Metro Manila not ready for MGCQ — expert

By Alexandria Dennise San Juan and Noreen Jazul

An expert from the OCTA Research Team studying the outbreak of the coronavirus disease (COVID-19) in the country said Metro Manila is still not ready to shift to the most relaxed community quarantine despite the continuing downward trend of confirmed cases.

In this photo taken on September 19, 2020, people wearing face shields queue up at a public market in Manila. (Photo by Ted ALJIBE / AFP / MANILA BULLETIN)

University of the Philippines (UP) professor Ranjit Rye, founder of the OCTA Research group, said the capital region has not yet achieved the "criteria" set by the government to enforce a modified general community quarantine (MGCQ).

"May mga lugar talaga na pwede nang mag-move to MGCQ pero sa tingin namin, hindi pa ready ang Metro Manila. Marami pa tayong kailangang gawin dito para ma-achieve ang mga criteria na kailangan para sa isang MGCQ," Rye said in a radio interview. (Some areas are ready to move into GCQ but not Metro Manila. We still have a lot of things to do to achieve the criteria needed for MGCQ.)

Among the standards for MGCQ, Rye said, is the required 28 days case doubling rate, which is the number of days it takes for the number of COVID-19 cases to double.

Citing the group's data, he said the current case doubling rate is now at 11 days, which has improved from the seven days recorded last month, but still below the 28 days criteria of the Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases.

"Ang kailangan ay 28 days para tayo ay makapag-MGCQ. Malayo pa po, marami pa tayong tatahakin at malabo natin maachieve ito by the end of September. Dapat hindi tayo lumipat sa lesser or more flexible lockdown," Rye said.

The political science professor added that the government should also look into the situation in the provinces near the capital region where the number of confirmed cases continues to rise.

"Strategic iyan dahil sa mga provinces na iyan nanggagaling ang mga workers sa Metro Manila. Dapat ay mababa rin sana ang mga numero ng kaso pero sa ngayon, medyo mataas pa sa Cavite, Bulacan, Rizal, at napupuno rin ang mga hospital dito," he said. (That is strategic because the workers in Metro Manila are coming from those provinces. The number of cases there should be low but for now, it is still relatively high particularly in Cavite, Bulacan, Rizal, and the hospitals there are also almost full.)

Trade Secretary Ramon Lopez had earlier said that the region can shift to MGCQ once the current quarantine status ends on September 30 as long as Filipinos continue to be more cautious and will strictly follow health protocols.

However, Rye said shifting to MGCQ "prematurely" could lead to another spike in cases, an increase in transmission rate, and a possible resurgence.

"We caution the government with regards to prematurely downgrading the quarantine status in the National Capital Region (NCR) dahil wala pang basehan para i-downgrade ito (as there is still no basis to downgrade it) at the moment," Rye said.

"Mapupuno ang mga hospitals at mahihirapan na naman ang mga health workers. Baka maraming mabiktima na mga COVID and non-COVID patients at makadagdag sa posibilidad na maraming mamatay (Hospitals will be full and health workers will have a hard time again. Many patients -- COVID and non-COVID -- will be affected and the number of deaths may increase.)," he added.

“Lowering the lockdown or lifting the lockdown may be too early at this point because we’re not zero cases, we’re still having cases, and in fact, there is still community transmission, so it’s very dangerous,” Dr. Rontgene Solante, Adult Infectious Disease Department Head at San Lazaro Hospital, told ANC on Wednesday.

According to Rye, the government's decision should always be based on data, as well as the recommendation or advice of the health experts.

Instead of implementing a less strict lockdown, Rye pointed out that the government should maintain the gains of the modified enhanced community quarantine which paved the way for a lower daily case and a reduced transmission rate.

The public should also continue to observe strict health and safety protocols to help in curbing the spread of the virus such as maintaining physical distancing and the mandatory wearing of face masks and face shields.

"Itong trend natin na maganda ngayon ay pwedeng magbago next week kung magpapabaya tayo o kung magkukumpyansa tayo at hindi natin makakamit ang inaasam natin na MGCQ. We have to work for it and work at it. Kakayanin natin ito dahil papunta na tayo doon (Our current trend is good but it can change next week if we will be neglectful. We will not achieve the MGCQ we are hoping for. We have to work for it and work at it. We can handle this.)," he added.

The Concerned Doctors and Citizens of the Philippines (CDC-PH) had a more drastic suggestion, calling for the “graduated” lifting of all quarantine restrictions in the country, given that a prophylaxis protocol will be implemented.

But Solante said the group’s recommendation to give hydroxychloroquine as prophylactic medication for pre-exposed patients is also “dangerous.”

“Hydroxychloroquine is not effective,” Solante said.

Citing the evaluation made by the World Health Organization (WHO), Solante said hydroxychloroquine made “no difference in terms of the effect on mortality” of COVID-19 patients.

“There is really no role for this hydroxychloroquine in that it can't really block the virus once you are exposed especially in the public setting,” Solante said.

The drug, according to Solante, was also found to be not effective both as a treatment and prophylaxis.

Solante also said that giving prophylaxis to people will give them “false relief."

The infectious disease expert said the lifting of the lockdown can only be done once there is a significant drop in COVID-19 cases in the country.

“It's very dangerous, premature lifting of a lockdown and taking this prophylaxis. You are facing two dangerous interventions here that have not been proven at this point when our cases are still ongoing and the prophylactic medications, even taking vitamins, are not yet also proven to be effective against COVID-19,” Solante said.