By using FluSurge with the analysis of COVID-19 case data in Iloilo, we have built projections to estimating the sufficiency of the hospital resources in the province during the 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 Iloilo Province’s Hospital Resources during the COVID-19 Pandemic

2. March 20
Iloilo City
ECQ
April 1
Panay-wide
Quarantine
March 15
Iloilo
CQ
March 21
Iloilo
# of cases: 1
CoViD-19 Timeline: Province of Iloilo
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
ILOILO
March 27
Iloilo
# of cases: 3
March 28
Iloilo
# of cases: 6
March 29
Iloilo
# of cases: 8
March 31
Iloilo
# of cases: 9
April 1
Iloilo
# of cases: 10

3. Input Variable COVID-19 (Iloilo Province)
Population 2,524,213
0-19 years old 939,743
20-64 years old 1,395,011
65 years old and above 189,459
Basic Hospital Resources
Total licensed non-ICU beds 1832
Licensed non-ICU beds staffed (%) 100%
Total licensed ICU beds 115
Licensed ICU beds staffed (%) 100%
Total number of ventilators 125
Ventilators available (%) 100%
Assumptions
Pandemic duration (6, 8, 12) 12 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 12 weeks (March 20
– June 5)
Gross clinical attack rate
(AR) = 25%

4. Pandemic Impact/ Attack Rate 25%
Total Hospital Admissions
Most Likely Scenario 7,259
Minimum Scenario 2,556
Maximum Scenario 10,390
Total Deaths
Most Likely Scenario 1270
Minimum Scenario 620
Maximum Scenario 2,347
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
At the end of 12 weeks,
Peak of hospital admissions: Weeks 6 and 7
Accumulated hospital admissions: 7,259
Accumulated deaths: 1,270

5. CoViD-19 Impact
Weeks
1 2 3 4 5 6 7 8 9 10 11 12
Hospital
Admission
Weekly
admissions
73 290 508 726 944 1089 1089 944 726 508 290 73
Peak
admissions /
day
237 237
Non-ICU
Bed
Capacity
Total =
1832
CoViD-19
PUIs/cases in
non-ICU
facilities
73 363 799 1234 1670 2033 2382 2382 1954 1575 1139 704
% non-ICU
capacity needed
4% 20% 44% 67% 91% 111% 130% 130% 107% 86% 62% 38%
ICU Bed
Capacity
Total = 115
CoViD-19
PUIs/cases in
the ICU
15 61 114 167 220 259 305 259 220 167 114 61
% ICU capacity
needed
13% 53% 99% 146% 192% 225% 265% 225% 192% 146% 99% 53%
Ventilator
Capacity
Total = 125
CoViD-19
PUIs/cases on
ventilators
4 15 25 36 47 54 69 53 45 34 23 12
% ventilator
usage
3% 12% 20% 29% 38% 44% 55% 42% 36% 27% 18% 10%
peak
Admissions vs Capacity
Weeks 6 - 9
Non-ICU admissions >
hospital capacity
Weeks 4 - 10
ICU admissions >
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%
Non-ICU capacity needed
(%)
108% 179% 251% 97% 161% 226% 78% 130% 182%
ICU capacity needed (%) 223% 371% 519% 201% 336% 470% 159% 265% 371%
Ventilator capacity needed
(%)
46% 77% 108% 42% 70% 98% 33% 55% 77%
Admissions will exceed ICU and Non-ICU capacity
(except Non-ICU capacity at 8,12 wks duration; AR = 15%)
Ventilator use will exceed ventilator capacity at 6 weeks pandemic duration, AR = 35%

7. RECOMMENDATIONS
April 04, 2020
Center for Informatics, University of San Agustin, Iloilo City/ informatics@usa.edu.ph
Extension of the ECQ in Iloilo Province 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 the Iloilo
Province, 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-
curfews-state-calamity-coronavirus
[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/
[17] Panay-wide ECQ Apr 1: https://www.pna.gov.ph/articles/1096857
[18] China reports zero new cases in coronavirus epicenter Hubei. Retrieved from:
https://www.latimes.com/world-nation/story/2020-03-19/coronavirus-china-cases-hubei.
[19] Philippine Health Atlas. Accessed from http://healthatlas.doh.gov.ph/. March 29, 2020.
[20] Population Projection Statistics. Accessed from https://psa.gov.ph/statistics/census/projected-
population. March 27, 2020
Dr. Sarah De Leon (IMH)
Dr. Al Jeson Chin (WVMC)
Mr. Patrick B. Jalandoni (TMCI)