Estimating the Sufficiency of Panay and Guimaras Islands’ Hospital Resources during the COVID-19 Pandemic

1. FluSurge Modeling of the COVID-19 Pandemic
Contributors:
Jonathan Adam A. Rico, MSc.
Pia Regina Fatima C. Zamora, M.D., Ph.D.
Jiye Kwon
Raphael Nelo S. Aguila
Jesus Emmanuel A. Sevilleja, M.D., MPhil
Romulo de Castro, Ph.D.
University of San Agustin
Center for Informatics
Iloilo City, 5000
April 10, 2020
Estimating the Sufficiency of Panay and Guimaras Islands’ Hospital Resources during the COVID-19 Pandemic

2. March 20
Iloilo City
ECQ
March 22
Antique
ECQ
March 25
Capiz
1st case
April 1
Panay-wide
Quarantine
March 25
Capiz
ECQ
March 15
Capiz, Iloilo
CQ
March 17
Antique
CQ
March 23
Aklan
ECQ
March 21
Iloilo
1st case
March 27
Aklan
3 cases
CoViD-19 Timeline: Panay and Guimaras
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph

3. Input Variable
COVID-19
(Panay Island + Guimaras)
Population 4,730,508
0-19 years old 1,797,417
20-64 years old 2,587,126
65 years old and above 345,965
Basic Hospital Resources
Total licensed non-ICU beds 1780
Licensed non-ICU beds staffed (%) 100%
Total licensed ICU beds 112
Licensed ICU beds staffed (%) 100%
Total number of ventilators 112
Ventilators available (%) 100%
Assumptions
Pandemic duration (6, 8, 12) 8 weeks
Gross clinical attack rate (15%, 25%, 35%) 25%
Average length of non-ICU hospital stay (1-14 days) 14 days
Average length of ICU stay (1-20 days) 8 days
Average length of ventilator usage (1-20 days) 7 days
Average proportion of admitted patients will need ICU care
(%) 20%
Average proportion of admitted patients will need ventilators
(%) 5%
Average proportion of deaths assumed to be hospitalized (%) 90%
Daily percentage increase in cases arriving compared to
preceding day (0.1% - 20%) 17%
SUMMARY OF INPUTS TO THE FLUSURGE TOOL
Based on
Wuhan, Hubei
Experience
Data from
DOH, WVMC,
TMCI
Projected Data
from PSA
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
ASSUMPTIONS
FluSurge 2.0 operates under
non-quarantine conditions
FULL CAPACITY of
DOH-retained hospitals
Utilize 50% of the capacity
of other Level II and Level
III hospitals
Pandemic duration of at
least 8 weeks (March 20 –
May 15)
Gross clinical attack rate
(AR) = 25%

4. Pandemic Impact/ Attack Rate 25%
Total Hospital Admissions
Most Likely Scenario 13,437
Minimum Scenario 4,713
Maximum Scenario 19,327
Total Deaths
Most Likely Scenario 2341
Minimum Scenario 1137
Maximum Scenario 4355
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
At the end of 8 weeks,
Peak of hospital admissions: Weeks 4 and 5
Accumulated hospital admissions: 13,437
Accumulated deaths: 2,341

5. CoViD-19 Impact
Weeks
1 2 3 4 5 6 7 8
Hospital Admission Weekly admissions 806 1344 2016 2553 2553 2016 1344 806
Peak admissions / day 556 556
Non-ICU Bed
Capacity
Total = 1780
CoViD-19 PUIs/cases in
non-ICU facilities
806 2150 3359 4569 5474 5474 4305 3096
% non-ICU capacity
needed
45% 121% 189% 257% 308% 308% 242% 174%
ICU Bed Capacity
Total = 112
CoViD-19 PUIs/cases in
the ICU
161 304 462 598 714 598 462 304
% ICU capacity needed 144% 271% 412% 534% 638% 534% 412% 271%
Ventilator Capacity
Total = 112
CoViD-19 PUIs/cases on
ventilators
40 67 101 128 161 122 93 61
% ventilator usage 36% 60% 90% 114% 144% 109% 83% 55%
peak
Admissions vs Capacity
Week 1
ICU admissions >
hospital capacity
Week 2
Non-ICU admissions >
hospital capacity
Weeks 4-6
Ventilator use >
hospital capacity
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph

6. April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
Peak of CoViD-19 outbreak vs Hospital capacity:
Other simulations (pandemic duration = 6, 8, 12, weeks; AR = 15%, 25%,35%)
Impact on Hospital Resources/
Duration, Attack Rate
6 Weeks 8 Weeks 12 Weeks
15% 25% 35% 15% 25% 35% 15% 25% 35%
Hospital capacity needed
(%)
205% 342% 478% 185% 308% 431% 149% 248% 347%
ICU capacity needed (%) 423% 705% 987% 383% 638% 893% 302% 503% 705%
Ventilator capacity needed
(%)
95% 159% 223% 86% 144% 201% 68% 114% 159%
Hospital admissions will exceed hospital capacity in Panay and Guimaras
(except ventilator capacity at AR = 15%)

7. RECOMMENDATIONS
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
Extension of the ECQ in Panay and Guimaras
beyond April 14, 2020 to prevent a surge of cases and
deaths, and/or set up other mitigating measures to
keep the number of cases below hospital capacity.
Augment hospital capacity quickly
- add non-ICU beds
- add ICU beds
- add ventilators
- add personnel
Enhance CoViD-19 testing and contact tracing
Protect the frontliners
- provision of adequate PPEs
- routine testing of hospital personnel,
even when they do not show
symptoms
This model simulates the impact of
the CoViD-19 outbreak in Panay
and Guimaras, if no preventive
measures are in place.
If the ECQ were to be lifted without
any mitigating measures, it is
possible to experience the disease
trajectory projected here.
SUMMARY

8. April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
ACKNOWLEDGEMENTS
REFERENCES
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[12]https://www.rappler.com/nation/254904-list-areas-visayas-under-community-quarantine-
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[13] Iloilo City Mar 20: https://www.rappler.com/nation/255350-iloilo-city-under-community-
quarantine
[14] Antique Mar 22: https://www.pna.gov.ph/articles/1097530
[15] Capiz Mar 25: https://pia.gov.ph/news/articles/1037135
[16] Capiz, ECQ: https://dailyguardian.com.ph/capiz-under-enhanced-community-quarantine/
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population. March 27, 2020
Dr. Sarah De Leon (IMH)
Dr. Al Jeson Chin (WVMC)
Mr. Patrick B. Jalandoni (TMCI)