By Joseph B.A. Marzan
Consistent high rate of cases and hospital facility utilizations propelled Guimaras to Alert Level 4 for coronavirus disease 2019 (COVID-19) alongside Iloilo City, according to the latest situationer of the Department of Health-Western Visayas Center for Health Development (DOH-WV CHD).
DOH-WV CHD designated spokesperson, Dr. Bea Camille Natalaray, explained in an online presser that the alert levels serve as a guide for local government units (LGUs) for their COVID prevention measures.
Alert levels are determined based on each area’s Average Daily Attack Rate (ADAR), 2-Week Growth Rate (2WGR), Health Care Utilization Rate (HCUR), and local detection of the Delta variant (lineage B.1.617.2).
The ADAR refers to the number of cases per 100,000 population in an area, while the 2WGR refers to the percentage rate of trends of COVID-19 cases in an area. Both are measured in a 14-day period.
The latest 2WGR and ADAR are based on the number of COVID-19 cases reported from July 30 to August 12.
The HCUR, meanwhile, is an updated percentage rate of utilized COVID-dedicated ward, isolation, and Intensive Care Unit (ICU) beds, as well as mechanical ventilators.
The alert level system is distinct from the Community Quarantine Decision Framework (CQDF), which relies only on the 2WGR and ADAR.
Alert Level 1 areas are those with Minimal to Low Risk CQDF classifications, negative 2WGR, Low HCUR risk, and no detected case of the Delta variant.
Alert Level 2 areas are those with Minimal to Low Risk CQDF classifications, but may be coupled with either of the three situations:
-Negative 2WGR, less than 50 percent HCUR with recorded Delta cases;
-Positive 2WGR; or
-Negative 2WGR, and HCUR is equal to or greater than 50 percent.
Alert Level 3 areas are those with Moderate to Critical CQDF classifications, with HCUR less than or equal to 70 percent, regardless of the presence of Delta variant cases or not.
Alert Level 4 areas have similar characteristics as Alert Level 3 areas, except that the HCUR must be greater than 70 percent.
Iloilo City, which is currently at Moderate Risk under the CQDF, has a 2WGR of –3 percent, an ADAR of 15.63, an HCUR of 71.66 percent, and 6 cases of the Delta variant.
Guimaras is also a Moderate Risk area, but is on Alert Level 4 due to its Critical Risk level of HCUR at 86.67 percent, 2WGR of 68 percent, and an ADAR of 6.98. The island province has no recorded Delta cases as of this writing.
Action points laid down by the DOH for areas under Alert Level 4 include:
-Active case finding and aggressive community testing (rapid antigen tests can be utilized for Delta variant cases);
-Urgent need to increase hospital beds especially in ICUs, ensure oxygen needs are available, proper and immediate referral of severe and critical cases, and accessibility of PhilHealth benefits for COVID-19 patients; and
-Health care capacity issues must be addressed from the LGU level to the regional and national levels.
REST OF THE REGION
The rest of Panay Island (Aklan, Antique, Capiz, and Iloilo province) is under Alert Level 3 while Bacolod City is under Level 2 and Negros Occidental is at Level 1.
Antique and Iloilo province are also at High Risk under the CQDF due to their respective 2WGRs (37 percent and 10 percent) and respective ADARs (9.37 and 7.34).
Both are also at Moderate Risk for their HCUR, with Antique at 65.75 percent, and Iloilo province at 63.04 percent.
Aklan and Capiz are at Moderate Risk based on their respective 2WGRs (-40 percent and 3 percent) and respective ADARs (18.97 and 4.35). Their respective HCURs are also considered at Low Risk (Aklan – 54. 30 percent, and Capiz – 56.55 percent).
Areas under Alert Level 3, said Natalaray, are also encouraged by the DOH to pursue granular lockdowns and active case finding, and addressing concerns to regional and national levels, same as Alert Level 4.
But unlike the higher alert level, those under Level 3 are only advised to target decongesting of hospitals of mild and asymptomatic cases, and to start increasing hospital and ICU beds.
Bacolod City, which had confirmed 2 local cases of the Delta variant, is the only area under Alert Level 2, with a Low Risk under CQDF due to its 2WGR (-18 percent) and ADAR (5.77). It also has a Low Risk HCUR of 39.16 percent.
Negros Occidental has had no recorded Delta variant cases, is at Low Risk CQDF classification based on its 2WGR (-29 percent) and ADAR (1.55), and has an HCUR of 32.93 percent, thus the lowest Alert Level 1.