‘Urgent ECQ needed to stop case surge in Bukidnon’–doctors’ leader

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MALAYBALAY CITY (BukidnonNews.Net/O4 September 2021) An urgent and total lockdown or Enhanced Community Quarantine (ECQ), not granular lockdown, is the best remedy to stop the spread of the COVID-19 in Bukidnon, an official of the 350-member medical doctors’ group told BukidnonNews.Net.

Dr. Efren D. Villahermosa Jr, president of the Bukidnon Medical Society, component society of the Philippine Medical Association, said at least a month-long total lockdown is ideal to control the surge.

“Without considering other factors, a one-month total lockdown is the answer. Two weeks is not enough. It is still risky,” Dr. Villahermosa said in a Zoom interview this week. 

There is no other way to ensure the decline of cases when the number of cases is already too high, said Dr. Villahermosa, who chairs the Department of Surgery of the Bukidnon Provincial Medical Center (BPMC).

Last week, Mr. Roderico Bioco, chair of the Philippine Red Cross (PRC) Bukidnon, cited the skyrocketing COVID-19 cases in Bukidnon in calling on officials to tighten the quarantine classification of the province from MGCQ to MECQ saying its coronavirus disease infection level is already nearing the “critical risk.”

Bukidnon has been under Modified General Community Quarantine (MGCQ) since August 18. Provincial board member Nemesio Beltran Jr. said Friday, the provincial government is unlikely to recommend an ECQ or total lockdown due to the prospect of jobs lost. He said granular lockdown is preferred because it only locks down selected areas.

Of the 1,228 new cases reported in Northern Mindanao on September 4, 2021, about 44% or 534 cases were reported from Bukidnon.

Dr. Villahermosa said granular lock down will not stop people from moving from one locality to another and from getting infected.

“If we cannot control them from moving around, we have to put them in their houses. That’s the only way,” he added.

Dr. Villahermosa said 90% of those who tested positive to COVID 19 are asymptomatic or with mild symptoms and can spread the virus.

“They (asymptomatic) are the more dangerous ones because you will not know if they have the virus,” he said.

Delta is here
He disagreed with statements that the COVID situation in the province is not yet “critical”. He said the Delta variant is already in the province. The Department of Health reported additional 13 cases of COVID-19 confirmed to be Delta Variant, as of September 1, 2021.

He added that municipal isolation units which were supposed to house only mild and asymptomatic patients have now turned into treatment facilities catering to moderate and even critical cases.

Dr. Villahermosa said they saw the pattern already from supposedly only one or two cases in a household.

“Now we have observed cases where the rest of the members of the household are already infected,” he added.

He also cited the full bed capacity of both public and private hospitals in Bukidnon.

There is an average of 100 patients on the waitlist in each hospital, he said.  There are a total of 1,319 patients waiting in 13 public and private hospitals in the province, according to One Hospital Command Center as of 1p.m. of September 3, 2021.

He added that patients died in their homes because they’ve been refused in the hospitals. In Valencia City, the deaths have reached 102 as of September 4, prompting the untimely opening of a new cemetery.

Critical risk
As of August 24, the Department of Health – Region 10 (DOH-10) reported that five Bukidnon localities breached the ADAR 20 category, which PRC’s Bioco suggests as threshold for “critical risk”: Malaybalay City with 27.66, Quezon with 25.30, Manolo Fortich with 24.40, Maramag with 20.78 and Valencia City with 20.40.

The same five localities are in the Top 10 municipalities and cities with active COVID -19 cases in Northern Mindanao.

As of August 24, Malaybalay City’s 793 cases placed second to Cagayan de Oro’s 3,770 cases. Valencia City placed third with 666 cases; Quezon, Bukidnon placed fifth with 531 cases; Manolo Fortich at sixth with 393 cases; and, Maramag at seventh with 260 cases.

Dr. Villahermosa cited a mismatch in hospital occupancy estimates like the DOH reported hospital occupancy at only 80%.

“They based it on the entries in the hospitals’ license to operate. In reality, it should be based on actual operational or functional capacity,” he added.

He said the hospitals are really squeezed in their capacity. They should factor in the fact that many nurses have resigned, some of them including doctors are in isolation for infection, he added.

Human factor
“It is not just the number of beds, it also is about human resources,” he said.

He said the surge in cases sometimes overwhelms the health workers. Exhaustion and pressure from their families, he added, contribute to the number of resignations.

Even with the shrinking health workers in the hospitals, he said, they still have to cover the committed bed capacity.

Business side
Dr. Villahermosa said if a lockdown is implemented, the government should support local business by imposing a moratorium on loan interests.

The Philippine Chamber of Commerce and Industry (PCCI), considered declaring a lockdown a knee-jerk reaction that is “disastrous to the economy” with the loss of thousands of jobs and business losses of enterprises.

Government should focus instead on accelerating vaccination of the population and to incentivize people who have been fully vaccinated, it added.

“The idea is to open the economy and allow greater mobility of people while taking stock of the basic health protocols to observe,” it added.

Dr. Villahermosa, who sits on the board of the Bukidnon Kaamulan Chamber of Commerce and Industry, said the local business community may not be able to take an additional lockdown.

When asked to consider other factors, Dr. Villahermosa said maybe the granular lockdown should at least be done.

“Granular lockdown with strict implementation of quarantine protocols, not just on paper,” he added. 

But he said strict implementation should be supported by a disciplined community.

The community as front liner
Dr. Villahermosa said he wanted to change the notion that the health sector is the front liner against COVID.

He said the community is the front liner in controlling the pandemic since the transmission is in the community.

“We have to slow down the spread of this disease so that our hospitals will not be overwhelmed. Oxygen supplies and medicines are already running out, machines are bogging down and health care workers are exhausted,” he said.

Doctors and nurses, he added, do not have the power to stop the spread of this virus.

 “It is the community that should take the lead in the frontline to prevent the spread by observance of the basic health protocols,” he added. 

He cited as examples physical distancing, proper wearing of face mask and face shield, and constant hand washing, which have been proven to slow down if not stop the transmission.

He said people should get vaccinated as it decreases one's chance of getting infected with the virus. In case, infected, he said, it helps one from becoming severe or critical. He cited that 90% of those who were reported to have died of COVID were unvaccinated.

Poor implementation
Dr. Villahermosa also hit poor implementation of some quarantine protocols issued by some local governments.  He said despite the policy on “heightened restrictions,” still a lot of people continue to roam around.

“There is no strict implementation (in the field),” he added.  A local task force, he said, should go around strictly implementing the rules to ensure it is followed, even to the extent of imposing penalties.

He acknowledged that some local government units may hesitate to strictly implement protocols with the fear of losing votes in the 2022 elections.

“But this (strict implementation) should be done. Otherwise it is useless, it’s just on paper,” he added.

Dr. Villahermosa said it is crucial that the government should boost its efforts to educate the people so that they will understand, especially with lockdown fatigue.

“It all boils down to discipline. Everybody should be responsible. We can’t always pass the burden only to the government,” he added.  (BukidnonNews.Net)


IN PHOTO: Health personnel bury a person who died due to COVID-19 in the New Valencia City Memorial Park on August 30, 2021.  With permission from Kein She Co

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