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Space for the sick People with mild cases of Covid-19 are urged to isolate in quarantine facilities to help ease congestion in hospitals.

Outgoing and energetic, daddy “Lodi,” an 78-year-old semi-retired businessman dealing in industrial chemicals suddenly found himself gasping for breath while taking short walks in his sprawling compound in Pateros.

Suspecting he had gotten the coronavirus disease 2019 (Covid-19), he availed of the swab test offered by their barangay on 31 March while putting himself in self-isolation in a house in Taguig City.

Days later, a daughter bought him medical oxygen to ease his labored breathing while taking him for another round of RT-PCR test in a private lab. The result returned within 24 hours, negative for Sars-CoV2, the causative agent of Covid-19.

With hospitals swamped with Covid cases, health officials turn to quarantine facilities but their services have remained spotty, according to experts. (Cherk Balagtas)

Yet, the patriarch still had to be hospitalized for a couple of days, coming out of confinement for what turned out to be pneumonia, with his and his daughter’s wallet lighter by about P35,000, but they being in high spirits.

Then the result of the senior’s barangay RT-PCR result came in on 16 April via email, informing him he was positive for the virus.

“It took them all of two weeks to give us the result that he was positive, at a time when his body had already rid itself of the virus even before hospitalization,” said his daughter “Mel.”

She recounted being told by barangay health workers that the release of the result was delayed during the Holy Week that ended on 4 April, Easter Sunday.

“We didn’t know Covid-19 takes a break from infecting people during holidays,” Mel told the Daily Tribune, exasperation apparent in her voice.

“It was good my father had the sense to go into self-quarantine, but I can imagine other people going about town, especially the asymptomatic, infecting others while awaiting their results,” she said.

On 2 April, Good Friday, a day commemorating the passion of the Christ nailed on the cross, the Philippines recorded the highest single-day number of new infections at 15,298. On Black Saturday, it dropped to 12,546 and on Easter was at 10,229 with a seven-day average of 11,008 new infections, figures that dwarfed many times over those recorded during the first wave of infections in 2020.

 

Stricter ECQ

The surge in new Covid-19 infections started in March this year, prompting the national government to impose from 29 March to 4 April the stricter enhanced community quarantine (ECQ) over Metro Manila and the outlying provinces of Bulacan, Cavite, Laguna and Rizal, the so-called National Capital Region (NCR) Plus bubble.

The ECQ — that brought back checkpoints and lockdowns but not as strict as last year — was extended one week before being eased into the modified ECQ on 11 April over falling new cases at NCR Plus. OCTA Research credited the enhanced community quarantine (ECQ) imposition for the virus reproduction rate dropping to 1.16 for the period 9 to 15 April.

For the same period, the Metropolitan Manila Development Authority said negative growth rates in Covid transmission were recorded in nine cities, namely, Manila (minus-eight percent), Makati (minus-one), Taguig (minus-13), Mandaluyong (minus-six), Valenzuela (minus-three), Pasay (minus-12), Marikina (minus-15), Muntinlupa (minus-17) and Navotas (minus-13).

The Center for Strategic and International Studies (CSIS), meanwhile, attributed the spike to “the relaxing of some mobility restrictions that allowed people to return to work.”

“The national government has largely left pandemic management to localities, (thereby) creating an inconsistent policy response and an uneven economic recovery. The Philippines in 2020 experienced a 9.6 percent contraction in gross domestic product, Southeast Asia’s deepest economic slump,” CSIS said.

With delayed results and the exorbitant cost of testing that limits testing ratio to less than two percent of the population fears are being expressed that the numbers may be actually higher than what are being reported.

The impression that a lot of people are enriching themselves during the pandemic have prompted the Department of Health (DoH) and the Department of Trade and Industry (DTI) to issue a warning against those who will overcharge for the tests, above the P5,000 cap for private laboratories and P3,800 for public laboratories.

 

Red Cross flak

Even the Philippine Red Cross (PRC) headed by Senator Richard Gordon has taken flak for Covid-19 nasopharyngeal and oropharyngeal swab test pricing seen, rightly or wrongly, to be saddled with a huge profit margin.

Gordon himself has been regularly going to media in a bid to collect reimbursements for the tests from the government, at one time warning that the PRC may go bankrupt and unable to continue its humanitarian mission because of delayed reimbursements from the Philippine Health Insurance Corporation.

His PRC, an organization that takes in donations from abroad, has offered a saliva-based Covid-19 test as a cheaper alternative to the nose and throat swabs.

With the easing of restrictions at NCR Plus to MECQ, concerns had been aired that the number of new cases may rise up anew.

While Covid-19 referral hospitals are swamped with patients awaiting admission, the utilization of quarantine facilities across the nation have remained spotty — maximized in some and grossly under-utilized as self-isolation at homes had been allowed.

Pau, a Covid survivor, told the Daily Tribune that she chose not to go to the Hope quarantine facility in Quezon City because of concerns like being left to fend on her own, including sourcing her food.

In what may serve as snapshots of how local government units are managing Covid-19 in their respective jurisdictions, isolation facilities and intensive care unit (ICU) beds were reported to be in “high critical situation” in Caloocan, Malabon, Navotas and Valenzuela.

The long wait for hospital beds, especially for those needing critical care, arises from the extended stay of patients — 10 days to as long as 30 days — before their ICU beds are freed up for others, a health worker told this paper.

Based on the latest DRRMO Covid report, the Caloocan City North Medical Center (CCNMC) tents and con-vans that are also used for Covid-19 positive patients are now full. With a total capacity for 42 people, 44 patients are currently admitted.

At the Macario B. Asistio High School with capacity for 186 people, 92 had been admitted with nearly as many vacancies, while at the Caloocan City Medical Center (CCMC) Covid ward, 20 had been admitted with 25 vacancies.

Still in Caloocan, the Kanlungan Rehabilitation Center which has also been built as an isolation facility with capacity for 38 has already admitted 29 patients. The Astrotel, which has a capacity of 58, only has five admitted, while The Oyo Spiral Hotel with capacity for 49 has 15 admitted.

Despite the seemingly low utilization of isolation facilities, several are under construction or being readied for operation, in what may be a portent of things going south or of government and the public sector bracing for worst-case scenarios.

A few of them are located at the Tala Elementary School good for 192 people and the Bagbaguin Elementary School that can house 129 people. Expansions at the CCMC and CCNMC being built in collaboration with the Department of Public Works and Highways will add a capacity for 44 patients.

In Navotas, people who tested positive had been allowed to isolate in their respective homes due to the severe lack of public accommodation for them. Among those allowed to self-quarantine are pregnant women, minors, seniors, and those with comorbidities.

Navotas authorities have resorted to having Covid patients and those awaiting their test results wear color-coded Q-Bands to restrict their movement and the possibility of them infecting others.

White Q-band wearers are residents living in granular lockdown areas or awaiting RT-PCR swab test results. Meanwhile, those wearing the colored Q-band are Covid-19 positive or those who live in their houses with Covid positive patients.

Navotas officials thanks several companies for donated equipment like the two units of ultra-violet light machines provided by Rite Products Incorporated for use in disinfecting hospitals and isolation facilities.

Schools as quarantine facilities Elsewhere, data provided by the Department of Education (DepEd) showed that 1,212 schools are already being used as Covid quarantine facilities across the country, including many in Malabon like the Imelda Elementary School serving those brought in by the Swab Cab Program of Vice President Leni Robredo.

DepEd has previously said that the use of schools as both isolation and vaccination centers should be avoided.

Valenzuela City, too, has been put under critical status in terms of bed capacity for Covid-19 patients, including at the Allied Care Experts (ACE) Medical Center Valenzuela.

From just 15 rooms initially, Ace ratcheted its Covid bed capacity to 48, utilizing air-conditioned field tents and medical mission trucks for patients waiting to be admitted. Meanwhile, in the capital city, Manila, all six district hospitals and 15 quarantine facilities are under “red-flag conditions” with the hospitals reporting a 75 percent occupancy rate for Covid patients.

Of the 971-bed capacity of Manila’s six district hospitals, 523 had been allocated for Covid-19 patients, with 391 occupied as of this writing tending to critical and severe cases in need of oxygen, ventilators and other medical intervention.

The 15 quarantine facilities ordered constructed by Mayor Francisco “Isko Moreno” Domagoso have a combined capacity of 910 beds, of which 403 are being used for people awaiting their test results.

The city of Pasay, the travel hub of Metro Manila, has opted to impose a localized lockdown in many of its barangays to control the spread of Covid-19 and somewhat recover from the economic effects brought by the hard lockdowns.

Mayor Emi Calixto-Rubiano told Daily Tribune that there are barangays under granular lockdown consisting of some 400 plus households.

Mayor Emi said they have also asked the help of Oplan Kalinga, which responded positively, and some of their patients were brought to Batangas while the city awaits the completion of their additional facilities.

Pasay is adding two facilities, each with a capacity for 100 beds, with the city taking advantage of personnel from the DoH coming in to attend to patients.

 

Longest days

For the Daily Tribune’s Central Desk man turned reporter — Jomelle Garner, life in the quarantine facility was difficult.

For a social animal that he is, keeping his thoughts to himself as he has nobody to talk to during his 14-day isolation in his quarantine room in Antipolo Institute of Technology was a curse.

He only sees people three times a day — morning, afternoon and evening — the nurses and quarantine personnel who deliver food and assist patients in the quarantine facility.

He said that it was the longest day in his life, every day seems to be a slow-paced movie.

Keeping himself sane has become an additional burden while he is treating his cough and cold as anxiety attacks became his nightly visitor.

Away from social media — his main information feeder — made him out of the loop on what is happening because getting stable cellular data in his room was also a struggle.

But he said if there is something he had realized during his stay inside the facility – it was “always cherish every moment that you have in your life because life is unpredictable.”

He had never thought he would catch the virus as he claimed he did everything he can to avoid contracting it, but as he says life is indeed unpredictable.

For now, he is already cleared of Covid-19 and living his life with extra caution, he assured he would never want to be trapped in four-cornered room for another 14 days. (With Alvin Murcia, Pat Santos, Paula Antolin and John Dodson)

 

 

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