Are we there yet?
ECQ or GCQ? With the two-month enhanced community quarantine (ECQ) ending this Friday, presidential spokesperson Harry Roque said over the weekend that parts of Metro Manila would likely remain under ECQ, while others would be placed under the less-restrictive general community quarantine or GCQ.
That is a momentous decision that will have far-reaching implications on the lives of the residents of Metro Manila, epicenter of COVID-19, and the rest of Luzon and other parts of the country affected by the pandemic.
The great debate on whether it is time to end or ease up on the strict lockdown measures hinges on today’s catchphrase: flattening the curve.
A country is flattening the curve when it has reduced the number of new COVID-19 cases from one day to the next, according to the Johns Hopkins University. When a country has fewer cases today than yesterday, that country is flattening the curve.
Are we there yet?
Epidemiologist Dr. John Wong, a member of the Inter-Agency Task Force for the Management of Emerging Infectious Diseases’ subtechnical working group on data analytics, raised hopes last week when he said that data from 10 to 14 days ago showed that it was now taking a longer time for the number of COVID-19 cases and deaths to double, an indication of flattening the curve.
On the average, it’s been taking 4.6 days for cases to double, longer than the 2.5 days before the lockdown on March 17. Likewise, a slowdown in deaths has been observed: From four days prior to the lockdown, the average mortality doubling time is now at 5.7 days. But Metro Manila’s doubling time for cases and deaths is shorter than the rest of the country, at 5.8 days for cases and 5.6 days for mortality.
Based on these numbers, Wong said there was already an improvement in the COVID-19 situation in the country. “We already saw that the curve had already flattened. If there are no significant changes, the flattening will continue, meaning, we will have very few additional cases.”
Health Undersecretary Maria Rosario Vergeire affirmed this, saying that apart from the slower case and mortality doubling time, the drop in “positivity rate’’ is another indicator that the country has flattened the curve.
Vergeire noted that as of May 6, among the 131,786 individuals tested for the virus, 13,405 returned positive, or a positivity rate of 10 percent. This, she said, was lower than April 6, when 4,144 out of 24,755 unique tests or 17 percent came back positive.
How reassuring are these claims? Other experts are vigorously countering the assertion that the country has flattened the curve, citing our limited testing capacity and backlog in testing results.
Ateneo math professor Dr. Felix Muga II said in an ABS-CBN interview that the number of cases is still increasing and that the reproduction number, or the average number of people that can be infected by one person, is still above 1. “If it is really flattening, the end (of the graph) should really be flat,’’ Muga said, pointing out that there is still an upward trend of cases.
A group of academicians behind the Citizens’ Urgent Response to End COVID-19 likewise cautioned against the DOH’s optimism, saying there was not enough data to support the claim.
The single biggest argument against the assertion that the Philippines has flattened the curve is the dismally low number of testing that has been done nearly two months since the lockdown. As of May 7, the 151,080 total tests conducted out of Metro Manila’s 12.8 million residents and the entire country’s 109.5 million population certainly do not show the complete picture of the COVID-19 infection in the country.
The DOH has been working to achieve 30,000 tests per day, but as of the end of April, it has failed to meet its target of 8,000 tests per day — a failure that Malacañang has admitted. Moreover, testing has been done mostly on people with symptoms, vulnerable individuals with preexisting health problems, and infected health workers. But global data indicate that three out of 10 people who tested positive of the virus did not show symptoms of the disease. Exactly how many in our communities are walking COVID-19 carriers remains unknown.
Compared to other countries, the Philippines is lagging behind in testing with 1,379 tests per one million, significantly lower than Vietnam’s 2,681 tests per one million, Thailand’s 3,264, and South Korea’s 12,773.
And that is the crux of the dilemma this crunch time: With mass testing still a dream and no vaccine yet in sight, the government’s efforts and the citizens’ tremendous sacrifices cannot be wasted on decisions based on faulty and incomplete data. But as to why, 57 days since the ECQ, there is still sparse testing resulting in dangerously incomplete data — now there is the 275-billion-peso question.
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