MANILA, Philippines— The Department of Health (DOH) met with Metro Manila hospital administrators on Monday to ensure that all of them complied with the mandatory 30 percent allocation of beds for COVID-19 cases, especially as the capital was seeing yet again a surge in new infections.
Health Undersecretary Maria Rosario Vergeire said that while there were reports that some hospitals were nearing or had already reached capacity, this did not necessarily mean that they were overwhelmed as was the case when the local outbreak started in March.
“When a hospital declares it is at full capacity, we must be very cautious in interpreting this. All hospitals were mandated to allot 30 percent of their bed capacity for COVID-19, but not all hospitals complied [with] this,” Vergeire told reporters.
For example, a 400-bed hospital may have allocated only 50 beds for COVID-19, or 12.5 percent of its capacity.
Not entire hospital
“So when they declare they are at full capacity, it’s only for the beds they have allocated for COVID-19 and not the entire hospital. There’s still room for every hospital to expand. That is what we are doing in our government hospitals,” she said.
Under DOH Administrative Order No. 2020-016, released on May 4, at least 30 percent of all public and private hospital beds should be dedicated to COVID-19 cases to meet the government’s minimum health system capacity.
Vergeire said many hospitals had not complied with the requirement, so they were instructed during Monday’s meeting to follow the order and to “be prepared to implement an additional 20 percent surge capacity if and when needed.”
Over the weekend, Chinese General Hospital and Medical Center said its COVID-19 ward was “running at full capacity” as the number of severe cases it was attending to was “more than those seen last March.”
“This has a palpable impact on our resident and nursing manpower with deleterious effects on their physical and mental health and residency training,” Dr. Samuel Ang, the hospital’s medical director, said in a statement.
The hospital, however, did not specify how many of its COVID-19 beds were occupied. But DOH data show that as of Thursday, all of Chinese General’s 23 isolation beds and seven intensive-care beds were occupied. As of this writing, no other hospital in Metro Manila has issued a similar announcement.
In a letter to Health Secretary Francisco Duque III on Monday, Ang clarified that what he meant by full capacity was Chinese General’s 30 percent COVID-19 bed allocation.
“What was not mentioned in my memo was the fact that we made arrangements with [Philippine General Hospital] and San Lazaro and other [quarantines] to accept our patients. This support from the government has provided tremendous effect on the morale of our hospital staff,” Ang said.
All COVID-19 beds occupied
Besides Chinese General, 10 other hospitals in Metro Manila have reported that all of their COVID-19 beds were occupied. These were Veterans Memorial Medical Center, University of Santo Tomas Hospital, University of Perpetual Help Hospital, Tondo Medical Center, Seamen’s Hospital, Philippine Children’s Medical Center, Metro North Medical Center and Hospital, Las Piñas Doctors Hospital, De Los Santos Medical Center and Capitol Medical Center.
Three other hospitals in the capital have reported nearing COVID-19 capacity — Lung Center of the Philippines, (97 percent), East Avenue Medical Center (89 percent) and UERM Memorial Medical Center (83 percent).
Citing reports from government-run hospitals in Metro Manila the DOH received on Sunday night, Vergeire said that though “there is still no shortage,” these hospitals are “already at the moderate risk level [in the use of] critical care resources.”
DOH data showed that in Metro Manila, 68 percent of all isolation beds, 79 percent of all ward beds and 51 percent of all intensive-care beds are occupied. Nearly 30 percent of all mechanical ventilators are in use.
“We still have enough room should our cases continue to rise,” Vergeire said.
As of Sunday, the national bed occupancy is 40.7 percent for intensive-care beds, 40.6 percent for isolation beds and 45.3 for ward beds.
Vergeire said that while the number of COVID-19 cases in the country continues to rise, nearly all of them are patients exhibiting mild symptoms or are asymptomatic.
4 Metro Manila cities watched
On Monday, Vergeire reported that the DOH is closely monitoring at least four cities in Metro Manila after they reported increasing infections over the last two weeks.
Vergeire identified the four cities as Marikina, Muntinlupa, Quezon City and Makati, which recorded a case growth rate of at least 30 percent in the last 14 days.
Marikina topped the list with 51 cases, for a case growth rate of 43.47 percent. Muntinlupa’s 30 cases represented a 35.16 percent case growth rate; Quezon City’s 406 cases, 34.5 percent, and Makati’s 135 new cases, 30.18 percent.
Vergeire also said 314 barangays in Metro Manila and 64 barangays in Cebu City had reported clustering of infections or more than two cases in a specific area.
In Metro Manila, she said the DOH was closely watching three closed settings with case clusters. One of the three is Metro Rail Transit 3, where at least 172 workers have caught the new coronavirus that causes COVID-19.
“We cannot overemphasize the fact that everyone should follow our minimum health standards. When we started easing our quarantine measures, a specific condition was that the minimum health standards should be implemented, followed and practiced by every [citizen],” Vergeire said.
Among those standards are wearing protective masks, observing cough etiquette, frequent hand-washing, physical distancing, avoiding mass gatherings, working from home and isolating people who have come in contact with confirmed COVID-19 cases.
Tougher restrictions
Sharp spikes in new infections have been reported since the government eased quarantine restrictions in Metro Manila on June 1 to reopen the economy. Malacañang, however, said on Monday it might reimpose stringent restrictions if the case doubling rate sped up again and hospitals got overwhelmed.
Presidential spokesperson Harry Roque told reporters that the further easing of restrictions or reimposing tougher measures would depend on the infection data by July 15.
“If critical care capacity goes down, which it has not and we are still at moderate risk as I said earlier, and if the case doubling rate speeds up, there is a possibility [of a stringent quarantine],” Roque said.
He, however, said that the government wanted to continue reopening the economy.
“Our economic managers said we cannot afford another complete lockdown,” Roque said.
On Monday, the DOH reported 2,099 additional infections, pushing the national caseload to 46,333.
Of the additional cases, 1,258 were patients who tested positive for the new coronavirus in the last three days. Of these patients, 601 were from Metro Manila, while 280 were from Central Visayas.
The remaining 841 cases were people who tested positive four days ago or earlier. Metro Manila also accounted for most of these cases, 397, followed by Central Visayas, which had 186.
The DOH also reported the recovery of 243 more patients, bringing the total number of COVID-19 survivors to 12,185. The death toll, however, rose to 1,303 with the deaths of six more patients.
—With a report from Julie M. Aurelio
/atm