Infectious diseases chief Nadine Yared, left, and head of nursing Gracia Dona confer as they move between COVID-19 floors at Mount Lebanon Hospital. (Credit: João Sousa/L’Orient Today)
BEIRUT — Lebanon’s largest public hospital has announced it will overhaul its services to reallocate maximum resources to the fight against COVID-19 as the country grapples with its deadliest wave of the pandemic yet.
The last 24 hours have been the most lethal to date — a record 53 people died from coronavirus, bringing the total death toll to 1,959. The Health Ministry also registered another new record for daily cases on a Monday — 3,144.
Earlier in the day, Firass Abiad, the director of Rafik Hariri University Hospital, announced on Twitter that “non-essential medical activities will be halted, and resources will be allocated to Covid wards.”
RHUH has been the front-line hospital for treating coronavirus patients since the first case of the disease was announced on Feb. 21, 2020, and it has already expanded its COVID-19 unit four times to accommodate rising numbers of patients.
A fifth expansion is now underway to bring the number of ICU beds dedicated to COVID-19 patients to 50, Abiad told L’Orient Today.
More beds, however, means more staff, so management is redirecting employees to the hospital’s sectioned-off COVID-19 unit. To free up nurses, elective and non-urgent surgeries, such as cataract operations or tonsil removals, are being rescheduled.
“We are diverting whatever we can save in terms of nursing time,” Abiad said.
At Nabih Berri Governmental University Hospital in Nabatieh, the situation is similar.
Resources, both human and physical, are being moved from the main hospital wing to the specialized COVID-19 unit, which has been running at full capacity for weeks, according to director Hassan Wazni.
“We are accepting patients from all over the country, and sometimes we don’t even have places for them,” he said. “So now, we are converting 27 rooms from the main hospital into COVID-19 units.”
“We have had to seriously cut back on the services we’re offering at the hospital,” he said, explaining that only life-saving emergency treatment and specialist cancer and cardiac departments are still operating more or less as usual.
They must also find staff to man the wings and care for patients — staff that often need specialist training on how to treat coronavirus patients.
At Mount Lebanon Hospital in Hazmieh, head of nursing Gracia Dona is working hard to recruit nurses to run a new 16-bed ICU unit, expected to open within the next week.
"Staffing is becoming a big challenge,” she told L’Orient Today on a recent visit. “Caring for a COVID-19 patient is difficult, they need a lot of specialist care."
Nadine Yared, the head of the infectious diseases department who works alongside Dona, said that “nearly all staff and equipment has been repurposed for COVID-19. We even stopped neonatal intensive care.”
Many private hospitals had begun redirecting some of their services a few months ago, said the head of the private hospitals’ syndicate, Sleiman Haroun, but “in the last few weeks, it has really ramped up.”
In the last month, Haroun said, 350 ICU beds and around 650 regular COVID-19 beds have been added to private hospitals. According to the latest figures published by the World Health Organization, there are now 858 ICU beds in Lebanon, up from 521 just two weeks ago.
“We are doing as much as we can,” Haroun said.
One such private hospital is Hôtel-Dieu de France in Beirut, where doctors have had to postpone non-urgent medical care, said Antoine Zoghbi, the head of the emergency department.
“In a month, the number of COVID-19 patients at the hospital has quadrupled, from 20 to above 80,” he continued. “We are at maximum capacity, so we are forced to convert any space we can into COVID-19 units; we have no choice.”
Similar decisions have been made at Haykel Hospital in Tripoli, where more than a third of total bed capacity is now dedicated to COVID-19 patients — 55 out of 140 beds, according to medical director Lise Abi Rafeh.
“We are almost full at all times,” she said. “Sometimes we have patients sleeping in their beds in the ER waiting for transfer.”
Just last week, the hospital added 10 new beds for COVID-19 patients. In less than 24 hours, all of them were full.
Meanwhile, the 11-day strict lockdown that came into force on Thursday is already proving challenging for food suppliers, who are restricted to operating on a delivery-only basis.
“The calls and the online orders are staggering, and we cannot keep up,” said Nabil Fahed, the head of the supermarket owners’ syndicate.
Many supermarkets have backlogs of orders for days, and in some cases, over a week, meaning significant amounts of fresh produce are going to waste, he explained.
Delayed deliveries and oscillating demand are affecting food producers too.
Farmers in the Bekaa Valley, Lebanon’s main agricultural region, are selling around 20 percent of what they normally would at this time of year, according to Ibrahim Tarshishi, the head of the Bekaa Farmers’ Association.
They are also sending less produce to wholesale markets, he said, knowing that most of it won’t get sold.
According to Fahed, this means that there is potential for a shortage of produce in the market.
“We were used to a certain type of demand, but it’s all been disrupted,” Fahed said. “We can’t figure out the quantities that are needed.”
Despite the reduced sales and loss of produce, Tarshishi was reluctant to complain.
“Everyone is paying the price for COVID-19 in Lebanon,” he said. “But at the end of the day, we’ll respect the measures, because they’re there to protect people’s health.”