By Karen Lema
MANILA (Reuters) - Private hospitals in the Philippines capital Manila have stopped accepting coronavirus patients in the face of surging numbers of sufferers and people seeking tests, the hospitals said.
The Philippines has reported relatively fewer infections than many other countries in Southeast Asia, but medical experts say a lack of testing has meant that the scale of the epidemic has gone undetected.
"It's like wartime," said Eugenio Ramos, a doctor and head of The Medical City, a Manila private hospital, which was among the first to turn away coronavirus patients.
It has attended to more than 1,000 people who feared they had coronavirus and is currently treating more than 100 suspected coronavirus patients, 14 in intensive care.
"More and more are coming, a lot of scared people, some of them already in their advanced stage," Ramos said this week - adding that facilities were so stretched that many who should be in the intensive care unit were just being intubated with breathing tubes to keep them alive.
The scenes are akin to those in hospitals in countries that have been overwhelmed by coronavirus cases, but comes less than three weeks since the country of 107 million reported its first case of local transmission.
The Philippines has reported 803 cases and 54 deaths. Malaysia, with the highest number of infections in Southeast Asia at 2,161, has had 26 deaths.
The situation in the Philippines is similar to that in Indonesia, the region's most populous country, where there is an even higher ratio of deaths to detected cases - an indicator for doctors that the number of infections may be much higher.
Former Health Minister Esperanza Cabral said the reported infection rate was probably just the tip of the iceberg, given the Philippines has so far only tested 2,147 people.
"We cannot gauge the extent of the outbreak until we have tested about 10,000 to 20,000 people," Cabral told Reuters.
Testing in the Philippines is to be ramped up with the arrival of 100,000 test kits from China.
Modeling from the Future of Humanity Institute at the University of Oxford suggests the number of infections in the Philippines may already be higher than 11,000.
The Philippines took drastic measures to contain the spread after its first domestic case on March 7, becoming the third country after China and Italy to put its people under home quarantine, suspend transport, work and commercial activity.
But the health system is weak.
The Philippines, which on average sends 19,000 trained nurses overseas each year, has 10 beds and 14 doctors per 10,000 people, according to data from the World Health Organization. Italy has more than 40 doctors and 30 beds per 10,000 people.
An emergency ward worker who spoke to Reuters described patients waiting up to six hours to be seen and inexperienced staff treating critical patients due to manpower shortages.
Nine medical workers have died, and hundreds more have been quarantined for being close to sufferers.
The University of Santo Tomas hospital has 530 staff quarantined. The Chinese General Hospital and Medical Center said it had insufficient testing kits and protective gear and could not take more coronavirus patients.
Under pressure from 11 private hospitals, the government has now dedicated three public hospitals to serve as special COVID-19 treatment centers - but they themselves are also under strain.
"We have every reason to be scared," the private hospitals said in a letter appealing for help.
The head of the emergency department of St. Luke's Medical Centre, Richard Enecilla, said it had received 120 possible coronavirus-related patients in one day, and made them line up on the hospital driveway to limit exposure.
"The way it exploded caught a lot us off-guard," he told Reuters. "The volume of cases went up and our capacity to serve went down at the same time."
(Additional reporting by Neil Jerome Morales; Editing by Martin Petty, Matthew Tostevin and Alex Richardson)