No business as usual

It can’t be just my imagination… in the past few weeks, relatives, colleagues and other people I know have caught COVID.

For most of them, it was their first bout with the disease. Fortunately for them, vaccines and boosters kept them out of the hospital. Their symptoms were mild or moderate compared with those of us who caught the virus pre-vaccines and suffered the dreadful plummeting oxygen level that felt like drowning plus the cytokine storm that quickly killed the vulnerable.

Still, the new cases are reporting high fever, chills and upper respiratory problems, and some still lose their senses of smell and taste. Others suffer diarrhea. And everyone faces the possibility of developing long COVID.

Nearly all of the new cases I know tested positive in antigen tests and no longer sought confirmatory RT-PCR testing, so they weren’t included in the Department of Health (DOH) count. I’m guessing this is common nationwide, and actual infections are significantly underreported.

Experts advising the DOH have noted that people seek confirmatory RT-PCR tests only when they have symptoms but get negative antigen results – and only when the symptoms are moderate or worse. This is also when they seek hospitalization.

The low COVID bed utilization rate is being cited as the reason for maintaining current alert levels in Metro Manila and neighboring regions, which account for the bulk of national economic productivity.

But COVID cases are undoubtedly rising, fueled by highly infectious Omicron subvariants.

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In many workplaces, COVID safety protocols implemented since the first year of the pandemic remain in place.

Typically, there’s a temperature scanner at the entrance, and alcohol dispensers in strategic spots. Where possible, there are vacant spaces between desks or workstations for proper distancing.

Eating together in large groups is still discouraged. Ventilation has been adjusted for better air circulation. People bring their own hand soap and alcohol or hand sanitizer packs.

And everyone wears a mask, except when eating.

It’s the new office normal, which could continue until global health authorities declare that the COVID-19 threat is over.

In certain countries, people are also taking precautions against the highly infectious monkeypox, such as by wearing long sleeves to avoid skin contact.

Offices have had over two years of adjusting to the pandemic normal.

But what about schools, which will be resuming face-to-face classes for the first time beginning this month?

We’re familiar with the scenes in grade school, especially on the first day. Except for the newest students – the five-year-olds in kindergarten – children will be reconnecting with friends.

After two years of seeing each other only on computer or cell phone screens, the excitement of reunion is certain to be greatly heightened. Distancing could be tough to enforce.

Unless adults intervene, students will be mingling cheek by jowl, from the moment they line up to enter the school building until they file out of their classrooms at the end of the school day.

Many will be taking cramped mass transportation to and from school. The crowding is aggravated during downpours and floods.

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With COVID-19 cases on the rise, and now with the entry of monkeypox, pediatric infectious disease doctor Anna Ong Lim, a member of the DOH’s Technical Advisory Group, is hoping that school administrators are ready for a new normal in face-to-face education.

The most important requirement, she told “The Chiefs” last week on One News, must be masking. Children will need constant reminders about this requirement and must be mindful of coughing and sneezing etiquette.

Masks will be taken off when eating, so Lim is even suggesting a review of the need for recess, especially if classes will be held for only half a day. Breaks can be allowed for resting and toilet trips, but the snacks can be done away with. Instead, she suggests sending kids to school with a heavy breakfast. Supplemental feeding items can be consumed after classes.

This precaution may be negated by one of the main objectives of resuming in-person classes ASAP – economic revival. This includes resuscitating the food establishments that depend heavily on schools for their business.

Still, the idea is to keep schools from turning into infection hot zones, with students and teachers bringing COVID home to vulnerable members of the household.

Lim knows most public schools have little room to adjust classroom interiors to allow distancing.

Aside from strict masking rules, Lim hopes ventilation in classrooms will be properly adjusted so that pathogens are not trapped. This is important particularly in air-conditioned classrooms. In many offices, exhaust fans have been installed.

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International experts had hoped that COVID would raise awareness of the role of proper ventilation in promoting health. Detailed suggestions were given by the experts to improve indoor ventilation, particularly in tightly enclosed spaces such as cinemas.

Some restaurant owners said they have always had such ventilation systems, for food sanitation and to keep out smoke and unwanted odors.

Others, however, balked at the additional cost. Schools, which are in the business for the long-term, should find the investment cost-effective.

Most public schools are not air-conditioned, but the air must still circulate. Window screens are also needed to keep out mosquitoes and prevent dengue, which has surged this year after two years of low cases due to the lockdowns.

As we can see even in the Senate, COVID infections are again on the rise. Let’s hope monkeypox doesn’t complicate the situation.

The vaccine available, which is not specifically for monkeypox, is in extremely limited supply worldwide. And while the disease doesn’t have the virulence of smallpox, you can get monkeypox from direct contact even with infected clothing. Victims report extreme pain and discomfort. And infections have been recorded even among children.

Many schools are reportedly planning hybrid face-to-face classes on Aug. 22; the target date for 100 percent F2F classes is Nov. 2.

That should provide enough time for putting in place the safety precautions suggested by health experts.

As far as infectious disease experts are concerned, the non-negotiable precaution must be masking. The requirement is not as simple as it sounds to implement among children, but there has to be a new normal in school.

As Dr. Anna Ong Lim stresses, schools can’t afford business as usual.