Trust issues on COVID data

It’s been 18 months already since our entire country has been under a state of public health emergency due to the coronavirus disease 2019 (COVID-19) pandemic. In fact, the Philippines has been placed under a state of public calamity not just once but twice extended already by President Rodrigo Duterte.

On Sept.10 this year, President Duterte signed Proclamation 1218 extending for the second time the nationwide state of calamity until Sept. 12, 2022, “unless earlier lifted or extended as circumstances may warrant.” This was a few weeks before the first extension under Proclamation 1021 lapsed last week.

President Duterte first issued Proclamation No. 929 on March 16 last year declaring a State of Public Calamity following the first confirmed local transmissions here of COVID-19 cases. At that time, a “Code Alert System” for COVID-19 was initially implemented by the Department of Health (DOH) and the Inter-Agency Task Force for Emerging Infectious Diseases (IATF).

Incidentally, Proclamation 929 also placed for the first time the entire country under Enhanced Community Quarantine (ECQ). This was after the IATF raised to “Code Red Sublevel-2” the COVID-19 Alert all over the country.

Despite the first extension of the state of public calamity, the President admitted “the number of COVID-19 positive cases and deaths continue to rise amid efforts and interventions to contain the same.” This, despite the “significant strides” in the joint government, private sector and the general public efforts to control the pandemic, the President stated in Proclamation 1218.

“This extension, will, among others, effectively afford the national government as well as local government units (LGUs) ample latitude to continue to implement the COVID-19 vaccination program; utilize appropriate funds, including the Quick Response Fund, in their disaster preparedness and response efforts to contain the spread of COVID-19; monitor and control prices of basic necessities and prime commodities; and provide basic services to the affected populations,” the President cited.

Proclamation 1218 further read: “All government agencies and LGUs are enjoined to continue rendering full assistance and cooperation with each other, and mobilize the necessary resources to undertake critical, urgent and appropriate disaster response aid and measures in a timely manner to curtail and eliminate the threat of COVID-19.”

Surprisingly, the President made no mention about the local transmissions of COVID-19 cases due to more transmissible foreign variants from “Alpha” to “Delta” that were mostly detected from returning Filipinos from trips abroad and overseas Filipino workers.

Other than the mention of vaccination program, Proclamation 1218 was generally a cut-and-paste of the first two Proclamations.

But somehow, somewhere along the way the previous DOH Alert System was done away while the IATF took over community quarantine classifications. It was just last month that the government suddenly decided to return this job to the DOH as well as the adoption of the new alphanumeric Alert Level System in the implementation of the original IATF “granular lockdown,” or COVID cases-based quarantine classification.

Using the revised system, the DOH will again be the one to determine Alert Level ranging from 1 to 4, with 1 as the low risk to 4 as the high risk for COVID-19 infection. At each level from 1 to 4 will have equivalent of specific “granular lockdown” while allowing business establishments to operate such as restaurants, beauty parlor salons and shops under restrictions ranging from 10 percent; 30 percent up to 50 percent capacity.

Logically, the DOH should and can do this Alert Level System since it is the agency that has been the central repository of data and statistics about the pandemic cases being reported from results of COVID-19 testing to treatment of patients who recovered and died. The COVID-19-related data are submitted to the DOH by accredited medical laboratories and hospitals as well as by LGUs.

However, local chief executives especially from Metro Manila and highly urbanized LGUs have questioned lately how come the DOH does not differentiate or separate COVID-19 cases according to the residence of patients admitted to hospitals. San Juan Mayor Francis Zamora has been vocal in raising this issue, citing in particular the Cardinal Santos Hospital in Greenhills that have a lot of non-residents who are admitted in the COVID-19 wards of his city’s premier hospital facility. Unfortunately, the Mayor complained, the number of COVID-19 cases is counted against the city.

The same situation applies with the entire Metro Manila LGUs where there are a lot of COVID-19 patients who are non-residents admitted to their respective hospital wards. This is indeed unfair to residents at the National Capital Region (NCR) who continue to carry the brunt of being placed by the DOH under Alert Level-4 because many of the hospitals with the most number of COVID-19 wards are located in their LGUs. On the other hand, the DOH pointed that some LGUs have not been submitting report of COVID-19 cases in their respective areas.

At the Malacañang daily virtual press briefing last Monday, DOH undersecretary Alethea de Guzman dismissed calls to downgrade to Alert Level 3 the NCR with the reported dramatic decline in COVID cases during the first week of the “granular lockdown” pilot-testing.

The pilot testing at the NCR lapses tomorrow. But De Guzman justified the need to retain the current Alert Level 4.  She described the DOH stand as merely being “cautious” not to prematurely ease the “granular lockdown” just because of the declining trend for now of the COVID-19 cases at the NCR.

De Guzman surmised the decline must have been due to less COVID laboratory test results submitted to the DOH from the NCR. Her rhetorical query amounts to asking: Is it truly because the pilot-test is a success, or were there other factors?

De Guzman cited glitches of DOH computer server lately bogged down as one factor. So how can we trust the COVID-19 data of the DOH?