By Debbie O. Noblezada-Uy, MD
“Gather the team. We need to meet now!” This was my final instruction that made everyone realize that the threat of Covid-19 has entered our borders. This was the start of a unique experience that has changed our perspectives, disrupted our beliefs, and challenged our character. A situation that we were expecting to happen, but we’re too scared to handle.
As the team was discussing on how to execute the intubation process safely and quickly, our Supervisor informed us that we only have a few PPEs left, 6 HazMat suits and 30 N95’s. The urgency of having to find ways on how to sustain our needed number of PPEs was glaring because after the intubation, the ICU team who will be handling the patient will be at a higher risk of contracting the disease if not given the proper protection. Contingency plans were formulated, the ones that we cannot believe we were actually discussing out of desperation and uncertainty. March 18, 2020 at 3:00 in the morning, while we were suiting up, I looked at the materials on the table and felt the burden on my shoulders while realizing that the safety of our team rests on its captain. I looked at everyone one last time before saying “We’re ready. Let’s go in.” Before opening the door of the ante room, I saw the worried-but-eager-to-help faces of our resident physicians who were part of the team stationed outside of the patient’s room and thought “We’ll be needing you when one of us inside this room gets unlucky.” Inside the room, our actions were calculated and swiftly executed. Our first real hard-core face-to-face encounter with Covid-19 was the time when we had the chance to talk to our patient and informed him of the procedure that we were about to do. Witnessing how he tried to answer us calmly with his heavy breaths, I realized how isolated our patient was. His illness alienated him from the physical presence of his family, from his nurses’ touch, from his doctors’ smiles, and from a lot more beautiful things that were being concealed inside PPEs. At that point, we hoped that aside from helping him to breathe comfortably, we could also offer a sense of companionship even for a short time. After finishing all three procedures, I decided to stay in the hospital with our team. The rT-PCR result of our patient was expected to be released anytime that week, and our team felt the need to receive this and face this together.
WV #2 was officially documented as the first Covid-19 case of Panay island on March 21, 2020, and he was just a few rooms away from where we were staying in the hospital’s isolation area. Fear enveloped the entire city after the news was released which subsequently made a lot of Ilonggos afraid to go near The Medical City Iloilo or to interact with its staff. Fear was the first response that we received from our families, friends, neighbors, local officials, and even from our colleagues and fellow healthcare providers. Suddenly, we were isolated. Suddenly, we felt that we were on our own. While I and the rest of the Isolation floor team spent the remaining of our broken morale treating and taking care of our patients, the rest of TMC Iloilo family— from our CEO to our security guards, took care of our displaced and discriminated staff, ensured everyone’s safety and ascertained that all the other patients in the hospital were not compromised. Everyone witnessed how we took the lead and remained steadfast, which eventually made everyone realize that our sense of humanity is bigger than our fear. Help and support started to reach us, delivery after delivery, messages after messages. Our seemingly isolated place suddenly became a place of hope, bravery and kindness. This kept the community together while we were gathering our senses and preparing for all the possibilities.
Being with our Isolation team for more than two weeks made me understand first-hand the effects of the complexity of the pandemic on the healthcare providers. Behind our team’s heroic composure and incomparable bravery, was a vulnerable morale that any given possibility of one of us contracting the disease would surely disintegrate it. Treating Covid-19 patients was already one big task for us, but leading a team with highly susceptible morale was even bigger and harder. This realization gave me my own share of fears and doubts: the possibility of contracting Covid-19 itself. I could not allow myself to get infected and to fight a disease without known treatment. I was afraid that if I get infected, our team would start to think that no amount of PPEs and preparation could prevent the spread of the disease, and that it was pointless to treat Covid-19 patients because of the very high risk of transmission. I was also more afraid of the possibility that if our team gets infected after intubating our first patient, the entire Ilonggo healthcare community would be consumed by fear leading to our fragmented and futile pandemic responses. At that point, we could not afford to be divided. At that point, we could not afford to get infected.
The release of our team’s negative swab results further ignited our courage and strengthened our hope. It was our testament to the entire healthcare community that it is not hopeless to take care of Covid-19 patients. Our celebration of gratitude to the Ilonggo community and to everyone who supported us became sweeter and more meaningful when we also sounded our first Code Joy and sent off Western Visayas’ first Covid-19 survivor. Our happiness doubled when at last, we sounded Code Joy for WV #2. With this, we suddenly found ourselves being liberated from isolation. And with this, we found out that indeed, we all share the same purpose.
It has been a year since we had our first Covid-19 patient. The battle is not yet over, but at least right now, we are more informed and more equipped. The complexities of this pandemic opened our minds to a lot of things and changed us as an individual and as a community. But more than the discovery of this new pool of scientific information, this crisis made us discover our own capabilities: that we are capable of fulfilling a purpose that is beyond our own.
The author is the medical director of The Medical City Iloilo
