MANILA — The Department of Health (DOH) and a public health expert on Tuesday explained the need to closely monitor the National Capital Region (NCR) and Cebu City, which will be under modified enhanced community quarantine starting May 16 until the end of the month.
“What we have now is an outbreak that has equal number of new cases coming from NCR and Visayas. Although NCR is still the epicenter, Visayas is becoming a hotspot,” said epidemiologist Dr. John Wong, also an associate professor of the Ateneo School of Medicine and Public Health.
Presidential spokesperson Harry Roque announced Tuesday that Metro Manila, Cebu City and Laguna province will shift to a modified ECQ in the next half of this month, while the rest of the country will be under general community quarantine
Wong, who is part of the sub-technical working group on data analytics of the Inter-Agency Task Force (IATF) on COVID-19, showed how while the number of new cases rose right after the initial ECQ was imposed, it went down around April 2.
By April 22 it went up again but he said the new cases were “mainly from Visayas, particularly in Cebu City.”
He pointed out that these were mostly from the two outbreaks in Cebu City — one from the city's jail and the other from Barangay Mambaling. There was another outbreak in a jail in Mandaue, also within Cebu province.
The Department of Health had earlier said it was closely monitoring COVID-19 outbreaks in jails around the country, especially in Cebu province and Zamboanga.
Barangay Mambaling was also recently cited as among the hotspots for COVID-19 in Cebu City.
“If we look at the curves for Luzon outside NCR and Mindanao they are actually at very, very low levels. Hardly contributing to the outbreak,” Wong explained.
Many of the provinces that do not have active COVID-19 cases are in Luzon and Mindanao.
“For Luzon, they started curving much earlier. Most are almost flat now,” Wong said, referring to the graph that shows if the number of new cases is flattening or decreasing. “For Mindanao same thing. For the mortality doubling time of Mindanao it actually exceeded the 7-day line.”
Wong explained that the purpose of the ECQ or lockdown is to buy time for the health sector to prepare.
Health Undersecretary Maria Rosario Vergeire explained that this was also why critical care utilization rates are taken into consideration when they recommended areas to be placed under ECQ. The said rate refers to how many ventilators and critical unit beds are occupied in hospitals in the area.
“Most of the regions are in the safe zone (in terms of critical care utilization rates),” said Wong. “We have about 4 or 5 regions that are in the warning zone but none of them are in the danger zone. So again because of the ECQ we have been able to buy time for the system.”
Under the Local Government Unit (LGU) epidemic response framework presented by the DOH, places that are considered low risk and are not under GCQ or ECQ are those with a case doubling time of 30 days and only utilize 30 percent of their hospitals’ critical care facilities. The case doubling time refers to the time it takes for COVID-19 cases in the area to double.
Those under moderate risk and the GCQ are areas with 7 to 30 days case doubling time or a regional critical care utilization rate of 30 percent to 70 percent. Meanwhile, those under ECQ are areas with a case doubling time of less than 7 days or a regional critical care utilization rate of 70 percent.
Vergeire said they also looked into the security, social and economic aspects of the situation. These include looking into COVID-related crimes, poverty and employment.
She said there will be a slow transition of areas from ECQ to GCQ and to minimum health standards.
“Ang lagi nating sinasabi kahit nagpapakita ng indikasyon na maganda kasi case doubling time humahaba ng ganun… talagang nakakapaghanda na. Hindi pa rin po tayo puwedeng maging complacent,” she said.
(What we always say is that although there are good indications that case doubling time is increasing and we are able to prepare, we still can’t be complacent.)
She said people should also expect the number of new cases to rise as the country’s testing capacity increases.