Cause of death

There has been so much confusion over the “Metro Manila Community Quarantine” in the last two days and the only thing that exceeded the confusion was the amount of criticism and unsolicited opinion and critics coming from different sectors and individuals.

But under the circumstance, we should all remind people that countries and governments who are a thousand times bigger, more developed and with more experience than the Philippines have stumbled all over themselves in trying to figure out what to do in order to control the spread of Covid-19. Remember that China as big and as powerful a nation as it is, went through the same things we are currently experiencing. They had an outbreak, they needed to manage public fear and information, and they also had problems instituting a lockdown in spite of the fact that they are a communist military state. Thousands if not millions managed to get out of Wuhan before the lockdown also because certain people as well as the foreign press leaked out the government’s plans.

The United States, where experts regularly declare that the US is the most advanced, developed and strongest nation to cope with Covid-19, continues to report their growing number of confirmed cases as well as deaths. US citizens, politicians and media have likewise been critical of the poor preparation, lack of testing kits, and the response of officials in various states. Europe has now become the epicenter of Covid-19 with Italy as the most damaged and infected. This is the sort of perspective we need to have in order to stay rational, constructive and useful not to mention productive.

A number of individuals have particularly been critical about the confusion between Community Quarantine versus Lockdown and the mention of Curfew. Ironically, if we all “went back to the tape” and actually listened to hear and not listened to respond, people would have heard the unfiltered view of President Duterte as well as the clear statements from MMDA officials. Right after President Duterte declared “Community Quarantine” he immediately stated that they “were calling it Community Quarantine because you are all apprehensive about a “Lockdown” which is what it is”. That’s what he said in Tagalog but most people missed it because they were thrown off by the euphemism Community Quarantine. When the MMDA officials talked to the media about “Curfew”, it was said very clearly that Metro Manila Mayors unanimously agreed that a Metro-wide curfew should be put in place, and that they will all ask their respective legislative councils to write and issue such by today or tomorrow. Subsequent “clarifications” and announcements by Spokespersons simply repeated that there was no curfew until the cities issued their respective ordinances.

If all the confusion and misunderstanding teaches us anything it is that we should make time to watch the actual events, press conference, or interviews and try to ask those on the ground or the government offices directly instead of reacting to Facebook posts or cut and paste news stories that unfortunately cannot give the whole story due to time constraint and editorial judgment.

On top of that, we should all see beyond our views and opinions and recognize that the Duterte government’s approach is a slow and calibrated strategy that is clearly trying to maintain the balance between managing a public health emergency and maintaining economic activity particularly employment for the greater majority of Filipinos who live in a No-Work = No Pay reality. Yes, their idea of Community Quarantine is like using a bucket full of holes but I dare say that there is a method in their madness. I am almost convinced that there is a wizard named Garfield the Cat lurking in the background chanting: “If you can’t convince them – Confuse them.”

To be honest, it would be almost impossible to get everyone in Metro Manila to voluntarily support a total “Lockdown” or a full on “Community Quarantine” as it is officially done. So what we are seeing is the slow dance towards an undeclared Lockdown.

Yes, you can still go in and out of Metro Manila but after a few days people will simply decide to stay home than spend eight hours in traffic just getting in and out of the NCR. The buses, jeepneys and UV Expresses are still running but the one foot social distancing of passengers means they have to drive half full, use up twice as much fuel and three times longer to make only one trip will be so pointless they will look for passengers outside of the Metro or stay only inside. The malls will cooperate with reduced hours because they will save on electricity and maintenance running malls that only one fourth of their usual customers. Their locators would love the cut in hours because customers will still go but not take their time. As for Curfews and No Kids on the Block, you are not hearing or reading about parents complaining about it. As for the exodus outside Metro Manila, the fact is, it also contributes to decongestion and reducing the population of potential victims.

Some argue that allowing people to leave defeats the idea of containing the contagion. Here’s the bad news: the virus is probably quite spread all over the country but the only reason we are not hearing about it because there are not enough testing kits, not enough trained specialist to determine if a person died from Covid-19 or Severe Acute Respiratory Infection (SARI) or a combination of pneumonia, TB, kidney and heart disease. A mayor recently got the urge to do some research on the state of respiratory diseases and mortality in his part of the country and he was shocked to learn about the unusual number of “Respiratory related Deaths” written on the death certificate. I asked a senior government epidemiologist if they actually tested those dying from SARI for Covid-19. No, they don’t. They simply write Cause of Death: SARI.

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