UNDER THE MICROSCOPE

It has been three years since the Covid-19 pandemic started. Early on, there was a lot of fear, anxiety, and phobias about the disease because it was an unknown entity. Most persons who contracted it at the start succumbed to it or had a critical, lengthy stay in intensive care units and suffered various complications and after-effects. The WHO had declared a public health emergency of international concern for Covid-19 in March 2020 and ended it in May 2023, stating that it is now time to transition to long-term management of the Covid-19 pandemic. Locally, the DOH stated that the state of public health emergency has been “de facto” lifted as of July 5, 2023. The mandatory-masking mandate was also lifted by EO No. 7 in October 2022. How did we get to this point? We now know more about the Covid-19 disease; we have good access to testing and quick diagnosis. Disease management has greatly improved, and most importantly, majority of the population has been vaccinated and many have availed themselves of boosters. Finally, there is the hard evidence of the low number of cases dying or requiring critical care (Worldometer Philippines). We all know that the immunocompromised, elderly, obese, and those with underlying diseases are at higher risk. But we have to factor in the state of immunity either through vaccination or past infection. It is true that if Covid doesn’t kill you, it makes you stronger because your immune system has managed to overcome it and is now equipped to handle future infections, barring a major shift in the virus’s genetics that may evade immunity. This is deemed less likely now with the experts saying the Covid virus has self-evolved into a mild organism. At this point, it is believed we have reached the level of herd immunity, where the few susceptible people are protected because of fewer viruses going around. Covid-19 is now considered an endemic disease, much like the ordinary flu. Mind you, there are still deaths caused by the flu, but we have taken it in stride, leaving it to the individual to decide if they will be vaccinated against the flu or not. The operative phrase is individual choice. It is now up to us to decide how to manage our lives in dealing with infectious diseases, including Covid-19. We still see many people wearing masks by choice, and we respect that. However, this may have been influenced by the perception that Covid-19 is still a threat because of the lingering fear engendered by media, which can be alarmist in its coverage of the subject. Covid fear is very real and can be a constant source of stress and anxiety or depression, even as we’ve controlled the pandemic. Numerous researches have detailed this phenomenon and its impact on mental health. But it is time to rein in this now-unfounded fear and prevent further psychological harm. We need to move on and live our lives free of fear. Instead, we should evaluate ourselves or ask our doctors as to the individual risks of possible Covid infection, complications, and risk of dying. Yet, we still have hospitals enforcing the mask mandate. The infectious-disease specialists in charge of the Infection Control Committees are still wary of Covid-19, so they order mandatory masking for all the staff, patients, and visitors. This creates an impression that Covid-19 is still very dangerous and that hospitals are sources of infection. That fear can lead people to avoid going to the hospital even if they need medical care. The past three years saw a big increase in late-stage cancer and terminal chronic diseases because people avoided hospitals. Fortunately, many have started going back to their doctors, though there will still be hospital-phobic individuals who will view the masking mandate as proof to avoid hospitals. A review of the US CDC and OSHA (Occupational Safety and Health Association) guidance for health-care personnel does not include a mask mandate, with OSHA citing the assessment of hazards, risk of exposure, and measures taken to “select, implement, and ensure workers use controls to prevent exposure.” The CDC information “reflects infection control recommendations that are based in part on PPE supply chain considerations.” We definitely need masks for certain patients, procedures, and settings but not in all areas of the hospital where the risk is low. And definitely, we don’t want to waste PPE unnecessarily. Surely, our PPE supply is not inexhaustible, and our waste management can be less stressed by fewer PPE wastes. No matter if masks are now cheap, its unnecessary use is still economically harmful, especially for our less fortunate countrymen and women. Plus, our patients can surely benefit from seeing the smiling faces of their health care givers.