Why 'NCR Plus' is shifting to Modified ECQ and what that means
MANILA, Philippines — Metro Manila and the nearby provinces of Bulacan, Cavite, Laguna, and Rizal will be under a more relaxed quarantine status this month despite the suggestion of some experts to extend the lockdown by one more week to further slow the spread of COVID-19.
President Rodrigo Duterte on Sunday approved the recommendation of the government's pandemic task force to place the capital region and the four provinces — collectively known as National Capital Region (NCR) Plus — under modified enhanced community quarantine (MECQ) from April 12 to 30, the Palace announced.
The NCR Plus areas were placed under the strictest enhanced community quarantine (ECQ) last March 29 as the surge in COVID-19 infections threatened to overwhelm hospitals. The enforcement of the lockdown was supposed to end last April 4 but it was extended by a week to ensure a sustained reduction in infections.
Santiago City in Isabela, and Abra and Quirino provinces will also be classified as MECQ areas until the end of the month.
On Saturday, the OCTA Research group suggested a week-long extension of the ECQ in NCR Plus, saying the lockdown has been effective in reducing the COVID-19 growth rate and reproduction number in Metro Manila.
The reproduction number in the capital region went down to 1.23 from April 3 to 9 from 1.88 the week before the implementation of the strictest quarantine, OCTA said. The extension of the ECQ would also decongest hospitals and relieve the pressure on the country's health workers, the group added.
More hospital beds available
Presidential spokesperson Harry Roque said the commitment of hospitals to increase the number of beds dedicated to COVID-19 patients was one of the factors that convinced the government to relax the quarantine restriction in NCR Plus.
"Because of the directive of the president for PhilHealth (Philippine Health Insurance Corp.) to pay hospitals with unpaid COVID-19 claims, many of our private, national government, and LGU (local government units) hospitals committed to increase the COVID-19 beds especially the ICU (intensive care unit) beds in NCR Plus," Roque said.
"This is one of the critical basis of the IATF (Inter-Agency Task Force for the Management of Emerging Infectious Diseases) to slightly recommend the MECQ classification in NCR Plus," he added.
Roque said as of April 11, hospitals in NCR Plus areas have committed an additional 164 critical ICU beds and 1,157 regular beds for moderate and severe cases.
The institutions that have vowed to allocate more beds for COVID-19 patients are Quezon Institute (110 beds for moderate and severe cases), National Center for Mental Health (960 beds for moderate cases), Manila Times College in Subic (300 beds for mild and asymptomatic cases), New Clark City Tarlac (165 beds for mild and asymptomatic), Eva Macapagal Terminal in Manila (200 beds for mild and asymptomatic), and Orion Bataan Port Terminal (100 beds for mild and asymptomatic).
Roque said a total of 3,156 beds (164 ICU beds for critical cases, 2,227 regular beds for moderate and severe cases, and 765 isolation beds for mild and asymptomatic cases) have been added to the NCR Plus healthcare capacity while the area was on lockdown.
For Metro Manila, Central Luzon, and CALABARZON, the utilization rate for ICU beds stood at 74.34% for ICU beds, 46.04 for war%d beds, and 59.56% for isolation beds.
MECQ rules
Under MECQ, establishments, persons, or activities not permitted to operate, work, or be undertaken during ECQ are allowed to operate at 50% on-site capacity, according to the latest quarantine guidelines issued by the government.
However, work-from-home and other flexible work arrangements are still encouraged when applicable.
The guidelines barred some sectors from operating or working during MECQ namely:
- entertainment venues with live performers
- recreational venues such as internet cafes, billiard halls, and amusement arcades
- amusement or theme parks
- outdoor and indoor sports courts or venues, fitness studios, gyms, spas or other indoor leisure centers or facilities, and swimming pools
- gaming establishments except for draws conducted by the Philippine Charity Sweepstakes Office
- indoor and outdoor tourist attractions
- venues for meetings, incentives, conferences, and exhibitions
- personal care services including beauty salons and medical aesthetic clinics
- indoor dine-in services of food preparation establishments.
All establishments, persons, or activities that were allowed to operate during ECQ may now do so at full on-site capacity.
Persons below 18 years old, those who are over 65 years old, individuals with health risks, and pregnant women will be required to remain in their residences except when accessing essential goods and services or reporting for work in permitted offices or establishments.
Local government units may relax the minimum age range down to 15 years old, depending on the COVID-19 situation in their respective areas.
According to the Metro Manila Development Authority, the curfew in Metro Manila from April 12 to 30 will be from 8 p.m. to 5 a.m. from the 6 p.m. to 5 a.m. imposed during ECQ.
Updated classifications
The Cordillera Administrative Region except Abra, the provinces of Cagayan, Isabela, and Nueva Vizcaya in Cagayan Valley region, Batangas and Quezon provinces in CALABARZON, Tacloban City in the Eastern Visayas, Iligan City in Northern Mindanao, Davao City in Davao region, and Lanao del Sur in the Bangsamoro Autonomous Region in Muslim Mindanao will be under the lenient general commmunity quarantine (GCQ) from April 12 to 30.
Under GCQ, about 50% of industries are allowed to operate but social gatherings remain limited.
The rest of the Philippines will be under the most lenient modified general community quarantine (MGCQ), where virtually all businesses can operate and gatherings are permitted as long as only up to half of the venues' capacities are filled up.
Roque said dedicated COVID-19 beds in isolation, quarantine and health facilities in NCR Plus and other MECQ areas must be increased through the joint effort of the Department of Education, the Metropolitan Manila Development Authority, the Department of Public Works and Highways, and the Department of Health.
"There must be an adequate number of COVID-19 dedicated beds, complementary health human resources, and well-coordinated triage and referral systems in place at the local government units, isolation and quarantine facilities, and health facilities," Roque said in a statement.
"Hospitals must also be decongested through the partnership of hospitals with temporary treatment and monitoring facilities, step-down facilities for mild and moderate care or home care, provided there is proof of capacity to do adequate quarantine or isolation," he added.
Roque said local governments in the NCR Plus are also enjoined to set-up their respective local telehealth triaging systems equipped with sufficient medical personnel available to provide immediate medical and patient referral advice. PhilHealth must ensure the continued responsive and timely payment of reimbursement claims for COVID-19, he added.
Roque also called on NCR Plus local governments to prioritize those with highest risk for severe disease and death, particularly senior citizens and those with comorbidities, in their vaccination plan.
"The Department of Labor and Employment and the Department of Trade and Industry are directed to ascertain the number of employees who may undertake alternative work arrangements and its impact on the maximum carrying capacity of the subject area," he added.
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