MANILA, Philippines — Four days after the government announced that it would prohibit home confinement for mild and asymptomatic COVID-19 cases, the Department of Transportation (DOTr) on Friday said it would start easing restrictions in public transportation in a bid to revive an economy in its worst recession in decades.
The DOTr said it wants to reduce to 0.75 meters the required distance between passengers, below the 1-meter distance recommended by the World Health Organization (WHO).
But the announcement prompted the Department of Health (DOH) to seek discussions, especially since these policy changes may strain the country’s health system or drive new infections, just like what happened to several countries that reopened as soon as they saw a leveling off in new infections.
The difficult balancing act has become the crux of discussions between economic and health managers, as 42 more people in the country died from the new coronavirus that still afflicts 62,250 patients from a nationwide tally of 252,964 infections. The death toll climbed to 4,108 while recoveries rose to 186,606.
The DOH reported an additional 4,040 new cases, the first time since Aug. 26 that new infections rose by over 4,000, but the agency clarified that this figure may be due to the delayed data submission of testing laboratories.
Of the 62,250 still active cases, 88.8 percent are mild, 8.4 percent asymptomatic, 1.1 percent severe and 1.7 percent critical.
In a statement on Friday, Transportation Secretary Arthur Tugade said “there is a need to safely optimize the carrying capacity of the various public transport modes as Metro Manila and its adjacent areas continue with the transition toward the ‘new normal.’”
“Talks are ongoing on how we can do this without of course compromising on these physical distance measures that we are saying,” Health Undersecretary Maria Rosario Vergeire said after the DOTr announced that it would defer the implementation of the new rule, supposedly on Sept. 14, until after a resolution has been reached.
Tugade said the physical distance requirement would remain but it would be reduced from 0.75 meters to 0.5 meter to 0.3 meter within four weeks. People would still be forbidden from taking or making phone calls while onboard public utility vehicles (PUVs).
The measure was apparently in response to pleas from the business sectors to ease restrictions on transportation and workplace capacity in order to restart the economy and help millions of Filipinos find jobs lost when the country went on lockdown.
Home quarantine
The DOTr’s policy revision comes just days after Interior Secretary Eduardo Año of the Inter-Agency Task Force for the Management of Emerging Infectious Diseases, announced that the government would ban home confinement for mild and asymptomatic patients.
But Vergeire said discussions on the ban were ongoing in order to reach an “accurate and more complete recommendation.”
As it is, Vergeire said there were already existing guidelines on who should be admitted to temporary treatment and monitoring facilities (TTMFs) and who could be allowed to isolate at home.
The DOH only allows home quarantine if a mild or asymptomatic patient has his own room and bath, does not interact with family members and does not live with people with comorbidities, pregnant women and elderly.
‘Unintended effects’
Former Health Scretary Manuel Dayrit, on the other hand, said the proposal to ban home quarantining could have “unintended effects” on measures against COVID-19 and people who do not want to be admitted to TTMFs may just opt to “hide their symptoms and [test] results.”
Not enough beds
Data also shows that there are just not enough available beds for mild and asymptomatic patients. As of Sept. 6, the average utilization rate of TTMFs across the country was at 41 percent.
In Metro Manila, there are a total of 5,846 beds, or a ratio of 1:2,362. Bed utilization was at 59 percent.
As of Thursday, Metro Manila accounts for nearly half of the close to 59,000 active cases, or 29,188. Nationally, 97 percent of all cases are mild and asymptomatic.
Applying that average to the capital region means that there are more than 28,000 mild and asymptomatic patients, nearly five times the current TTMF capacity in the metropolis.
Even if the lower global threshold of 80 percent mild cases is used, the current TTMF bed capacity is still not enough since at this rate the quarantines should be able to accommodate at least 23,000 patients.
Dayrit added that if the physical distancing requirement would be reduced, the government should know if the other protective measures, such as wearing masks, could “offset any of the protection that you might theoretically lose.”
Cooperation
He recognized though that trade-offs would have to be made given the economic impact of the outbreak.
“People should very consciously follow the rules—no talking, no using of phones, no eating [in public transport]. There has to be a lot of cooperation. Unless that public education is there, then it might not work,” he said.