Lessons learned from ongoing COVID-19 response

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    Large-scale COVID-19 testing has started in Metro Manila. (Photo by Rhoy Cobilla)

    On 23 March 2020, the Department of Health (DOH) designated the Philippine General Hospital (PGH) as one of the three COVID-19 referral centers in Metro Manila. PGH quickly created the PGH COVID Crisis Team to oversee the hospital’s COVID-19 response. PGH is one of the major frontlines in the country’s battle against the novel coronavirus, with the university hospital’s health care workers (HCWs) dealing with an unprecedented crisis and working round-the-clock to treat patients with COVID-19.

    After several months battling the pandemic, the PGH COVID Crisis Team released an 11-page policy paper entitled “UP-PGH Shares Lessons Learned During Ongoing Efforts to Prevent COVID-19 Transmission.” The policy paper was written by Dr. Regina Berba, Dr. Eric Berberabe, Dr. Bill Veloso, Dr. Rodney Dofitas, Dr. Lilibeth Genuino and Dr. Gap Legaspi.

    The Crisis Team outlined 5 key lessons they learned over time, firstly, that COVID-19 operations must be based on science, implemented with calculated precision and evaluated objectively. Nothing can be left to chance.

    The team also reiterated that RT-PCR Tests are only point-in-time tests. The assurance the tests provide are brief and last only up to the point when a person was tested. A negative test result means that you are negative at the time you were tested. It does not guarantee you will be negative the next day, and the week after.

    COVID-19 is so efficiently contagious that the only true guarantee that any institution is safe is when our entire community works together to get infection rates as low as possible. Vigilance must continue. Precautions and all the difficult rules need to stay in place and be complied with.

    The policy paper also noted that Rapid Antibody Tests (RATs) cannot be used to screen for or to detect active infectious COVID-19. RATs done in PGH showed that the test had a sensitivity of only 20 percent to detect COVID-19.

    Routine Mass Testing of the 5000 HCWs of PGH every two weeks is not feasible. Instead we recommend low-threshold targeted testing.

    The team also reiterated the importance of contact tracing. It is also time-sensitive and thus every COVID suspect and confirmed case demands that contact tracing should be initiated at once. Contact tracing loses its impact if initiated one day, one week, one month after the case is identified. Quarantine must start upon identification of a high-risk exposure. If we wait for the COVID test results as many contact tracers usually do, it might already be too late and many more persons may have already been exposed.

    The most valuable resource in the COVID crisis are our healthcare workers. The people must listen to them. The COVID-19 pandemic has put an additional and very heavy burden on HCWs. To help ease this burden, PGH is supporting our HCWs by addressing factors that impact knowledge, access, economics, and fear.

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