
Originally Posted by
Verbl Kint
REPOSTING FROM SocMed
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From the Chairman of The Medical City, Mr. Eckie Gonzales.
Directly addressed to our government leaders (Via Dr. Louie Racelis).
"My opinion -
The Covid19 tidal wave is almost upon us. And we did not prepare enough to evacuate our population to higher medical ground.
This stealth virus was a real sleeper. Asymptomatic transmission. Airborne. Accelerating difficulty of breathing later in the second week of the sickness for the 20% of the cases that will ultimately require hospital admission. And yet there were zero new cases for over a month between the 3 Wuhan tourists and the Greenhills super-spreader.
NEW CASES
Jan
30 - 3
March
6- 2
7 - 1
8 - 4
9 - 14
10 - 9
11 - 16
12 - 3
13 - 12
14 - 47
15 - 29
16 - 2
17 - 45
18 - 15
19 - 15
20 - 13
21 - 77
22 - 73
Why zero? Did we underestimate the transmission impact from international inbound travel, especially from our OFWs especially from the US and Europe? Did we undercommunicate the symptoms that should have brought people to our clinics and hospitals for testing? And finally, did we underprovide for the test kits necessary to identify the infectious people early enough, and trace their contacts to minimize the virus spread?
This is why for example, in the latest daily patient census of The Medical City, the number of PUI s (patients under investigation) to covid19s is 71:19, or 3.7 PUI s for every one covid19. Likely most of these PUIs are covid19s. The test results backlog at the one institution that is doing it now, the Research Institute of Tropical Medicine (RITM) is one week or more. So people could be walking around not knowing they have the virus. People actually die before knowing their results. And because the number of kits available is small, the mildly symptomatic (who are probably the most infectious), are asked to stay at home and self-quarantine.
This shows that we are clearly underreporting our cases. Therefore, expect the numbers to shoot through the roof with the 100,000 test kits from China that just arrived, with the DOH enlisting 10 other hospitals to do tests.
Why didn’t we prepare for mass testing much earlier?
Whatever it is, we are now beyond case containment, and now into slowing disease transmission and averting excess morbidity and mortality.
A lockdown helps. It stops people from moving around and infecting each other randomly. Effective community surveillance at the LGU level will detect and monitor the unwell.
But once you get beyond the tests, and having identified the sick, how do you minimize getting the frontline Health Care Workers (HCWs) also sick? Just yesterday UST hospital announced a pause in its services as 530 HCW s had to go on quarantining. There are clearly not enough N95 masks, face shields, goggles, impermeable gowns, etc.. to provide a safety net for the HCWs. The private hospitals have also picked up most of the covid19 slack, because DOH had failed to mobilize the government hospitals sooner. Too little, nearly late.
Finally... two days ago, the DOH consented to dedicating certain government hospitals as covid19. But are they ready?
Do we have enough mechanical ventilators for the 20% of cases that may need assistance in breathing, even intubation? The largest and most well-equipped government hospital has only 22, about the same number as the largest private hospital. Let the government hospitals pick up best practices from the private ones that have led the way on covid19. Don’t hoist this nationalization petard on them. We know that gets us nowhere in terms of results.
Our economy is in crisis, and with limited resources the government needs to redeploy funding from physical to social infrastructure to support a creaking national health ecosystem before it gets overwhelmed by the expected huge jump in covid19 cases. The best way is for the government to pay for services efficiently rendered, not to manage the private sector.
So whether it s for a hotel for covid19 mildly symptomatic patients, or buses to transport HCWs, or reimbursements to hospitals for intubations, let this be done efficiently, transparently, and quickly, without boorish reference to nationalization. That is a historical bygone to be left buried 10 feet under.
Most importantly, during this 1-2 month (hopefully) hiatus, let us feed our poor by leveraging the established CCT infrastructure, and make sure that food can get to marketplaces where it can be effectively bought under new norms of social distance (now 6 feet instead of 3).
Italy also ignored the virus for over a month. It now has 53,578 cases and 4825 deaths, a mortality rate of 9%. We have 380 cases today and 25 deaths, a mortality rate of 6.6%. Will we see 100,000 cases soon? Our median population age, at half Italy s, is 23.5 years. On the other hand, our total population, at 110 million, is almost double theirs.
Is Korea a better model? They did massive testing quickly and early on. Their daily case rate peaked at 800 by end February, but has since come down to the mid-70s, our current level.
Can we flatten the curve till we find a vaccine, or a promising cure like hydroxychloroquine, before the curve flattens us?
Time is not on our side."
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