[Right-Up] As I see it (Reflections of a Covid19 front-line worker) -by MAJ, nurse and FDC advocate

As I see it
(Reflections of a Covid19 front-line worker)
MAJ, nurse and FDC advocate

April 3, 2020

Lockdown, physical distancing.

In the second half of March, the government declared a lockdown for the whole of Luzon to supposedly prevent the spread of the COVID-19 virus. This has been extended to the whole month of April.

The government was not prepared to handle the multi-faceted challenges of a lockdown, including the necessary program of taking care of its own front-liners. As health workers, we were not provided PPEs, N95 masks, and other basic materials. For one whole shift, we were only provided 1 surgical mask per staff. Hospitals were selective in providing PPEs and N95 masks. The DOH guidelines in the screening of COVID-19 patients, PUIs, and PUMs are not automatically or uniformly implemented in various hospitals across the country. In the hospital where I’m assigned, the protocols in Infection Control are either not in place or not fully observed.

The COVID-19 virus is an invisible enemy and dangerous to all. The health workers are highly vulnerable given the nature of their work, that is, to minister to the afflicted. Thus, the general rule to maintain physical distance in order to be protected from the virus, which is transmitted via droplet transmission from human to human, is hardly observed in the kind of work we do. Worse, there are studies that the virus can be airborne for several hours. This explains the high rate of fatalities among attending physicians, nurses, and hospital personnel.

The government thought that a lockdown will freeze the mobility of people. There will be fewer vehicles on the roads. Well, the government forgot that that Metro Manila has numerous street dwellers, homeless and vagrants. It also forgot that we, the health workers, need transport to go to the hospitals. In my case, walking home from duty takes one hour. For others, especially the orderlies, longer.

The physical distancing rule was applied by the LGUs for customers entering grocery stores and talipapa’s. Lines to the supermarket can be very long and can extend up to 3 km at our place. And yet, once you are inside the store or talipapa, no distancing happens because you even bump into each other.

Also, I have noticed while walking from the hospital to our house, the people in the communities in barangay San Roque and other nearby barangays have not been wearing any protective masks.

Budget

Right at the beginning, in early March, they say there is a budget for hospitals and personnel to combat the COVID-19 virus. But during the first two weeks of the lockdown, hospitals relied on donations. And not all hospital personnel were given PPEs and N95 masks.

It was only at the beginning of April that the government announced the procurement of PPEs. Why the huge time gap?

Testing kits

Testing kits were severely limited in the first three weeks of the lockdown. And yet the thick-skinned and privileged politicians and their families were the first to be tested and the first also to get the results. On the other hand, ordinary patients who were tested have to wait for a week or longer. There were instances when the patients had already died when the results came out.

PUIs should also be tested. Much better if there will be mass testing. Of course, how can we identify the existence of COVID-19 patients if there will be no mass testing? Not too many patients, especially the poor, will go to the hospitals given the lockdown and the difficulty in the transport system. The allegation that COVID-19 is a “middle-class” disease is not true. Most of the affected poor do not bother to go to the hospitals even if Philhealth announced that they will shoulder the expenses for COVID-19 victims. The poor were also frightened by widespread reports on how hospitals, particularly private hospitals, have been charging patients at atrocious rates. Look at the billing for rich survivors in the Asian Hospital, reaching around two million pesos or more.

Fear, anxiety

The work of health workers is full of anxiety. How to take care of PUIs and PUMs? How to deal with patients who refuse to disclose all the necessary information on their health situation?

We had one patient who had difficulty breathing. The doctor ordered intubation. This is a procedure wherein an endotracheal tube is inserted to assist the patient to breathe. This can be bloody and messy as the patient may have lots of phlegm. After the intubation process, the patient was transferred to the ICU. A day after, news circulated that that patient was a PUI and had a history of traveling in the US in the first week of March. However, this information was not given by the patient during the interview-admission process even if he had symptoms like cough and fever. This patient died.

However, the said patient, who hid the history of his condition, placed at risk quite a number of people – doctors, nurses, nursing aides, and co-patients in the room. I also did not understand that since the deceased patient tested positive, why did the hospital did not test the other patients who were roommates of the deceased COVID-19 patient.

To attend to my work, I have to keep myself strong. The DOH’s guideline states that contact with a PUI should make one a PUI too. Since I am prone to cough, colds and even pneumonia, I have taken steps to boost my immune system – taking vitamins, drinking hot water, ginger tea, and onion soup. I also self-medicated with antibiotics for my cough.

In the last week of March, I had “the swab”. The result was supposed to come out in 3 days. But we were told that it would take a week. It was a long wait. While waiting, I prayed very hard. I thought of my son. We are only 2 at the house at the moment. My two brothers are staying with my mother in Bulacan. I thought about what would happen if the result is positive. It was depressing. At the hospital, the Nursing Service told us to resume duty. But our medical certificate said that we are on quarantine until the swab results are in. In short, we still have to assert what is good for us and for the patients. We did not report for duty.

Luckily, the results are negative for me. But not everyone in the health service work is lucky. Almost every day, there is news that doctors and/or nurses died because of COVID-19. Such a waste. Yes, they are heroes and heroines. But how can we win the war against COVID-19 if there are not so many of them? Doctors/nurses cannot be replaced in an instant.

Discrimination

Our neighbor asked if there are COVID-19 cases at the hospital. I said yes. Upon hearing that, our neighbor immediately went inside her house.

Even at the hospital, there is also discrimination. One colleague would like to spend the night at the Nurse’s Home because she missed the shuttle going to their place. The Nurse’s Home manager nearly did not allow my colleague to stay the night because she was involved in the handling of a PUI patient the day before. The reality is that some supervisors do not make rounds in all the wards which may have PUIs.

Benefits of health workers

Duterte announced the additional benefits for health workers:

  • Additional hazard pay – P500/duty day
  • Special risk allowance which may amount to (a one time ) more or less P5,000 depending on the number of days you have reported for work
  • P100,000 for COVID-19 positive with moderate to severe symptoms
  • P1 M for those who died due to COVID-19

I think life has more worth than what these benefits suggest. Life is precious. Is that how they perceive life?

The DOH has been looking for volunteers and has offered P500/day as compensation. Many have negatively reacted to this offer from DOH.

What can DOH, DILG, and other agencies do?

The DOH needs to be more decisive and forthright.

It should be able to tell the country about the true state of health care and the weaknesses of the entire system. And it cannot lead the fight against the COVID-19 virus if it cannot attend fully to the welfare and protection needs of its front liners.

As it is, DOH’s figures under-estimate the gravity of the COVID-19 situation because testings are limited despite the so-called arrival of kits and assistance from China. The DOH should also monitor fully the hospitals’ compliance with protocols. And yes, the DOH should welcome the help and participation of LGUs and CSOs.

The DOH and other government agencies should avoid turning the pandemic into a political issue. Why should some officials like those in the PACC and NBI even bother to criticize the efforts of Leni Robredo, Mayor Vico Sotto, and others to join the national effort to ease the plight of those affected by the lockdown? There’s no space for competition at this time.

Why should the initiative of Mayor Teodoro of Marikina to have the testing center be subjected to unnecessary bureaucratic processes? We all need to help one another.

Hope

There is not a single day that I hope and pray for the pandemic to end. The pandemics, like others before, will eventually pass. But we want fewer victims, fewer fatalities, fewer hardships for those locked out, and less pain for all. We hope the cures or vaccines can be developed soonest.

But here at home, we can lessen the suffering if we work together and if we attend to one another. Mass testing for all, especially health workers, should be conducted. And social protection for the least capable should be guaranteed. All the poor and near-poor in a given community should be assisted. No need to maintain an exclusionary “lista” of those registered with a given barangay. All, including street dwellers and migrant families, should be treated equally.

“Let whoever is in charge keep this simple question in her head ( not, how can I always do this right thing myself, but) how can I provide for this right thing to be always done.” – Florence Nightingale, founder of modern nursing

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