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Headed for the worst

SKETCHES - Ana Marie Pamintuan (The Philippine Star) - April 19, 2021 - 12:00am

Give him an A for candor. Maybe President Duterte has seen too many friends, or friends of friends, dying of COVID. Seeing people in your age group dying, many in just a matter of days, can make you contemplate your own mortality.

Or maybe the street-smart Chief Executive is assessing the infection figures and is finding them discouraging.

And so, even as he agreed with the recommendation of his inter-agency task force to ease pandemic restrictions, he warned that the worst isn’t over, that many more will get sick and die.

With average daily infections last week placed at 10,631, that’s a pessimistic but realistic assessment of the current state of the pandemic in our country.

There are health professionals who think it’s madness – from a health perspective, of course – to ease the National Capital Region and four adjacent provinces to modified enhanced community quarantine when the cases remain so high and the variants are so infectious. Last Saturday, fresh infections stood at 11,101, for a record high total of 203,710 active cases. The figure did not include results from nine laboratories.

Most of those cases were likely in the so-called NCR Plus. As OCTA Research has pointed out, the region is on its way to achieving herd immunity the natural (and lethal) way, with 8.5 million people infected by the end of June.

*      *      *

Authorities seem to be in denial about the virulence of the COVID variants. Yes they are variants; I know people who were manic about adherence to health safety protocols but still got infected – reason unknown – and then passed on the virus to their household members. The original virus did not behave that way. And the Philippine Genome Center has no capability to test 11,101 specimens a day for variant presence.

Entire households and offices are being hit. The light railway services are sputtering because of the spiraling cases of infection among their personnel. For sure the infection has jumped to passengers.

A TV report last week provided a scary picture. An air-conditioned bus had tossed out the window the requirement to keep passengers one seat apart; all the seats were occupied, with people sitting side by side.

Sure, passengers wore masks and several wore face shields. But how many wore their masks below their noses – as many people do to breathe easier?

In another news report, a UV Express driver said his passengers expected air conditioning so he could not switch it off and raise windows at least three inches to let air circulate, as required by health protocols for mass transportation. I don’t know how many more weeks he will last in this surge before he catches the killer COVID mutants.

With the virus rampaging even in the Philippine National Police, there are no more people enforcing the health protocols on public transportation. Jeepneys are packed again, to maximize each trip.

If the driver or any passenger is infected, the contacts can’t be traced, because this capability has been reduced to zilch in the middle of the killer surge.

So yes, things will truly get worse before they get better; we ain’t seen nothing yet. And many more will die.

*      *      *

Ordinary viruses have not taken a rest during the pandemic. Even as people struggled to dodge COVID in the past year, people continued to experience colds, coughs, fever, flu. Those who got past these ailments with just Biogesic, Tuseran and Decolgen – certainly no SARS-CoV-2 infection – are at high risk of COVID complacency in the ongoing surge.

But they are not the only ones who might deliberately ignore such symptoms, including the loss of smell and taste that is unique to COVID. Others ignore the symptoms because they fear they won’t be able to earn a living if they are forced into isolation. Still others find the cost of RT-PCR tests too steep, and put off testing until their COVID infection becomes undeniable. By that time, in this variant surge, a person might have already infected his entire household, workplace, and passengers in the mass transport vehicles he has taken.

Until COVID testing becomes widely available and affordable, we haven’t seen the worst in this crisis.

If the infection is passed on to the elderly and those with comorbidities, OCTA has already noted that the COVID death rate in these sectors has jumped exponentially in less than a month.

*      *      *

Some things can be done. Health hotlines, for example, must be set up where people can consult for free about early symptoms.

With infections and deaths soaring, people do worry about COVID symptoms, but they don’t know where to get professional medical advice. The lines at hospitals are dismaying (and pose risks of infection), and many people don’t have the bank accounts needed for telemedicine online payments. They aren’t even sure which telemedicine service is reliable.

Public health hotlines (emphasis on the plural) operating 24/7 can be set up in each barangay, so that people suspecting their symptoms to be COVID can consult medical professionals for free and anonymously, at any time of the day or night. The hotline numbers must be prominently displayed all over the barangay. Many people especially in informal settlements worry about their homes being locked down in case household members are infected, so the anonymity is essential.

From these hotlines, the caller should be able to obtain timely advice on initial medication, what to do to protect other household members from infection, and whether it would be necessary to seek quarantine outside the home. The hotline can provide information on free RT-PCR testing (where available), and at what point it would be advisable to leave home isolation and seek hospitalization.

There are people who can’t afford to leave their homes even if infected: single parents with young children and no house helpers, or who are caring for the elderly and infirm. People are also worried about stories of poorly maintained isolation centers.

Epidemiologists have stressed that the frontline in this war is the home. Such hotlines can then serve as Step 1 in triaging, to ease the burden on hospitals.

At this point, there have been enough horror stories about COVID; you have to be living in a cave not to know how terrible it can be. People who get professional advice from the hotlines can be expected to take the necessary steps, to save themselves and their loved ones from infection.

With vaccines coming in trickles, more people will still get sick and die. But everyone can play a part in reducing the tragic toll.

COVID-19
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