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Sense of immunity

SKETCHES - Ana Marie Pamintuan (The Philippine Star) - March 10, 2021 - 12:00am

People are wearing their masks below their noses, or not at all, and face shields are on their heads rather than covering their faces.

Toddlers are not just playing outside their homes but are walking in parks and open commercial areas, and riding with adult companions in jeepneys where distancing is no longer observed.

In some informal communities that I pass on my way home late at night, I see people including adolescents huddled together, without masks, without distancing.

As for hand hygiene, this has always been challenging in communities with limited access to clean water, and where regular use of alcohol and sanitizers is a luxury. These days there must be even less urgency in these communities to observe hand hygiene.

Call it complacency; call it pandemic fatigue: people are letting down their guard. And at this point, health officials are pinning the blame on this lax compliance with health safety protocols for the spike in COVID cases in recent weeks.

It could take about a week, according to some experts, before it can be safely concluded that the more infectious variants of SARS-CoV-2, the virus that causes COVID, are in fact behind the surge in infections particularly in Metro Manila.

Infectious disease expert Dr. Anna Ong-Lim, a member of the DOH Technical Advisory Group, says that so far, only seven percent of the new COVID cases have been confirmed to be of the variants.

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Several local government units (LGUs) particularly in Metro Manila aren’t waiting for such confirmation. They are seeing rapid transmission and are implementing granular lockdowns.

Already, the case spike has prompted another deferment of the reopening of cinemas and gaming arcades. More cops are being fielded to enforce mask wearing and distancing in the streets and mass transportation. Disinfection is being required per trip for buses.

The Philippine National Police is even prohibiting public displays of affection even among couples and family members.

Some LGUs have extended their curfew hours again and are requiring quarantine passes to discourage non-essential activities outside homes. A return to 10 p.m. to 4 a.m. curfew Metro-wide is likely. It’s like enhanced community quarantine, without the formal ECQ classification.

Barangay officials must earn their keep and act as the enforcer of protocols at the grassroots. The problem is if barangay personnel themselves are the top violators of the protocols.

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Complacency undoubtedly is being fueled by the rollout of vaccines. Considering the pace of vaccination, however, such complacency can place the country at risk of a second wave.

Thanks to the World Health Organization (WHO)’s Covax Facility and Beijing’s donations, COVID vaccination is finally underway in our country.

At this point, however, the acutely limited doses are being administered mainly on health frontliners.

WHO officials say another 4.5 million doses are expected under COVAX, including the initial 117,000 jabs of Pfizer that we thought we would get on Feb. 14 or 15, and for which we saw a surge in registrations for vaccination among the healthcare workers. But delivery will still be within the next two months.

For vaccines procured by the government on its own, the DOH has just signed the agreement for one million doses of Chinese biotech firm Sinovac’s CoronaVac. A supply agreement for 30 million doses of US firm Novavax’s jabs will be signed today, according to Malacañang.

The Sinovac jabs could arrive fairly quickly. That’s good for 500,000 people. As for the rest – including more doses from AstraZeneca plus US firms Pfizer, Moderna and Novavax – they will be arriving through the third quarter of the year.

To achieve herd immunity, the government aims to vaccinate 70 percent of the population, or nearly 80 million Filipinos. In Metro Manila, still the epicenter of the COVID pestilence and its variants, this means over 9.7 million needing vaccination, or nearly 45 million for the entire Luzon, the most densely populated of the three major island groups.

Metro Manila and the rest of Luzon can’t hog the shots; there are other areas with high cases and therefore also needing urgent vaccination.

As we are seeing in other countries, there is an interval of several weeks between the two COVID doses, and a few more weeks after the second shot before the vaccine takes full effect. In the case of AstraZeneca, it reportedly works better if the interval is at least 12 weeks. It could take four months from the first dose before full efficacy kicks in.

So we’re still months away from being out of the woods. And now here comes the highly infectious new variants, threatening more sickness and death.

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The efficacy of all COVID vaccines against the variants is still uncertain. And we must remember that no vaccine is 100 percent effective.

Epidemiologists say that if SARS-CoV-2 behaves like the flu virus, it could keep reappearing and infecting people, which is why scientists are studying whether people will need annual COVID shots.

The basic health protocols could in fact be even more effective in preventing viral infection – and there’s no risk of severe allergic reaction. This is what Health Secretary Francisco Duque III said Monday night, during a Cabinet cluster meeting with President Duterte.

Yet with the vaccine rollout plus talks of a possible shift nationwide to the most lenient modified enhanced community quarantine, people are behaving as if immunity has been achieved, and tossing out health safety protocols.

Department of Health officials met last Saturday night with Metro Manila mayors to discuss the problem. Duque said the DOH asked the mayors to intensify prevention measures, contact tracing, aggressive isolation and treatment response.

“We have to cut the chains of transmission and the clustering of cases,” Duque said.

In his Monday night address to the nation, Duterte (after yet another harangue against Vice President Leni Robredo) reminded the public to continue wearing masks, hand washing and physical distancing.

Areas where people have become lax, either because of pandemic fatigue or because of a misplaced sense of safety with the arrival of the vaccines, will find their communities back to last year’s lockdowns.

And if the variants make their way to these communities and households, and infect the vulnerable, the worst is always possible.

President Duterte’s admonition last Monday bears heeding: “It’s your life. You only live once… You have one life to live. So please guard yourself.”

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