DOH REPORTING ON HOSPITAL CAPACITY ‘WRONG,’ MED GROUPS SAY

The Department of Health (DOH) continues to use the “wrong” standards in measuring the capacity of hospitals in dealing with coronavirus cases, according to an umbrella organization of medical professionals monitoring the government’s pandemic response.

Instead of focusing only on COVID-19 wards, intensive care units (ICUs) and isolation facilities, the DOH should conduct a daily census of emergency rooms (ER) to get an accurate picture of how overwhelmed the health-care system is, said Dr. Leonila Dans, an epidemiologist and coconvenor of Healthcare Professionals Alliance Against COVID-19.

“We have been saying since last year that their indicators are wrong. They need to conduct an emergency room census daily,” Dans told the Inquirer on Friday.

“The gateway is the ER— the transfers, those who are dead on arrival, the mild cases, and the ones waiting for admissions. Those are all in the ER and not in the ICU,” she added.

Alert level

The health-care utilization rate, one of the metrics of the DOH in its daily case bulletin, includes figures on the availability of beds in COVID-19 referral hospitals.

The department continued to report the same information on Friday’s bulletin, saying that 77 percent of all ICU beds, 73 percent of ward beds and 68 percent of isolation beds were currently occupied, while 57 percent of all mechanical ventilators were in use.

This data serves as a guide for the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF) to determine the alert level in Metro Manila under a new quarantine system which took effect on Thursday.

Alert level 5, the highest alert level under that system, refers to areas where COVID-19 transmission and hospital bed capacity are both critical.

But on Thursday, the capital region was placed under alert level 4, which prompted Dans to ask: “Shouldn’t we be at alert level 5?”

‘How to set a standard’

She said hospitals were already overwhelmed, with the Philippine General Hospital in particular already looking for volunteer doctors to augment its staff.

Health Undersecretary Maria Rosario Vergeire said at her online briefing: “We are considering this, but the challenge is that it is hard to set standards in ERs, since the capacities of ERs prepandemic and their capacities now have changed.”

She added: “We are studying how to set a standard … to measure and analyze emergency room occupancy in all hospitals. It’s not that we don’t have the data, we do have a daily census but we just can’t release the metrics yet.”

Dans, however, said in response to those remarks: “Just peg the usual ER capacity prepandemic, then take note of the number of patients in the ER. They don’t want to do it since the number of ER beds can be expanded to include beds in the corridor or parking lot.”

Vergeire, at her briefing, also cited that situation, as she sought to explain how ER capacity has changed.

But for Dans, “if the ER is adding additional beds or seeing patients in the parking lot, it’s already a sign that there is overflow.”

Virus case update

The DOH on Friday said it recorded 20,336 new COVID-19 infections, bringing the total count to 2,324,475 cases.

There are now 188,108 active cases, of which the majority, or 87.6 percent, are mild, 8.1 percent are asymptomatic, 2.49 percent are moderate, 1.3 percent are severe and 0.6 percent are critical.

The positivity rate remained high at 26.6 percent, meaning more than one in four of 75,766 who were tested on Wednesday turned out positive.

The department said 10,028 have recovered, which brought total survivors to 2,100,039.

But 310 have succumbed to the disease, pushing the death toll to 36,328.

Four labs failed to submit their data on time, while 53 duplicate cases were removed from the total case count.

Another 176 cases previously tagged as recoveries were reclassified as deaths following final validation.