Learning curve

For weeks after we were first put on lockdown in March, we were bombarded with “flattening the curve” messages, saying that we needed to sacrifice and stay home to slow down the spread of COVID-19.

Then government boasted about having flattened the curve, only to get spikes in the infections, the daily increases worsening until the President finally declared going back to a stricter lockdown, modified enhanced community quarantine (MECQ), for two weeks in Metro Manila,

To be fair, we are not the only country having to go back to lockdowns, but we’ve seen many of these countries do so only for a short period, and often with great success.

The governments who are most effective here are those who deal with another curve: the learning curve, showing that they are willing to learn from successes as well as failures — not just of their own, but also those of other countries.

Tackling the learning curve is going to be the main challenge — a survival challenge — for the Philippines, from Day 1 of this reimposed MECQ. I had a long list of the lessons we should have picked up, but am limiting them to six of the most important ones:

First, quarantines and lock-ins alone will not work, and seem to be even increasing risks. Unlike March 15 when the lockdown first began, the virus is now in the communities, thriving on the congested living conditions of locked-in communities to spread.

Now more than ever, we need to promote a larger public health package of proven “non-pharmaceutical interventions” (NPI), mainly the use of face coverings, handwashing, and physical distancing, reinforced with more positive health campaigns. Banish the word “bawal” and provide people with the means to protect themselves. Note how I used “face coverings,” which is what many governments have shifted to, recognizing that there are so many options now, including face shields.

Second, people need to be given the means to do what needs to be done. We’ve only had one social amelioration program (SAP) given and sporadic “ayuda” (help packages), with many reports of kupit-COVID (corruption). Abandoned, people will find their own ways (hahanap ng paraan) to feed their families, including leaving their homes to earn money.

Third, give meaningful protection to our frontliners. After all, this new lockdown was made in response to their request. The ones in the hospital, as well as those outside — caregivers, security guards, public transport drivers, police and soldiers — need to be given extra protection in terms of protective personal equipment, safe transport, hazard pay, AND, this is still missing, psychosocial support to reduce caregiver fatigue, which puts them, and their patients, at risk.

Fourth, government has to get its act right on testing, tracing, and tracking. (I’m grinding my teeth here because I’ve harped about this since March.)

It took weeks to ramp up testing, and now we need to get the contact tracing improved, finding out how a cluster of infections started. Testing and tracking also go together, and this is another exasperated appeal to start random surveillance testing so we can catch outbreaks early. In Cebu and Navotas, infections in some barangays went past the hundred mark before officials took action — often overkill at that, including bringing in tanks and dozens of Special Action Force police.

It’s not enough to just keep churning out numbers. Contact tracing, done properly, offers us valuable lessons. I know of several clusters of infections involving health workers who were vigilant in preventing themselves from being infected by patients, but let their guard down when socializing with fellow health workers and ending up infected, because one of them had been infected in his or her home community.

Fifth, ramp up barangay preparedness with better training for barangay health workers and putting up decent barangay-based quarantine services, more of shelters. A lesson to pick up from Spain, which had very strict quarantine: It had safe public spaces where people could come out at designated hours for sunlight, fresh air, exercise. Even prisoners get that privilege; why are we even more cruel to our locked-in elderly and children, their incarceration then wreaking havoc on their immune systems and physical and mental development?

Finally, stop the war on people and get to the virus. Respecting human rights and being humane, makatao, is not idealistic; it is the only way to go for effective public health. I hope we don’t learn only when it’s too late, as I feel it is right now in many parts of our cities.

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