On 26 May 2020, the UP-PGH Department of Medicine Grand Rounds had PGH Director Gerardo Legaspi share how the hospital was transformed into a COVID-19 Referral Center and his strategy to win this war against COVID.

The enemy has shown its ugly crown and war was inevitable. With private hospitals choked by an unmanageable number of severe COVID cases, the public sector had to send its warships. The PGH warrior emerged. He felt like a soldier against an unseen enemy and started his talk by quoting from a Rudyard Kipling poem: 

“If you can fill the unforgiving minute
With sixty seconds’ worth of distance run…”

19 March: Marching Orders
The Director received a letter from Secretary of Health Dr. Duque requesting PGH to be one of three COVID-19 referral centers, to which UP President Danilo Concepcion concurred. 

Like Churchill, our Director wrote a heartfelt letter to the “People Giving Hope (PGH)”. It was a call for solidarity and reminisced the role of PGH during WWII. Despite many obstacles, including hurtful attacks on himself, he decided that becoming a COVID-19 Referral Center was the right thing to do.

Preparing the Battlefield
After scoping out the air, land, and beaches of war, his team of “Crisis Men” led by Dr. Bok Ocampo pledged logistical support to the Hospital Infection Control Unit and the clinical team of the Department of Medicine; the latter headed by the formidable Infectious Disease specialist, Dr. Nina Berba. The Manpower Committee was headed by Dr. Rodney Dofitas, who worked tirelessly to provide the needs of its healthworkers (HCWs). Dr. Dennis Serrano took charge of the massive donations that started to pour in. Significant support came from UP architects and structural engineers; and the 48 electrical beds from St. Luke’s QC were a big help. The Bayanihan Na! Operations Center established by UP Manila Chancellor Padilla provided synchrony to this massive machinery.

29 March: Off to War
During the First Staff Orientation, Gap likened the HCWs to soldiers being sent off to war. He saw their fearful eyes but felt their hearts full of courage. That was a momentous occasion in our lives, he reminded them. Showing a photo of himself during the EDSA revolution and saying that that was his moment, he exhorted the trainees, “This is your moment now!”

Rebooting PGH
To win the war, PGH needed innovative solutions to defeat the enemy. Safety Officers checked the integrity of the personal protective equipment of frontliners. Donning and doffing areas were upgraded and manned by residents from Dermatology and other departments. To understand the enemy’s movements and position our weapons, Electronic Medical Records and Dashboard were adapted by Dr. Homer Co. TeleKumusta by UP Engineers and communications team leader Dr. Eric Berberabe helped patients communicate with staff and their families, a good move towards mental health.

A new Molecular Laboratory was established, led by Dr. Bill Veloso, to increase testing capabilities. Research continued with PGH serving as a major host for local and international COVID-19 researches. Teaching was expanded to other UP constituents such as Diliman UP Health Service. Numerous teleconferences were led by our consultants. Service support was extended to seafarers and Sta. Ana Hospital. 

Stabilize the Fort
Gap quoted Charles A de Callone, “The difficult we do immediately, the impossible will take a little longer”. Future Plans for PGH include a gradual de-escalation by building a COVID Isolation Ward. There will be gradual resumption of non-COVID services led by a Transition Team and the Department of Medicine. Service Delivery Networks will be strengthened by PGH primary care centers to be led by the Dept. of Family Medicine. This will help preserve the mission of the current PGH as the country’s premier tertiary hospital. 

Lessons Learned
One of Director Gap’s first lessons was that of humility. Realizing that he was not the only GAP or “God’s Answer to Prayers”, he needed a reliable team, his “lost command” of excellent colleagues. As somebody who tested positive to COVID himself, he learned to fight fear with science and heal thru faith in other physicians. He now has hope. The unforgiving minute has been outrun by COURAGE. 

“Yours is the Earth and everything that’s in it, 
And—which is more— you’ll be a Man, my son!”
-Kipling

The surgeon has become a warrior and a MAN. Thank you Director Gap.

Shelley de la Vega, MD, MSc(Clin Epi)  |  Published in Healthscape Special COVID-19 Issue No. 7