With the spike of COVID-19 admissions in the hospitals over the past weeks along with the increasing infections among healthcare workers (HCWs), there is an urgent need to protect those who are working to care for patients. The Stop Covid Deaths webinar series of the University of the Philippines and Philippine Health Insurance Corporation held the first virtual national town hall meeting for hospitals entitled “Keeping Our Health Care Workers Safe: The PGH Experience” on August 21, 2020. In this virtual event, officials of three COVID referral hospitals shared the infection control protocols developed by their respective teams to keep their HCWs safe.
Given that there is no playbook on how to respond to this pandemic, Philippine General Hospital (PGH) Director Gerardo Legaspi admitted that most of the lessons PGH learned were realized through painful experiences. He highlighted the formation of a crisis management team, setting up of a command and call center, and infrastructure changes as among the initial responses of PGH. To protect its doctors, nurses, and staff, accommodation and transport were arranged and provided for their comfort and protection; hospital zoning, donning and doffing areas with the presence of safety officers, fit testing of masks, and a unidirectional natural airflow system to ensure air exchange were likewise implemented.
In addition, PGH limited the wearing of Level 3 PPEs to only four hours; surfaces were disinfected using UV light and sodium hydrochloride; and dermatologic care, psychosocial care hotline, and spiritual care through telechaplaincy were also provided, the Information Education Committee has so far produced 700 infographics for advisories, reminders, and appeals to keep everyone informed inside and outside PGH.
For contact tracing, Dr. Legaspi noted that targeted testing is the proper way to go and that it should start when one is suspected or exposed, not when tested positive. He pointed out the need for solidarity, the use of science as a solution, and deliver that solution to every Filipino.
According to Lung Center of the Philippines (LCP) Executive Director Vincent Balanag, Jr., the LCP efforts to keep their health workers safe include installation of exhaust systems in all COVID rooms, equipping rooms with CCTV and remote vital signs monitors connected to a central monitor in the nurses’ station, staff communication through handheld radios, replacement of doors with plastic sheets to facilitate entry and exit, and one-way flow of traffic. For administrative measures, the LCP designated color-coded zones with strict implementation of proper use of PPE, designating safety officers in both clinical and non-clinical areas, periodic swabbing, and clinical monitoring.
Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium (DJNRMHS) Medical Chief Dr. Alfonso Famaran said that the safety measures of PGH and LCP are also being done in DJNRMHS. Apart from those mentioned, the following were instituted: CCTVs in donning and doffing areas and isolation rooms were installed in their hospital for ease of monitoring, implementation of a 7 day-COVID wards duty and 14 day-hospital quarantine, swabbing of all HCWs/staff/personnel and immediate family with symptoms using GENEXPERT PCR with results out within the day, and a mandatory pre- and post-duty medical evaluation prior to entry to all COVID wards.
Weekly disinfection of all areas using filters, UV light, and disinfectants is also being done in DJNRMHS. When an HCW in one area is infected, all are tested. If the majority tested positive, they get a replacement from the buffer group of HCWs. HCWs who tested positive are admitted while asymptomatic and negatively tested HCWs continue their 7-day duty in the COVID wards.
Anne Marie Alto
Featured in UP Manila Healthscape (Special COVID-19 Issue No. 15, 10 September 2020)
