Return health responsibility to Filipinos

It is time to return the responsibility for individual health to the Filipino people. Over the past several weeks, Singapore has been experiencing a surge of COVID-19 driven by the XBB variant. Strikingly, in the middle of the surge, the Singaporean government lifted most of the remaining pandemic mandates. Why do this at a critical time?

Because the Singaporean government had determined that the country’s health care infrastructure was secure. So it lifted its mask and social distancing mandates and returned responsibility for individual health to its people. This is right and proper because the government’s responsibility should be limited to protecting the health care system. It should not have the responsibility of protecting the health of each and every citizen. Rather, this is the responsibility of the individual and his or her family.

Note that this does not mean that there would be no more masking in the city-state. Rather, citizens are now given the responsibility of determining whether or not they would wear a mask. Some citizens—especially those who are young, vaccinated, boosted, and have already been infected by COVID-19—are bound to stop wearing masks after determining that the reduced risks aren’t worth the inconvenience. The opposite is true among other Singaporeans—especially the elderly and those with comorbidities, and those who live with them. It is left to each Singaporean to determine whether or not the benefits of the vaccine outweigh the costs. Again, the responsibility for individual health has been returned to the people, with citizens assessing their own threshold of risk.

This strategy has an added benefit, as it is now becoming increasingly clear that vaccines alone will not make COVID-19 an endemic disease. There have been recent medical reports, including two in the Lancet Respiratory Medicine and the British Medical Journal, that show how vaccine protection against moderate and severe COVID-19, and therefore protection from hospitalization, only lasts for months and is not permanent. Thus, pursuing a threshold of booster vaccination to secure population immunity—like we are doing here in the Philippines at this time—is like running after the wind. After six months, those who were boosted will need to be boosted again. We cannot keep boosting the entire population every year. Since vaccines alone cannot bring about endemic disease, natural immunity—which has already been reported to last 15 months or more—has an important role to play.

Modeling suggests that young, healthy individuals will need to be infected a handful of times with COVID-19 to bring about sufficient population immunity to stabilize the spread of the virus. Singapore is not encouraging getting infected, but by returning responsibility to individuals, it is also accelerating the transition from pandemic to endemic disease. Since younger, healthy individuals will have a higher risk tolerance for disease, especially with the mild Omicron variants of SARS-CoV-2, they will indirectly protect those who are more vulnerable if they unintentionally get infected earlier. The quickened shift to endemic disease will benefit everyone.

How strong must a COVID-19 surge be to overwhelm our health care system? Since July 3 to last week, the Department of Health (DOH) has officially recorded 270,575 new cases of COVID-19, driven by different Omicron variants. Of these, 640 were severe or critical cases requiring ICU care. This is 0.237 percent of total reported cases. Thus, assuming the DOH-reported capacity of 2,500 ICU beds, and a median stay of 14 days in the ICU, we would need a surge of 60,000 new cases every day for 14 days to overwhelm our ICUs. Even if we account for a nursing shortage with only 50 percent-staffed ICU beds, we would still need a surge of 30,000 new cases every day for 14 days to overwhelm our current health care system. We have never seen a surge this size! And given the significant hybrid immunity from previous vaccinations, boosters, and natural infections, it is unlikely that we will see a COVID-19 surge of this magnitude now. The health care system in the Philippines appears to be secure.

Therefore, I applaud President Marcos Jr.’s recent decision to lift both the indoor and outdoor mask mandates in the country. It is time to begin returning responsibility for COVID-19 health to the Filipino people. Time for us to return to the old normal by lifting the remaining pandemic mandates. Let us educate our kababayans. Let us empower and trust them, and let them take responsibility for their own well-being. Indeed, an OCTA survey completed several months ago revealed that a majority of Filipinos would continue to wear a mask despite the lifting of the mask mandate. Time to return to normal. It is time for pasko.

Rev. Fr. Nicanor Pier Giorgio Austriaco, OP, is a molecular biologist and a professor of biological sciences at the University of Santo Tomas. He was a part of Task Force T3 (Test, Trace, Treat), which coordinated private sector COVID-19 response.