The Philippine General Hospital also recently reported that they have exceeded COVID bed capacity. Photo from official Facebook page
Culture Spotlight

80% of COVID beds in Manila are filled, with 65 percent of hospitals in the danger zone

4,325 recoveries and 65 more deaths were also reported. But with the number of new cases still high, our resident expert feels it will be difficult to ease current restrictions without a strong plan on how to address the numbers. BY BENJAMIN CO MD
ANCX | Jul 13 2020

Infectious diseases and clinical pharmacology expert Dr. Benjamin Co has been thankfully breaking down coronavirus numbers in his personal blog since the outbreak started. The perspective he provides is informative, and comforting in those who are craving for a clear picture of how we are faring against the virus. Dr. Co will share daily updates and analysis of the Department of Health reported numbers with ANCX. 

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Let me start off with a disclaimer, as the Health Agency would do. Whatever is written here is based on the information released by the Department of Health (DoH) at the time of publication. Whatever changes DoH makes in their data later on, well, that’s a different story in itself. As they say in their disclaimer that “the total cases reported may be subject to change as these numbers undergo constant cleaning and validation.”

In today’s 4 PM report, there were 836 positive cases from 57 out of 82 laboratories (69.5 percent), fewer than this morning’s report of 2,124 cases. Unlike this morning’s report, the summary of cases this afternoon does not provide a breakdown of the provinces or regions where these cases came from. Most likely, majority were still from National Capital Region (NCR) and Region VII.

The number of active cases significantly dropped from 38,679 to 35,036 since this morning’s announcement with 4,325 more recoveries reported. But the deaths increased as well with 65 additional deaths to the 162 reported this morning. This brings our recovery rate up to 35.7 percent and our death rate rise to 2.8 percent (from this morning’s 2.73 percent). The 65 deaths reported this afternoon occurred mostly occurred in June.

Most of the current deaths were from Region VII. The deaths reported NCR were mostly from May and a few in July. In the graph below, Region VII (in orange) had the most deaths and they occurred mostly in June.

According to the case bulletin, as of July 12, 2020, there are 85 testing sites (63 RT-PCR and 22 GeneXpert laboratories) in the country. A total of 926,252 total individual tests have been done.

Finally, the DoH reports on the health capacity of the country in this infographic showing less than 50 percent occupancy of ICU beds, and less than 23 percent utilization of ventilators. Caution is advised in the interpretation of the data provided below. This is an overall or whole country picture of hospital beds and mechanical ventilators for COVID-19. Private hospitals are requested to provide 30 percent of their capacity for COVID-19 cases. Because of lack of dedicated government facilities for COVID cases, particularly in epicenter areas (NCR and Region VII), the information from the Health Agency may not be an accurate reflection of the capacity in these places.

Let’s use the data from the DoH COVID Tracker. In NCR, the bed occupancy is at 73.3 percent with 66 (or 52 percent) of the hospitals in the danger level.

NCR is divided into four districts. The first district comprises Manila where more than 80 percent bed occupancy from COVID cases is already observed and where fifteen (65 percent) of its hospitals are in the danger level.

District two comprises Mandaluyong, Marikina, Pasig, Quezon City, and San Juan. The bed occupancy is at over 72 percent with 29 (47.5 percent) in the danger level.

The third district is made up of the cities of Caloocan, Malabon, Navotas and Valenzuela. This district seems the least overwhelmed with 67.2 percent bed occupancy. Only 50 percent of its hospitals are in the danger level.

The fourth district is a relatively large area that comprises Las Piñas, Makati, Muntinlupa, Parañaque, Pasay, Pateros, and Taguig. Many private residential areas belong to this district. Bed occupancy is at 72.2 percent with 50 percent of the hospitals in the danger level as well.

The table below summarizes the bed occupancy and health capacity in NCR from July 2 (black) compared to July 4 (red) and July 12 (green). The rising bed occupancy including the increase in number of hospitals in the danger level is definitely a cause for concern.

The same picture is seen in Cebu City. While Region VII has 62.7 percent overall beds occupied with COVID-19 cases, 51 out of 88 (58 percent) facilities are in the safe zone.

However, when it is broken down by province already, notice that the bed occupancy for COVID cases increases now to 72.3 percentm and 21 of 48 (44 percent) are now in the danger level. 

Breaking it down further to cities, Cebu City has almost 76 percent beds occupied for COVID-19 patients with nine of 14 (64.3 percent) of health facilities in the danger level.

The situation in NCR and Region VII remain volatile. Mostly because of continuing increase in new confirmed cases and deaths. The lack of granular data, in general, is also disturbing considering that majority of patients are classified under “unknown,” or have no tagged location. Finally, because of the ongoing community transmission, I personally feel that it is going to be a difficult balancing act of easing current quarantine restrictions without a stronger plan on how to address the challenges of increasing cases and deaths.

 

The world

The 13 million mark has been crossed. If the seven-day average for new cases of approximately 200,000/day does not decline, the next million will be reached on or before the weekend (or every five days). Total number of cases overnight was down at a little over 192,000 cases. Total number of deaths was also lower at a little less than 4,000 deaths. Nevertheless, the seven-day average for deaths is 4,948 deaths/day. 

The global case fatality rate is lower at 4.38 percent and recovery rate lower at 58.18 percent due to a record high number of cases over the past week. Recovery rates are not very reliable indicators because they are subjective to the country’s definition of how and when they consider patients “recovered.” 

Data from WorldOMeters.info.

The United States passed the 3.4 million mark with 58,349 new confirmed cases for the day. It now has a seven-day average of > 60,114 cases/day or more than 120,000 cases every other day. It was a reprieve yesterday when the US reported only 380 deaths. However, the seven-day average is up at 740 deaths/day. Top three states contributing to yesterday’s haul were Florida (+15,300), California (+7,702), and Texas (+6,091). 

The case fatality rate in the US is now at 4.04 percent with 3,414,0452 cases as of this report. 

Brazil stays in second spot with close to 1.9 million cases and continues to report the highest number of deaths in the world with 659 deaths yesterday. At the current growth rate in new cases in Brazil, they are bound to reach the two million mark in four days.

The top 10 countries that had the highest new cases overnight were:

  • USA – 58,349
  • India – 29,108
  • Brazil – 25,364
  • South Africa – 12,058
  • Russia – 6,615
  • Mexico – 6,094
  • Colombia – 5,083
  • Peru – 3,616
  • Chile – 3,012
  • Saudi Arabia -2,779

Total coronavirus cases from South America now totals 2,894,611. It has passed the total number of cases of Europe (2,579,162).

Because of two reports from the Philippines today—this morning and at the 4 o’clock habit—the cases are tabulated as a single day’s haul in the global community. The Philippines remains in 33rd place with more cases and more deaths reported than Indonesia.