A couple of days into 2022, nurse Micah Collong saw how relatively loose restrictions during the Christmas holiday paved the way to a surge that had hospitals returning to pandemic mode. It was time to suit up and get to work.
What made the January surge different was that the hyper-contagious omicron variant easily infected hospital staff and forced others to isolating, leaving them short on manpower. Collong, a nurse of 14 years, narrowly escaped catching COVID after her husband got sick earlier in the month.
“All hospitals experienced this. So many tested positive and a significant number also fell in the high risk exposure category due to family members they live with (one bubble) or they celebrated the holidays turned out to be positive," she told reportr.
In December 2021, the Philippine Heart Center where Collong works had just 16 COVID patients. Morale was high and staff assigned to COVID units were able to take days off. Armed with vaccinations and mastery of health protocols, “a lot of us were hoping that this could be it, we might get a less than 10 COVID census,” she said.
Then the Christmas surge came in January. Long queues of patients needed triage at emergency rooms and a lack of rooms led to beds filling up hallways. The days-long wait for an available room transformed the ER into a critical care area.
When the frontliners get COVID
Healthcare teams took a hit and even allied services — those in housekeeping, engineering, and dietary staff powering the hospital — tested positive.
Just like all COVID-positive Filipinos, healthcare workers must immediately isolate. Reporting to the hospital is prohibited until the mandatory quarantine period is complete and they are given a “fit to work” order. Those with moderate to severe symptoms are admitted and managed accordingly by their colleagues if there’s a surge among staff. Nurses recovering at home means fewer people working at the hospital.
In such instances, a COVID surge protocol specific to each institution is activated to address the lack of manpower.
“Our hospital, for example, may limit elective patient admission, elective surgical procedures. Anything elective may be deferred. The [outpatient department] and doctor’s clinics are closed. Resources are used for extreme emergency cases only. Since admission is low, some units are closed or are merged with other units if they cater to similar patients,” she said.
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It's a call of duty
Collong heads a non-COVID pediatric nursing unit. At most, the hospital runs 1 to 2 COVID units, with four units running at the height of surges.
Despite speedy response from hospital management and adaptable nurses, staffing remains the biggest problem: “Patient ratio is difficult to maintain. To begin with, this ratio has always been a big issue in the Philippine healthcare setting. Add to that this pandemic and it can result in detrimental staffing scenarios,” Collong said.
“If this was the start of the pandemic, I would also be saying maintaining a high morale would be the most challenging thing. But 2022 being year three of this pandemic, I can say that we are able to manage our reactions to these surges in a more mature and accepting manner,” Collong said. Many COVID-positive staff this month were reinfections and came back to work after recovery, she added.
“Three of my staff even said they can’t wait to get back to work as quarantining, especially if asymptomatic, can be maddening. Can I say some are nasanay na? This is, of course, from our standpoint, a non-COVID unit. We do handle the occasional COVID pediatric patient but not to the same extent and degree of exposure as those organic staff in COVID units,” she said.
“For some, it’s just another workday. Others are still really affected by it,” Collong said. Two of her staff tested positive for the first time: “They expressed frustration because all this time they have been very careful following the infection control protocols at work and at home. Some experience guilt at the possibility of bringing home the virus to their families,” she added.
Supporting healthcare workers
The most anyone can do to ease the burden on frontliners is to “practice caution in everything we do,” Collong said. This means isolating when you’re sick, wearing masks at all times, and getting vaccinated for yourself, your loved ones, and for healthcare workers.
“It helps protect you and the people around you. If you are not vaccinated, do not lie about being vaccinated—that is stupidity and negligence of the highest order,” she said.
Local government units and pharmacies are offering vaccines and booster shots for those who are eligible.
“If you are symptomatic or tested positive, isolate. Complete your quarantine period. Be smart about it. These are opportunities to stop the spread of this virus. Soon we will be vaccinating 5 to 11-year-old kids. Seize that opportunity to protect your kids,” she said.
If you’ve got frontliner friends or family or you’re at your hospital for a checkup, “express your concern—ask your friendly local HCW how they are doing. Send a get well soon card or simple care package for a quarantining nurse, doctor, medtech, or other essential workers. It's not cheesy and I swear it will be appreciated,” Collong added.
In a March 2021 interview with reportr, Collong said she was counting the days for the pandemic to be over, adding that she had “learned not to hope too much.” Some experts say the less severe disease from Omicron and the breadth of its spread could mean that COVID-19 could soon be an endemic disease.
“I am not in any way saying chill na tayong lahat—sanay na ang healthcare workers. In the first place, this is not the way it should be,” Collong said.
“Twenty twenty-two welcomed us with a massive bang, reminding everyone that it is still not over. I was going to say we are 'more ready' as a community but I change my mind. A ready society, for me, is one with a good vaccination compliance rate and I personally think we are not there yet. So, instead of “more ready” we are just “more accepting” of this reality,” she said.