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‘Scary part’: Can provinces deal with COVID-19 case surge?

Posted 2 years ago


Hospital frontliners wear protective suits as they man the entrance of the emergency room at the Gat Andres Bonifacio Memorial Medical Center in Tondo, Manila on March 24, 2020. George Calvelo, ABS-CBN News

MANILA — The Luzon-wide lockdown has achieved “relative success” but COVID-19 could still trigger outbreaks in Metro Manila and 15 provinces, experts from the University of the Philippines said.

The Philippines currently has the most number of COVID-19 cases in Southeast Asia with 4,932 as of Monday, even if the UP study noted that it now took 6 days for confirmed cases to double compared to 3 previously.

“Based on these trends, one can estimate about 9,000 to 44,000 possible cases reported by the end of April 2020,” according to the study by the UP COVID-19 Pandemic Response Team.

“In general, this indicates the relative success of the enhanced community quarantine–along with other interventions–in containing the spread of the virus.”


But the government should also prepare for possible outbreaks in 13 areas in Luzon, 2 provinces in the Visayas, and 1 in Mindanao, according to study, which cited reported cases from these areas as of April 9.

Based on the group’s mathematical model, these provinces registered a probability of more than 90 percent that they would experience a COVID-19 outbreak.

“May expectation kami na next na so we’re telling government, dito kayo maghanda,” Dr. Teodoro Herbosa, UP executive vice president who co-leads the study group, too ABS-CBN News.

(We expect that they’ll come next so we’re telling the government to prepare in these places.)

GRADUATED ACTIVATION

Aside from Metro Manila, the study identified the provinces as: Aklan, Bataan, Batangas, Benguet, Bulacan, Cavite, Cebu, Davao Del Sur, Laguna, Nueva Ecija, Pampanga, Pangasinan, Quezon, Rizal, and Tarlac.

The model was intended to help guide both the national and local governments on what to do after the end of the Luzon lockdown on April 30.

One option, according to the study, is to continue the enhanced community quarantine in high-risk areas, and implement stricter measures in those with an even higher probability of an outbreak, according to the study.

Others with “80 to less than 90-percent probability” of an outbreak may be covered by a less stringent “general community quarantine.”

For the rest of the provinces, community quarantine may be lifted but the government should still implement physical distancing, information campaigns, contact tracing, and home quarantine for probable cases, the study said.

“Successful as it may seem, an enhanced community quarantine covering a wide area may not be sustainable over the long run,” it said.

“Our best recourse after April 30 is to implement graduated activation of enhanced community quarantine depending on the level of risk in certain areas at a given time.”

The UP experts clarified that the projections were based on existing Department of Health reports and “highly dependent on efforts in discovering new cases.”

DO WE HAVE ENOUGH HOSPITAL BEDS?

The government has quarantined the entire island of Luzon, home to more than 57 million people, to “flatten” the COVID-19 infection curve and avoid overburdening hospitals.

The Philippines has a total of 101,688 hospital beds, according to health department data as of 2018.

But Level 3 hospitals—those “ideal” for COVID-19 cases—have only 38,763 beds or less than the minimum 42,954 hospital beds needed during the projected peak of the infection, said Herbosa, citing estimates prepared by the UP study group.

The figure was based on a reproduction number of 2, meaning a person sick with COVID-19 can infect 2 others.

A reproduction number of 3 (as many as 3 persons can be infected) would require 57,272 hospital beds nationwide.

If the infection rate is 4, the country would need 64,431 beds. In this case, Metro Manila alone would need 53,612 beds.

ONLY 3 VENTILATORS FOR BARMM

Ventilators might also be a problem despite the country’s current supply of 1,572 units, based on a survey by the Philippine College of Physicians (PCP) as of March 22 this year.

But 80 to 90 percent of these ventilators are currently in use for other patients “that’s why our problem is bigger,” said Herbosa, who serves as a medical adviser to the government on COVID-19.

“Wala naman sa store room yan. Nakakabit sa pasyente. So pag may bagong pasyente, wala kang ikakabit,” he added.

(They’re not in store rooms. They’re attached to patients. So if you have a new patient, you may not have something to use.)

Studies showed that some 5 percent of COVID-19 patients are considered critically ill and need to be attached to a ventilator.

Metro Manila hospitals have most of the ventilators with 423 units, followed by Region 11 with 253, and Region 7 with 160.

The Bangsamoro Autonomous Region in Muslim Mindanao, which has a population of around 4 million, has only 3 ventilators, according to the PCP survey.

The region has 3 fatalities out of 8 cases as of April 6, according to the DOH website.

“Once you go out of the metropolitan cities… you probably have only Level 2 hospitals that don’t have a lot of ICUs and probably won’t have a single ventilator. This is the scary part,” Herbosa said.

“This is why we’re pushing for more public health measures to flatten the curve or decrease transmission because if you just allow transmission to happen, so many of our fellow Filipinos will die.

Source: ABS-CBN News

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