Buying time
SEARCH FOR TRUTH - Ernesto P. Maceda Jr. (The Philippine Star) - March 21, 2020 - 12:00am

Day 6 in lockdown. Lessen person to person contact and we lessen the spread. 

With fewer hosts for the virus to transfer to, the transmission rate drops. The virus does not disappear. Widespread transmission is still inevitable. But we need lesser people getting sick for now. Explosive transmission may still be avoidable.

This is crucial because of the limited capacity of our health care system. It simply can’t keep pace with the surging numbers. Testing kits, ventilators, beds, medicines, masks and protective gear, doctors and health professionals – there aren’t enough. And they’re just there to relieve symptoms of a virus that has no cure. It is this capacity deficit, not the virus per se, that inflates the mortality rate. 

So that more can receive medical attention should their time come, it is critical that we buy time now. Hence, be obsessively clean, stay home, observe social distancing and convince as many as we can to do the same. 

Already, the alliance of private hospitals in Metro Manila has called attention to their dire situation: dwindling resources, depleted staff, and increasing casualty rates. And it is more severe in the public hospitals. As of yesterday, the government designated one building of UP-PGH and the Dr. Jose M. Rodriguez Memorial as dedicated COVID-19 facilities. Metro Manila has 13 million people. A TIME Special report called us the most densely populated city in the world. Wuhan has only 11.08 million. 

Nowhere to run. We totally get Pasig City Mayor Vico Sotto’s lament about tricycle services being disallowed. There are collateral consequences to the strict policies for “suppression” of the virus. The public transportation ban disproportionately impacts the poor and the also sick who are unable to access hospitals and treatment for other morbidities. This is equally tragic. And the national government is leaving that pickle for him to digest. 

I’m sure that none of our local chief executives had anticipated this wild card pandemic during their watch. Even with the models, trend mapping and scenarios, no one was prepared for this. 

But as the other front line of the nation’s response, they have to share the awful decisions with the national government. And we can’t thank them enough, with our doctors and health workers manning the line, for remaining standing for all of us.

You herd? The UK, under the government of Prime Minister Boris Johnson, initially surrendered to the scenario of up to a 60 percent infection of the population. This was supposed to result to a “herd immunity” from all the recoveries. Keep calm and carry on, a tamer “mitigation” approach. They would just focus efforts on protecting and treating the vulnerable groups, like the elderly and those with underlying health issues. This approach implied an openness to surrendering the very people they’d protect to the higher mortality rate of their age group. 

But their own scientists from the Imperial College in London warned that managing the spread this way results in around 250,000 fatalities and their ICUs being overwhelmed. They’ve since rebooted by announcing sweeping measures, short of government enforced lockdown.

Sleeping giant. The models of this Imperial report are the same relied upon by the US government to justify ramped up federal recommendations. Worst case scenario for the US, under President Donald Trump’s initial trajectory of inaction, would have been 2.2 million fatalities. 

China, South Korea may have emerged on the other side but there is still no telling what happens should another outbreak flare up. Our own April 14 countdown is, in no way, the end of our tunnel. With no relief in sight but for the prospect of a vaccine in 12 to 18 months (currently undergoing trials), it seems that lockdowns and suppressive measures will be the new normal. 

Doing time. Its harsh. And the social and economic costs, specially on the wage earning sector, will be staggering. No such intervention has ever been attempted on so wide a scale and for so long a period. We can only hope for the most optimal outcomes and do what we can to mitigate the cost to those we can help. 

Critics continue to second guess PRRD’s decision, wondering aloud how we are the only ASEAN country with its metropolis in lockdown. Did we really deserve this fate? We have the balance of a month to be philosophical about it. 

But if we can do the time, then that would be immense help in shoring up defenses. There will be bed space for those who need it; we refill our stash of medicine, gear and equipment; build COVID-19 hospitals like in Wuhan (China can help or otherwise make available their high tech hospital ships for the coming spread in the provinces); commandeer and retrofit more hotels (just like Wuhan did); and train more health care workers for the front line. 

Heartbreaking stories have been shared about how even in highly urbanized cities outside Metro Manila, hospital professionals suddenly called to serve are not familiar with how to intubate a patient. Some, we are told, learn by YouTube.  

Lockdown anxiety. We wage daily battles on the mental wellness front. It was challenge enough to manage anxieties, pre COVID-19. With this new normal, what can we do to stay safe, psychologically?  

Yesterday, People Management Association of the Philippines hosted a much needed and welcome Webinar, “Coping with COVID-19” with Dr. Robert Buenaventura of the Philippine Psychiatric Association as resource speaker. 

Key takeaways: 1. Limit access to reliable mass media/social media resources like the DOH and WHO websites or major news organizations. Skip others so as not to be overwhelmed with information/misinformation; 2. Look for one or two knowledgeable, level-headed, trustworthy people to discuss one’s fears or anxieties, like a personal physician or a pastor; 3. Follow important recommendations such as handwashing and social distancing; 4. Maintain a healthy lifestyle: get enough sleep, eat a nutritious diet, avoid vices such as smoking and heavy drinking, and others; 5. If helpful or significant to the individual, pray or seek spiritual help.

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