SKETCHES - Ana Marie Pamintuan (The Philippine Star) - June 16, 2021 - 12:00am

The good news is that there’s a surge of people wanting to get vaccinated against COVID-19, at least from what we’re seeing in Metro Manila.

The bad news is that there simply aren’t enough vaccines, and infections are surging outside the National Capital Region, even as critical COVID cases have also surged in the NCR in the past week.

Pulmonologist Maricar Limpin, vice president of the Philippine College of Physicians, says the group is urging the government to go slow on easing COVID restrictions because of the spike in serious infections in the NCR as well as the flare-ups outside the capital.

The government appears to be heeding the doctors’ advice. Last Monday night, President Duterte announced that the NCR and Bulacan would remain under general community quarantine “with some restrictions,” while the other provinces in the NCR Plus – Cavite Laguna and Rizal – would be under GCQ “with heightened restrictions.”

In the same televised address, Duterte also warned that those who don’t want to get vaccinated should prepare their coffins or cremation plans.

The warning was no exaggeration. The coronavirus and its more virulent variants are very much around and continue to claim an average of 100 lives daily across the country.

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Doctor Limpin told us on One News’ “The Chiefs” last Monday that intensive care unit bed occupancy at the Philippine Heart Center where she works, for example, has jumped from about 50 percent three weeks ago to 70 percent two weeks ago and, as of a week ago, 80 percent. As of Monday, ICU beds at the Heart Center were occupied 100 percent. She said she believes other hospitals in the NCR face similar situations.

Along with this worrisome surge in severe and critical cases, with ICU capacity again running out in the NCR, infections have spiked in the provinces.

Limpin said their colleagues from the Visayas and particularly from Mindanao began sending an SOS two weeks ago to Metro Manila for critical care equipment. Physicians in the NCR, who have experience with the surge, have sent their colleagues “algorithms” on the graduated responses for dealing with the more transmissible and deadlier cases.

Infections in Duterte’s home city of Davao have surpassed cases in Quezon City while the OCTA Research Group has tagged Dumaguete City as the “area of most serious concern” in COVID transmission.

Like OCTA, Limpin is suggesting the maintenance if not the tightening of border controls between the NCR Plus, which is just starting to emerge from the summer’s killer COVID surge, and the rest of the country. She agrees that the easing of travel restrictions can be blamed for the surge in COVID cases outside the NCR Plus.

She also expressed concern over scenes of crowding for mass transport rides in Metro Manila.

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It’s good that President Duterte is making a stronger pitch for vaccination. He’s correct in pointing out that we can return to some semblance of pre-pandemic normal only when a sufficient percentage of the population has been inoculated against COVID-19.

Now if only his administration could do a better job of procuring vaccines.

A visit to many vaccination centers in Metro Manila will show the inadequacy of the supply. Waiting areas are full, and there are crowds hoping they can be accommodated as walk-ins in case some of those scheduled for the day don’t show up.

The throngs of hopefuls have grown exponentially since the inclusion of essential workers in the A4 priority category.

Local government units (LGUs) must implement an orderly system of scheduling and administering the jabs. Otherwise, those scenes of crowd disorganization can turn into COVID super spreader events.

Last Monday a media colleague woke up at 5 a.m. on her day off so she could try her luck at a mall in Manila. She has her QR code and the city does not give time slots for vaccination.

There was already a large crowd at the mall, which was giving out free food to the people, some of whom had reportedly been there as early as 2 a.m. I asked my colleague if she didn’t actually line up at a community pantry for free breakfast. At 6:30 a.m. she was told that all the 900 jab slots were already filled, long before the actual vaccination would start. Now she plans to try her luck in a city hospital.

Another colleague said the waiting lines are much longer than they look. Certain persons wait in place of five or more individuals. Is this a money-making scheme?

The NCR Plus mayors will also have to streamline their rules for non-resident workers. It can wreak havoc on planning for the vaccine allocations needed by each city or municipality, which might lead either to shortages or waste of unused jabs.

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The other side of the problem is continuing vaccine hesitancy. I know several persons who were registered online by their employer and received their schedule alert for vaccination, but refused to get their jabs.

I don’t know if Duterte’s warning will sink in, that if you don’t get vaccinated, you’re dead.

Carrots dangled by certain LGUs to encourage vaccination, such as raffles and rewards, appear to be working in dispelling vaccine hesitancy. The private sector has also pitched in, offering discounts for their products and services and assisting in pro-vaccination information campaigns.

What could be more persuasive, however, is requiring vaccination cards (pass or passport) for certain activities such as air, sea and long-distance land travel, or for certain types of employment.

Such a scheme will have to wait until the country has vaccinated at least 70 percent of the population (some say 80 percent is needed if it’s the China-made vaccines) for herd immunity. But at the current pace of vaccine rollout, this could be achieved only by mid-2022. The best we can hope for this year would be vaccine “containment,” with about 50 percent of the population inoculated.

Also, the vaccination card will have to be made tamper-proof. The current one is so easy to fake. Considering how long our typical wait is for tamper-proof government-issued ID cards, however, this could take even longer than achieving herd immunity.

These problems are generating a surge of public discontent. For politicians, this kind of surge could prove as lethal as COVID.

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