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Friday, March 29, 2024

Have we truly flattened the curve?

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"The virus is still here, though, and we will have to live with it for a long time."

 

University of the Philippines professor and OCTA Research fellow Guido David said yesterday that the we have “flattened the COVID-19 case curve” as the country’s corona virus reproduction rate or R0 or R-naught – the epidemiological metric used to describe the contagiousness or transmission potential of infectious agents – has decreased to a value less than one.

In an interview, David noted that the COVID-19 reproductive number has lowered to around 0.94 from 0.99 last week. “So nagde-decrease pa siya and that is very good news. Ibig sabihin, nasu-sustain natin ‘yung flattening of the curve.”

He noted that in the known epicenters like Mega Manila area (NCR, Calabarzon and Central Luzon) the rate has declined to 0.95 while Metro Cebu has likewise seen a decrease below one. Except in Bacolod and a limited number of areas in Visayas and Mindanao, the rate of transmission has been on the decline.

We note that the R-naught or transmission rate is critically important as a guide in the determination of our response measures against the pandemic. This has become the metric of record in the case of

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COVID-19 given that this is a novel (new) kind of disease without any known record of its provenance and contagiousness. Most importantly, there is neither vaccination nor a cure on hand.

In a word, we have been confronted not only with an invisible enemy but one we have to scrutinize and understand as we go along. In a word, the science of this disease is continuously evolving which makes any effort to contain and cure it iffy at best.

Thus, we have to keep an eye on this metric to guide us in putting together the best possible response against this contagion as we proceed to open the economy and transition to a new kind of living. We note that until a proven vaccine or a clear-cut cure comes along, the possibilities for the potential transmission or decline of this contagious disease remain. Studies show that if it is less than one, meaning each existing infection causes less than one new infection, the disease is on the decline and will eventually die. If it equals one, each existing case causes one new infection so the disease stays alive and stable but will not result in an outbreak or a pandemic. Now, if the R-naught is more than one, each existing infection causes more than one new infection. The disease then has the potential to result in an outbreak.

For now, the welcome news is that we may have found the right combination of measures to mitigate the possibility of a second wave or another outbreak. Indeed, this collaborative research group which has over the last few months correctly predicted the expected number of cases over specific period, has actually managed to get the Department of Health to admit, albeit grudgingly, that their figures were more accurate than theirs. But that is another story. What matters is the public and I have no doubt our policy makers are taking their word for it that finally, yes finally, we have flattened the curve – a most welcome development after six months of quarantine.

David, however, urged the public not to be overly excited as he warned that the COVID-19 trends are subject to change and can be reversed at any time. Yes, we're seeing it but the trends are not irreversible, meaning, we could have another surge.

Indeed, the flattening only means that we have reached a kind of plateau as the virus is still here, with new cases remaining at 3,000 cases per day. Of course, that daily average has been going down from a peak of 7,000 cases in mid August to 4,000 cases towards the end of that month and finally 3,000 by the first week of September. Coupled with the mandated protocols which have been in place since the start of the lockdown, what brings up our level of confidence is the fact that we have actually enhanced the level of our healthcare capacity with more testing centers, isolation facilities, medical equipment and supplies and, more importantly, provided better care and compensation packages for our health workers. Pretty soon, if the cobwebs in a number of the frontline agencies like the DoH and our LGUs are washed away, we may be able to declare ourselves ready to live with COVID-19.

Truth be told, this virus will not go away anytime soon. We will really have to learn to live with it just like we have come to live with the common colds, flu and even pneumonia. In fact, there is increasing evidence that COVID-19 is not as deadly as we were once told. It need not be looked at as more fearsome than those diseases we have come to live with in times past and even up to this day.

Just a close look at the statistics of death per day in the Philippines should give us a measure of relief. The latest figures show that on a daily basis, 211 Filipinos die of pneumonia and flu; 233 of heart disease; 167 due to stroke; 178 to cancer; 33 to vehicular accidents; 19 due to suicide and 20 to Covid. On the other hand, the fatality rate for COVID-19 has been consistently below the global rate while case fatality has been equally below that of the global standard. Finally, our recoveries have been on the rise which can only mean that most of those testing positive for COVID-19 eventually overcome the same.

We are highlighting these figures and the latest developments as we get into our sixth month of quarantine if only to remind our policy makers and the public that it is time we review the response measures we have set in place since the lockdown. We have to tell our people that while we still have

to have a vaccine against Covid, there have been a number of prescribed cures to help each one of us recover from the infection.

It is time we insisted that the restrictive measures such as enhanced police presence, mandated

use of double shields (masks and shields) in public or enclosed spaces, use of universities and schools as quarantine facilities, imposing all kinds of restrictions on the opening of retail, tourism and other sectors, restricting public transport and a hundred and more other such measures some of which like the use of barriers on motorcycle tandem riding would eventually be revisited and eventually set aside.

It is about time we reminded our people that ultimately their health and the nation’s health rests heavily on their complying with the basic protocols, and that if they want to be free from any unwarranted restrictions, get back to work and live more normal lives under COVID-19 they should stay the course and take care of themselves foremost.

It is about time we told ourselves that like in the past, pandemics like COVID-19 can be conquered and that we should now prepare to live with it in as responsible and proper a manner as possible. Even with COVID, we need not live in fear. We can live with the new, right lifestyle, with the proper protocols and with compassion for others. 

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