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The fight against Covid-19 at FV Hospital – Part 1

The most intense period of the Covid-19 pandemic lasted more than a year, yet the memories of that time will never fade for those embroiled in the fierce battle to save patients.

Together with all healthcare staff in Ho Chi Minh City, the doctors and staff of FV Hospital participated in community vaccination campaigns and treated Covid-19 patients at FV with courage and determination. They have made the seemingly impossible, possible, and made valuable contributions to the fight against the pandemic, gradually helping to revive a dynamic city.

During the launch of photo exhibition “Memorable moments during COVID-19 at FV” in December, people shared stories, experiences and the hard decisions that were made in reflection on those difficult days and to motivate everyone to overcome the challenges ahead.

The quick action to split the hospital into two separate bodies was unforgettable for all staff. When the violent outbreak of Covid-19 in mid-2021 in Ho Chi Minh City led to overcrowding, a lack of resources and an increased patient mortality rate, FV made prompt, courageous decisions so that staff could treat more patients.

“Patients don’t know where to go”

At the end of June 2021, the number of new cases of Covid-19 in Ho Chi Minh City was increasing rapidly. Field hospitals and hospitals specialising in Covid-19 treatment had been established but there were still not enough beds as many other hospitals were either in a state of lockdown or closure. At that time, the number of patients coming to FV Hospital climbed day by day, most of which were severe cases with underlying diseases such as heart disease and diabetes.

Dr Trinh Van Hai, Head of the Accident and Emergency Department, FV Hospital, recalled that he has never seen patients crowd the A&E Department as they did during the Covid-19 pandemic. Completely overloaded, patients had to wait for treatment on stretchers from the hallway to the parking lot under temporary tents.

“We were shocked. The number of patients was huge, and they all arrived within a short period of time, most in a serious condition with respiratory failure. The entire health system was almost frozen and many people who needed emergency support and medical care didn’t know where to go,” he said.

As the same time that patient numbers suddenly increased, the medical examination and treatment staff and other support at FV dwindled as staff became exposed or ill. At times FV’s human resources decreased by nearly 200 employees at once, due to F0 and F1 social distancing regulations. Hospital leaders needed to rent hotels near the hospital for staff to safely isolate before returning to work.

In the midst of this extremely difficult situation, FV did not close its doors. The remaining medical staff worked more hours, determined to “not refuse any patient” as Dr Jean-Marcel Guillon, FV’s CEO had encouraged.

A quick decision to “split the hospital”

With the goal to “not refuse any patient” in early July 2021, the Board of Directors of FV Hospital quickly made a brave decision—to covert FV’s operations into a split hospital model.

Accordingly, half of the hospital treated Covid-19 patients, with special requirements for staff and medical equipment, while the other accepted regular patients and women delivering babies who were not infected with Covid-19.

FV Hospital was split into two so that it could treat Covid-19 patients and patients with other diseases (Photo: FV)

This quick decision was also not too surprising to staff as FV had been planning for how to safely accept patients since being allowed by the Health Ministry to carry out real-time PCR Covid-19 testing, joining the frontline fight from April, 2020. However, this was still a challenging decision for a private hospital like FV, especially in the context of a serious shortage of medical equipment resources, as well as difficulties in transportation due to social distancing and supply chain issues.

The first necessity was creating the right facilities. The inpatient treatment area of the Internal Medicine Department was the first to be reimagined as a Covid-19 Treatment Department. Initially, the department had four rooms, which was later increased to nine rooms encompassing 22 beds. When the pandemic reached its peak, the Covid-19 Treatment Department was expanded into the entire inpatient area on the fourth floor with 63 beds for people who do not require ventilators, and 15 beds for high flow nasal cannulas (HFNC), which deliver high-flow oxygen through a nasal cannula.

However, with the number of positive cases rapidly increasing in the community, whenever the hospital opened more space to receive Covid-19 patients, those rooms were immediately filled. Phones in the patient reception call centre kept ringing with desperate cries for help.

In response to the flow of patients, FV’s Medical Facilities and Engineering Department had to work continuously to and set up and adapt many facilities to fit the situation.

There was also an urgent need to invest in necessary medical equipment such as negative pressure rooms, liquid oxygen systems, and other machines and oxygen tanks to treat a number of patients in need of high-dose oxygen. The hospital needed to arrange a separate entrance to minimise the infection risk for non-Covid-19 patients. The A&E department quickly created more rooms, bought more containers to act as reception booths, and set up temporary tents. All of these efforts only partially supported the needs of patient care. During FV’s history of establishment and development, a similar situation had never occurred.

“In a short time, FV invested heavily in both human and financial resources, generously purchasing equipment and carrying out construction day and night to quickly implement that plan. Our goal was to maintain the role of the hospital on the front line against the pandemic and continue to provide safe treatment for patients who did not test positive for Covid-19 at the hospital. Splitting the hospital was a brave decision by the FV team,” says Ms Pham Thi Thanh Mai, COO of FV Hospital.

Another big challenge was the human factor. Since FV has been operating on the basis of quality standards set by Joint Commission International (JCI), the world’s leading medical quality assessment organisation, in any treatment process, medical staff must meet various requirements to ensure patient safety.

However, at that time, the team of doctors, nurses, nurse aides, and other supporting staff faced a shortage in number of people, and those that were able to work had never treated or cared for patients with Covid-19 before. This was a novel coronavirus, with the risk of rapid, unexpected serious symptoms. Many doctors with decades of experience admitted they have never encountered such a difficult situation and senior nurses said they felt like newcomers.

FV’s Covid-19 Treatment Department was quickly established. Doctors and nurses were transferred from different departments to form this new department, led by Dr Ho Minh Tuan, Head of Cardiology, who volunteered to take on the additional responsibility as head of this new department. All team members worked hard to learn more about the virus from research undertaken by world-renowned organisations, the top-down process at FV, and their own day-to-day experience of treating patients. The treatment team needed get to grips with a huge amount of knowledge at the same time as practicing according to the international guidelines of the UK, US, EU and Vietnam’s Ministry of Health.

“Everything was new, so everyone had to study to update their knowledge and learn practically on the job. Some people only had two or three days to read up on this virus before facing the fierce reality inside hospital rooms,” says Ms Chu Thi Nguyet Anh, Nurse Head of the Internal Medicine Department.

Through the consensus of experts and determination from hundreds of people, the war being waged by staff against Covid-19 at FV Hospital gradually effected positive changes. More and more patients recovered and were able to return home, including elderly patients with many underlying diseases. Their smiles upon being discharged by the hospital were a source of encouragement for FV’s frontline team and showed the humanitarian decisions that FV had made when people were in need the most were justified.

From December 8, 2022, FV Hospital has posted the photo exhibition “Memorable moments during COVID-19 at FV” to honour the dedication of our team members who worked tirelessly to overcome difficulties together and ensure the hospital delivered on its commitment to offer to care to everyone in the community who needed it.

This exhibition, displayed in the hospital campus, shows the many intense moments of the pandemic captured by the lens of French photographer Pier Laurenza, who was also a Covid-19 patient at FV. After receiving a second dose of the vaccine, Pier asked if he could stay in the hospital, silently documenting an unprecedented moment in FV’s nearly 20-year history. This exhibit also documents the difficulties facing Vietnam and the world during COVID-19.

The fight against Covid-19 at FV Hospital – Part 2: Where every day was a battle

 

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