Marco Carvalho
The four rehabilitation centers managed by Caritas Macau joined last week the organization’s nursing homes that were put under a stringent “closed circuit” preventive management regime on June 23rd. More than 1,700 patients and employees of Caritas are currently in strict isolation.
The Social Welfare Bureau ordered a total of 24 nursing homes to be managed in a closed loop in order to safeguard the health of both the inpatients and the workers of these facilities. In accordance with the government’s decision, the elderly and the employees – with a few exceptions – are not allowed to leave the premises. Twelve rehabilitation centers were added to the list last week by the local authorities. In the aforementioned facilities, visits are suspended indefinitely and the delivery of basic subsistence goods has to be carried out “without any kind of physical contact.”
In the specific case of Caritas Macau, the adoption of a closed-circuit preventive management regime affects around 1,700 people, more than five hundred of whom are employees of the institution. The workers had to sacrifice their privacy and their domestic comfort for the sake of the safety of the elders they work with. “Eight nursing homes are following this policy since the 23rd of June. Our four rehabilitation centers are also being managed according to a closed-loop plan since Wednesday last week,” Paul Pun Chi Meng, the secretary-general of Caritas, tells O Clarim. He continues, adding, “Generally speaking, this measure affects about 1,200 users, both in our nursing homes and rehabilitation centers. We have 800 elderly patients in our homes and about 400 or so users in our rehabilitation units. More than 500 employees are tending to these patients.”
The transition to a closed-circuit preventive management regime was not without challenges, Paul Pun Chi Meng admits. The secretary-general of the local Catholic relief and development agency recognizes that the adoption of the new prophylactic management regime left Caritas with a shortage of financial resources. But that was not the only hindrance felt by the organization. A few employees found it difficult to adapt to the new circumstances. “We had to find ways to support our workers. They have to remain inside the premises, and some of these workers had never been away from their families. This is the first experience of its kind that they have had to endure, and some had a few problems to adapt in the early days,” says Paul Pun Chi Meng. The secretary-general of Caritas emphasizes, “On the other hand, due to the adoption of this new policy, our resources are now very limited. We had to use a lot of our resources. We had to buy sufficient food for our patients and our staff. We had to buy large quantities at once, which was quite expensive. We were forced to find a way to deal with this, but a lot of resources were needed.”
Avoiding the repetition of Hong Kong’s mistakes
Despite the financial burden that the transition to a closed-loop management regime represented for Caritas, Paul Pun Chi Meng applauds the enforcement of the preventive measures. As draconian as they seem to be, the procedures are seen as essential if Macau wants to avoid the same scenario that haunted the neighboring Hong Kong Special Administrative Region. The secretary-general of Caritas recalls, “In nearby Hong Kong, during the most severe phase of the Covid-19 outbreak, many people died and, if I am not wrong, about half of those who died were elderly who were living in nursing homes. In Hong Kong, there were many deaths in nursing homes. Nevertheless, about two percent of Hong Kong’s nursing homes chose to do what we are doing now and they were spared high rates of mortality. The elderly were protected and these homes averted a tragedy.”
More than just safeguarding the elderly and the employees of the nursing homes, the secretary-general of Caritas contends that the option of subjecting these facilities to strict confinement practices is also a way of protecting society. The closed-loop preventive management regime, Paul Pun argues, might avert a scenario in which critically ill elderly patients constitute the larger proportion of those that are admitted to intensive care units. “In fact, this policy is a way to protect not only the elderly and our workers, but also to protect society, generally speaking. Imagine that some of these nursing homes were affected and that the patients contracted the disease. These patients would be probably considered severe cases, and they would certainly occupy beds in the Intensive Care Units. If that happens, the Health Bureau will have a big problem on their hands,” Paul Pun Chi Meng warns.
The confined employees and patients of Caritas are submitted to nucleic acid tests every day in order to ensure that the facilities remain Covid-free and to guarantee that the draconian strategy enforced by the government is successful. The daily tests, which Caritas pays for out of its own pocket, represents an additional financial effort. But money is not the main concern of the organization at the moment. “We have a different concern altogether. We have to find a way to persuade the local population to stay put so that the epidemic can be controlled. If people keep moving and travelling around, the people who are currently locked in our facilities will have to stay there until God knows when. In the long term, this option is not feasible.”
He concludes, “If any of our employees, for whatever reason, stop working, we will have to hire new laborers. And recruiting new laborers is very difficult. It is an increasingly arduous task. Therefore, our priority is to persuade the population to make an effort to stay at home.”
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