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Protecting Health Workers on Puerto Rico’s Covid-19 Frontlines

Direct Relief donated 124 Powered Air Purifying Respirators to community centers and hospitals across the island.

A medical team at the San Lucas Hospital in Ponce, Puerto Rico works on a patient. The health worker at the patient's head wears a Powered Air Purifying Respirator. ( Photo courtesy of Dr. Carlos García Goubern)
A medical team at the San Lucas Hospital in Ponce, Puerto Rico works on a patient. The health worker at the patient's head wears a Powered Air Purifying Respirator. ( Photo courtesy of Dr. Carlos García Goubern)

Puerto Rican physician Dr. Carlos García Goubern knows that Covid-19 isn’t going away.

“Everybody is waiting on a magic pill that, when you take it, will eradicate Covid. Unfortunately, that will not happen,” said Dr. García Goubern, an emergency room doctor at San Lucas Hospital in Ponce. “We are dealing with a virus that, while it is being transmitted, we are learning how to treat, manage, and [understand] the implications it has.”

At the beginning of the pandemic, Dr. García Goubern noticed a decrease in the number of visits to his hospital’s emergency room. At the same time, he observed an increase in mortality in patients with chronic conditions.

“In the first months, patients were scared to come to the emergency room,” he recalled. “Unfortunately, some of those who had chronic conditions that became acute did not leave their houses due to fear, and unfortunately died.”

Dr. Jesse Alemán Ortiz, chief of the intensive care unit at Ponce’s Damas Hospital, saw similar effects.

Dr. García Goubern emphasized that many of these chronic condition’s deaths can be preventable if people seek help on time. The key is early diagnosis and the continuity of treatment. “There are some conditions where you can’t let 3 days go by,” he said.

But Puerto Ricans have adapted to living with Covid. In recent months, both doctors said, patients have felt more comfortable continuing their primary and specialty care. They’ve also increased their visits to the emergency room – which, while it may help to reduce chronic disease-related deaths, also places more strain on medical staff.

Both doctors admitted that their biggest fear is bringing the virus home. “My fear is to take the virus to my house and infect my wife and kids who have been in isolation [during the lockdown] and know that [I am] their only exposure to the virus,” Dr. Alemán Ortiz said.

As part of Direct Relief’s ongoing strategy to protect frontline workers during the pandemic, the organization has donated 124 Powered Air Purifying Respirators (PAPRs), non-disposable equipment that protects against contaminated air, to community health centers and hospitals across Puerto Rico.

The PAPRs were donated by the 3M, which is a longtime partner of Direct Relief’s, and manufactured by Ford. 3M approached Direct Relief to offer the respirators, and the organization quickly began distributing them to health care providers caring for patients amid the Covid-19 crisis.

According to the CDC, this equipment can be used for protection during healthcare procedures in which health care professionals are exposed to greater risks of aerosolized pathogens such as intubations, CPR, autopsies, certain dentistry procedures, and pulmonary function tests.

Three PAPRs were delivered to the San Lucas Hospital; two were placed in the Intensive Care Unit and one in the emergency room. Intensivists, who care for critically ill patients, will be among those using the equipment, Dr. García Goubern said.

“We do a series of procedures where we are in direct contact with the patient. [With this equipment] we can protect ourselves. It can be reused, so we disinfect it as we would with any other equipment. It provides us with safety, trust and mobility,” he said.

Dr. Alemán Ortiz, whose hospital also received three respirators, said that “it has been amazing.”

At Damas Hospital, the PAPRs were delivered to the emergency room and intensive care unit, where doctors were most exposed. Dr. Alemán Ortiz explained that health care workers initially felt a great deal of resistance to treating suspected Covid patients. But with this equipment, he said, “they now feel safe.”

In light of the recent executive order allowing most commercial establishments to reopen, both physicians expect that positive cases will continue to rise. Indeed, both said that they expect conditions to worsen unless people follow social distancing guidelines and continue the use of masks.

But they are confident the PAPRs will offer the protection they need to weather the next few months.

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