Why this week is crucial for Metro Manila

MANILA, Philippines — The Department of Health (DOH) on Monday said it needed to see this week that the health system, particularly in Metro Manila, could cope with and manage the increasing number of COVID-19 cases to determine what level of community quarantine should be imposed on the metropolis by August.

“Our indicators and our basis for us to be able to determine the community quarantine of an area, most important is we see that our health system capacity is improving,” Health Undersecretary Maria Rosario Vergeire said.

“We have other indicators like economic, social, security. These are being studied and the subtechnical working group of the [Inter-Agency Task Force for the Management of Emerging Infectious Diseases] began discussions last week. [Today], they will already present to [the task force] what will be the decision for the coming two weeks,” she added.

Command center

Currently, Vergeire said concerns of the health system were already being dealt with through the DOH’s “One Hospital Command” framework.

Under this system, an incident command center was set up at the Metropolitan Manila Development Authority’s headquarters in Makati City, which will map out the hospitals in the metropolis that can still accommodate COVID-19 patients.

“This is strengthening our referral system not just in the government but with the private hospitals as well. With this, we are also able to strengthen our protocols [on] mild and asymptomatic individuals … that they be placed on quarantine facilities to further decongest our hospitals,” she said.

On Monday, the DOH recorded an additional 1,657 COVID-19 cases, pushing the national caseload to 82,040.

Presidential spokesperson Harry Roque earlier said there was a “distinct possibility” for Metro Manila to be placed back on the stringent modified enhanced community quarantine should cases breach 85,000 by the end of the month.

Of the additional cases reported to the DOH by 59 of the 90 operational laboratories, Metro Manila accounted for 61 percent of the total, or 1,017.

A distant second was Laguna with 89, followed by Cavite, 38, and Cebu and Rizal, which both had 31 cases.

The DOH said 359 more patients had recovered, raising the total number of recoveries to 26,446. The death toll, however, increased to 1,945 as 16 more patients succumbed to the severe respiratory disease.

Of the newly recorded fatalities, 14 died in July while the two others died in May and June. Eight of the deaths were from Central Visayas, seven were from Metro Manila and one was from Soccsksargen.

Hospital capacity

Nationwide, half of the hospital beds dedicated to COVID-19 were occupied.

In Metro Manila, only 27 percent of the total 505 intensive care beds, 18 percent of the more than 3,200 isolation beds, and 14 percent of the around 1,500 ward beds remained available.

Of the 757 mechanical ventilators in the metropolis, 46 percent were in use.

Despite the increasing number of new cases, the DOH said the country was “faring better” in such metrics as the case fatality rate, the coronavirus’ reproduction number, and the case and mortality doubling time.

The Philippines’ case fatality rate of 2.37 percent is lower than the global average of 3.91 percent. As of July 5, the reproduction number is 1.044 percent, lower than the global average of 2 to 3.

The case doubling time is 8.87 days, while the mortality doubling time is 12.72 days, as of July 27. At the start of the Luzon lockdown in March, cases doubled every 1.55 days, while deaths doubled every 0.96 days.

On June 1, the case and mortality doubling time was 6.26 and 8.28 days, respectively.

Positivity rate

The DOH admitted though that the country’s positivity rate “needs improvement” as it currently stands at 8.92 percent, which is higher than the World Health Organization’s benchmark of less than 5 percent.

Vergeire said the DOH had expected cases to rise, especially with the reopening of the economy and the increase in the country’s testing capacity and expansion of the agency’s testing protocol.

Meanwhile, Vergeire said that the DOH was “saddened” with the condition of stranded people at Rizal Memorial Stadium in Manila, as they risked getting infected by not observing physical distancing.

“We are saddened that this happened in spite of all of our reminders. We have existing protocols against mass gatherings, yet this still happened,” Vergeire said.

She noted that the DOH had relayed its concerns to the other agencies, such as the Department of the Interior and Local Government, to deal with the situation.

“This will be discussed in the [task force’s] meeting [today]. We have guidelines on minimum health standards. They must be observed so this is really enforcement. We will discuss how to prevent a repeat of this incident,” she said.