Dengue, Covid-19 combo could crash Philippine healthcare system

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According to the Philippines’ Department of Health, there are now two species of mosquitoes that carry the dengue virus: Aedes aegypti and Aedes albopictus. AFP

The Covid-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its cases have been on a rapid rise in the Philippines since March. Simultaneously, the Philippines is facing a probable outbreak of dengue fever, a known tropical disease which normally kicks in during wet season but is recently believed to be present all year round. It is currently on its record high in Singapore.

In August last year, the Department of Health (DOH) declared a national dengue fever epidemic, sounding a public health alarm when it recorded more than 146,000 dengue cases during the first half of last year, or a whopping 98-per cent increase compared to the same period in 2018, with more than 700 deaths.

Unknown to many, there are now two species of mosquitoes that carry the dengue virus, according to the DOH website: Aedes aegypti and Aedes albopictus.

Dengue fever (DF) or dengue hemorrhagic fever (DHF), which affects the body’s multi-organ system, is difficult to distinguish from Covid-19 because they share similar clinical and laboratory features, according to Dr Rey D Acis, president of the Philippine College of Integrative Medicine and Homotoxicology (PCIMH).

In other countries, for example, many frontliners described cases that were wrongly diagnosed as dengue but later confirmed to be Covid-19, and perhaps vice versa. Hence, research on co-infections with arboviruses and SARS-CoV-2 need to be done immediately and thoroughly for our health experts, policymakers and implementers to consider in their tasks.

In the midst of this complex epidemiological scenario, the Philippines’ already fragile healthcare system is facing the risk of collapse amid multiple socioeconomic issues, like the grievances of private hospitals over PhilHealth. With millions of Filipinos depending entirely on PhilHealth, this scenario can certainly be critical as people begin to ask which agency or government entity will shoulder the cost of hospitalisation due to dengue fever once Philhealth’s funds no longer allow it.

If dengue fever outbreak starts, this burden would be even greater, especially among cities and municipalities since the country’s healthcare system has been devolved to the local governments. Covid-19 alone has great potential to overwhelm the country’s health system, only in our fourth month of battle against the virus.

Another concern is the critical utilisation rate of hospitals and their ICU surge capacity, based on the assumption that a secondary Covid-19 transmission might occur aside from the reported ongoing surge of active coronavirus patients in our cities due to wider testing coverage being conducted.

With the number of active Covid-19 patients still on the rise, there may not be enough intensive care units to accommodate even 30 per cent of hospitalised patients with dengue, and other patients needing critical care that impact on Covid-19 patients in hospitals. The lack of specific diagnostic tests, especially the real-time RT-PCR, would also make it challenging for all concerned.

The availability of a vaccine for both dengue and Covid-19 is still uncertain. The authorities should remain vigilant, proactive, and on top of the game to prevent another health crisis looming on the horizon to happen.

Ron Enrilenarca, Health Reform & Advocacy Group, Philippine College of Integrative Medicine and Homotoxicology.

PHILIPPINE DAILY INQUIRER/ASIA NEWS NETWORK