Gov’t says no lockdown even as hospitals start hitting full capacity

PUBLIC ADVISORY Makati Medical Center in Makati City has advised the public that the hospital has reached capacity for COVID-19 patients as coronavirus infections in Metro Manila continue to increase. —RICHARD A. REYES

MANILA, Philippines — Hospitals in Metro Manila and the Cordillera Administrative Region are running out of beds for critically ill COVID-19 patients as coronavirus cases surge to post the highest daily count this year.

In Metro Manila, according to data as of the weekend from the Department of Health (DOH), seven out of 10 of the 679 intensive-care beds meant for COVID-19 patients are occupied.

Six out of 10 of the 4,094 isolation beds are being used by COVID-19 patients.

About a third of the 808 mechanical ventilators in Metro Manila’s hospitals are being used by COVID-19 patients, while about four out of 10 of the 3,006 ward beds for COVID-19 patients are occupied.

Out of 149 hospitals in Metro Manila, 40 are in danger of being overrun with COVID-19 cases.

Eighteen of these hospitals are in a “critical” situation with at least 85 percent bed occupancy, while 22 other hospitals are at “high risk” of being overrun, with bed occupancy of 70 percent to 84 percent.

In Cordillera, 77 percent of the 48 intensive-care beds allocated for COVID-19 patients are occupied, while the 426 isolation beds for COVID-19 patients are 53 percent occupied.

Out of the 250 ward beds for COVID-19 patients in the region, 138 or 55 percent are occupied, while 11 out of 39 mechanical ventilators, or 28 percent, are occupied.

In Metro Manila, hitting capacity are Philippine General Hospital (PGH) in Manila and St. Luke’s Hospital in Quezon City and Taguig.

Speaking for PGH in a radio interview on Monday, Dr. Jonas del Rosario said the hospital had 134 COVID-19 patients and more were scheduled to be admitted.

“This is our highest case number for the last four months. It has decreased before—we were only at 60 to 70 patients per day. But now it has doubled,” Del Rosario said.

The hospital has expanded its emergency room to stretch capacity to 180, now 75 percent occupied, he said.

But he just learned, he said, that the hospital’s intensive care unit (ICU) was already full.

Del Rosario said the hospital was accepting only emergency non-COVID-19 cases. Other cases are being referred to other hospitals, he said.

The hospital said 82 of its health workers were infected with the coronavirus.

Dr. Benjo Campomanes, vice president and chief medical officer of St. Luke’s, said the Quezon City and Taguig emergency rooms of the hospital were already full.

Waitlisted patients

In Quezon City, he said, 18 patients were waiting to be admitted and in Taguig 33 were waiting to be taken in.

“As of now we have no vacancy,” Campomanes said.

The government, however, is not considering a return to blanket lockdown.

“Going on a total lockdown is difficult. There are many more who are suffering due to the lockdown than those who get seriously ill due to COVID-19,” said presidential spokesperson Harry Roque, who announced earlier on Monday that he had tested positive for the coronavirus.

Roque said the country “could do better” with contact tracing to keep the virus from further spreading, monitoring communities and isolating the infected, and enforcing the minimum public health standards.

More cases

Whatever the Inter-Agency Task Force for the Management of Emerging Infectious Diseases will recommend to President Rodrigo Duterte will be the result of a “delicate balancing act” that will consider the number of cases but also health-care use rate, he said.

“If the number [of cases] rises and most of them are mild and asymptomatic, we should not close the economy if we have enough capacity to treat those who get seriously ill,” Roque said.

On Monday, a year after the government placed the entire island of Luzon on lockdown, the DOH logged 5,404 new coronavirus infections, the highest daily count this year and since Aug. 14, pushing the total number of confirmed COVID-19 cases in the country to 626,893.

The DOH said eight more patients had died, including three who were previously recorded as recoveries, raising the death toll to 12,837. It said 71 other patients had recovered, bringing the total number of COVID-19 survivors to 560,577.

The country still had 53,479 active cases, of which 92.4 percent were mild, 4 percent asymptomatic, 0.73 percent moderate, 1.4 percent severe, and 1.4 percent critical.

At an online briefing on Monday, Beverly Ho, director of the DOH Disease Prevention and Control Bureau, said hospitals in Metro Manila were at a “moderate risk” of being overrun, with intensive-care beds 65 percent occupied by COVID-19 patients.

The other regions with high numbers of cases of coronavirus infections are Cordillera, Central Visayas and Davao, she said.

In Metro Manila, she said, the average use of COVID-19 beds is 49 percent.

“However, we need to highlight that while hospital care utilization is 49 percent, ICU beds are already 65 percent occupied, which means moderate risk, while mechanical ventilators are 38 percent occupied,” Ho said.

Local lockdowns

An independent group of university experts said on Monday that local lockdowns such as those imposed in Pasay City and Navotas City could slow down the spread of the coronavirus in Metro Manila, likely triggered by new variants of the COVID-19 virus.

“[Local] lockdowns may work against variant-driven surges, but they are more effective in tandem with expanded testing, contact tracing and supported isolation. [Local] lockdowns are also more effective when communities support them,” OCTA Research said.

OCTA conducted its own assessment of the spike in infections in Metro Manila that started around Feb. 21.

In Pasay City, host to an international airport, the flare-up began around Feb. 22, with the reproduction rate increasing from 1 to 2.5. The spike in Navotas started a bit earlier and reached a reproduction rate of 2.4.

Reproduction rate refers to how fast the infection spreads.

“Both [cities] swiftly [placed barangays with infections on local lockdown]. These [local] lockdowns helped reduce the rate of transmission and the reproduction number to 1.8 so far,” OCTA said.

A graph released by the group showed that it took about two weeks of community restrictions in Pasay and Navotas before the numbers of cases went down.

Local governments in Metro Manila have imposed a 10 p.m. to 5 a.m. curfew to limit movement and reduce infections.

Currently, OCTA said, the reproduction rate in Metro Manila is 1.95 and the goal is to reduce this to 1.5 for the rest of March.

If this is achieved, “the projected number of new COVID-19 cases in [Metro Manila] will be reduced from 6,000 (with a reproduction rate of 1.95) … to 3,000 per day by March 31,” the group said.

—WITH REPORTS FROM JEROME ANING, MARICAR CINCO, CRISTINA ELOISA BACLIG AND JODEE A. AGONCILLO