An isolation unit at Rafik Hariri Hospital. AFP archive photo
Deputy Assem Araji, chairman of the parliamentary health committee, told L'Orient-Le Jour that following the efforts made since the start of the coronavirus crisis, Lebanon currently has 2,500 intensive care beds, of which, 600 may be rendered available to Covid-19 patients (in public and private hospitals). However, this capacity may quickly reach a saturation point in the event of a dramatic increase in infections. "Rafik Hariri hospital, the leading hospital [in the fight against coronavirus], had 21 beds occupied on Sunday," Araji noted. According to a hospital source, the hospital has around 25 intensive care beds for Covid-19 patients.
Making an overall assessment, Araji said 12 public hospitals are on alert (including hospitals in Tripoli, Sidon, etc.) while 15 others are on standby; making a total of 27 establishments equipped to receive coronavirus patients. "If there is a significant additional surge in the number of patients, we will have to dedicate entire hospitals to coronavirus and open specialized services in other hospitals," he warned.
Araji said the patients are in priority transferred to Beirut, although hospitals in the regions are prepared to accept such cases. "In the Bekaa, for example, only the public hospital Elias Hraoui is open to coronavirus patients; the others have so far refused to receive patients, which is a worrying practice," he cautioned. "In this region, we currently have 20 beds available to Covid-19 patients, but in an emergency, we should take steps to ensure that around 100 beds are available."
The MP's greatest fear is that private hospitals refuse to open their doors to Covid-19 patients due to their economic problems, while large university hospitals have already dedicated specific units. "When in February we put forward our emergency plan, which included a scenario of escalating cases, the economic situation was not as bad as today," he said. “I am concerned that, due to the economic conditions, a sudden sharp increase in coronavirus cases may lead to the collapse of the healthcare system." Araji also believes that if necessary, the Council of Ministers will have to oblige private hospitals to accept coronavirus patients, but hoped not to reach this point.
An unbearable infection rate
"Thirty private hospitals are ready today to receive Covid-19 patients," Syndicate of Private Hospitals President Sleiman Haroun told OLJ. "These establishments were selected because they can equip special wings located far from the rest of the hospital or completely independent from it to receive coronavirus patients. These hospitals are spread across the country, in addition to the capital where the leading university hospitals equipped for this purpose are located." Haroun explained that 500 beds are available for Covid-19 patients in the private hospitals, some intended to accommodate moderate cases, others severe cases (negative pressure rooms), and a hundred beds dedicated for intensive care for the most critical cases that need respirators.
What if the situation worsens? "In a darker scenario, we could dedicate entire hospitals to coronavirus patients," he said. However, this is not so simple in practice because the establishments, which receive coronavirus patients, must be equipped with specific facilities. Meanwhile, the sector is lacking the means and is in crisis, noting that a single negative pressure chamber costs no less than $30,000.
Haroun warned that if the current rate of contaminations continues, the health system will not hold up. He pleaded for the multiplication of quarantine centers where asymptomatic patients can stay without spreading the virus.
Nurses, the unknown "soldiers"
Tackling an unexpected coronavirus outbreak involves not only the number of beds and hospital capacities but also to medical personnel. According to Araji, no less than 250 infections were reported within the nursing staff, including doctors, nurses, and others. With each infection, entire teams are quarantined, which drastically reduces the number of active hospital staff.
According to Mirna Doumit, President of the Order of Nurses, the nursing teams are already strained by the successive crises. "Since the start of the crisis, we have identified nearly 90 infections among the nursing staff," she told OLJ. However, none of them were infected in a unit specially designed for Covid-19, but in other departments, or in their own communities. This raises questions about the means of protection allocated to them by their establishments. She further added that the union was providing hotel rooms to affected nurses.
While the infections are likely to impact, at least temporarily, the number of operational medical staff, the massive layoffs in recent months have hit the nursing staff even more severely. "Between 35% and 40% of nurses have either been dismissed, are receiving half or a quarter of their salary, or are subject to unfair mass dismissals," said Doumit. "For this reason, we have called for a strike on August 5th after trying everything we can with the authorities and the hospitals. Let us see what they can do without us. The reduction in the number of nurses will indeed have dramatic consequences on patient safety in hospitals." She said the strike is not just directed against hospitals but also aimed at pushing the government to pay its dues to the medical facilities to save the sector.
Doumit used the word "war" to describe the fight against the coronavirus and did not hesitate comparing the nurses to "soldiers." She found the indifference toward them hard to explain. "Maybe some people think the nurses are timid and they will not dare to go on strike… That’s why I hope our appeal will be heard this time. If this does not happen, I cannot do anything more for them. "
(This article was originally published in French in L'Orient-Le Jour on the 28th of July)
