EDITORIAL - Stepping down

The tragic stories keep piling up. There’s the unemployed hotel worker whose wife succumbed to COVID last month after waiting two days for hospital admission. As her condition deteriorated, her husband put her in a taxi and rushed her to a hospital, where she was declared dead.

Then there’s the 61-year-old pastor who died while hooked up to an oxygen tank, waiting outside the emergency ward for admission. The pastor, with no comorbidities and who suffered only mild symptoms for 10 days before he collapsed, had to be driven to eight hospitals before finding one that would accept him.

The Department of Health has reminded hospitals about the protocols for triaging, so that the worst cases get priority in the emergency rooms and ICU, but there are simply too many cases. As fresh infections refuse to go down despite the two-week return to enhanced community quarantine, the DOH is intensifying its “step-down” effort – to transfer mild and asymptomatic patients from hospitals to isolation and quarantine facilities.

Meanwhile, the One Hospital Command set up by the DOH is also swamped. There are numerous reports of people who can’t get the hospital referrals that they need, and can’t even access the command’s hotlines. This is not surprising since the referrals are dependent on hospitals’ critical care capacity.

The stepping down, which the DOH says has been in place since last year, must be complemented by the provision of viable and safe alternatives to those who would be moved out of hospitals or referred to quarantine and isolation facilities.

The story of a patient who died in a hotel converted into an isolation center in Batangas does not inspire confidence. GMA 7 reported that the man was isolated with his wife and four children, all of them infected. He complained of an acute sore throat and breathing problems on the night of March 11. His widow said the facility provided them with sufficient food and other amenities. But the deficiencies were the most critical for COVID management: no oxygen tanks, few nurses and no doctor. For his throat, the man was given herbal anti-cough lagundi. He was put in an ambulance the next morning, but it took two hours before they could find a hospital that would admit him. By that time, his heart had already given way.

Treatment czar and One Hospital Command head Leopoldo Vega said hotels and other accommodations converted into isolation facilities must provide the minimum health personnel contingent of five nurses and one doctor. The tragedy at the Batangas center – which looks fine as a hotel but does not meet the requirements for isolation service – will derail the hospital step-down effort.