Photo courtesy of 3rd Marine Brigade.

Hospital authorities may seek assistance from the police in enforcing strict protocol measures when dealing with “uncooperative” patients under investigation (PUIs) in order to protect the public from the possible spread of the coronavirus.

This was expressed Tuesday by Dr. Mario Baquilod, regional health director, in a virtual press conference. Dr. Baquilod was responding to a recent incident at the Ospital ng Palawan where a PUI from Puerto Princesa City had refused to undergo laboratory testing for COVID-19 and insisted to be discharged from the hospital instead. The patient died at his residence two days later.

Dr. Baquilod, however, said the ONP had the authority to allow the patient to reject treatment and executive a waiver instead.

“Based on our initial investigation, wala namang na-violate ang Ospital Ng Palawan (ONP) because they explained to the patient and the family the implications of signing the refusal and going home against medical advice,” he said.

Baquilod pointed out that health facilities have sole discretion on patient management so long as guidelines set by the Department of Health (DOH) were being strictly followed.

“May mga instances talaga na may makukulit na pasyente. We respect their rights, kaya ang bilin natin sa hospitals is to ensure public safety will not be compromised,” he added.

He said also that medical personnel and staff are required to wear personal protective equipment (PPE) to protect themselves and contain the spread of the deadly disease.

Dr. Audie Cipriano, chief of medical professional staff of Palawan provincial hospital, said that the doctors and nurses who had direct contact with the patient had been placed under quarantine as a protocol measure.

“For precautionary measure, pina-quarantine na namin ang mga doctors at nurses na nag-assist sa pasyente,” Cipriano said.

Rotational shift was assigned per team on a two-week basis to ensure that the hospital has adequate workforce while the other personnel is on quarantine.

Mental Health of Patients

Meanwhile, the local government unit (LGU) of Puerto Princesa City has been preparing Skylight Hotel as a quarantine area that will house PUIs who are not showing symptoms or those who are qualified for home quarantine.

Preparations are being supervised by the City Health Office (CHO) and Palawan Medical Society (PMS) to ensure that the quarantine facility will not pose a danger to the nearby communities and the general public.

Baquilod said that the regional office is also preparing materials and mental care experts that may assist PUIs who will be isolated from their families and friends.

“We recognize that it may cause mental distress to some PUIs kaya naman naghahanda na kami ng videos, information materials, at meron din kaming designated personnel na makakatulong sa patient to be at ease while under isolation,” he said.

A civic group recently demanded to cancel the quarantine facility operation, stating that the location was not ideal as it is located in the central part of the city.

“Kaming residente ng Barangay Manggahan ay tahasang tumututol at hindi kailanman papayag na gawing quarantine accommodation ang Skylight Hotel sa kadahilanang kaka-anunsyo lamang ng World Health Organization (WHO) na maaaringg airborne and COVID-19 virus,” said Tyron Sarmiento, civic group leader.

There was still no scientific evidence that the deadly coronavirus disease (COVID-19) is airborne, according to WHO.

Richard Ligad, chief of City Information Office (CIO), responding to the concerns raised, assured the public that tight precautionary protocols will be set up around the facility.

“Sinisigurado natin na hindi kakalat sa mga malalapit na lugar doon. Isa lang ang magiging entry-exit point at lahat ng lalabas at papasok ay sisiguraduhing nadisinfect. Lahat yan inaayos pa,” he added.

No target date was set as the area needs to pass the quality check that will be conducted by the medical professionals.

“Hindi natin masabi kailan sila pwede lumipat. Ayaw natin madaliin yan kasi buhay ng mga tao ang nakasalalay d’yan,” he said.

Mass Testing

The health department recently announced that mass testing for PUIs and PUMs will start on April 14.

Baquilod clarified that prioritization will be set and not all PUIs may be tested pointing out that categorization will be carefully studied.

“For example, Palawan has 86 PUIs and as of yesterday only around 40 were tested, but it doesn’t mean that the remaining 46 will all be tested. We have to consider their symptoms, time of exposure, and other risk factors,” he explained.

Palawan Governor Jose Alvarez recently received some 800 rapid test kits from a Chinese “friend”. This, however, has not been certified for use by the Food and Drug Administration (FDA).

“Wala pang binababang guidelines from the central office about the use of rapid test kits. We were informed by the provincial health office (PHO) but we advised them to take caution on those kinds of tests and still rely sa confirmatory tests na ginagawa ng Research Institute for Tropical Medicine (RITM),” he said.

PPEs for Health Workers

The regional office has recently allocated some P7 million for 2,250 units of personal protective equipment (PPE) and other essential logistics.

The supplies, which were in response to the call of augmentation of certain health facilities, were carried by the Office of Civil Defense (OCD) on Friday and was received by the PHO on Sunday.

“Despite the increasing number of positive cases, we want to assure the public that we are prepared to respond. The logistics were direct from the central office to OCD, who is in charge of distribution to the provinces provided by the allocation from the region,” Baquilod said.