In the emergency room of a large Beirut hospital, thirty coronavirus patients are receiving the necessary care while waiting for a bed to become available. In another establishment, patients are treated in their vehicles or seated on chairs in front of the building… also waiting for a bed.
In recent days, the situation in hospitals with Covid-19 units, all regions combined, has resembled scenes from an apocalyptic film: overwhelmed doctors and nurses, on the verge of burnout, running through all senses to administer patient care, fearing that they could no longer provide relief to them all.
The picture is just as gloomy on the side of the Lebanese Red Cross, whose rescuers systematically spend several hours before being able to find a hospital for a Covid-19 patient in distress.
Faced with this “disaster” and the “irresponsible” behavior of many citizens who continue to act in total denial of the epidemic, voices were raised again yesterday calling for “a total closure of at least two to three weeks” , with cancellation of the exemptions granted to “non-vital” sectors, “to try to contain a situation that has become almost uncontrollable”, as the president of the medical order, Charaf Abou Charaf, told L’Orient-Le Jour. A call in this direction was also launched by the head of the Lebanese Forces, Samir Geagea.
“We have crossed the forbidden threshold,” laments Dr Abou Charaf. Rightly so: for the past few days, the contaminations curve has continued its vertiginous rise. Just last weekend, the country recorded 9,157 new contaminations (5,414 on Saturday and 3,743 yesterday) and 36 deaths (20 Saturday and 16 yesterday). This brings up to 215,553 the cumulative number of contaminations since the detection of the first case of the virus in February 2020, including 1,590 deaths and 140,597 recoveries. Among the cases still active, 1,425 people are hospitalized, including 535 in intensive care. This equates to 74 more hospitalizations in 48 hours (39 Saturday and 34 yesterday) and 34 additional intensive care admissions (ten Saturday and 24 yesterday).
“The closure must be firm and serious, at the risk of finding ourselves in an even more catastrophic situation,” he warns. We have a lot of cases among the medical profession. Twenty of them are in intensive care and nearly 300 others in isolation at home. The numbers are bigger among the nursing profession. It is difficult to find replacements for them, especially since they have been working tirelessly for several months already. They are exhausted. Many of them also emigrated. It is therefore important to protect them and to unload them a little so that they can continue. Hence the need to train new nurses in the care of Covid-19 patients. ”
During this closure, “the private hospitals which have not yet got their hands dirty must acquire Covid-19 units”, insists Dr. Abou Charaf, also calling on the Ministry of Health to equip more government hospitals to deal with the pandemic… “until the vaccine arrives”.
Over a thousand newly graduated nurses
The question of providing hospitals with Covid-19 units or of expanding existing ones is not new. It has been more than ten months, since the start of the epidemic on February 21, that such requests have been formulated and renewed on the eve of each closure, which should primarily serve these establishments to prepare to welcome more intensive care cases. But only 580 beds in the private and public sectors have been fitted out to date, according to a source from the Ministry of Health, who pointed out to the OLJ “that the problem does not arise only at the level of the beds, but of all the ‘infrastructure that goes with it, such as high flow of oxygen, negative pressure, respirators… and manpower ”.
In negative pressure rooms, the atmospheric pressure is lower than in the rest of the building, preventing the infectious particles in them from circulating outside.
Mirna Doumit, president of the Lebanese Nurses Union, tells us that the sector is not lacking in staff. “We have 1,200 newly graduated nurses just waiting to work,” she says. But nurses have been so mistreated in many establishments that have either fired them, failed to pay their salaries or paid them half-wages, that they have ended up looking for their fortunes elsewhere. You have to motivate them to keep them. These nurses are able to take care of Covid-19 patients. On the other hand, they must be trained to work in intensive care. ”
What about field hospitals? “These hospitals must be an extension to the country’s hospitals, especially since the management of hospital records is complicated,” explains the aforementioned ministerial source. The concept of a field hospital is to treat cases in the context of a disaster while transporting them to a hospital. If these hospitals are going to be permanent hospitals, they have to have the right infrastructure. We are still in the process of looking for hospitals to which they will be attached. ”
Scandal
“Out of the 160 hospitals in the country, they haven’t found a single establishment that agreed to do so?” »Protested Dr. Salim Adib, professor of epidemiology and public health at the American University of Beirut. “It’s a scandal”, he continues to the OLJ, denouncing “the failure of the administration to manage the Covid-19”.
“The epidemic is dangerous, but it is not fatal”, adds Dr Adib, noting in this context that nearly 1,600 deaths have been recorded since the start of the epidemic so far, “ie less than 1% mortality rate ”,“ knowing that according to my calculations, nearly a million of the population has already contracted the virus ”. He thus emphasizes that the reported cases are only the tip of the iceberg. You have to multiply them by at least five to get the real number.
For Dr Adib, “by the end of March, Lebanon would have reached the threshold of collective immunity which makes it possible to stop the progression of the disease”. Even with the new variant? “It seems, according to studies published in Great Britain, that this new variant spreads more quickly, but it is not the cause of re-infections,” he replies. Studies also show that the vaccine is effective against this strain. ”
While waiting for the arrival of the vaccine – “this file is an additional failure of the administration” – and the formation of collective immunity, “the contaminations curve will continue to climb until the end of the current month”, estimates the epidemiologist, stressing that these are the harmful consequences of “behavioral overflow observed during the holidays”. “By the end of March, we should continue to take a lot of precautions and protect our seniors,” he recommends.
Reinforcement of closure measures
Faced with the urgency of the situation, the Head of State Michel Aoun convened the Superior Council of Defense for an extraordinary meeting this afternoon at 3 p.m. to decide on the measures to be followed. Everything seems to indicate, however, that the closure measures will be strengthened. Indeed, the national commission in charge of the fight against Covid-19, which had met virtually yesterday, issued measures in this direction. According to a close source, the closure will encompass virtually all sectors, as well as Beirut International Airport, which will be closed for a week. Only medical and nursing professionals, as well as bakeries, would be exempt. This prompted the president of the journalists’ union, Joseph Kossaïfi, to ask the outgoing Minister of Information Manal Abdel Samad to also include journalists in this decision. In a statement, he said that “the majority of journalists have to travel to do their work.”
The interministerial commission responsible for combating the pandemic should meet this morning in order to submit its recommendations to the Supreme Defense Council.
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In the emergency room of a large Beirut hospital, thirty coronavirus patients are receiving the necessary care while waiting for a bed to become available. In another establishment, patients are treated in their vehicles or seated on chairs in front of the building … also waiting for a bed. For a few days, the situation in hospitals …
