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Brave New World

 

By Michael Mo

It is becoming clear that overcoming this pandemic is the challenge of our generation. The robust government response to the virus is a clear indication of what is at stake. Millions of lives of Filipinos are on the line. The enhanced community quarantine (ECQ), a lockdown in practice, has been quite successful in limiting the number of cases in the country. But the government cannot sustain this solution for long, not for 18 months until we find a vaccine to end the pandemic. It’s unconscionable to sacrifice lives for livelihood, but sweeping restrictions against work will eventually have to be lifted or the government ends up hurting the very people it is trying to protect. How do we strike a balance between these competing concerns? These are the rough outlines of a pragmatic post-ECQ strategy.

COVID-TEST (REUTERS / MANILA BULLETIN)

Mass testing needs to takeover

Aggressive testing and meticulous contact tracing will be critical in managing the pandemic. Knowing who is infected is critical in enforcing the quarantine. Meticulous contact tracing will prevent the virus from spreading more widely. The anticipated adoption of antibody tests (pending validation) will not only make the turnaround time faster, but will give physicians and government planners more information by distinguishing individuals who were infected in the past (and have recovered) and those who are presently harboring an active infection. Recovered individuals are of no risk to others and may return safely to their communities. 

Over time, knowledge on how many people have been infected and have recovered from the virus will inform government planners if the threshold for herd immunity has been reached and will form the basis for the relaxation of physical distancing measures. In theory, true mass testing can replace physical distancing as infected individuals can be rapidly isolated from the rest of society. The rapid and massive expansion of our testing capacity should be one of the main goals of the ECQ. Scaling foreign estimates to the Philippines population, we may need to build capacity to conduct 100,000 tests daily. 

Healthcare system should be ready 

The capacity of the healthcare system should likewise be augmented to anticipate the surge of cases. This ECQ should be seen as nothing more than a stop-gap measure. This lockdown only buys us time to beef up our preparations. The eventual easing of the lockdown will inevitably open avenues where the virus can spread into our communities. The healthcare system must be able to rise up to the challenge. Partnering with the private sector, the Department of Public Works and Highways (DPWH) has converted and retrofitted the Rizal Memorial Coliseum, the World Trade Center, and other venues into quarantine facilities. This is a good start. It is important for the healthcare system not to be overwhelmed by the surge of cases. 

Chinese experience suggests these: around four to five percent of all those infected with the virus will require hospitalization, a third of those hospitalized will require critical care, and about half those in critical care will perish. If our hospitals fail to manage the surge of cases and the critically ill don’t get optimal medical care, the infection mortality rate of the virus in the Philippines will far exceed those recorded in other countries, and the results will be catastrophic. The government should also set a plan in place on how it would source, procure, and deliver the vaccine or treatment once these become available.

Months to years

Physical distancing measures will have to be put in place for months to years. Slowing down the march of the virus will entail many necessary sacrifices on the part of the public. We have to wake up to the new normal. Venues like malls, schools, restaurants, churches, gyms, and other places where the public might be expected to congregate in numbers will have to be shuttered until the population has achieved herd immunity (either through infection or vaccination), or a potent cocktail of antiretrovirals become available. It will be business unusual. The vulnerable, including the sick and the elderly, must be shielded from the worst of the epidemic. Enforced quarantine of the infected and their contacts must be implemented. Punitive measures must be brought upon people who put their communities at risk. Arrangements must be made for the urban poor and other households for whom the quarantine may be impossible to carry out. Adequate government assistance must be extended to those in quarantine (such as through in-kind transfers) to ensure compliance. Over the remaining period of the lockdown, delayed government aid must be delivered as expediently as possible. The government must not overlook the effectiveness of the public health campaigns to promote personal hygiene such as frequent handwashing, and responsible citizenry of going on self-quarantine when sick and wearing face masks.

Recession looms

Finally, the economic implications of this health crisis must not be ignored. The enhanced community quarantine imposes undeniable hardship on the population. These are felt most acutely by the poor. Those belonging in the informal labor sector or the gig economy are likewise vulnerable. More than 70 percent of Filipino workers are in ‘no work, no pay’ arrangement. A phased easing of the lockdown can restart the economy while mitigating the risk of a runaway epidemic. Certain “non-essential” sectors like construction and manufacturing, where physical distancing can be reliably implemented, can resume work first. 

A recession looms large on the horizon, and this presents all sorts of new challenges for the government. The government will have to enact measures to support companies and to tide over workers who are made redundant by the physical distancing measures or the recession. Hard choices will have to be made in the struggle to save lives and to keep society functioning.  Social cohesion should be the overarching goal of government during these troubled times. Measures to control the virus will fail if social order collapses, and the economy will not find its footing until the virus is controlled.

Unity

 Time to rebuild

Amid the disruption, we shouldn’t rush to rebuild the old normal. We have to rebuild our society through the exacting standards of our collective aspirations. It’s time for a “new deal.” Why do we put up with a social safety net that only catches the affluent? A society cannot be kind nor fair nor just if the vulnerable cannot access social support or medical care. The organizational and structural weaknesses in how healthcare is funded and delivered in the country have left many Filipinos vulnerable and exposed. Indecisive and ineffective planners and leaders around the world have ignored scientific advice about the need to prepare for a pandemic despite the outbreaks of SARS, MERS, bird flu, and swine flu. The emergence of a highly infectious and deadly virus has long been identified as a systemic risk to society. It is not the only one. 

Globally, not enough action has been done to thwart or address the emergence of antibiotic resistance. Locally, not enough has been done to address the persistence of preventable and controllable infectious diseases like tuberculosis and HIV, and noncommunicable diseases like hypertension and diabetes. These diseases kill more than a hundred thousand Filipinos every year. Beyond the healthcare setting, politicians around the world have long deferred from acting on climate change despite the overwhelming scientific consensus that it is the central risk of tomorrow. We have to push our leaders to act now to make a better and safer world of tomorrow.


Source: Manila Bulletin (https://lifestyle.mb.com.ph/2020/04/25/brave-new-world/)

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