“What if Dr. Manzanero had conceded for a test to be done on him on Friday the 27th? Maybe he would have received treatment and would be safe. How can he make such a decision when someone has the majority of the symptoms. Just because he had not been in touch with other patients? Because he had not travelled recently? The questions asked were more about who he had been with and not how he is doing, what were the symptoms. He can’t be so naive to deal with the situation as per contact of the first three cases, we do not know exactly how many of us are walking around without symptoms as yet.
“We said HERE WE ARE, HE IS SICK and no one paid us mind. We asked for test and they refused, why? To hide that the virus is spreading? Do we have little test? Why did they not close the boarders earlier? Why wait until we had the first case?
“Western Regional is not ready to handle any incoming patients, their staff is not ready!!” per words of Maria Estella posted on her Facebook page on Sunday, April 5, 2020.
Since then, of course, I reposted her detailed account of how her husband, Hubert Pipersburgh, referred to as Patient #4, was treated before he was hospitalized and later died and, in fairness to all those I tagged, no other than the Director of Health services, Dr. Marvin Manzanero, had this response to her statement:
“She didn’t call me on the 27th, her first attempt at reaching me was on the 31st but as my phone is always busy never got to talk thus my phone logs are always kept. …
“No, didn’t happen and I don’t really want to get into a back and forth out of respect for a grieving family.”
(Facebook response of Dr. Marvin Manzanero — 6th April, 2020
It is very interesting that the DHS has a conflicting account and denies being contacted when Maria Estella was emboldened to not only write that she called the good doctor but to describe the nature of the conversation, and she assured readers of her post that she called him, because she knows him. She further wrote:
“They ask me how did he get infected, if he had no contact with the first patients? Well let me tell you when the first case was announced, a lot of people left the island in the precise moment it was being announced as people were scared. When they closed it was too late.
“Now my husband is no longer with us and we ask for respect as we grief. I make this public since the people that are supposedly handling this pandemic in Belize, have demonstrated to being incapable to do so. They have to act with urgency and none was shown, that is the difference between people surviving this virus or not. He was the first serious case and could not get the attention he required.”
Now the critical truth, from my viewpoint, is not about the personalities of the DHGS, Ms. Estella or the deceased, Mr. Pipersburgh. To me it is the fact that this first case tested our state of preparedness and thus could have been the basis upon which we, the larger populace at risk of getting this disease, would feel re-assured that we are prepared for what is next and who is the next patient.
Now it leaves us the public to wonder what is the real situation. Who is telling the truth and why would anyone lie about such a critical issue of life and death? We want to know, from my end, not so much for the purpose of finger-pointing, but more for us to act and remedy any shortcomings so that we can be prepared. However, the indication is really that we are not prepared.
Nurses say we are not prepared!
Remember that Ms. Maria Estella spoke in her account about the conduct of the medical personnel towards her husband. She wrote:
“He arrived at Belmopan with pneumonia and there was no one to attend to us or who was willing to since he was already a suspected case of COVID-19 [sic]. During the night he finally got the test for COVID-19 [sic]. We were told that the test was going to be given the next day. He was placed in an area outside the hospital that is there for emergencies and given IV fluids and oxygen due to difficulties in breathing. It does not even have a bathroom…. April 3rd: At 1:30 a.m. I received a call from Dr. Manzanero informing me that the results of the Coronavirus test that was given to Hubert was positive. From that moment forward, throughout the entire morning we were treated with great indifference and little care by the personnel of the hospital, they saw us as delinquents and my husband stopped receiving any attention with relation to his sickness. That entire morning no one did anything for the health of my husband. I pressured my contacts for him to be transferred to Belize City and thanks to Dr. Hidalgo he was finally moved to intensive care at KHMH and he arrived already in a critical state.”
Her account, in my view, highlights several concerns:
1. The protocol to test leaves much to be desired and the selective testing is making us miss carriers, and in this case even those with almost all the signs are not getting prompt testing.
2. There is an obvious stigma against COVID-19 patients, and she tells of the reluctance of personnel to give her husband attention [see the highlighted portion above].
3. The isolation area outside this hospital (and maybe others) is inadequate and lacks basic facilities such as a bathroom.
4. If she did not have contacts she would not have gotten help. Sadly, many of us do not have contacts.
5. We are currently not prepared to deal with one case. How will we deal with two or ten or a dozen?
Following on the heels of this personal account by the wife of Patient #4, if we had any doubt about the state of preparedness, the Nurses Association confirmed that indeed we are not prepared, and what they have reported might explain the reasons Ms. Estella could complain that the hospital personnel “treated [them] with great indifference and little care”.
It would seem that it is not that hospital personnel do not want to help, but that they are afraid for their own safety and they feel that they are unable to do their work, without, they themselves, becoming infected. In a press release issued, they pinpointed six areas of concern, but three of these, in my view, specifically concern the issue of “preparedness. These are:
1. Full biohazard PPEs are needed for the entire first contact staff and those working anywhere in the designated COVID-19 areas.
2. Proper areas are needed for quarantine of the staff who are exposed and proper areas for all staff who cannot afford to self-isolate, and who work in the COVID19 areas and have a family.
3. Outside tents currently set up as flu clinics at the different hospitals must be replaced with more secure buildings or retrofitted with adequate ventilation and cooling systems. A tent, though acceptable in a dire emergency, is no place for rendering high-quality service. The conditions that the staff is expected to work under are deplorable, and in some instances, like in Dangriga, San Ignacio and Punta Gorda, are inhumane. Working in the heat under the tent is unbearable and further compromises safety, as PPEs get soiled by perspiration.
Truth is, we are not prepared.
It cannot be that those on the ground, as opposed to those on television, are lying about our level of preparedness, when even the Belize Dental and Medical Association is saying the same things as the nurses. BDMA too raised the alarm on behalf of doctors, and sadly, the issue of PPEs is the very same concern addressed in their statement! The timely disbursement of these PPEs and the quality of them is of grave concern for doctors all over the country, as the association has spoken to their doctors who lodged this complaint. Sadly, BDM noted that the practice thus far has been to distribute PPEs just before doctors conduct procedures, which is not a safe practice and a waste of time, especially because the PPEs have been reported to have been of very poor quality.
To me even more disturbing is the fact that the response of the Ministry of Health, when doctors complain, is to råðr³mànd the complaining doctors, instead of resolving the problem. Imagine the indignity we are treating our frontline workers with, when we are actually calling on them to risk their lives to save ourselves. This is rather disturbing, as if there should be no dissent.
It is concerning that while the press conferences and the “Meet the Experts” try and paint a rosy picture for the cameras, the reality of those on the ground is morbid and requires immediate attention. Pretending we are prepared when we are not is a lie, and we already see how one lie has caused the spread of COVID-19 in this country. We do not need any more lies to raise the death toll in this country. I say we address it NOW and stop playing petty politics just for the optics, when the statistics will eventually tell the truth of how prepared we are.
This is such a serious matter that the BMDA had to make it clear that they have to look out for the welfare of doctors. In their press release, they stated: “BMDA is ready to support the doctors who will not work without adequate PPE. We will never forgive ourselves if a colleague dies because of inadequate PPE. BMDA demands that the KHMH and GOB and the Social Security Board design a compensation package for hazardous work since the heathcare workers risk health and life in the line of duty.”
All our lives, as we know it, for now stand interrupted. This is made worse by knowing that we are not prepared for what COVID-19 will unleash on us, while those in authority keep giving us a false narrative and a false sense of security!