No bed for COVID as Davao City experiences “unusually high volumes of patients needing admission”

DAVAO CITY (MindaNews / 04 September) –  From 427 ward beds for COVID-19 patients on August 18 to 432 on August 26, the state-run Southern Philippines Medical Center (SPMC) added 16 more beds on August 27 to make it 448 and yet another 27 on September 2 for a total of 475. The number of Intensive Care Unit (ICU) beds has remained at 92 — but all 567 beds for COVID-19 patients are occupied and many patients are being attended to while seated on plastic chairs or standing, or inside ambulances, awaiting admission.

“We are experiencing an unusually high volume of patients needing admission for COVID-19. Please bear with us as we try to allocate rooms/beds and provide the healthcare you need,” the SPMC announced on its social media page in the early hours of Saturday.

On September 4, Davao City posted its highest single-day increase in COVID-19 statistics since March 2020, with 498 new cases out of the region’s 1,031, also the highest single-day record for the region – and Mindanao.  It was the first time the Davao region breached the 1,000 mark in new cases.

Southern Philippines Medical Center in Davao City. MindaNews photo by GREGORIO BUENO

Private hospitals in Davao City had earlier put up  signages declaring there are no beds for COVID patients, prompting those who were turned away to proceed to Tagum City, at least 50 kilometers away. But as early as August 29, finding a hospital in Tagum that would admit a COVID-19 patient was already a major challenge as the COVID-19 beds in the hospital there were also occupied.

A “spillage of patients,” was how SPMC chief Dr. Ricardo Audan described the situation on Thursday, the same day the hospital added 27 more ward beds, all immediately occupied, with many more on the waitlist.

“A tsunami of COVID-19 patients,” was the description offered by other doctors.

A month earlier, Audan declared in an online presser on August 9 that “we will not be like India, we will not be like Cebu” where the health care system was overwhelmed and oxygen supply, among others, was a major concern.

Audan was confident that the SPMC was ready for the expected surge of patients infected with the Delta variant of the SARS-Cov-2, the virus that causes COVID-19.

Because of the huge number of patients needing high-flow oxygen, SPMC ran out of oxygen supply on Thursday, Dr. Yvette Barez, infectious disease specialist and chair of the SPMC’s Infection Prevention and Control Unit, told MindaNews on Saturday evening.

Last month, Audan said SPMC has two oxygen plants with six fully functional oxygen generators with a combined maximum production of 873 tanks per day. He said the average daily consumption of the hospital was 1,223 tanks with the rest of the requirement supplied by two private suppliers. He said SPMC was going to open its hyperbaric oxygen plant that is capable of producing 300 tanks of oxygen.

Barez said the supply ran out because of the sheer volume of patients requiring high-flow oxygen and a delay in the delivery of externally sourced supply. The delay issue has been addressed by one of the two suppliers, which promised to increase supply to SPMC.

“Patients on high flow machine need 40 to 60 liters of oxygen per hour so a total of about two to four tanks per hour ang ma-consume,” Barez explained.

A health worker in personal protective equipment crosses the street outside the emergency department of the Southern Philippines Medical Center in Davao City on 29 August 2021 as three ambulances await their turn to unload their patients. MindaNews photo by Carolyn O. Arguillas

She said recommendations have been made  for the city to be placed under Enhanced Community Quarantine (ECQ) but this has yet to be acted upon. The city is presently under General Community Quarantine (GCQ) with restrictions.

She reminded the public to stay home, stay away from parties, leisure biking and other gatherings and observe minimum public health standards.

She said there are many patients still on the waitlist at the isolation triage and in the emergency department.  The sheer number of patients has made physical distancing a problem, Barez said.

SPMC, the country’s largest hospital, has an authorized bed capacity of 1,500 but presently has 1,200 beds due to physical distancing protocols

In that same presser on August 9, Dr. Rachel Joy Pasion, head of the Department of Health (DOH)-Davao’s Regional Epidemiology Surveillance Unit said eight Delta variant cases had been detected in the region. By August 29, it rose to 48 but this number represents only those whose specimens were sent to the University of the Philippines-Philippine Genome Center in Diliman for whole genome sequencing, and confirmed to be a Delta case.

In an online press briefing on Tuesday, Dr. Rabindra Abeyasinghe, Philippines country representative of the World Health Organization (WHO) announced that the highly contagious Delta variant “has emerged as the dominant variant,” and that  “we are in community transmission.”

Highest single-day increases

The highest single-day increases posted by Davao City with 498 cases and the Davao region with 1,031 cases on September 4 are the highest among Mindanao’s 27 provinces and 33 cities since the region recorded its first COVID-19 positive in mid-March last year.

Davao City (population: 1.8 million as of 2020 census), has consistently topped the number of COVID-19 cases since. On September 4, it recorded a total of 39,397 or 54.3%  of the Davao region’s 72,509. The city posted 6,208 out of the region’s 13,636 active cases; 31,945 out of the 56,600 recoveries and 1,244 out of the regional total of  2,273 deaths.

COVID-19 testing at the Southern Philippines Medical Center in Davao City shows a high positivity rate for the period August 27 to September 2, 2021

Positivity rate or the number of those who tested positive among the total tested in SPMC ranged between 26.27% and 40.90%  in seven days, from August 27 to September 2.  Out of a total of 8,917 who underwent RT-PCR (Reverse Transcription-Polymerase Chain Reaction) testing at SPMC during that period, 2,861 or 32.1 % tested positive.

The  WHO  notes that a positivity rate of below 5% is one of the indications the infection is under control.

ADAR, Delta variant cases

Davao City recorded a total of 4,562 new cases out of the regional total of 9,120 within the two-week period from August 22 to September 4.  MindaNews noted the average daily attack rate (ADAR) of the city at 18.3 per 100,000 population and the region at 12.4, both falling under the “high risk” classification. An ADAR of less than one means low risk, 1 to 7 is moderate and more than that is considered high.

Davao region (population: 5.2 million) comprises the provinces of Davao de Oro,  Davao del Norte, Davao del Sur, Davao Occidental and Davao Oriental, and the cities of Davao, Digos, Panabo, Samal, Tagum, and Mati.

Out of 48 Delta variant cases detected in the region as of August 29, Davao City also posted the highest at 18 followed by 10 in Davao Oriental, nine in Davao Occidental, five each in Davao Del Norte and Davao del Sur and one in Davao de Oro.

Mindanao recorded a total of 157 Delta variant cases as of August 29, with 86 in Northern Mindanao.

Vaccination status  

The Davao region, which has the highest number of COVID-19 cases among Mindanao’s six regions, received the highest number of vaccine doses at 2,403,770 doses as of August 30, according to DOH-Davao.

As of August 30, only 627,182 residents have been fully vaccinated in the entire Davao region: 488,732 completed their second of the two-dose vaccine while 137,450 were administered the single-dose Janssen.  The region has a population of 5,243,536, out of which only 12%  (627,182) are fully vaccinated.

Where are these 627,182 fully vaccinated residents? 307,649 in Davao City (17.3 % of its 1.77 million population); 83,617 in Davao de Oro (10.9% of its 767,547 population);  83,266 in Davao del Norte (7.4% of its 1.12 million population); 45,063 in Davao del Sur (6.6% of its 680,481 population);  36,389 in Davao Occidental (11.5% of its 317,159 population); and 70,198 in Davao Oriental or 12.2% of its 576,343 population. (Carolyn O. Arguillas / MindaNews)