Inappropriate Tests, Failing Strategies: Why The Gov’t Is Losing The Battle Against COVID-19, According To Healthcare Workers
“Pagod na pagod na po kami,” Dr. Maricar Limpin, vice president of the Philippine College of Physicians, said as the medical community asked the government to revert Mega Manila to enhanced community quarantine amid the COVID-19 pandemic.
Healthcare workers led by doctors and nurses on Saturday, Aug. 1, wrote a letter to President Duterte and pleaded in a virtual press conference for the government to revert Mega Manila to enhanced community quarantine or ECQ and to come up with a more comprehensive plan to deal with the coronavirus disease 2019 pandemic.
This was a day after Duterte announced on Friday, July 31, that Metro Manila and several other areas would remain under general community quarantine or GCQ.
In the letter that was supported by 100 medical groups as of Sunday, Aug. 2 – a jump from the 40 last Saturday – the healthcare workers enumerated the reasons why they united to sound off a distress call to the nation.
Healthcare system has been overwhelmed
• On July 30, the Department of Health reported 3,954 new COVID-19 cases. As of Sunday, the DOH had recorded a total of 103,185 cases.
• Having witnessed the consistent rise in the number of infections, the medical frontliners want to act now and act fast.
• On July 31, the city government of Manila announced the temporary closure of two of its largest state-run hospitals – the Ospital ng Maynila and Dr. Fabella Memorial Hospital – citing the increasing number of their hospital workers testing positive for COVID and their need to decongest due to the overwhelming number of patients being admitted.
• Healthcare workers are falling ill as they take care of patients, responding to the call of duty while battling the fear and anxiety engendered by COVID-19.
• Healthcare workers are burned out, with the seemingly endless number of patients trooping to hospitals for emergency care and admission.
“We are waging a losing battle against COVID-19, and we need to draw up a consolidated, definitive plan of action. Hence, we, as your healthcare frontliners call on our national government to return” Metro Manila to ECQ from Aug. I to 15, the medical groups wrote in their letter.
The groups proposed that the two-week ECQ be used as a “timeout” to refine pandemic control strategies, addressing the following urgent problems:
• Hospital workforce deficiency: Since hospitals in Metro Manila are being overwhelmed by COVID-19 cases, the workforce is again effectively reduced because of the need for intermittent quarantine of personnel, and isolation of many who have fallen ill. To compound this problem, many health workers have resigned because of fear of infection, fatigue, and working conditions. Health facilities have had to close because of these problems.
• Failure of case finding and isolation: Real-time reverse transcription polymerase chain reaction or RT -PCR tests are now being denied to patients with symptoms. Local government units or LGUS that conduct testing continue to insist on the use of rapid antibody tests to identify possible COVID cases, sending home patients with symptoms who test negative. This may be responsible for the recent surge in cases, the medical groups point out, because antibody tests miss more than half of people with active, contagious illness. In addition, persons with infections confirmed by RT-PCR were turned away from isolation centers and forced to isolate at home even where this was hardly feasible.
• Failure of contact tracing and quarantine: The groups say contact tracing is failing miserably. There is guidance on contact tracing from the DOH and the Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases guidance, but LGU compliance is optional. The guidelines must be cascaded to community leaders, health officers and local authorities and strictly enforced. A whole-of-society approach must be implemented, integrating the use of non-uniformed personnel and volunteers.
• Transportation safety: This problem cannot be addressed by long-term infrastructure plans. Prompt and rapid solutions with long-term impact are needed, such as the immediate implementation of service contracting, pop-up bicycle lanes and pedestrian lanes. Workers need more public transportation to prevent congestion in the streets. These are needed now, not next year, because people need to get to work but have no safe transport options.
• Workplace safety: Workplace safety is assured only in a few, mostly high-income settings, but there is a clear failure in most settings, especially among the poor. Employees and laborers are required by LGUs and their companies to have rapid antibody tests, despite what the medical groups say is international agreement among health experts that these antibody tests are not for work clearance, and just lead to missed cases and local outbreaks. To make matters worse, employees and laborers, already impoverished by the lockdowns, are asked to shoulder the costs.
• Public compliance with self-protection: The progressive easing of quarantine restrictions has inadvertently fueled public misperception that the pandemic situation is improving. It is not. The progressive decline in compliance will push the country to the brink, to become the next New York, where COVID-19 patients die at home or in stretchers, unable to find vacancies in hospitals. The first line of defense is the public, so people need to be reminded about the need to use masks and face shields, wash hands and practice social or physical distancing – now more than ever.
• Social amelioration: The medical groups asked the Department of Social Welfare and Development, Department of Agriculture, Department of Labor and Employment, Department of the Interior and Local Government, LGUs and other relevant government agencies to provide the necessary support for those whose livelihoods will be affected by the proposed timeout for the health sector.
The healthcare workers also appealed for a reconsideration of the approval by the Department of Trade and Industry of the Aug. 1 reopening of businesses such as gyms, fitness centers, tutorial services, review centers, internet cafes, pet grooming services and drive-in cinemas.
“We understand that imposing an enhanced community quarantine is a complex decision. Though health may be just one dimension, 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. These solutions can have far-reaching effects once implemented,” the letter read.
“The health sector cannot hold the line for much longer. Our health care workers should not bear the burden of deciding who lives and who dies. If the health system collapses, it is ultimately our poor who are most compromised. In the end, winning the war against COVID-19 relies heavily on being able to keep the health system capacitated to address the needs of all Filipinos. We hope that our government heeds this plea,” it added.