Use hotels as treatment centers, doctors urge gov’t

MANILA, Philippines — With coronavirus (COVID-19) cases rising rapidly since last week and overwhelming hospitals in Metro Manila, medical doctors have pushed for “out-of-the-box” measures to contain the raging virus, including the conversion of hotels into isolation units for patients, in a near-desperate call for help.

“We see patients, like some needing dialysis, left sitting (in the hallways) because there are no more beds. We couldn’t turn them away because they have to be managed (by a doctor), but a problem is people, health-care workers, [who] are all so overwhelmed already,” said Dr. Maricar Limpin, vice president of the Philippine College of Physicians (PCP).

The Philippines has experienced a recent surge in COVID-19 cases, which prompted the government to place Metro Manila and its four adjacent provinces of Bulacan, Cavite, Laguna and Rizal under an enhanced community quarantine (ECQ), the strictest lockdown level, for two weeks to stem the spread of the virus.

A total of some 800,000 cases has so far been recorded and researchers expect the number to reach one million before the end of the month, based on current projections.

Hospitals in Metro Manila are currently swamped with patients, with lines forming outside the emergency rooms.

In a phone interview on Monday, Limpin said the PCP sent a letter to President Rodrigo Duterte over the weekend, pleading for assistance like additional medicines and manpower, and suggesting ways to unburden hospitals handling COVID-19 patients.

“This time, we could use these (hotels) as hospitals and put equipment in there like IV (intravenous) lines. Many sick people are going to one hospital [after] another only to die along the way,” she said.

Repurposing hotels

Limpin said the President could convince hotel owners to repurpose rooms and amenities into an actual medical facility. This could be done quicker than setting up modular tents or constructing hospital building extensions, she said.

The PCP also appealed to hotel owners not to charge patients their usual room rates.

In the early months of the pandemic, the government had converted hotels and even resorts into quarantines for overseas travelers. But never have hotels been used to host patients with COVID-19 or other diseases.

In Metro Manila, the Department of Health (DOH) on Monday estimated overall utilization of health-care facilities at 70 to 80 percent and for intensive care unit beds at almost 100 percent in most cities.

“So we need to bring that down so that we will be able to say that our health-care system can manage,” Health Undersecretary Maria Rosario Vergeire said in a media briefing. She added that 60 percent utilization could be considered a “safe level.”

No downward trend

Vergeire explained that the health-care utilization rate is a key factor that the DOH would consider before it could recommend an easing of quarantine restrictions.

At the Laging Handa briefing on Monday, Guido David of OCTA Research said the recent restrictions, including the ECQ in Metro Manila and four surrounding provinces, had slowed down the rate of increase in COVID-19 cases in the country. His group projected a million cases before the end of April.

With the ECQ, David said the reproduction number of the disease improved from 1.9 to 1.6, and could go down to 1.3 to 1.2 by the end of this week.

But so far, he said, there had not been a downward trend in cases. OCTA, he said, expected daily cases to remain at 11,000 to 12,000 per day for the next week or so before the downward trend comes.

On Monday, the DOH said the country’s total COVID-19 cases breached 800,000, with 8,355 new infections confirmed in laboratory tests. This pushed the total detected cases to 803,398, about a quarter of which was detected in March alone.

Ten more deaths pushed the toll to 13,435, while 145 more have recovered, bringing total recoveries to 646,237.

The DOH said 143,726 people were actively battling the disease, 97.5 percent of whom were mild, 1.1 percent asymptomatic, 0.34 percent moderate, 0.6 percent severe and 0.5 percent critical.

Moving hospital patients

Health authorities have found that 41 percent of patients admitted to hospitals in Metro Manila were mildly ill or even asymptomatic. “If we can remove the mild and asymptomatic from the hospitals, we can have 30 to 40 percent more beds available,” said Vergeire.

“We will start to extract them from the hospitals and bring them to (the isolation) beds from the LGUs (local government units). We are trying to see how we can set up the transfer immediately to ease the load of our hospitals and we can have space for those who need to be hospitalized,” she said.

Vergeire said “big isolation centers” would be opened in Metro Manila this week with combined 257 beds for mild or asymptomatic COVID-19 cases, while eight hospitals requested modular tents.

OCTA’s Butch Ong said hospital utilization was expected to remain at critical level from the middle of this week to the end of this week.

Variants

Vergeire acknowledged that the official DOH bulletin did not show the “true picture” of hospital admissions and health-care utilization since it was only relying on data submitted by hospitals.

The government, she said, did not expect the surge in the number of COVID-19 cases, even as she denied that it had not been ready. It was due to the more transmissible COVID-19 variants, she said.

“So in a normal situation, like if we do not have the variants, we are prepared, because we were able to reach that mandated 20 percent or 30 percent in private facilities for the number of COVID beds. Unfortunately, the variants have increased much faster and the spread has been tremendous, that is why the numbers of cases have increased this much,” Vergeire said.

She also noted a decline in compliance with minimum health protocols, which she described as the “root cause” of the problem. “So if you are not complying and the compliance is low, the variants would easily spread and that is what happened to all of us,” she said.