Why is COVID-19 killing Filipino healthcare professionals?

 

He was pursuing a career in cardiology. He chose to serve for two years as a doctor in the barrio in Occidental Mindoro before pursuing this professional route, and right away one would have recognized that this cardiology fellow's heart was in the right place. His social media images met all of the standards. The news of Dr. Israel Bactol's passing rippled across the Filipino medical community on March 21 as everyone struggled to make sense of what had happened so suddenly and unexpectedly. He was 34.


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It was challenging to keep count of how many doctors were admitted to the hospitals where they worked and attached to the mechanical ventilators they controlled in the days that followed. During ward rounds, their names were hesitantly murmured, primarily out of respect. Prayer requests and offerings inundated our messaging apps. They were just numbers to the majority of news readers. They served as our medical school instructors, role models during our residency and fellowship training, junior hospital staff members, and dear friends and family to us. Since I've been a doctor for more than ten years and deal with life and death on a regular basis, the possibility that I might pass away while working in my sector never occurred to me.

There must be a solution to the country's health care personnel becoming infected with COVID-19. 2,067 Filipino healthcare professionals have been diagnosed with COVID-19 as of this writing (May 11), which has resulted in 35 fatalities. That amounts to nearly one in five patients or 19 percent of confirmed cases. For instance, Thailand reported 103 infections among medical personnel among 3015 patients (3.4%) over the same time frame. In late April, the Ministry of Health in Singapore reported 66 medical personnel among 13,624 patients (0.5%). The infection rate in the Philippines, which is among the highest in the world and is getting close to that of Wuhan at the beginning of the pandemic, has already drawn the attention of the World Health Organization. The figures do not take into account Filipino healthcare personnel who have passed away abroad from COVID-19.

In order to properly diagnose and manage COVID-19 individuals, the medical community is crucial. In addition to doctors and nurses, it also includes nursing assistants, midwives, medical technologists, radiation technologists, respiratory therapists, dentists, laboratory personnel, office employees, barangay health workers, and even the cleaners who make sure that COVID wards are thoroughly sanitized. Any nation's ability to combat the current pandemic will be hampered by a lack of medical personnel.

Furthermore, we now know that infected healthcare professionals have the ability to greatly contribute to the virus's spread thanks to the severe acute respiratory syndrome (SARS) outbreak in 2002. An outbreak in the community that is harder to control and that affects a greater proportion of the susceptible population results from unchecked disease transmission within healthcare facilities.

Why has COVID-19 infected so many Filipino healthcare professionals? Although official figures from the Department of Health indicate a decline in new infections among Filipino healthcare professionals over the past two weeks, it is still unknown how many of them contracted COVID-19 at work.

Some contend that the higher figures are a result of the nation's preferential testing of health professionals. Despite its plausibility, this argument dangerously diverts attention away from the real causes of the issue, which are a lack of personal protective equipment (PPE) and a disregard for workplace infection control procedures. Studies on health workers infected with SARS in Hong Kong and Singapore and COVID-19 in Wuhan have repeatedly demonstrated this.

Strict regulations requiring the use of PPE during patient interactions were not yet in place in the majority of emergency rooms and clinics at the outset of the COVID-19 issue in the nation, when people were still learning more about how the virus acts. In spite of the fact that we now know that contagious individuals can be perfectly asymptomatic, we used to check the general population for fever and cough in hospitals, airports, and shopping centers. Early case identification and isolation were further hampered by the Philippines' inadequate testing capacity and careless contact tracing. Early occupational exposure among our health workers would have been the result of any combination of these circumstances.

The practice of holistic medicine forces one to pause and consider "Why would a patient lie?" If it's fear of being denied hospital admission or the social stigma associated with the acronyms PUI and PUM, could you really blame the patient? Many have blamed patients for not disclosing accurate medical and travel histories, but the holistic practice of medicine compels one to pause and ask.


Although the administration continues to claim that there is "no lack of PPE," the repeated cries from administrators, physicians, and nurses on social media reveal otherwise. We have never received more than a two-week supply of N95 masks in the six weeks that I have been in charge of allocating PPE for the Philippine General Hospital's medical staff. We had to come up with backup strategies, which included cleaning and reusing N95 masks. PPE quality varies greatly, whether it comes from commercial merchants or charitable givers. The Centers for Disease Control and Prevention keeps track of respirators that are fake or do not adhere to certification standards, endangering medical professionals who use them. PPEs' global supply chain has become unreliable as a result of some local distributors' outrageously high price demands.

The provision of proper PPE is only one component in ensuring the safety of health workers. PPE regulations must be strictly followed, especially during high-risk procedures. Health professionals need to receive ongoing training in the proper wearing and doffing of PPE. Given that health professionals frequently put in long hours under demanding circumstances, the latter is especially laborious and presents a high risk of contamination. When a qualified observer is there to monitor the procedure at all times, the stress on the health professional is reduced and the risk is reduced..

Even during breaks or at the end of the day, when personnel typically congregates to eat or indulge in natural Filipino banter, social distance must be maintained. Health professionals who exhibit symptoms must be tested and treated right away in the hospital, according to a set procedure. Psychosocial support must be easily accessible, and staff members must receive any necessary help with accommodation and transportation in order to avoid burnout and tiredness..

Long-term effects on the Philippine health care system will result from neglecting to care for our medical personnel during the COVID-19 outbreak. It will simply make the workforce shortages caused by spatial inequity, health worker migration, and underemployment worse. It may become impossible to provide basic healthcare services at all levels, which is especially important as the nation works to recover from the socioeconomic effects of the pandemic.

We cannot lose sight of the fact that healthcare professionals have families and friends of their own during this time of global health crisis. When everyone else has been told to stay at home, they are those who have been reminded of their sworn obligation to serve. Construction of entire hospitals can be completed in a matter of weeks, yet it takes years of dedication and sacrifice to train a health professional. Applause won't ever be enough if we actually think that healthcare professionals are heroes. Act now rather than merely watching them perish on the front lines.




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