A signage at the Makati Medical Center says it is already at full capacity for Covid-19 cases, March 15, 2021. Photo by Fernando G. Sepe Jr., ABS-CBN News

ICU occupancy in NCR remains at critical level at 79 percent

Today’s slightly low numbers in new cases are due to the less than optimum testing during Holy Week   
BENJAMIN CO, MD | Apr 05 2021

The DOH reports 8,355 new cases in the Philippines. The data announced today is from testing done during the Holy Week (with some testing centers closed for the long holiday). Note that the number of tests done in the past few days are less than optimum, with the positivity rate at more than 20 percent for the past week. With the more than 8,000 new cases today, the Philippines has now breached the 800,000 mark in total Covid cases. 

The healthcare capacity, in spite of hospitals opening additional beds, remains at a critical high with 79 percent ICU occupancy and 72 percent isolation bed occupancy in the NCR. Notice, however, that the ICU beds in the Philippines has increased as well. It is now at 61 percent from a previous 51 percent occupancy in mid March.

The OCTA Monitoring Report shows that the reproduction number in the NCR has declined from 1.88 to 1.61 after one week of ECQ. The goal of a lockdown is meant to slow down the increase in new cases. With an additional week of strict ECQ, we can hopefully bring down the Rt to 1.0 (or anywhere near it).

The average number of new COVID-19 cases reported per day in the NCR was 5,538 over the past week, an increase of 20 percent compared to the previous week. The NCR as a whole is now on a period where the increase in new COVID-19 cases is slowing down. The moving average trend lines have started to level off.

OCTA Research Monitoring Report, Philippine COVID-19 Update, April 5, 2021

The table below shows significant increases in the provinces of Laguna, Batangas and Pampanga. Only the province of Cebu has seen a significant decrease in daily new cases. In terms of ICU capacity, all top ten provinces are past the 70 percent critical level except for Batangas (65 percent) and Cebu (23 percent). Only Cebu has a positivity rate less than 10 percent for testing. All other provinces in the top 10 have a positivity rate ranging from 17-38 percent.  

The top 20 LGUs with highest cases are in the table below. Makati and Pasay are the only LGUs seeing a negative change (decline) in daily new cases. Attack rates are highest, however, with Makati, Navotas, Mandaluyong and San Juan. Hospital bed occupancy is at critical levels in 15 of the 20 top LGUs. ICU occupancy is at critical levels in 14 of the top 20 LGUs in the list. Taguig, Mandaluyong, Antipolo, Imus and Cainta are at 100 percent ICU occupancy as of this writing.

What makes it difficult for ICU occupancy is the management of critically ill COVID-19 patients. They occupy ventilators longer and are managed in intensive care for a significantly longer duration than non-COVID patients. In addition, they also add to the challenge of healthcare worker manpower in the hospitals. When HCWs are infected because of the hazard from being exposed to ill patients, the healthcare system becomes overwhelmed and the quality of care becomes compromised during these difficult times.

The government should work on efforts to alleviate the burden of caring for mild (and some moderately ill) patients in hospitals by creating more isolation facilities dedicated to COVID19 cases alone. The healthcare staff caring for COVID19 patients should receive better pay and additional personal and health hazard benefits because of the antecedent risks when caring for patients with COVID.