'Alay' of PGH: Frontliners offer their lives in the battle vs. COVID-19

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Metro Manila (CNN Philippines, March 25) — They refer to themselves as "alay" or sacrifice.

They are emergency room nurses at the Philippine General Hospital (PGH) in Manila City who have been treating people suspected of having coronavirus disease.

One of them, Jill Bañares said that for one shift, two to three nurses are assigned at the persons under investigation (PUI) zone. When they are on duty, it is like they are already offering their lives, exposing themselves to the risk of contracting the viral disease.

“'Pag hindi ikaw ang 'alay,' natatakot ka para sa buhay ng mga isasalang. 'Pag ikaw naman ang 'alay' sa loob, natatakot ka para sa buhay mo dahil may pamilya kang nagmamahal at kailangan mong uwian once lahat ito matapos at siyempre may mga pangarap ka sa buhay,” she wrote on her Facebook page.

[Translation: When you are not the chosen one to go in, you are worried about your colleagues. When you are sent in, you are worried about your life because you also worry about your family. And, of course, you still have your dreams.]

In an interview with CNN Philippines on Wednesday, Bañares said that during their shift, no one leaves the PUI zone for 8 hours. If they go out, they would have to remove their personal protective equipment or PPE, then change to a new set before going in.

She said this is not only to ensure they won’t get contaminated, but also because since supply is limited, they try to only use one set of PPE per shift.

“Yung pag-CR po, pag-kain, pag-ihi — 'yung mga ganoon po — hindi po namin nagagawa dahil ayun po takot din po kami tanggalin yung PPEs namin since nandun kami within the zone. And, ayun po, dahil nagtitipid, hindi po namin alam kung meron pa po kasi hindi namin alam kung gaano katagal itong krisis na to sa Pilipinas,” she said.

[Translation: We have to forego going to the restroom or eating during our shift because we are scared to take off our PPEs since we are in the PUI zone. We are also trying to maximize its use because of the limited supply, because we don't know how long this crisis will last.

The 24-year old Bañares said this is all new to her, despite being a nurse for almost three years. She revealed she didn't even know how to properly put on her PPE, so she and fellow nurses watched “donning” and “doffing” tutorials on YouTube.

Wearing PPE is also not that easy. She said it’s hot and hard to breathe, due to the goggles and the full headgear — making sure no part of the body is exposed. While inside the zone, they only communicate through handheld radios.

With all the challenges, the young nurse received encouragement from one of the PUIs she was monitoring.

“Sabi nga po sa akin ng isa kong pasyente, “Kaya mo 'yan, iha.' Habang nagbibigay ako ng meds, nagluluha mata ko sa hapdi ng bawat pagpasok ng pawis sa mata ko,” Bañares said.

[Translation: One of my patients told me, “You can do it, “ while I was giving medication. I was teary-eyed because sweat was getting into my eyes.]

PGH as a referral center

As of Tuesday, there is one COVID-19-positive patient confined at the PGH and 21 PUIs, according to spokesman Dr. Jonas del Rosario.

PGH has been named by the Department of Health as one of three COVID-19 referral centers in Metro Manila.

These centers will take in patients from other hospitals with suspected and confirmed cases.

Bañares thinks PGH may not be ready for to operate as a referral center,

“Nakakafrustrate po kasi talaga yung system kasi kahit anong ayos po ng institusyon namin - ng sistema, ang realidad po ay kakaunti lang po ang aming resources. Ang facilities po namin ay hindi handa. Kokonti lang ang aming empleyado. Tapos ho ang PPEs po namin ay hindi rin ganoon ka dami. Tapos po pati rin po sa mga testing kits, may available po, pero limited din po yun,” she said.

[Translation: It’s frustrating because no matter how good the institution is – the system, the reality is we have limited resources. Our facilities are not ready. We only have a few employees. Even our PPE is scarce. We have available testing kits, but these are limited too.]

Del Rosario however told CNN Philippines preparations are being made and that PGH can start operating as a referral center by Friday or Saturday.

He said the health department is also expected to beef up the hospital’s medical equipment and other needed supplies with the expected increase in patients.

Up to 130 beds will be available for COVID-19 patients.

“That’s the reason kung bakit di pa kami nag-uumpisa. Kasi ayaw naman namin isabak ang aming mga tauhan hanggang hindi kami ready. Dahil responisibilidad din namin na poroteksyunan di lang iyong mga pasyente, kundi iyong mga doktor, nurses at iba pang healthcare workers na frontliners sa sakit na ito,” Del Rosario said.

[Translation: That’s the reason we haven’t started operating. We don’t want to deploy our staff until we are ready. We have a responsibility to protect not just the patients but the doctors, nurses and other healthcare workers who are the frontliners in the fight against this disease.

Frontliners’ fears

PGH Director Gerardo Legaspi, in a briefing Tuesday said almost a hundred of its personnel were considered as PUIs. The hospital has 4,500 employees, more than half are doctors.

Bañares explained since they were assigned at the PUI zone, they were required to go on duty for 7 days straight, then rest for 14 days also as a way to self-quarantine. But she said their mindset for now is that any one of them sooner or later may become a PUI, too.

Bañares said medical workers are not asking for any recognition or praise because they will continue to perform their tasks, no matter what.

All they want is this: “Mag-cooperate po kayo. Iwasan po ang lumabas dahil makakatulong po kayo ng sobra-sobra sa aming mga health care workers na hindi na po kayo dumagdag sa mga aalagaan pa po namin.”

[Translation: Please cooperate. Stay in your homes. This will be a big help for health workers, if you do not add to the number of patients that we have to care for.]