Ready for the coronavirus crisis in the Galilee‏

Ready for the coronavirus crisis in the Galilee‏
The new coronavirus ward was completed in three days last week

By DIANA BLETTER
Originally published by the Jerusalem Post on MARCH 26, 2020

Just when doctors and nurses at the Galilee Medical Center in Nahariya could breathe a collective sigh of relief after treating 3,000 wounded Syrians during the Syrian Civil War from 2013 to 2018, they are faced with the next enormous challenge: COVID-19, the coronavirus. After the Health Ministry gave orders to set up a special unit last week, the hospital accomplished that in a matter of a few days. There is now a special ward, separated from the rest of the hospital, which includes 30 beds, including six beds for ventilated patients. There are currently four coronavirus patients in the hospital: two men, 23 and 29-years old, and two women, 24 and 28, all in mild, stable condition.

The hospital is 10 kilometers (six miles) away from Israel’s border with Lebanon. Although it is considered the periphery of Israel, it is often on the frontlines, as during the First and Second Lebanon Wars. It serves the Galilee community, which is comprised of more than 600,000 residents of diverse ethnic, religious and cultural backgrounds. Its 2,700-member staff also reflects that diversity. Its employees are Jews, Muslims, Christians and Druze, along with several employees whose families fled from Southern Lebanon during the withdrawal of Israel troops from the region in 2000. In some ways, all these factors have helped the hospital staff better prepare for this current emergency because there is a sense, as Galilee Medical Center’s CEO, Dr. Masad Barhoum said in a recent telephone interview, “We are used to being in a crisis.”

Barhoum admitted that he didn’t know if he feels “sorry or lucky” that the hospital has become accustomed to preparing for all kinds of emergencies. Although this virus is, “hopefully, a once-in-a-lifetime occurrence,” the hospital and entire health organization is always “prepared for rapid deployment.”

“I have no doubt that once again, our professional staff will be able to cope with the crisis caused by the spread of the virus in the best manner possible,” Barhoum said.

Dr. Yael Ziv, head of the Infectious Diseases and Control Unit, has worked with Dr. Edward Kaykov, director of the Unit, to set up the unit and determine maintenance and logistics following Health Ministry guidelines. Ziv said the new ward includes a protected station for nurses, a separate area for caregivers, and a sophisticated medical control room to remotely monitor and care for patients.

Ziv has specialized in infectious disease at the hospital since 2006. She said that she and her colleagues always believed it was “only a matter of time” before a flu pandemic would break out. In the past few years, health care officials had become more and more concerned about the growing danger of flu epidemics. For that reason, there has been a greater emphasis on telling people to get flu shots during the past few flu seasons (normal winter months). These factors explain why Ziv wasn’t shocked by this outbreak.

“The coronavirus doesn’t surprise me,” explained Ziv. “But the rapidity of its spread does surprise me.” Since the outbreak, she has been on her phone constantly, whether in the hospital or at home, determining hospital and outpatient care for patients. “As you can imagine, I haven’t been sleeping a lot,” she said. “But it seems like this is what I’ve been training for since I began my medical specialty.”

The Hospital is gearing up to face all emergencies. Hospital staff in all the departments have completed drills to face a range of scenarios. Some wards face special precautions, including the maternity ward. There are no clear studies about the effect of coronavirus on the fetus or on a pregnant woman.

Dr. Jacob Bornstein, director of Galilee Center’s Women’s Health Wing, said that the most recent study showed that the virus did not cross the placenta during pregnancy. In addition, the virus does not pass via breastfeeding, but a mother who is infected should pump breast milk rather than feed the baby directly. There is now an isolated area for any pregnant woman infected with coronavirus who is giving birth, and a separate outpatient department. In the past, swine flu and SARS viruses have increased the rate of natural miscarriages, premature births, and the slowing of intrauterine growth. It is not certain if COVID-19 will behave in the same way.

 

The hospital began as a simple birthing center with wooden huts in 1947. During the Second Lebanon War in 2006, Katyusha rockets fired from Lebanon hit the Department of Ophthalmology. There was damage to the building but there were no injuries since patients and staff had already been evacuated. At the time, the Center had Israel’s sole underground hospital facility, including 450 beds and eight modern operating rooms. During the War, the hospital treated 1,800 civilians and 300 IDF troops. (Full disclosure: this reporter’s son was one of those troops.)

This week, the hospital also opened a respiratory emergency room in the Emergency Department, to provide critical care to patients with respiratory symptoms, but not coronavirus. The special room will treat patients who suffer from various respiratory symptoms, such as pneumonia or bronchitis.

Barhoum, the first Arab to run a hospital in Israel, recalled the night of March 2013, when he received a telephone call in the middle of the night from an Israeli military medical officer who asked to bring two wounded Syrians to the emergency ward. Over the next six years, Syrian babies, children, men and women arrived for treatment. He said that the hospital employees were “united in a mission” that was “a professional duty as well as a paramount moral prerogative.”

The Syrians who arrived in the hospital were sometimes unconscious and when they woke up in the intensive care unit and realized that they were in Israel, “at first they were stunned by the devoted care, love and compassion they received from those who they had been educated to view as their enemy.” He said the fact that many of the hospital staff spoke Arabic helped break down “walls of fear,” replacing them with a sense of appreciation and gratitude for the care given to them.

Dr. Barhoum hopes that the coronavirus patients will feel the same way down the road. He also envisions “the entire world joining forces to overcome this problem.” He added solemnly, “And then we can use this as an opportunity to also make peace with one another.