By Ellalyn De Vera-Ruiz
Experts from the University of the Philippines (UP) have recommended a review of the government's strategies for social distancing and other health protocols, as well as the continued easing of restrictions, particularly in Metro Manila and Cebu province, to prevent the pandemic from "getting out of control."
Using the Department of Health's (DOH) data from March 1 to June 8, 2020, professors Guido David and Ranjit Singh Rye, with research associate Ma. Patricia Agbulos examined the effects of increased mobility on community transmissions.
The team pointed out that there is still significant community transmission in the Philippines.
"As of June 8, 2020, the data shows an escalation in new COVID-19 cases in the Philippines, from an average of 222 new COVID-19 cases per day during enhanced community quarantine (ECQ) in NCR (National Capital Region), to 375 new cases per day during modified enhanced community quarantine (MECQ) in NCR, to 549 cases per day during general community quarantine (GCQ) in NCR," the team said in the study.
The current reproduction number in the country at 1.2, "indicates that the pandemic is still spreading and the curve has not yet flattened," the researchers noted.
If the reproduction number is less than 1, the infection is spreading slowly and this could lead to the epidemic dying out. If the number is higher, the progress of the epidemic will also be faster.
Using the current reproduction number for the Philippines of 1.2, the UP team's forecast for the number of COVID-19 cases, assuming a continuation of current trends, is a total of 40,000 cases and 1,850 total deaths by June 30.
HIGHEST TRANSMISSIONS IN METRO MANILA, CEBU
The study pointed out that around 60 percent of all active COVID-19 cases are in Metro Manila, which is still at medium-to-high risk for virus transmission.
As estimated by the UP team, the reproduction number in the metropolis is between 0.96 and 1.19.
Using the lower value of current reproduction, the experts have estimated 16,500 COVID-19 cases and 1,070 deaths in Metro Manila by June 30. As of June 12, DOH has reported 13,099 cases and 766 deaths in Metro Manila.
The study also showed that the current hospital load in Metro Manila has decreased to 1,200 admitted patients, lessening the current burden to hospitals.
The recovery rate has also increased to almost 50 percent, while the hospital mortality rate is currently at 15 percent.
According to the UP experts, the province of Cebu is the second major battleground in the country's fight against coronavirus disease.
The current reproduction number has decreased to below 1 in May 20, but surge in new cases and increased testing have caused the value to increase again to 2, putting the province in the high-risk classification once again.
Assuming that the value of reproduction is maintained, the team's forecast for Cebu province showed 11,000 cases and 90 deaths by June 30.
RECOMMENDATIONS
The possible escalation to 40,000 cases and 1,850 deaths in the country by the end of June, the researches said, "needs to be examined and given appropriate and immediate response by the government."
"If the progressive increase continues, we could possibly experience exponential growth in the number of cases and deaths seriously compromising our collective efforts to contain the virus," they added.
The group pointed out that while the increase in the reproduction number is a cause for concern, "it is not a reason for all of us to panic" as the situation is "still manageable."
In Metro Manila, the team has recommended a need to reduce the number of new COVID-19 cases for 14 days as per international health policy consensus.
Likewise, the continuous spread of the virus in Cebu province should be a cause for concern for both the national and local government.
"We recommend that the government review its strategies for social distancing and other health protocols in NCR and Cebu," they said.
"The easing of quarantine restrictions must be matched with tighter monitoring, stricter social distancing, and the wearing of PPEs (masks and other protective equipment) and increased testing and surveillance as the working population begins to increase their exposure," they added.
In addition, the study suggested that the government should ensure the increased capacity of the national health care system to deal with the potential outbreaks; enough testing capability, including maximization of increased capacity, to cope with the expected increase in cases; enough PPE supplies for our front-liners; and effective and aggressive contact tracing.
It also exhorted the DOH to urgently resolve issues regarding the accuracy and timeliness of its data on COVID-19 cases in the country, citing that there still exists a significant backlog of 6,359 unvalidated cases and 1,855 uncategorized cases in the DOH COVID-19 database, as of June 8.
"If not urgently resolved, these significant and continuing challenges regarding DOH COVID-19 data will undermine not just the government’s ability to monitor spread of the virus but also hamper its ability to implement appropriate and timely responses to manage the pandemic on the ground," it added.