We need to emerge from the current recession that has severely impacted livelihoods, so that our countrymen can feed their families and support their communities. The economic enablement of Filipinos translates to their health and welfare.
We cannot build back the economy without increasing public transport capacity, which has been operating at only 20-30 percent of pre-pandemic levels.
We write this statement as an expert panel of doctors with diverse backgrounds, including public health, epidemiology, and infectious diseases, all with the intention of seeing our country get back on its feet as safely as possible. What we outline below was presented to several Inter-Agency Task Force for the Management of Emerging Infectious Diseases members on Sept. 14, 2020, as part of a more comprehensive set of recommendations to aid the country in reviving the economy while adhering to comprehensive public health standards.
We advocate strictly implementing what we call the 7 Commandments, for all public transportation: (1) Wearing of proper face masks, (2) Wearing of face shields, (3) No talking and no eating, (4) Adequate ventilation, (5) Frequent and proper disinfection, (6) No symptomatic passengers, and (7) Appropriate physical distancing.
The combination of these measures will be among the most comprehensive in the world, based on our consultation with international experts. These 7 Commandments need to be strictly enforced and independently monitored in their implementation. By imposing these strict measures, we believe we can gradually relax social distancing rules, in order to double or even triple our current public transport capacity, without compromising public health.
A recent study from Duke University, for example, shows that surgical masks reduce droplet transmission by up to 99 percent, and that the simple act of not talking can reduce droplet counts by up to 4x. In addition, a meta-analysis published on June 22, 2020 in The Lancet, a leading international medical journal, shows that face masks and face shields can independently reduce the chance of viral transmission by up to fivefold and threefold, respectively. In China, Japan, Korea, Singapore, Taiwan, Vietnam, and other countries, passengers wear face masks while sitting side by side in trains, while COVID-19 cases remain manageable.
With regard to appropriate physical distancing, the World Health Organization (WHO) recommends: “To the extent possible, keep a distance of at least 1 meter from other passengers when purchasing tickets, waiting to board public transport, and moving around public transport stations.”
While the WHO recommends keeping a distance of 1 meter from other passengers to the extent possible, it allows for adjustments based on context. Given this, we propose the gradual reduction of the physical distancing norm during transit to 0.5 meter or lower. Based on our review of the scientific literature and the experiences of neighboring countries, we believe the evidence shows physical distancing can be maintained below 1 meter, so long as other health measures are also implemented.
Public policy has no quick and easy solutions. We would like to engage in further dialogue with the IATF and all stakeholders about our proposal and others, including the overall increase of the supply of safe transportation such as rail, buses, jeepneys, motorcycle taxis, TNVS, cycling, walking, and private shuttles. We also recommend the full institutionalization of private sector expert consultation.
The toll on Filipinos from a prolonged recession is devastating. We believe there is a way forward that carefully balances the reopening of public transport capacity with public health, while allowing flexibility to readjust measures based on data from the ground.
The success of this plan relies on proper implementation, education of the public, and continuous monitoring and evaluation by public health experts.
By working together, we can implement these public health measures to revitalize our country safely and give Filipinos their lives back.
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Dr. Manuel M. Dayrit and Dr. Esperanza Cabral are former health secretaries; Dr. Vicente Belizario Jr. is dean, UP College of Public Health; Dr. Teodoro Herbosa is special advisor, COVID-19 National Task Force; Dr. Manuel Francisco T. Roxas is director, Philippine College of Surgeons Cancer Commission; Dr. Ma. Dominga Padilla is founder, Eye Bank of the Philippines; Dr. Rontgene Solante is an infectious disease specialist.
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