Reality bites and the extended ECQ

The pressure is on to ease the protracted restriction brought about by the 30-day nationwide Enhanced Community Quarantine (ECQ). Behind closed doors over the weekend, an intense discussion raged among inter-agency officials, Duterte’s economic team, legislators, local chief executives, and epidemiology experts.

In a news interview, Interior Secretary Eduardo Año have declared that an extended ECQ due to the threat of COVID-19 is not advisable for it will adversely affect the country’s economy. On the other hand, Senate Minority Floor Leader Frank Drilon is open to relaxing the ECQ, but starting May 1 (not mid-April) underscoring that the interventions against COVID-19 were effective yet it’s too early to tell.

The dilemma is real. The economic calendar is on a downward trend indicating that the economy has suffered with the implementation of the ECQ. However, we are not the only nation with a suffering economy because of the pandemic. The economy is yawning globally.

On the other hand, the epidemic calendar illustrated a fast climbing COVID-19 cases in over a month. In March 5 we have five cases but by April 5 it reached 3,246. The numbers may appear manageable at this time, however, the situation is constantly evolving and one stone left unturned may transform the circumstances for the worse. 

Lifting or easing the ECQ is premature and President Duterte has recognized the threat by declaring that the Luzon lockdown will now be until April 30. Reality bites. 

First reality – we have fragile systems. The weak preparedness and the lack of capacity to respond on the demands required by a pandemic-level crisis by the Duterte administration suggests that the first round of ECQ (March 17 to April 14) is not enough.

Some countries are now confronting first to second wave impacts in spite of the advanced health systems that they possess. This is further strengthened by their hold on internal resources and the programmatic system of spending during a period of calamity. 

It only shows that the components of intervention and the timetable of implementation varies from government to government and it depends on the level of its acquired capacities: decisive leadership, financial support, and effectiveness of systems in place from preparedness, to response, and up to recovery from a pandemic.

The Philippines currently occupy the second rank as far as numbers with COVID-19 cases in Southeast Asia based from worldmeters.info data. Malaysia has the highest number of cases with a total of 3,662, Philippines (3,246), Indonesia (2,273), Thailand (2,169), and Singapore (1,189). On the sixth spot is Vietnam with only 240 cases. An NGO colleague, Melvin Purzuelo, made it a point to enter these numbers manually each day as part of his “ECQ honeymoon” and he shared a more organized data on his Facebook timeline.

Can our fragile system handle the succeeding round of cases, say, from April 15 to May 15?

Second reality – the ECQ is not a first line of defense; it is the only defense. Containing the spread of COVID through a community quarantine has started a momentum. The momentum, however, will be disrupted once regulation will be relaxed at midway.

Singapore, for instance, learned a painful lesson when it imposed a “calibrated quarantine” by implementing travel restriction, strong quarantine procedure, aggressive contact tracing, and massive testing – all without closing operations of schools and malls. However, the regulatory intervention that it maintained resulted on the quick rise of COVID cases in the period of one month after its residents returned travel from virus stricken countries abroad like the US and Britain. The outcome? 100 cases recorded first week of March ballooned to 1,309 cases by April 5. 

The rise of cases is described by Singaporean health authorities as the “second wave.” It prompted the government to level up self-quarantine effort among its residents, stricter imposition of social distancing measures, limit large gatherings, and shut operations of restos, bars, and night spots. If the rise of cases continues, it announced that public transport system will be shutdown and all public places will be closed.

Does our government possess preparedness for the second wave? 

Third reality – the needed complementary interventions to quarantine is not in place. With the exception of mass testing at the preliminary stage, the “second wave” procedures that are now being implemented by Singapore were among the major component of the “first wave” interventions in Iloilo. 

The component that the Governor and the City Mayor of Iloilo enforced are the following: boundary lockdown with check points, limited movement among the vulnerable and immuno-compromised, citizens’ mobility prioritized access on essential needs, strict social distancing in public spaces, sustained observance of self-protection practices like handwashing and wearing of a face mask in public, voluntary self-quarantine, and a curfew. 

As far as Iloilo Province-wide case status is concerned, it follows a fairly gradual increase with zero at the start of the declaration of an Enhanced Community Quarantine in March 17 to a total of 12 cases as of April 6, 2020. Iloilo City recorded with four (4) cases, one (1) death, and one (1) has recovered from COVID-19.

While Singapore is confronting a second wave, Iloilo Province has delayed the first wave of Coronavirus spread. It is buying time to “flatten the curve.”

Therefore, at this particular stage, the ECQ has effectively postponed the rampage of COVID-19 to enter into a human body for reproduction. The coronavirus carries a 2.5 Reproductive Number for the Philippines (RO 2.5) or one asymptomatic carrier has a potential to infect two to three persons once tested positive. The RO 2.5 looks like a negligible figure, but when you have 4 positive cases on your province, it will only be a matter of time that cases will increase to 12 and 12 to 36 in just one day.

Admittedly at the onset, the slow increase of cases is also a result of a lack of testing kits, absence of mass testing effort, late establishment of testing centers, and insufficient number of accredited medical technologists who can perform the testing. 

These are direct manifestations of the realities that we are in under a proud 75 year old leader whose street-smart leadership has not been tried and tested by a pandemic crisis. Now, the question: to end, or not to end the ECQ by April 30?

*The opinion piece has appeared at the Opinion Section of www.imtnews.net

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