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Overrun and overwhelmed

SKETCHES - Ana Marie Pamintuan (The Philippine Star) - April 5, 2021 - 12:00am

On Black Saturday, fresh COVID cases in our country hit 12,576.

That looks lower than the record high 15,310 on Good Friday. But this figure included the 3,709 backlog that was not reported on March 31, so the total for Friday was actually 11,601 cases, and the Black Saturday figure was the new record high.

While we’ve been told that over 90 percent of COVID cases are mild or asymptomatic and qualify for home isolation, that’s still thousands of people needing hospitalization. How can our healthcare facilities possibly cope with that surge in patients?

You’ve heard the horror stories: singer Claire dela Fuente waiting for about a week to be admitted to the COVID ward of a private hospital, and then being forced to move to another hospital, where she also had to wait in line to be admitted. She died of a heart attack in the emergency room.

Then there’s the resident of Novaliches, Quezon City, who went hospital hopping all the way to Pampanga on March 29, to find one that would admit his father who was showing COVID symptoms: fever, cough and difficulty breathing. At least they found him a spot in a hospital in nearby Valenzuela. The father was admitted… after a wait of 12 hours.

An interesting sidelight of this story is that the guy called the hotline of the “One Hospital Command Center” of the Department of Health (DOH), which is supposed to direct people to the nearest available COVID health facility. He said he was told that they were 32nd in line.

With daily fresh COVID cases averaging 8,997 in the week until March 31, of course hospitals have become overwhelmed. Even wealthy Makati has sent out an SOS to the national government.

The government is reportedly ordering an increase in COVID bed allotments and expansion of isolation facilities. But the expansion can be finished only in about three to four weeks. And while more hospital rooms can be set aside for COVID patients, the problem is the lack of health personnel trained to handle this problem. There has been no rush among the country’s reserve nursing force to work in COVID wards.

As for intensive care units, their ventilators for severe cases are limited and cannot be immediately augmented.

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It’s not just hospital capacity but also contact tracing that has “deteriorated” – as described by Baguio City Mayor Benjamin Magalong himself, whose “irrevocable resignation” as contact tracing czar is in limbo. In the meantime, he himself has contracted COVID.

Last year, due to lack of funds, the Department of the Interior and Local Government decided not to rehire 50,000 contact tracers who were tapped for “augmentation” in the fourth quarter. DILG officials say local executives can hire their own contact tracers.

By the end of June, the DILG could lose 15,000 of the total 255,000 contact tracers. The 15,000 were hired under a six-month contract. The DILG needs about P1 billion to keep the tracers employed until yearend.

The DILG has also ordered local government units particularly in Metro Manila to use only the StaySafe.ph contact tracing app. But with several LGUs using apps uniquely linked to their central data systems, which are used for accessing many local basic services, the full shift to StaySafe.ph is a work in progress. Because of previous controversies involving privacy issues, there is also resistance to the StaySafe.ph app among the general public.

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Officials stress that viral transmission had been flattening since January, and they admit that they are scrambling for a response to the surge that has taken them by surprise.

Still, you wonder if we could have been better prepared to handle this. There was extensive coverage of the more infectious COVID variants rampaging across Brazil, South Africa, the United Kingdom and then across Europe and the US, which were forced to reimpose various types of restrictions including lockdowns. Their hospitals again overflowed with patients.

We never completely closed our borders especially to our compatriots returning from all over the planet, including Brazil. Epidemiologists said early on that it was just a matter of time before the variants reached the Philippines. Learning from the other countries grappling with the variants, could we have boosted our healthcare capacity early on?

The government remains in denial about the likely significant role played by the variants in the surge (and the government still refuses to call 8,997 average daily cases a surge).

Why is this? Because there isn’t enough data to pin the blame largely on the variants, according to epidemiologists. In fact only about 10 percent of fresh infections have been attributed to the variants, according to Dr. Anna Ong-Lim, a member of the DOH’s Technical Advisory Group and the study group formed on the COVID variants.

But where is the data based? The Philippine Genome Center is the only place that can sequence specimens for confirmation that the virus is a mutant. The PGC can sequence only 750 specimens a week.

Doctor Lim admits, “Obviously, we cannot test 9,000 samples, right?”

“What has been done is a sampling framework to try to get representative numbers across different areas,” she told us on One News’ “The Chiefs” on March 30. “So each run is about 750 samples. Then you distribute it depending on the number of cases per area so that what you get is representative of whatever it is you’re running. So we don’t have each and every sequence, but we have an idea of how much it has spread.”

I don’t know about you, but that looks to me like a high likelihood that the variants are mainly behind the surge. Wouldn’t the variants call for restrictions tighter than usual?

Shouldn’t we review the policy on mass transportation, for example? People sit side by side for more than 15 minutes (the time it takes for the virus to latch on to you) in jeepneys, their knees almost touching across the narrow aisle, with only plastic sheets separating them. Are the sheets disinfected after every use?

Since the government has been forced to reimpose ECQ, it should maximize the limited lockdown period with bitter pills to make the cure work.

COVID-19
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