All that glitters is not gold

In Metro Manila hospitals, we see two kinds of admissions: (A) those with COVID (e.g. even if admitted for appendicitis or a broken arm but later test positive in the routine hospital COVID check); and (B) those hospitalized because of COVID, i.e. patients complaining of marker symptoms like pneumonia, fever, sore throat and diarrhea.

The DOH refers to category A as “incidental” cases which far outnumber category B in admissions. This is in contrast to the September Delta surge which had numbers trending disproportionately toward B. They ascribe this development to vaccination rates. Metro Manila is now reportedly approximately 72 percent fully vaccinated. Of course, both categories still combine in the single COVID hospitalization tally.

Original sin. This A v. B nuance is not new and has been contentious since the beginning. Imperfect metrics and uncertain counts have long informed decisions of economic and public health policy makers.

In the US, the overcounting of COVID infections has been controversial since Day 1. This skewed way of counting (combining categories) has been blamed for inflating statistics. It was reignited last November by Dr. Anthony Fauci, Chief Medical Advisor to the President, who acknowledged the practice in children’s COVID cases.

New York Governor Kathy Hochul has already announced that her State will change how they report cases, of both children and adults, accordingly. Incidentals shall be counted separately. Other states are expected to follow suit. This should usher in a dramatic reduction in the numbers.

Another notorious skew is counting positive tests as opposed to positive individuals. If you take 2 tests and are found positive each time, that makes 2 cases counted instead of just 1.  Case counting depends on who get tested, not who are infected.

The latest positives of our friends, families, neighbors, officemates, classmates are discovered via home antigen tests, none of which are acknowledged in the daily DOH statistics.

Reality check. If still freaking out over the latest COVID case bulletins, it’s clear that obsessing over them has become counterproductive.

A brief sampling of things we’ve taken with a grain of salt and where we are now:

1. Tomorrow, we may reach a milestone 50 percent of the population fully vaccinated. What now when the game changing vaccination campaign has been changed by the game? The bullet was not as silver as we thought.

Whoever coined the term “breakthrough” to denote infections of the fully vaccinated must be scratching his head. Anecdotally, there is no breakthrough to speak of as vaccines do not prevent infection, reinfection and transmission. For now, however, we still concede their efficacy against severe sickness and death.

2. The definition of fully vaccinated is becoming a moving variable. In the US, the requirement of booster shots in several states is fast transforming the official two primary doses into a 2 plus 1. No one is ruling out a 2 plus 2 or more in the future.

Again, the prospect of flexible definitions wreaks havoc on policies, especially with mandates. The alternative to lockdowns become equally or even more burdensome.

3. Speaking of boosters, comes now the WHO questioning if repeated jabs of the original vaccine formulations prove viable against new variants. They argue that new vaccines are needed.

In addition to this eye opener, European Union regulators have warned against the feasibility of repeating booster shots as the same may weaken our immune responses.

Vaccination’s yoke. The unvaccinated are being made to bear their cross instead of having the vaccinated bearing it for them. Around the world, countries begin the extraordinary step of firing perfectly healthy unvaccinated employees. The absurdity of this development is highlighted when contrasted with policies requiring even COVID positive health care workers to stay on the job if mild or asymptomatic.

Here at home, the same “genius” step is being mimicked in the “optional” lowering of isolation/quarantine to 5 days for positive or exposed health care workers. At the same time, sweeping and overbroad limitations have been inflicted on the movement of the unvaccinated by restricting access to public transport. The DTI’s controversial “no vax, no ride” policy in PUVs begins Monday.

The common refrain is that there ought to be a law. Vaccination mandates need to be legislated mandates. The DTI’s department order does what only a law can do as the same falls clearly within the classic understanding of police power - i.e. the interference by the State with private rights for the public good. The limitation on freedom of movement is a delicate matter that only Congress, not the DTI, is empowered to authorize.

Who is your public? The justification provided by the DTI is debatable. It may even be legally tenable -- that they’re not limiting the right to travel but merely regulating the operation of public transport. The unvaccinated, after all, still have their feet.

But this makes the argument problematic. The bottom line is that public transports are public utilities. For public utilities, the rule is access by all or by none at all unless the law itself supplies an exception. “The principal determinative characteristic of a public utility is that of service to, or readiness to serve, an indefinite public or portion of the public as such which has a legal right to demand and receive its services or commodities” (JG Summit v Court of Appeals). Even the controversial Senate Bill 2094 which endeavors to reshape the Public Service Act’s 86-year-old definition of a public utility has retained PUVs in its coverage.

Congress, itself, has not provided for an exception. Au contraire, the legislative policy on mandatory vaccination is etched in R.A. 11525 -- that a person’s vaccination status should not be “considered as an additional mandatory requirement for education, employment and other similar government transaction purposes.” This was an amendment purposely introduced by Senator Francis Tolentino to protect the non-vaccinated from discrimination.

Worldwide, nations are struggling with policies to get more people vaccinated. Incentives work better when they do not amount to punishments.

Passages. Our prayers and condolences to the family of Ma’m Consuelo “Connie” Rufino Lopez. She was a woman of uncommon grace.