DOH sets up new ‘command system’ as hospitals strain under more COVID-19 cases

With coronavirus cases on the rise in the country, the Department of Health (DOH) said on Wednesday, July 22, that it would implement a more robust referral system between hospitals to avoid overwhelming critical care facilities. 

The DOH’s move comes as several hospitals in Metro Manila, the epicenter of the outbreak of the country, earlier announced they reached capacity. In the last two weeks, at least 15 hospitals declared their intensive care unit COVID-19 dedicated beds – and for some, their isolation and ward beds – were already filled. (READ: Metro Manila's COVID-19 bed capacity in 'danger zone,' 4 regions at warning level)

Health Undersecretary Maria Rosario Vergeire said the agency tweaked earlier guidelines on the mandatory allocation of critical care facilities to allow public and private hospitals to improve management of patients under a program called the “One hospital command.” 

“We think that this is very appropriate and this is very rational and this will address what is taking place in our hospitals,” Vergeire said in a mix of English and Filipino during a press forum on Wednesday morning. 

“‘One hospital command’ would really address our gaps in our referral system and our gaps in the identification and protocols that have to be adhered to when determining who will be admitted to hospitals and who will be referred out for a much lower facility,” she added. 

What to expect

The program will be headed by newly-appointed DOH Undersecretary Leopoldo Vega, who was also earlier named one of the government’s 3 new “anti-COVID czars” specially focused on managing the treatment of patients. 

Under the program, Vergeire said public and private hospitals would no longer need to each allocate at least 30% of their facilities for coronavirus patients, and up to 50% for surge capacity. 

Instead, treatment will shift increasingly towards public hospitals which will now need to allocate a mandatory 30% of their facilities for patients, an additional 20% for surge capacity, and up until a total of 70% of its bed capacity if needed. 

For private hospitals, the DOH will now mandate 20% of their beds to be allocated for COVID-19 patients with the capacity to set aside 10% more in case of a surge. 

Along with the new levels of allocation for hospital beds, Vergeire said there would also be an “incident command system” where details of patients will be listed to facilitate their referral among hospitals and other health facilities. 

“This incident command system will look for which among all hospitals here in Metro Manila the patient can be brought to,” Vergeire said in Filipino, adding the system will be also be implemented in different regions. 

What goes with a command system

Vergeire said the hospital command system would be implemented alongside its rules for referring mild and asymptomatic patients to temporary treatment and monitoring facilities specifically prepared for the outbreak. 

Meanwhile, the DOH eyed granting incentives to private hospitals to convince them to expand the allocation of facilities to accept more patients. Among those being considered were tax breaks and quicker reimbursement of fees owed by the Philippine Health Insurance corporation. – Rappler.com

Sofia Tomacruz

Sofia Tomacruz covers foreign affairs, the overseas Filipino workers, and elections. She also writes stories on the treatment of women and children. Follow her on Twitter @sofiatomacruz. Email her at sofia.tomacruz@rappler.com.

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