THE CLOCK IS TICKING! BUILD MORE BEDS!

By Prof. Enrique M. Soriano

The staggering scope of the coronavirus pandemic came into increasingly stark focus last week when Malacañang announced it would declare a Community Quarantine (CQ).

Effective 12:01 last Sunday March 15, 2020, Metro Manila was officially placed under CQ. Residents of Metro Manila (or National Capital Region) remained essentially under house arrest as the government ordered extraordinary restrictions on their movement to prevent contagions. The area under lockdown comprises 17 cities in the National Capital Region.

A day later, public health officials revised their restrictions and declared an Enhanced Community Qurantine (ECQ) blanketing the entire Luzon. For the first time in its history, the entire Metro Manila, Luzon and parts of Central and Western Visayas are now on indefinite hiatus.

Painful as it is, it’s for the best. It’s going to hurt but we know what we need to do to stop the spread of the coronavirus. If we know a few things right now, it is decisiveness, compliance and acknowledging the wisdom of our public health officials. Those three attributes are our best antidote to stop the virus from spreading. Waiting until things get dire is about the worst mistake we can make.

But whatever circumstances you are currently in, it’s time to step back and put everything in context. CONVID-19 is now officially declared a pandemic by the World Health Organization (WHO). With close to 350,000 confirmed cases worldwide, deaths about to top 15000 and new cases happening outside of China, WHO confirmed over the weekend that Europe has now become the epicenter of the pandemic with more reported cases and deaths than the rest of the world combined.

Based on figures on the ground, WHO highlighted around 3% mortality rate across the infected countries. This figure is relative. Variation will happen to a large extent on the adequacy of a country’s healthcare system.  This means that for as long as a country’s healthcare infrastructure is not overwhelmed, mortality rates should even be 1% or lower. The contagion has severely damaged international health systems as well as social structures. Even the US and European countries are taking a beating. Currently the US has recorded close to 35,000 cases and a little less than 500 deaths.

Let’s take the case of Italy. No doubt it has been slammed by the virus. Their government didn’t heed the warnings a month earlier and the consequences are devastating…more than 60,000 infected cases and closing in on 6,000 deaths and surging. Their lack of preparation and initial confusion is threatening not just their health-care infrastructure but their entire economy. And take note, Italy has one of the best health care systems among EU countries but as I write this column, it is on the verge of collapse.

 

The State of our Healthcare Ecosystem 

The most worrisome sight is our very own health care infrastructure. It may be premature to assess the state of our medical infrastructure but the mortality rate of more than 6% is factual. It is almost two times more than the WHO mortality declaration of 3%. Out of the close to 400 infected persons as of this writing, 25 have died. In Singapore, out of more than 310 persons infected, 2 deaths have been reported so far. That’s less than 1% mortality rate.

Based on figures I researched, our entire health sector has more than 1224 hospitals, 2587 city/rural health centers and 20,216 barangay health centers. And two thirds of these hospital beds are in Luzon which includes the National Capital Region (NCR). In layman’s language, there are 2.3 hospital beds for 1,000 people in NCR while the rest of Luzon, Visayas and Mindanao have a dismal average of less than 1 hospital bed per 1,000 population. WHO recommends 5 hospital beds per 1,000 population.

I also got an alarming message a few days ago that there are only 89,000 hospital beds servicing the entire 109 million population. That is a ratio of less than one bed per 1000 population. What is even more frightening is that there are only 1,000 beds dedicated to ICU patients in the entire country. These are disturbing numbers. As early as last week, we have already been hearing stories about hospitals turning away patients. If local transmission were to spread rapidly and we do not have the facilities and beds to accommodate the infected ones, the burden on our health workers could be crippling. The war has yet to start but it appears that we have already run out of ammunition.

It is time to build these beds. Now!