We are making slow progress with our LGU-dependent pandemic response despite repeated lockdowns. Having porous borders, an LGU cannot control the local transmission within its changing population, flush out the virus from its open jurisdiction, and prevent re-infection from imported cases. The LGU network is simply not designed to deal with global public health threats. By analogy, local police forces working independently cannot catch a group of global terrorists. We can gain more grounds by forming virus-free bubbles one “island” at a time. An “island” bubble is a natural formation enclosed by natural borders like water or mountains that can serve as barriers in deterring human crossings. The Philippines has many of such small islands, peninsulas, valleys, highlands, and enclosed coastal areas which together host 40% of the population.
Having a protective natural barrier and a small population, a bubble needs less resources and time to eradicate the virus and protect itself from imported re-infection. It can establish herd immunity with less vaccines without waiting for the whole country. An LGU with a shifting population cannot achieve this even if it vaccinates all its residents. Bubbles residents can return to unrestricted normal lives even as the rest of the country battles the pandemic. An LGU cannot do this since no LGU is safe until every LGU is safe. But a bubble is safe even if everyplace around it is not. LGU’s within the same bubble could pool their resources and together drive the virus out of their island, a feat not possible if each fought the virus separately. Lockdowns, testing, vaccination and financial assistance would achieve better and faster results if done by bubble, instead of by LGU’s, type of industry, profession, and age group as we do currently.
Enclosed entirely by water, an island like Catanduanes, Negros, Sulu, or Boracay, is the ideal bubble. A peninsula like Bicol or Zamboanga can be formed into a bubble by securing the narrow strip connecting it to the mainland. Another bubble is a coastal area fringed by a mountain range, like the long stretch flanked by the Luzon Sea and the Cordillera Mountains.
Another is a valley like the Cagayan Valley enclosed by the Cordillera and Sierra Madre mountain ranges. Highlands, plateaus and mountain cities isolated by their elevation can form bubbles, like the Bukidnon plateau and Baguio. The remaining landlocked provinces of Luzon and Mindanao would eventually be formed into huge bubbles by the bubbles that would enclose them. For quick wins and proof of concept, bubble formation can start with a couple of island provinces or small holiday islands.
The LGU’s that comprise a bubble are combined into one administrative region in the duration of the pandemic. Every bubble will undergo the same “cleansing” process. To contain all local transmission, the bubble is closed from outside. All residents are tested and home quarantined for 14 days or longer if necessary. No one is allowed to enter or leave the bubble during the lockdown. Positive cases will either be home quarantined or admitted to a medical facility inside the bubble. Residents follow all health protocols like mask wearing until all the work is completed. If there are no cases for a certain period like 14 days, the bubble is declared virus-free and all restrictions are lifted. Residents of all ages can return to normal activities like in-person schooling, unrestricted mass transport, dining, and religious gatherings. Travel into and out of bubbles will be strictly controlled. Anyone coming from non-bubble areas must show negative test results and undergo 14-day quarantine upon arrival. Flights, land and sea travel between bubbles can resume, except those transiting at non-bubble areas. Healthy residents from non-bubble areas may relocate to nearby bubbles to seek temporary or permanent refuge. A smaller population would help these non-bubble areas transform faster into bubbles later.
A travel corridor between two countries with infection cases, like Philippines and South Korea, no matter how low, is risky and not stable because the possibility of resurgence. But if they would have virus-free bubbles in the future, like Cebu and Jeju, these could be linked with a travel corridor instead of the two countries.
The bubble network can be part of our pandemic disaster-readiness. In future outbreaks from human or livestock infection, bubbles can be reactivated and mobilized to contain the spread early. Instead of infection rates, progress can now be measured in terms of the number of virus-free bubbles formed and their combined land area and population. National fatality rates should come down as no one dies of Covid-19 inside bubbles.
Rene T. Domingo is an adjunct faculty member of the Asian Institute of Management and served as consultant to WHO, DOH and major Philippine hospitals on hospital management. Email: [email protected].