Balancing act: Health and the economy

We have just finished our fourth month of quarantine, and the questions on everyone’s mind are: “Is it safe to go back to work?” and “Are we getting any closer to opening up the economy?” Sadly, not quite yet. What has started as a public health crisis has evolved into an economic crisis and may escalate into a social crisis.

While there have been improvements introduced in the last three months, we are not yet out of the woods. We will need to muster greater coordination and cooperation to pull together to get us out of this problem. Opening up the economy safely to enable more people to regain their livelihoods and income will require a delicate balancing act.

Central to this will be our ability to test whether people are COVID-19 positive. In this regard, there have been improvements. Before Task Force T3 (for Test, Trace, and Treat) was formed on April 24, the entire country’s testing capacity was only 4,500 PCR tests per day. Today, there are over 80 public and private labs operating with a combined capacity of roughly 80,000 tests per day. Last May, less than 9,000 actual tests were performed daily. That number now runs between 17,000 and 25,000 tests daily. There’s plenty of room for expansion.

Two key developments should lead to wider testing. The first is a new Expanded Community Testing protocol recently released by the Department of Health. When capacity was low, testing was limited to those who were symptomatic, had exposure to a COVID-19-positive, or who had a travel history to a country with COVID-19. Medical frontliners were also given priority for testing. The new protocol now opens the door for nonmedical frontliners and asymptomatics to be tested.

The second development is Pooled Testing, the practice of pooling 5, 10, or 20 samples into a single test. If the pooled sample tests negative, then all persons in the pool are negative. If the pooled sample tests positive, then all persons in the pool will need to be tested individually. A protocol is being tested. If this is successful, this will reduce test costs and increase the number of people tested. Both developments would have an impact on opening the economy up safely.

More testing, however, will mean that we spot more cases. This has certainly been the case recently. One key number to look for is the “positivity” rate, or the number of positive cases as a percentage of tests given for that day. That number has been rising lately in some parts of the country, most notably Metro Manila and Cebu. Nationally, the positivity rate peaked at 23.8 percent back in April and dropped to average 8 percent up to this week. On a daily basis, however, in the last few days it has been running at 11.8 to 13.5 percent.

Expanded testing is just one aspect of the health equation necessary for enabling the safe opening of the economy. Contact tracing, quarantine and isolation, and treatment are also part of that equation. Of these three items, contact tracing needs the most work. There seems to be a disconnect between the good contact training practice of Baguio City (where direct and indirect contacts of positives are traced) and a recent announcement where police will go house-to-house in search of cases. Doesn’t inspire confidence.

The bottom line is that for the economy to open up safely, the public—particularly workers—will need some reassurance that they will be safe. We can’t afford to have the economy moving at this pace for much longer. All but two weeks of the second quarter this year has been under some form of quarantine. If Singapore’s performance is any indication, its economy contracted almost 40 percent quarter-on-quarter and 12.6 percent versus year-ago levels. It’s a level of loss we can ill afford. We will need to find a way to tackle this health crisis before we see it escalate into an economic and social crisis as well.

Guillermo M. Luz is chief resilience officer of the Philippine Disaster Resilience Foundation.

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