EFFECTIVE 12:01 am of Sunday, March 15, 2020, Metro Manila was officially placed under community quarantine. Residents of Metro Manila or National Capital Region (NCR) remained essentially under house arrest as the government ordered extraordinary restrictions on their movement to prevent contagions. The area under lockdown comprises 16 cities and one municipality. It covers a land area of 620 kilometers (240 square miles) with a daytime population of more than 13 million.
For the first time in its history, the entire Metro Manila is 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 novel 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. Covid-19 is now officially declared a pandemic by the World Health Organization (WHO). With close to 165,000 confirmed cases worldwide, deaths breaching 6,200 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, apart from China. Based on figures on the ground, WHO highlighted around three percent 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 one percent or lower. The contagion has severely damaged international health systems as well as social structures. Even the United States and European countries are taking a beating.
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 21,000 infected cases, including 1,500 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 European Union countries. But as I write this column, it is on the verge of collapse.
The state of our health care 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 10 percent is factual. It is almost three times more than the WHO mortality declaration of three percent. Out of the 140 infected persons as of this writing, 11 have died. In Singapore, out of more than 220 persons infected, no deaths have been reported so far.
Based on figures I researched, our entire health sector has more than 1,224 hospitals, 2,587 city/rural health centers and 20,216 barangay health centers. And two-thirds of these hospital beds are in Luzon, which includes the 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 one hospital bed per 1,000 population. WHO recommends five hospital beds per 1,000 population.
I also got an alarming message the other day that there are only 89,000 hospital beds servicing the entire 109 million population. That is a ratio of less than one bed per 1,000 population. What is even more frightening is that there are only 1,000 beds dedicated to intensive care unit patients. 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.
It is time to build these beds.