No choice

DEMAND AND SUPPLY - Boo Chanco - The Philippine Star

Metro Manila is back to ECQ and that is a good thing given the serious threat of the Delta variant of the COVID virus.

In a briefing conducted by OCTA, the volunteer group of academics monitoring COVID numbers, Fr. Nicanor Austriaco emphasized the need to move quickly.

“It is not a question of whether or not we will have a hard lockdown. Instead, it is when and for how long. An earlier lockdown is a shorter lockdown.”

The Dominican priest, a visiting professor of biological science at UST, gave his reasons for recommending drastic measures:

“Once a Delta-surge begins, it accelerates in an explosive fashion. Projections based on the behavior of the Delta variant in our ASEAN neighbors suggest that the surge will begin to impact our healthcare system in the NCR by the middle of August. Our hospitals will become overwhelmed by the end of August.

“No country in ASEAN has been able to halt and reverse a Delta-surge without a hard lockdown of major cities. The longer we wait to act, the harder it will be to halt and reverse the surge.”

It was the same message from US CDC director Dr. Rochelle Walensky: “It’s one of the most transmissible viruses we know about. Measles, chickenpox, this – they’re all up there… The measures we need to get this under control – they’re extreme. The measures you need are extreme,” Walensky told CNN.

This is why the US CDC was recommending that even fully vaccinated people wear masks indoors in places where transmission of the virus is sustained or high. It is not a blanket recommendation for all of the US, which confuses the message they want to deliver about how dangerous the Delta variant is.

A US CDC presentation says the Delta variant is very transmissible, with each infected person on average infecting eight or nine others. The original COVID virus was about as transmissible as the common cold, with each infected person passing the virus to about two other people on average.

What also confuses the story is the point about vaccinated people getting infected anyway, and having as much virus in their bodies as unvaccinated people. That means they’re as likely to infect someone else as infected unvaccinated people.

But, the US CDC document says, vaccinated people are safer.

“Vaccines prevent more than 90 percent of severe disease, but may be less effective at preventing infection or transmission,” it reads. “Therefore, expect more breakthroughs and more community spread despite vaccination.”

It reassures that vaccines reduce the risk of severe disease or death 10-fold and reduce the risk of infection three-fold.

So, the danger posed by the Delta variant is clear. The so-called circuit breaker lockdowns are necessary to reduce the potential of the virus spreading.

But we can’t do it the way we did it last year. Our government must focus on certain desired outcomes. Fr. Austriaco highlights the goals of a two-week circuit breaker lockdown:

“To shut down the mobility of people so we do not feed the virus; to do intensive contact tracing to identify and to isolate every COVID-19 positive person. This breaks chains of transmission;

“To accelerate vaccination in the NCR to achieve 30 percent Delta resilience in the population. This slows viral transmission; to fully vaccinate more people in the NCR.

“Shorten Sinovac two-dose interval to 14 days. The Turkish trial published in The Lancet showed 83.5 percent protection with this schedule, though with an earlier variant of SARS-CoV2.

“Shorten the AZ two-dose interval to eight weeks. Studies have shown that this schedule is still effective and responds to the Delta threat;

“To enhance our healthcare infrastructure, especially oxygen supplies.”

It is easy to see from our year and a half experience with our government’s COVID response that contact tracing will be the most problematic. The IATF-endorsed StaySafe app suffers from strong distrust to be effective. The tracing apps of some LGUs are probably more effective, but not coordinated.

Pasig, Mandaluyong, and Valenzuela have made their respective apps work together. It would be ideal if all LGUs in Metro Manila followed suit. We also probably need a full time tracing czar and not one who has his hands full as mayor of Baguio.

As for vaccination, there is an obvious demand for it and it is often a question of supply and better coordination at vaccination sites. There is a need to cut the red tape and long lines to encourage more people to get vaxxed.

Government should also increase testing and decrease the cost of testing so we can get a more accurate picture of how the virus is spreading. In hotspots, the government must test for free.

More support should be given for UP’s genome sequencing operations. It is likely that we are undercounting the spread of the Delta variant. That explains why  DOH thought for the longest time that there was no community spread yet.

While the strict ECQ approach is necessary, lockdowns have economic and social costs. We shouldn’t again waste all the sacrifices associated in an ECQ by doing nothing much on tracing and testing.

The business sector has endorsed this ECQ because they saw the need.

The Management Association of the Philippines (MAP) noted that “while this will further hurt our struggling businesses, we expect the government to mitigate the damage by increasing vaccine supply and ensuring that vaccination programs continue under ECQ as this is really the solution to controlling the pandemic.”

One important point noted by the US CDC is the need to address new “communication challenges” as a result of breakthrough infections. People are confused about the messages on the need for vaccination, but vaccinated people can still have as much virus in their noses as unvaccinated folks and pass on Delta.

We have to improve public health messaging to highlight vaccination as the best defense against the Delta variant. There is also a need to explain individual risk among vaccinated people.

Above all, DOH must tell us the truth as it happens and not worry about causing panic. Truthful communication earns public trust. Cover-ups make things more difficult than they already are.



Boo Chanco’s email address is bchanco@gmail.com. Follow him on Twitter @boochanco

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