Get the jab done

The Philippine General Hospital, the country’s main COVID referral center, has sent out an SOS: doctors, nurses, even medical graduates whose board exam has been postponed, you might want to work at the COVID wards of the PGH. Even for a month, or even a few days, while the Delta-driven surge continues.

The pay is “nothing” compared to earnings in private practice, the hours are long, and as for the workload… there was a waiting line of about 100 patients for COVID ward accommodation as of last Monday, with about 60 waiting in the emergency room.

But perhaps the medical graduates – as well as nursing graduates – would consider performing “charity work” in this unprecedented health crisis, according to PGH spokesperson Dr. Jonas del Rosario.

Since last year, Del Rosario told “The Chiefs” on OneNews, the PGH has lost about 150 nurses. This year, 20 of the 25 new doctors sent to the PGH by the Department of Health to augment the COVID staff have not renewed their residency contracts, Del Rosario told us. The PGH can only hope that the remaining five will not follow suit.

Many of the 20 wanted to pursue specializations, Del Rosario said. But I’m sure the two killer COVID surges this year – with the latest still raging and infecting many healthcare workers (HCWs) – contributed to their decision.

“We are in a war. We really need more soldiers,” Del Rosario said.

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Except for several top private hospitals, government hospitals used to give HCWs higher pay than the private facilities. But now, Del Rosario said, many private hospitals are dangling higher salaries and benefits to doctors, nurses and other HCWs especially for COVID wards.

He pointed out that Philippine hospitals must also contend with other countries that are now also competing aggressively to lure HCWs as all signs point to a protracted pandemic. Not even the top Philippine hospitals can match the pay packages offered by these countries.

The government is implementing a “step-down” policy, under which patients who are deemed to be recovering from COVID are transferred to non-COVID-dedicated wards or hospitals.

Seventy percent of the COVID patients at PGH, however, are severe to critical cases and cannot be transferred, Del Rosario told us. That kind of COVID care can take from two to five weeks so hospital bed turnover can be slow.

PGH has already augmented its COVID bed capacity by reducing the beds dedicated to non-COVID cases. And yet there’s still that long waiting line, compounded by the exodus of doctors and nurses. The hospital is now operating “beyond capacity,” Del Rosario said.

Another problem, Del Rosario noted, is that there aren’t many doctors with the specialization required for COVID critical care. This disease being a respiratory affliction, the most indispensable are the pulmonologists – like Dr. Maricar Limpin, president of the Philippine College of Physicians, whose colleagues at the Philippine Heart Center are also feeling overwhelmed in this Delta-driven surge.

Yes, that’s the same Doctor Limpin who was rudely scolded by presidential spokesman Harry Roque last week. With that kind of treatment from Malacañang, can you blame HCWs for opting to work overseas? The infection risks are the same, but they get much higher pay plus benefits. And in the UK – a top destination for our nurses – they are showered with words of appreciation by the prime minister and Prince Charles for their “truly wonderful contribution” in this pandemic.

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So if HCWs are unmoved by the desperate SOS from the PGH, what other options are there?

For the ever growing line of patients waiting for admission, not much, apart from praying, and rolling the dice with the Grim Reaper.

For the hospital, Jonas del Rosario has one message to the public: get vaccinated.

It will bring down the risk of infection, he said, consequently easing the burden on hospitals and their harried staff. Medicine is one profession where low demand is good news for the nation.

Sure, there are breakthrough infections for all COVID vaccine brands, with some deaths reported. But reports from around the world (and from the experience of the PGH) show that the infections in the Delta surge are overwhelmingly among the unvaccinated, and most of the breakthrough cases are either asymptomatic or mild.

The internet is now replete with stories of unvaccinated people ruing their failure to get jabbed, and leaving instructions on their deathbed for their loved ones to get their COVID shots.

Among the fatalities were couples who left behind young children, and persons whose vaccinated siblings have survived the pandemic.

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Vaccination is also the only hope for resuming face-to-face classes. Unfortunately, we still don’t have enough vaccines to complete the inoculation even of the adult priority groups. And with Delta, more vaccines will be needed as epidemiologists say herd immunity will require the inoculation of up to 90 percent of the population rather than just 70 percent.

Del Rosario has no objections to the pilot test of in-person classes in areas with low COVID cases. A pediatric cardiologist, Del Rosario says his kids don’t like online learning. But at this point, he isn’t recommending a pilot-test of in-person classes in Metro Manila and other areas experiencing the Delta-driven surge.

Blended learning, as we have seen in the past year, has its limits. Vaccination will make face-to-face classes relatively safe, although epidemiologists believe COVID will eventually become endemic, always lurking in the shadows, like dengue. By then, however, scientists may have already come up with stronger vaccines, better treatments and perhaps even a cure for COVID.

Restarting face-to-face classes will not only be good for students and educators alike but will also revive livelihoods that thrive on in-person school operations – food businesses, school supplies, jeepney and tricycle operators, makers of uniforms and other school apparel.

What can we do to speed up the resumption of in-person classes and at the same time help our overwhelmed health workers?

Don’t get sick. Observe COVID safety protocols.

And get vaccinated.