Lebanese hospitals falling apart as coronavirus cases surge

Lebanon witnessed a surge in Covid-19 cases as health professionals cautioned that local hospitals were “falling apart” because of the country’s severe economic crisis.

The 86 new cases reported on Saturday was the highest daily increase since Lebanon was hit by the coronavirus pandemic in late February.

With only 36 deaths and 2,168 cases, the small Mediterranean country has been relatively spared up to now. But hospitals, which were already suffering from the country’s nine-month economic crisis, worry that they will not be able to cope if infections surge.

"We cannot afford rampant coronavirus in this country, because our capabilities are low," Firass Abiad, director of Lebanon's Rafic Hariri hospital, where most of the Covid-19 cases are treated, told The National.

Mr Abiad pointed to the recent increase in power cuts that “almost crippled the healthcare industry in Lebanon”.

Electricity cuts, which normally last between three and eight hours a day, increased nationwide in recent weeks because of a fuel shortage.

Rafic Hariri hospital, Lebanon’s largest public healthcare facility with 430 beds and 10 operating theatres, had to cope with daily power cuts of up to 18 hours.

State electricity company Electricite du Liban usually gives preference to hospitals by switching power off for only one to two hours a day, said Mr Abiad.

“When you have severe cuts from the power grid, then you have to resort to your generators. But without fuel, those generators cannot run indefinitely, and without generators, a hospital can simply not function ... That’s why we had to cut our fuel usage to be able to continue,” he said.

From July 2 to July 7, the hospital turned off the air conditioning for administrative staff – but not patients – despite the sweltering heat and humidity. It also closed two of its operating rooms and postponed non-urgent surgeries.

Fuel importer Total Liban donated diesel for the hospital’s generators last week but Mr Abiad said the situation was far from stable.

“We are working on reopening the last [operating room],” he said. “We are scheduling cases and I think we can clear” the backlog."

But the hospital is rationing fuel as much as possible. “This problem might come back again,” said Mr Abiad.

Mr Abiad said an increase in Covid-19 cases was expected after the reopening of Beirut's airport on July 1, after more than two and a half months.

“The question is, will this increase stay within capacity? Or will you see a surge that spirals out of control? This is the main question.

“You see a lot of people not wearing masks and not respecting social distancing rules. A lot of restaurants are functioning at 100 per cent capacity. All of these are bad omens. You put them all together with the surge of new cases, and this is how the disease spread in other countries,” he said.

Lebanese hospitals struggle to import medical supplies because of the collapse of the local currency and restrictions on access to US dollars. Despite a partial subsidy mechanism set up by the central bank, the cost of supplies has skyrocketed for hospitals as they have to buy them with dollars bought on the black market, where the greenback is traded for nearly 8,000 Lebanese pounds instead of the official 1,507.5 exchange rate.

Because of the increasingly high running costs, about 60 per cent of private hospitals have reduced their operations, with some only admitting emergency cases. "The whole system is falling apart slowly,” said Sleiman Haroun, head of the syndicate of private hospitals. This is affecting patient care at private hospitals, which treated 85 per cent of Lebanon’s patients before the pandemic.

“Quite a few hospitals are not admitting oncology patients because they cannot afford to buy the drugs,” he said. “Some hospitals are not doing orthopaedic surgery because the actual prices of implants are higher than the official prices.”

To make matters worse, the healthcare system is in crisis just when the Lebanese need it most.

Mr Abiad said public hospitals "are seeing a surge in patients outside the coronavirus” pandemic.

This is because hundreds of thousands of people have lost their jobs in the past months, which cuts them off private health insurance and national security coverage.

“Because of that, they are now all coming to the public hospitals to be treated,” he said.

“What’s interesting – or worrying – is that we are also seeing an increase in the number of critical patients. These patients are delaying their visit to the doctor. They may not have access to basic medication, or delay coming to the hospital for fear of the costs that they will incur,” Mr Abiad said.