Public health, public response

The times we live in now are harrowing. While we never believed ourselves to be free of the COVID-19 pandemic, the increasing numbers of vaccinated people and the decreasing new cases towards the tail end of the year was a much needed reprieve, and a source of cautious optimism. But even that was mixed with fear as the news of the Omicron variant arrived. At the end of the first week of 2022, we had over 20,000 new COVID-19 cases – a monstrous increase from 288 barely half a month before, and the highest since September 2021.

The Omicron surge of the past two weeks has led to our highest COVID cases in a single day, with the highest recorded tallies broken day after day. As of writing this article, the latest highest number of new cases is 39,004 – logged last Jan. 15, 2022. Almost all of the new cases occurred from Dec. 31 to Jan. 13. This highly transmissible virus has spread mostly in Metro Manila, Calabarzon and Central Luzon; and whole households are getting infected.

When we feel powerless, it’s easy to look for someone to blame. In our country, those who flaunt mandatory quarantine protocols have been placed beneath an unforgiving spotlight. Around the world, governments have singled out the unvaccinated as being the drivers of the pandemic, a continued risk to those around them. Increasingly there have been efforts to paint the pandemic as a matter of individual choice, with Rochelle Walensky, the director of the Center of Disease Control of the United States, stated that “your health is in your hands.”

In our powerlessness, these kinds of statements can feel comforting. But is our health truly in our own hands?

If the problem is the spoiled and the powerful flaunting quarantine regulations, then harsh punishments for them and a tightening of regulations seem an easy answer. If the unvaccinated are what drives the continuation of the pandemic, then a strategy aimed at “pissing them off” until they accept shots should become a primary goal of public policy, similar to the strategy of French President Emmanuel Macron. If our health is in our hands, then if we do everything correctly, we can keep ourselves and those that we love completely safe from the thread of COVID-19.

But such comforts are false, and as we enter the third year of this pandemic, we cannot afford to take succor from falsehoods. One of the things that the pandemic has taught us is how we are all connected. While this means that the individual decisions we make can have wide-ranging effects in our community, it also means that the decisions of others can and will affect us, whether directly or indirectly.

This is one of the reasons why we must battle the pairing of a COVID-positive result and some sort of personal failing. You can be fully vaccinated, firmly masked, only go out for essentials – you can do everything right on a personal level and still get hit by the virus.

This doesn’t mean that individual decisions don’t matter. We’ve seen how the actions of quarantine breakers can endanger those closest to them, and we know that, scientifically, those who refuse vaccinations even when these are available to them pose a greater risk to both themselves and their communities. There are things that we can do, things we must take personal responsibility for.

However, it must be made clear that acknowledging personal responsibility doesn’t mean that other forms do not – responsibilities of employers, of the media, of national and local governments, of organizations and communities beyond our own selves. This is something that should be obvious – there are many things that are beyond the power of an individual to do.

We can choose to get vaccinated, but the authorization of these vaccines must come from national bodies, the distribution of vaccines lies in the hands of local governments and the supply may depend on rich nations recognizing their responsibility not to hoard vaccines. We can choose to properly isolate if we have symptoms of COVID-19, but if we do not have prompt and affordable access to tests, our asymptomatic close contacts will not know if they too should isolate or inform their own contacts.

We can choose to wear masks, but our risk will still increase if the office/establishment doesn’t enforce the proper wearing of masks, if we are forced to wait for public transportation without adequate social distancing, if stores do not take the proper precautions to ensure that the masks we were sold are authentic. Our responsibilities towards health are not a zero sum game – they exist side-by-side with each other, build and assume each other, depend on each other.

A pandemic such as this one is a matter of public health, and a public health problem cannot be resolved solely by personal choices. It requires that the personal choices we make be supported and enabled by government institutions and multi-sectoral initiatives, within the context of a communal responsibility.

A community pools its strengths and builds upon what others have made. In a sense, the various COVID waves have attacked us in a communal manner, each new wave adding to the destruction of the last, battering and eroding our frontliners, our systems, our willpower. This is one of the reasons why the latest waves – perpetuated by the Omicron variant across much of the globe – have been so devastating to health care systems. As a recent article in the Atlantic states: “Here, then, is the most important difference about this surge: It comes on the back of all the prior ones. COVID’s burden is additive.”

Yet just as the effects of these COVID waves accumulate, so too can our efforts to battle it. Our individual decisions – to get vaccinated, to wear masks, to follow quarantine protocols, to minimize our exposure to others – all of these can cause ripple effects that make things easier for other people, for our communities, for our frontliners.

But these individual efforts cannot take the place of, and must be supported by, institutional and community interventions. Part of our individual efforts must be to continue to fight for and demand these.

Public health demands nothing less than a public response.