wala namang sintomas, at dun na lang din nanganganak."
(Sometimes, what happens is we no longer have additional beds so we just include them with other patients without COVID-19 symptoms, and that's where they give birth.)
POSITION OF ISOLATION ROOM FOR COVID-19 PATIENTS
Both Irma and Rene blamed the reported infections to the hospital administration’s supposed decision to put up an “isolation room” for virus patients and people probably with the disease, just next to the regular patients’ labor, delivery and operating rooms.
“Naka-isolate, pero dadaan ka pa rin sa hallway na dinadaanan ng mismong regular patients... In danger din (health workers) because not all the time we’re wearing a PPE,” according to Irma.
(They are isolated but you still have to pass by the hallway used by regular patients, which also endangers health workers because not all the time we're wearing a PPE.)
Hospital staff like Irma and Rene conveyed their group’s appeal to Fabella medical chief Dr. Esmeraldo Ilem, urging him to provide a separate dedicated COVID complex for patients, considering that their existing complex can no longer accommodate all COVID-19 patients and those probably infected.
“Kasi talagang mag-i-spread po ito (COVID). Dadami at dadami po ito dun pa lang sa Fabella... kapag hindi tama ang pagsunod sa health protocol,” Rene explained.
(COVID-19 will really spread and it would increase in the hospital if the protocols are not followed.)
“Kami, sa totoo lang, eh nababahala. Pero para bang ang nangyayari sa amin, bahala na lang. Sa shift ko pa lang, 4 [hanggang] 5. Nakakapag-handle kami ng suspect… magkaroon talaga ng pasilidad para sa COVID patients at suspects… para hindi nahahalo sa regular ward,” said Rene.
(We are bothered but we are left on our own. We handle suspected COVID-19 cases. We want them to have a facility for COVID-19 patients and suspects so they will not be mixed in the regular ward.)
Ilem, in a separate interview with ABS-CBN News, confirmed that as of April 20, they have 11 patients with COVID-19, of whom 1 is a newborn.
All are asymptomatic.
Two of the 11 hospital staff with COVID-19, on the other hand, are now confined but they remain stable in Fabella’s isolation area, according to Ilem.
Ilem pointed out that more than a hundred hospital staff have already contracted the respiratory disease since last year, which he primarily blamed on their personnel’s habit of “eating together.”
He also insisted that upon checking with the hospital's infected health personnel, only 20 percent of them got it from their patients.
“Nakikita ko pa rin sila, kumakain na sabay-sabay. Kung sila ay natatakot, dapat pina-practice pa rin nila yung infection prevention measures… Do their share… Lalo na nung March and April, nagsimula yung pagdagsa ng aming personnel na COVID positive dahil nanggaling na sa kanilang mga bahay-bahay," he said.
(I still see them eating together. If they are afraid to get the disease, they should practice the infection prevention measures... The high number of COVID-19 cases among our personnel is because they got infected at home.)
"Mayroon na pa lang mga symptomatic sa bahay nila… Pumapasok pa sila. Tatlong empleyado namin yun. Pumasok pa, nanghawa,” the hospital chief added.
(They have companions at home who are already symptomatic... But they still came to the hospital for work. These are three employees. They came to work, and infected others.)
“'Yung mga doctors and nurses, nahahawa lang sila during situation na sobrang emergency, na hindi na talaga sila mabigyan ng time makapag-prepare. Maisuot nang tama.. at kailangan na nilang operahan o paanakin ang kanilang emergency."
(Some doctors and nurses were infected during emergency situations. They were not given time to prepare donning their PPEs because they need to attend to the situation immediately.)
COVID-19 infection among patients has also increased because many of those who want to be admitted in the hospital are lying, he said.
“May mga instances din na bago pumunta sa Fabella, may lagnat na pala, iinom ng paracetamol para pag-check ng temperature, normal. So malalaman na lang namin, nanganak na. So may instances na habang nagle-labor, inuubo. O kaya, habang nasa ward na after na manganak, nakikita namin nilagnat o inuubo. Mako-call yung attention ng mga nurse bakit inuubo, only to find out na COVID positive pala sila,” according to Ilem.
(There are other instances that before they go to the hospital, they have fever and they would drink paracetamol to normalize their temperature. We will only know it once they give birth. Sometimes they show symptoms when they are already in labor. Then we discover they have COVID-19.)
He also recalled that some of their patients did not declare their real health condition.
The hospital, according to him, is avoiding bed-sharing among patients since they have a dedicated COVID-19 isolation center.
This is also aside from the tent that can handle 48 patients at a time.
MANDATORY ANTIGEN TESTING
Ilem assured his personnel that the isolation room adjacent to the OR-DR has plastic covers. The personnel and patients inside, he added, are all properly covered and protected.
Starting Thursday, the maternity hospital plans to impose mandatory antigen testing on incoming patients to ensure the health and safety of their health personnel and the general public as well, he pointed out.
“'Yung antigen testing, para may result na in 15-20 minutes. Hopefully, maka-start kami tomorrow. This will be provided sa mga pasyente, lalo na yung mga symptomatic,” the hospital chief noted.
(The antigen testing can give results within 15-20 minutes. We hope to start this tomorrow. This will also be provided to patients, especially those with symptoms.)
“Ang assurance sa kanila (health personnel) na ang hina-handle nila na pasyente ay COVID negative,” he added.
(Our assurance to the health personnel is they will handle patients who are COVID-19 negative.)
Fabella has a 3-month supply of PPE and has already ordered additional N95 face masks. These do not include, however, supplies for the overall PPE of the units not directly handling COVID-19 patients.
“Mayroon kasing personnel na hindi man angkop dun sa area nila na mag-overall, gusto nila naka-overall sila. Hindi na namin sakop yun," he said.
(There are personnel who wanted to wear overall PPE even if the situation does not warrant it. We cannot cover them anymore.)
"If they want to over-dress, nasa office sila at they want to don, magsuot sila ng overall, sila na gagastos noon, dahil they want themselves to be protected. Pero hindi naman angkop na gusto mong mag-overall sa isang area na hindi naman COVID area,” he explained.
(They have to shoulder the price of PPEs if they insist on wearing it inside their offices. It is not proper for you to wear overall PPE in an area without COVID-19 patients.)
To avoid the continuous spread of COVID-19 in the hospital, Ilem appealed to the public not to withhold their real health status as he assured them they would still be admitted to the hospital even if they are positive for the virus.
Health Undersecretary Maria Rosario Vergeire made the same appeal during an interview on TeleRadyo.
“Pakiusap po natin sa ating mga kababayan, kung talaga pong kayo ay nagkakaroon ng sintomas, o di kaya ay alam n'yo na na-expose po kayo sa isang tao na may sakit, sabihin po natin sa ating mga health care workers pagdating natin sa hospital, para naman po ma-prevent na magkaroon din ng sakit ang ating mga health care workers,” said Vergeire.
(I am appealing to my fellow Filipinos, if you have symptoms, or were exposed to someone with the virus, tell it to health care workers when we go to hospitals so our health care workers can also be protected.)
The Philippines is facing one of the worst COVID-19 outbreaks in Asia, with infections reaching to over 962,000. So far, more than 16,000 people died from the disease.
A sharp rise in COVID-19 infections is straining the health-care system in Metro Manila, an urban sprawl of 16 cities and a municipality that is home to at least 13 million people.
- With a report from Reuters