May 8, 2020

Our Response to COVID-19: Puerto Rico

The medical shelter at Damas Hospital in Ponce.
The medical shelter at Damas Hospital in Ponce.

As a result of rapidly rising cases of COVID-19 in Puerto Rico, International Medical Corps has been collaborating with local hospitals to help them prepare for and respond effectively to COVID-19, integrated as far as possible into our response to the Puerto Rico earthquakes. As of May 5, 2020, COVID-19 has caused 1,843 confirmed infections and 54 related deaths in Puerto Rico according to the World Health Organization.

To help bring this pandemic to an end, International Medical Corps is supporting healthcare worker safety in the 30 countries where we provide services. We are leveraging our 35 years of experience and the knowledge of our epidemiologists from the 2014-2015 Ebola outbreak, the 2003 SARS outbreaks, and infectious disease response efforts to ensure that at-risk countries and regions, like Puerto Rico, are best able to respond to COVID-19 outbreaks.

Globally, International Medical Corps is supporting relief efforts with the provision of supplies, screenings and case management, capacity building, mental health and psychosocial support, and the deployment of an Epidemic Response Team, as needed. For more details on our global response to the COVID-19 pandemic, visit: https://www.globalgiving.org/projects/emergency-response-to-the-coronavirus-2019-ncov/

In Puerto Rico, we are collaborating with the Department of Health, Damas Hospital in Ponce, Hospital Universitario de Dr. Ramon Ruiz Arnau (HURRA) in Bayamon, Hospital San Cristobal in Juana Diaz, and Interamericano de Medicina Avanzada (HIMA) Cupey in San Juan to help them prepare for and respond effectively to the COVID-19 pandemic.

Damas Hospital is a 330-bed teaching hospital in Ponce and Hospital San Cristobal is a public hospital located in Juana Díaz. The San Cristobal Health Network also includes three primary care clinics in nearby rural municipalities. Both Ponce and Juana Díaz are located on the southern coastal plain region — close to the epicenter of the series of earthquakes that damaged infrastructure, destroyed homes and reduced access to critical services in January 2020. We deployed four medical shelters to Damas Hospital and will supply additional shelters to San Cristobal next week to provide medical surge support that is integrated within our existing emergency response interventions for those affected by the earthquakes. Damas Hospital is using the temporary medical shelters to create an additional Emergency Department, and San Cristobal will do the same, with the inclusion of extra respiratory wards as well.

HURRA is a 306-bed hospital administered by the Department of Health and is affiliated with the University of Puerto Rico. HIMA-Cupey is a 70-bed hospital located in San Juan, the capital of Puerto Rico, which has the highest number of COVID-19 cases in the territory. The HIMA Health Network also extends into San Juan, Caguas, Fayardo and Bayamon. We are supplementing the capacity at the hospitals with three temporary medical shelters at HURRA and additional shelters to be constructed at HIMA-Cupey next week. At HURRA, the medical shelters are being used as an extra triage and check-in area for two patients at a time, allowing for six feet of space in-between them. HIMA-Cupey will use the temporary medical shelters to screen patients for COVID-19 outside of the Emergency Department, to decrease the risk of exposure for non-coronavirus patients.

Within International Medical Corps’ temporary medical shelters, our four partner hospitals will have the much needed additional capacity to support patients who test positive for COVID-19.

We thank the GlobalGiving community for continuing to support our emergency response efforts in Puerto Rico.

The view inside the medical shelter.
The view inside the medical shelter.
Medical shelters provide necessary extra capacity.
Medical shelters provide necessary extra capacity.
Apr 29, 2020

Our Response to COVID-19: Philippines

COVID-19 training on PPE in Manila.
COVID-19 training on PPE in Manila.

As a result of rapidly rising cases of COVID-19 in the Philippines, International Medical Corps is temporarily shifting from providing emergency relief and recovery in response to Typhoon Phanfone and the Taal Volcano to focusing on the most emerging need – the prevention and treatment of COVID-19. As of April 22, 2020, COVID-19 has caused 6,710 confirmed infections and 446 related deaths as well as 693 recoveries in the Philippines.

To bring this pandemic to an end as quickly as possible, International Medical Corps is supporting healthcare worker safety in the 30 countries where we provide services. We are leveraging our 35 years of experience and the knowledge of our epidemiologists from the 2014 – 2015 Ebola outbreak, the 2003 SARS outbreaks, and infectious disease response efforts to ensure at-risk countries and regions, like the Philippines, are best able to respond to COVID-19 outbreaks.

Globally, International Medical Corps is supporting relief and recovery efforts with the provision of supplies, screenings and case management, capacity building, mental health and psychosocial support, and the deployment of an Epidemic Response Team, as needed. For more details on our global response to the COVID-19 pandemic, visit: https://www.globalgiving.org/projects/emergency-response-to-the-coronavirus-2019-ncov/

Specifically, in the Philippines, we have temporarily transitioned from our Typhoon Phanfone response and are now working with the Department of Health and Manila Health Officers to help prepare for and respond effectively to the COVID-19 pandemic. In anticipation of additional cases, the Department of Health identified a total of four hospitals that may act as testing facilities. At one of these hospitals, the Santa Ana Hospital in Manila, we provided a medical shelter where the team is supporting surge operations, screening those suspected of having COVID-19, and establishing triage units and patient flow.

Prior to the outbreak, one N95 mask cost approximately $0.50; this price has now more than tripled, limiting local health systems’ ability to purchase crucial supplies. As a result of a global shortage of medical supplies and rising costs, we procured and delivered 200 PPE kits, each containing items such as masks, gloves, goggles, gowns, and others, to the Manila Health Department to help alleviate the strain on their local health system. In total, we have distributed more than 865,000 PPE and infection prevention and control (IPC) supplies in the Philippines as of April 17, 2020.

Complementing the PPE and IPC donations, we provided training to 44 healthcare staff, including physicians, nurses, non-medical staff, outreach workers, and more, on how to appropriately use the donated supplies — building their capacity to be more effective First Responders. Our teams also trained these same participants on related topics, such as: infection prevention and control procedures, the epidemiology of COVID-19, and isolation and quarantining protocols.

Finally, in addition to the previous trainings, we are working with the Manila Health Department to finalize a training-of-trainers curriculum related to the management of emerging infectious diseases by health facilities. The teams plan to include a variety of participants, including health professionals from the city’s six district health offices and hospitals who will use the knowledge and tools they gain to train staff in the city’s 58 health centers. Furthermore, the trainers will also host training sessions for Emergency Response Teams that have been established in the city’s barangays, or neighborhoods — exponentially spreading awareness and preventing the spread of COVID-19.

Thank you to the GlobalGiving community for continuing to support our emergency response and recovery services in the Philippines.

Medical Shelter deployed to Santa Ana Hospital.
Medical Shelter deployed to Santa Ana Hospital.
Mar 19, 2020

Using Research to Replicate Success

Dr. Adam Levine leads the research in May 2019.
Dr. Adam Levine leads the research in May 2019.

Throughout the West African Ebola outbreak from 2014 to 2015, the 2018 outbreak in Northwestern Democratic Republic of the Congo (DRC) and the current, second-largest outbreak in history in Northeastern DRC, International Medical Corps was there – gathering data to identify successes and extract lessons learned even as we provided care and technical training. As a result, the International Medical Corps’ Ebola Research Team has assembled one of the world’s largest — if not the largest — archive of published research on the Ebola virus and its treatment.

Two recent studies highlight the importance of collecting information to record lessons learned for the benefit of future responses: 1) the Pamoja Tulinde Maisha (PALM), or Together Save Lives, trial, which studied the effectiveness of four drugs to treat the Ebola virus; and 2) a study on prophylactic antibiotics, or the use of the antibiotics to prevent secondary infections.

With support from national, international, intergovernmental, such as the WHO, and other humanitarian organizations during the PALM trial, International Medical Corps helped test the effectiveness of four drugs in treating Ebola among more than 680 patients. After a string of disappointments in the quest for useful treatments, the results demonstrated that two of the four drugs dramatically increase patients’ chances of survival.

In the 2019 Science magazine, Kai Kupferschmidt writes, “the results [of the PALM study] should help combat the disease not only by improving patients’ chances of survival, but also by encouraging people to seek treatment early. With no effective drugs available, people with symptoms have often tried to evade detection and sought out traditional healers, which has fueled outbreaks.”

Misinformation can make the spread of diseases, such as the Ebola virus, more likely and also encourage people to be more resistant to treatment. However, results of studies like these, ones that demonstrate fewer lives lost and more effective treatments, may help convince people to seek care if they believe there is hope. 

The second study, using data gathered during the West African Ebola outbreak from 2014 to 2015, involved 360 patients diagnosed with the virus. The results found that the mortality rate among patients given the antibiotic fell to just more than half—54.7%, compared to a death rate of more than 73% among those who did not receive the drug. Our study constitutes the first evidence-based research to support the well-known practice. Evidence-based research is important because it helps transform subjective knowledge into objective data, informing not just our future responses, but also those of humanitarian agencies worldwide.

Today, our teams are again collecting data to identify the successes of our work in northeastern DRC and learn as many lessons as we can before the next emergency. Research and knowledge enhance the value of our work – and, most importantly, save lives.

We thank the GlobalGiving community of donors for supporting our efforts to inform and prevent future outbreaks.

Citations

 “Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favorable Results with Two of Four Candidates.” National Institute of Allergy and Infectious Diseases, 12 Aug. 2019, Retrieved on 12 March 2020, from: www.niaid.nih.gov/news-events/independent-monitoring-board-recommends-early-termination-ebola-therapeutics-trial-drc

K. Kupferschmidt, Successful Ebola treatments promise to tame outbreaksScience, Vol. 365, p. 628, 16 August 2019, Retrieved on 12 March 2020, from: https://science.sciencemag.org/content/365/6454/628

Tyler Marshall, International Medical Corps Study Offers First Evidence That a Low-Cost Antibiotic Can Reduce Deaths in Ebola Patients, International Medical Corps, 10 February 2020, retrieved on 12 March 2020, from:https://internationalmedicalcorps.org/story/international-medical-corps-study-offers-first-evidence-that-a-low-cost-antibiotic-can-reduce-deaths-in-ebola-patients/

Ebola survivors leaving the treatment facility.
Ebola survivors leaving the treatment facility.
 
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