Bursting bubbles

Burt Bachrach asked what do you get when you fall in love? Answer: a guy with a pin to burst your bubble. That’s what this entire COVID-19 experience has been “all about”. One pin after another bursting the bubbles of security, complacency and growth that we built around us. And it includes the bubble of safety we thought we enjoyed with our government’s response.

The shotgun solution of Enhanced Community Quarantine (ECQ) was meant to be a trade off. Stay confined for peace of mind. With discipline, deliverance. This was the illusion.

Finding a vaccine or developing a cure is the duty of government and the experts; getting our economic engines back on track is the job of government and the business sector. Our role was simple: to survive. To do that, the strict observance of the collateral Non Pharmaceutical Interventions (NPI) was key, i.e. isolation, self quarantine, hygiene and sanitation, social distancing, no school, no work, no travel.

To our credit, the great number behaved and surrendered liberty, luxury and license. Even with the least monitoring and supervision. Honor system rules.

Delusion. And then the sight of beneficiaries of the Emergency Subsidy-Social Amelioration Program with horror stories of standing in place through the night. The latest was in Bagong Silang, Kalookan. In Tondo, at the “Adopt an Indigent Family” Relief Assistance Program under the auspices of NCRPO Director P/Major Gen. Debold Sinas, again the long queues. At both, the alarming disregard of social distancing and hygiene protocols. Gen. Sinas also starred in that thoughtless extravagance of an extraordinary birthday asalto/mañanita in this time of acute public sacrifice.

ECQ is the most socially and economically disruptive of the interventions. We know that even with its relaxation today, the same can be reintroduced, as needed. But it was never meant as a stand alone policy. It is one layer in a multipronged range of response options which, to be effective, must be religiously observed. The obligation here is collective and not individual.

The quickest way to sabotage this is for those with the duty to enforce to be the first to defy. The second quickest is to slacken the monitoring and supervision of quarantine protocols specially at events conducted by government itself.

Senators speak of an erosion of confidence. When our survival is precariously held together like a sword of Damocles hanging on a slender thread, the last thing we want is to lose our nerve.

BGCM. The Bayanihan law grants cities and municipalities an equivalent of one month Internal Revenue Allotment (a lá 13th month pay), more or less P30.8 billion, as a one time financial assistance to boost capacity to respond. Guidelines from DBM on the use of BGCM includes: procurement of equipment, reagents and kits for COVID-19 testing.

Several LGUs have exercised the initiative to conduct their own mass testing. Notably, Marikina, Valenzuela, Manila, Quezon City, Taguig, Muntinlupa, among others, were first to share in the burden. These particular LGUs use RT-PCR, better known as the swab tests. The IATF has, in fact yielded the lead to LGUs in testing responsibility.

Acid tests. The RT-PCR tests, though more reliable, have a long turn around time. Backlogs remain, notwithstanding the ramped up testing capacities of joint national and private sector efforts. The target is to go from the current 8,000 capacity up to 30,000 daily tests by end of May; from the present 30 testing centers to a total of 78 accredited testing labs.

Even if we should hit these targets, we are still far from optimal. So far, only 189,469 Filipinos have been tested (or 198,190, reconciling the discrepancies in DOH official updates). UN data pegs our population at 109,383,963. You do the math.

Hence, to catch up, the pivot to the rapid, serological anti-body test kits which are less expensive and provide results in minutes. PRRD has ordered two million kits. As of May 14, there have been a total of 44 rapid tests licensed by the FDA. Other LGUs are agitating to be allowed to use rapid tests as diagnostic or screening tools, to be funded by their BGCM allotments as well as by their 20 percent IRA development funds.

Whole of government? And here lies the road block. The Health Technology Assessment Council does not recommend it for mass testing. Hence, the DOH, at first, prohibited the use of public funds to pay for such kits. The DOH/IATF later relented, allowing its purchase by LGUs, but still strictly as an adjunct tool for monitoring patient status. In short, the kits can only be used in relation to patients that have been previously tested by RT-PCR or otherwise diagnosed, in order to clear them if they have antibodies.

The reliability issues of rapid test kits, with the propensity to produce false negatives and false positives, have resulted in their being banned in Belgium, Dubai and India. The message for LGUs is it’s better to invest in RT-PCR and their collaterals like labs and personnel training for today and for future eventualities.

Disease detectives. Last May 5, PRRD spoke of LGUs’ responsibility for contact tracing. The DOF Secretary has proposed the two birds proposition of hiring up to 1.5 million displaced workers for contact tracing. Health Sec. Duque’s ideal ratio is at least 1 tracer for 800 persons.

Testing and tracing are critical. They are what bridges the lockdown and NPI measures. Otherwise, we proceed blindly. As we go from ECQ to GCQ, it is vital that we ensure strong tracing mechanisms are in place to detect and stop virus clusters from exploding.

Rep. Joey Salceda calls the lockdown a wasted sacrifice due to the lack of testing and tracing. He cited data that when only 77,000 total tests were conducted, a mere 5,000 of them were of contacts. The National Union of People’s Lawyers protests that government is more interested in critic tracing than contact tracing.

Passages. Senator and Congresswoman Teresa Aquino-Oreta was a true champion of teachers’ rights, early childhood education and education modernization. We join a grateful nation in celebrating her life of principled service. Our deepest sympathies to the family.