Only 1,263 ventilators on hand; DOH rushing to get 1,500 more

The Dept. of Health has disclosed the number of ventilators in the country: 1,263. That’s 300 less than the 1,572 that Medical City chairman Jose Xavier Gonzales quoted from various sources.

Ventilators are crucial in support care for severe Covid-19 cases. The breathing machines pump oxygen into the lungs of patients with acute respiratory difficulties. They can prevent lung failure, a common cause of death of coronavirus infectees. Patients need to be intubated for three to five days till able to breathe on their own.

The 1,263 is a pivotal number. It is at that point when the country’s critical care system would peak. Italy and Spain, each with over six times the Philippines’ ventilator inventory, had reached their thresholds weeks ago. Hospital staffs were instructed to prioritize patients with highest chances of surviving as there were no more spare life-saving machines. Choosing who were to live or die, anguished doctors had to pull out oxygen tubes from elderly patients for use on younger ones (see https://www.philstar.com/opinion/2020/04/01/2004677/who-will-live-or-die-depends-availability-ventilators).

That can happen to the Philippines’ weaker critical care resources. As of Wed., Apr. 1, there were 2,311 Covid-19 positives. Most are aged 51-70. From the experience of China where the virus originated, 20 percent of infectees can be severe. A third of them would need to be put in intensive care units, the World Health Organization says. By Philippine protocol, only moderate to severe infectees are hospitalized; mild and asymptomatic cases are sent to home-quarantine. Of the nearly 70,000 hospital beds, only 4,300 are for ICU, Gonzales said.

DOH U-Sec. Maria Rosario Vergeire said they are acquiring 1,500 more. That would cost P2.5 billion, by Gonzales’ estimate. Aside from purchasing, DOH and private hospitals can lease or solicit donations. Local governments can tap sister-city or -province ties abroad.

That’s assuming there are stocks available. As pandemic rages, some hospitals in the United States have taken to sharing ventilators, two patients to one machine. Governments in Europe are intensifying searches for more ventilators, Financial Times reported. Germany has ordered an additional 10,000 units from a domestic manufacturer. France is surveying availability even in small private clinics as it anticipates shortage. Britain’s prime minister has asked domestic makers to increase national production. Italy, Europe’s outbreak epicenter, told its only fabricator to quadruple monthly production. Armed Forces specialists have been deployed to help meet the new quota.

Vergeire expects new ventilator stocks to arrive from abroad in June. By then the 75,000 infectees that WHO-Philippines anticipates might already have come true. Is there possibility for local manufacture?

Two years ago a Filipino company rolled out a prototype called Ginhawa Relief Vent. It was publicized as designed by health and computer specialists. DOH and the Dept. of Science and Technology might wish to search it out for mass production. The Dept. of Trade and Industry can help source the raw materials. A car or motorcycle assembly plant can be retrofitted, and military engineers mobilized for the purpose.

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Imports of Covid-19 protective and other emergency medical gear are now temporarily exempt from duties and taxes. The Customs bureau finally issued guidelines Wed., Apr. 1.

It came eight days after Indonesia lifted all fees and rules except bills of lading. (That ASEAN neighbor was able to acquire much needed supplies amidst the regional demand.)

Better than never, the BOC move came with similarly relaxed rules from the Bureau of Internal Revenue and the Food and Drug Administration.

Not importers but private donors had sought the BOC measure, effective till Apr. 12 or when the Luzon lockdown ends, whichever comes first. Though willing to pay tariffs, the Good Samaritans couldn’t bring in surgical gowns, facemasks and shields, goggles, gloves, and booties solicited from Asian friends. BIR and FDA require prior licenses and clearances that take weeks to process. A one-stop shop set up as early as Mar. 20, consisting of nine government agencies, had failed to untangle the maze of documentation.

A 20-footer cargo container of personal protective equipment, destined for Manila from China, was rerouted to another ASEAN capital. The donor, aided by a Cabinet man, couldn’t secure all the permits by sail time.

Yesterday donors began to face a new problem. They may no longer be able to give directly to hospitals in their home regions or alma maters. All donations are now centralized for deployment by the Office of Civil Defense. OCD will need to weigh individual intents against equitable distribution.

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Documentation is delaying as well the release of social amelioration funds. Congress had passed the emergency Bayanihan Act in one day because people forced into community quarantines cannot earn a living. Cash, P5,000 to P8,000, must be doled to 18 million poor families nationwide. Each family must have a social amelioration card. Barangay officials are to distribute application forms, identify the truly needy, encode the entries, and submit to the Dept. of Social Welfare and Development. Beneficiaries must open online payment accounts.

 Bureaucrats no doubt want foolproof systems, no theft nor family left behind. Time-and-motion and workflow experts need to help.          

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Catch Sapol radio show, temporarily moved to Fridays, 10 a.m.-12 nn, DWIZ, (882-AM).

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