Minus Iloilo and Bacolod cities, WV on Alert Level 2 for COVID

By Joseph B.A. Marzan

Except for the cities of Iloilo and Bacolod, Western Visayas is on Alert Level 2 for the coronavirus disease 2019 (COVID-19), according to the latest report from the Department of Health-Western Visayas Center for Health Development (DOH-WV CHD).

The DOH said Iloilo City is under Alert Level 3 while Bacolod City is under Level 4.

An area is classified under Alert Level 2 if case transmission is low and decreasing, healthcare utilization is low but the Delta variant (B.1.617.2) is present.

DOH-WV CHD data as of Oct. 17, 2021 showed that case transmission has lowered in the region from Oct. 1 to 14, with a 2-Week Growth Rate (2WGR) of -38 percent and an Average Daily Attack Rate (ADAR) of 5.99, translating the region as ‘Low Risk’ for COVID-19.

The 2WGR is the percentage rate of increase in new COVID cases, while the ADAR is the number of new cases per 100,000 population of an area. Both are measured in 14-day periods.

The region logged 6,624 new COVID cases on Oct. 1 to 14, lower than the 10,624 recorded on Sept. 17 to 30, and 12,484 on Sept. 3 to 16.

As to the Health Care Utilization Rate (HCUR), the region is considered at low risk with 52.38 percent.

This includes usage rates of 52.04 percent of COVID ward beds (344 out of 661), 55.08 percent of intensive care unit (ICU) beds (141 out of 256), 52.11 percent of isolation beds (790 out of 1516), and 52.17 percent of mechanical ventilators (120 out of 230).

As to the presence of the Delta variant, the region has 243 total cases which includes 69 in Iloilo province, followed by Bacolod City (35), Antique (29), Aklan, Negros Occidental, and Iloilo City (28 each), Capiz (18), and Guimaras (8).

DOH-WV CHD spokesperson Dr. Bea Camille Natalaray said in a virtual press briefing on Monday that last Oct. 16, the Philippine Genome Center reported 27 Delta variant cases in the region. These include cases from Capiz (16), Bacolod City (9), and Negros Occidental (2).

“These results are still for verification since the results arrived only on [Oct. 16]. We have forwarded these to the provincial health offices, and they will do the contact tracing to verify the addresses of these Delta cases,” Natalaray said.

The DOH-WV CHD has the following recommendations for areas under Alert Level 2:

• Ramp up active case finding (Find clusters and superspreading events to explain increase in case);
• Secure samples submitted for representatives;
• Submit samples from identified clusters;
• Aggressive community testing;
• Intensive contact tracing (2nd to 3rd generation);
• Facility isolation;
• Ensure mild/asymptomatic are in a Temporary Treatment and Monitoring Facility or step-down facility;
• Severe and critical are in an ICU;
• Determine an increase in HCUR; and
• Vaccinate priority groups first.

ILOILO AND BACOLOD CITIES

The cities of Iloilo and Bacolod are the only ones with higher Alert Levels, both being at Moderate Risk, with the former at Alert Level 3, and the latter on Alert Level 4.

Under Alert Level 3, case counts are high but with increasing healthcare capacity utilization; while in Alert Level 4, case counts are high with healthcare capacity at high utilization.

While the two cities both have negative 2WGRs (-12 percent for Bacolod City and -46 percent for Iloilo City), their respective ADARs remain in the red at 19.86 for Bacolod City and 11.48 for Iloilo City.

As to their respective HCURs, Iloilo City enjoys a low 55.73 percent while Bacolod City has the region’s highest with 75.81 percent.

The DOH-WV CHD made the following recommendations for areas under Alert Level 3:

• Ramp up active case finding (Find clusters and superspreading events to explain increase in case);
• Secure samples submitted from priority areas;
• Aggressive community testing;
• For areas with local Delta variant case (city or municipality), rapid antigen test can be utilized;
• Ensure all close contacts are traced, tested, and quarantined;
• Facility isolation, especially for areas with local Delta variant cases;
• Decongest hospitals and improve triage and referral systems (Promote the use of telemedicine, home care packages, step-down care facilities);
• Target decongesting hospitals of mild and asymptomatic cases (Ensuring adequacy of ICU beds in Level 2 and 3 hospitals);
• Reprioritization of vaccine deployment and logistics and other resources needed to areas with increasing cases; and
• Avoid using hospitals as vaccination sites in preparation for surge capacity.

Meanwhile, the following recommendations are made for areas under Alert Level 4:

• Continue active case finding;
• Secure samples submitted from priority areas;
• Aggressive community testing;
• For areas with local Delta variant case (city or municipality), rapid antigen test can be utilized;
• Prioritize tracing close contacts;
• Identification of high risk transmission areas for public or community advisory;
• Facility isolation, especially for areas with local Delta variant cases;
• Urgently address critical care capacity needs (Strong triage and referral to ensure that moderate, severe, and critical cases are immediately referred and admitted);
• Immediately convert or add ICU beds and equipment in Level 2 and 3 hospitals;
• Priority is active cases (No elective surgeries);
• Ensure continuity of other essential services;
• Reprioritization of vaccine deployment and logistics and other resources needed to areas with increasing cases; and
• Avoid using hospitals as vaccination sites in preparation for surge capacity.

The region’s six provinces – Aklan, Antique, Capiz, Guimaras, Iloilo province, and Negros Occidental – are all under low risk for COVID-19 and on Alert Level 2.

Negros Occidental has the lowest 2WGR (-33 percent), followed by Antique (-36 percent), Aklan (-47 percent), Capiz (-50 percent), Iloilo province (-51 percent), and Guimaras (-64 percent).

Negros Occidental also has the highest ADAR (6.36), followed by Guimaras (5.28), Iloilo province (4.16), Capiz (3.19), Antique (1.81), and Aklan (1.05).

As to the HCUR, Negros Occidental also leads the provinces (71.63 percent), followed by Capiz (60.43 percent), Guimaras (53.45 percent), Iloilo province (50.35 percent), Antique (20.71 percent), and Aklan (0.86 percent).