A Call to Nationalize Select Private Hospitals in Metro Manila as COVID-19 Centers
I’m putting these ideas across, hopefully to generate movement in both public and private sectors. This was triggered by a report that Spain also had to nationalize private hospitals in the light of their COVID- 19 crisis.
The move to designate U.P. Philippine General Hospital (UP-PGH), Lung Center of the Philippines (LCP), and the Dr. Jose N. Rodriguez Memorial Hospital (DJNRMH) as COVID-19 Centers is misdirected and may only excacerbate this crisis.
The ICU of UP-PGH is under renovation, DJNRMH is underdeveloped, and LCP is reluctant to expose its existing patients with lung cancer and TB to COVID-19 patients. In short, all three hospitals are neither ideal nor ready to become COVID-19 Centers. It will be difficult to segregate COVID-19 patients from the thousands of non-COVID-19 patients in UP-PGH who require just as important medical care, being the most highly sub-specialized government hospital in the country.
Which hospitals in Manila will be able to take over this volume? From what we have experienced so far, it is very difficult for one hospital to serve both COVID-19 and Non-COVID-19 patients. Aside from the risk of cross-contamination, the care of COVID-19 patients takes a huge toll on health manpower and resources (quarantine,PPE, respirators, etc.)
At present, the most number of COVID-19 patients admitted for care are in private hospitals, overwhelming their capacity, and forcing them to shut down many non—COVID-19 services. These private hospitals have the best ICU, ER, and infectious disease facilities and staff in the country. They also have a lot of vacant beds and spaces now as they have been forced to shut down non-COVID-19 services.
They are therefore in the best position to become COVID-19 centers. These hospitals are already seeing large volumes of PUM, PUI and Confirmed cases, and it will be difficult to transfer these patients out to any other facility. Certainly, wealthier patients may not want to transfer to government facilities. The financial losses to these private hospitals and their patients will be substantial. Their consultants are not salaried and are also therefore vulnerable to the economic consequences of this catastrophe.
Given this dire scenario, the only viable strategy is for the Philippine government to temporarily nationalize and take over these large private hospitals, under the following conditions:
Service only COVID-19 patients, whether PUM, PUI or Confirmed.
Designate their staff to serve as full time COVID-19 teams, with appropriate rest and quarantine, if need be. Provide full financial support and reimbursement for these hospitals Expand their current capabilities by providing them with additional manpower, PPEs, respirators, etc...., possibly from the other hospitals.
Salary their health workforce and provide lodging and quarantine facilities for them.. Ensure optimal protection for them at all times, as well as psychosocial support. Provide free services for all COVID-19 patients, irrespective of severity or economic status.
Keep other hospitals COVID-19 free, allowing them to provide services just as important for other types of patients.
This is a national emergency. We cannot delay our response again. I can think of no better strategy, before this contagion engulfs all hospitals. Strong government leadership and decisiveness is imperative!
Dr. Ramy Roxas is a former professor of UP-PGH and Chief of Surgery of The Medical City.