Self-regulation

There are four basic measures for preventing COVID infection: vaccination, wearing a face mask, hand hygiene and physical distancing.

The vaccination program is shifting to a house-to-house search for the holdouts. Mask mandates remain in public places as Metro Manila and several other areas de-escalate to the most lenient Alert Level 1 from March 1 to 15.

Alcohol dispensers for customers’ use will also likely remain in place in most commercial establishments; practicing hand hygiene will be every person’s lookout.

What could disappear under Alert Level 1 is distancing. All mass transport facilities, including the light railway services, now allow 100 percent capacity. Health experts worry that this could be allowed to reach even 150 percent in vehicles such as buses where passengers can stand along the aisles.

With fuel prices soaring, transport operators will want to maximize each trip. Passengers packed like sardines can be a joyful sight for transport operators.

The government pandemic response team is hoping this will not happen, and that people will have enough sense to practice self-regulation. The coronavirus, after all, is still around, killing 56,451 people in the country so far and infecting 1,067 others as reported yesterday (with nine laboratories not submitting their weekend data).

Unfortunately, there are people who might find the government’s messaging confusing. They think that if it’s safe enough to de-escalate to Level 1, with all businesses allowed to reopen at full capacity, the pandemic must be over. Acrylic dividers are no longer needed in restaurants. More and more schools are resuming in-person classes.

Health officials are even saying the coronavirus has now become endemic. Doesn’t that mean it has become just like the flu and dengue virus?

*      *      *

Endemic, however, doesn’t mean the virus has disappeared. And if a considerable segment of the population remains unvaccinated, new COVID-causing SARS-CoV-2 variants may still emerge.

The highly infectious Omicron variant is also still here. Because of underreporting of cases due to people’s preference for cheaper antigen testing, wherein positive results are not recorded by the government, the OCTA Research group believes the actual infection numbers could be up to 10 times greater than what is being officially reported.

Pulmonologist Maricar Limpin, president of the Philippine College of Physicians, points to the resurgent Omicron-driven spikes in COVID cases in Indonesia, Singapore and Thailand.

Hong Kong, which like the Chinese mainland has followed a zero-COVID policy, saw daily infections surge from just over 100 at the start of February to a dizzying 34,000 last Monday as Omicron penetrated the city’s defenses. Panic buying was reported across Hong Kong yesterday amid reports of a looming total lockdown.

New Zealand, until a few weeks ago also with only a handful of COVID cases since the start of the pandemic, saw new daily infections rise with the arrival of Omicron, soaring to 19,588 as of Feb. 28. That’s a lot of people in a country with a population of only 4.88 million.

The fully vaccinated and boosted are mostly asymptomatic or have mild symptoms when they suffer breakthrough infections. But the unvaccinated and even the vaccinated elderly and immune compromised who have not been boosted can still need critical care hospitalization. Death is still possible.

Doctor Limpin told us on One News’ “The Chiefs” last Monday that people living with HIV now account for a large number of critical COVID cases. With Omicron, she has also noted a prevalence of people dying not directly of COVID, which usually causes lung collapse and a cytokine storm that leads to multiple organ failure, but of underlying illnesses, with the patient succumbing to a heart attack or a stroke, for example.

COVID can also cause long-term brain fog, and can aggravate Alzheimer’s among the elderly.

So the jubilation over the de-escalation to Alert Level 1 must be tempered with great caution. Limpin told us that health professionals are bracing for a possible spike in COVID hospitalizations beginning later this month as they watch crowding particularly in mass transport.

*      *      *

The doctors do acknowledge the need for people to get their livelihoods back. Even medical practice has been disrupted by pandemic restrictions. Many people have put off non-essential visits to dermatologists, dentists and ophthalmologists, for example. And not all afflictions can be treated through telemedicine.

My mother’s cardiologist caught COVID twice over the past two years and closeted herself at home. But doctors are beginning to live with the virus; the cardiologist returned to her clinic for the first time last week, with my mother as her second of only four patients accepted for the day.

Other countries are doing the same. New Zealand, despite the ongoing surge – its first since the pandemic – is easing its restrictions on travelers. Resident Kiwis returning from abroad no longer need quarantine in a hotel guarded by the military. But the country, which has one of the world’s strictest border controls, is targeting a full reopening to foreigners only in October.

New Zealand neighbor “Fortress Australia” reopened its borders to vaccinated tourists beginning Feb. 21. Israel, with one of the highest vaccination rates in the world, also reopened to all tourists including the unvaxxed beginning yesterday, but a negative RT-PCR test result is required prior to entry and another RT-PCR test is needed upon arrival.

*      *      *

It looks like microbiologist-theologian Nicanor Austriaco, the Dominican priest in OCTA, was right after all in saying Omicron heralded the shift for COVID from pandemic to endemic stage.

The operative phrase in reopening is to proceed with caution, and to continue observing basic health safety protocols.

Yesterday, the first day of Alert Level 1, traffic was bad along my long route to the office. Video footage showed worrisome crowding in mass transport. But at a mall supermarket where I made a brief stop, the guard still sprayed alcohol on the hands of all customers upon entry. Everyone still wore masks, and several still wore face shields.

Among those whose households have suffered illness and death from COVID, there is surely high awareness of the need to continue observing the minimum COVID safety protocols. They will be self-regulating long after the alert levels are gone, wearing masks in crowded public places and keeping alcohol sprays in their purses.

Endemic state doesn’t mean COVID has disappeared for good. It will continue to lurk, like the flu, waiting to infect particularly the vulnerable. It can still kill.