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Doctors Apprehensive Over Alert Downgrading; NTF Adviser Says Reopening Of Cinemas To Be Reconsidered If COVID Cases Rise Again

Doctors Apprehensive Over Alert Downgrading; NTF Adviser Says Reopening Of Cinemas To Be Reconsidered If COVID Cases Rise Again
A sanitation team disinfects seats in a cinema at the Eastwood Mall in Quezon City on Thursday, Oct. 14, 2021. Movie houses in Metro Manila are allowed to reopen at 30% capacity for fully vaccinated individuals under Alert Level 3. Photo by Michael Varcas, The Philippine STAR

A group of doctors has expressed apprehension over the downgrading of the alert level in Metro Manila, noting that emergency hospitals are still filled with COVID-19 patients.

Dr. Maricar Limpin of the Philippine College of Physicians (PCP) warned that the downgrading of alert status could trigger another COVID-19 surge in Metro Manila.

“We are a little bit apprehensive over the downgrading of the alert level because it means more people will come out and there will be greater chance of them testing positive for COVID-19,” Limpin said on Wednesday, Oct. 13, in an interview with One News’ “The Chiefs.”

Reacting to the PCP’s concerns, Health Secretary Francisco Duque III said doctors need not worry as health authorities will continue to monitor the situation and recommend an escalation of the alert level if and when necessary.

“No worries, we can always escalate. That has always been the system,” Duque said in a television interview on Thursday, Oct. 14.

Compared to the past weeks, Limpin said health care utilization rate (HCUR) in the National Capital Region (NCR) has slightly improved and many COVID patients can already be accommodated inside emergency rooms.

Hindi siya (ER) katulad ng dati na apaw na apaw pero puno pa rin (The emergency rooms are not overflowing unlike before, but still full),” Limpin pointed out. Most of those taken to hospitals, particularly to intensive care units were unvaccinated or had received only one dose.

“We can actually say the situation has improved, except that many people are still infected with COVID-19. It’s not as bad as before but there are still many,” she said in Filipino and English.

Starting Oct. 16, Alert Level 3 takes effect in NCR. In recommending the downgrading of the alert status, Limpin said the business sector apparently has failed to consider the likely surge of people going to Metro Manila to work.

She said many non-NCR residents were likely unvaccinated considering that the government’s ongoing immunization is focused on Metro Manila.

In hospitals alone, Limpin said about 30% of personnel are non-Metro Manila residents.

Limpin said PCP has yet to formally inform the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF) of their concern. She said hospitals still experience shortage of workers and personnel, many of whom got infected or exposed to the virus.

“There’s hardly a moment hospitals have complete HCWs (healthcare workers). There are always those tested positive for COVID or placed under quarantine because they got exposed,” she said. “There is always shortage, especially now that we’re also taking care of non-COVID patients.”

She added the manpower shortage could further worsen with many nurses opting to go abroad and those hired by the Department of Health opting not to renew their contracts.

The lack of supply of medicines for treating COVID also remains a problem. She said the anti-inflammatory drug Tocilizumab is inaccessible to many COVID patients.

Alternative medicines for COVID treatment, she said, are still being checked of their efficacy. “We’re still checking evidence if these drugs can really help,” she said without naming the drugs.

Limpin expressed hope that next year’s elected government officials will implement a more aggressive pandemic control response including procuring sufficient medical supplies for COVID patients.

Newly elected officials, she said, must also ensure that COVID patients are provided full health coverage.

Reopening of cinemas

Meanwhile, Duque also expressed full support for the reopening of cinemas “as long as the minimum public health standards are followed.”

“We can give it a try and then monitor. We’ll see if there’s going to be an unusual increase of cases if and when cinemas are opened,” he said. He stressed the operation of cinemas in Metro Manila is still controlled and regulated.

National Task Force (NTF) Against COVID-19 special adviser Dr. Teodoro “Ted” Herbosa said reopening of cinemas may be reconsidered once COVID-19 cases surge again.

“The movie house, as it is, is (at) high risk but if you maintain the safety standards of the DTI (Department of Trade and Industry) – where people are one-meter apart, they are wearing face masks, there are air purifiers, there’s ventilation – I think there will be minimization of risk,”  Herbosa said in a mix of English and Filipino in an interview with “Sa Totoo Lang” on One PH on Thursday.

“I think you are seeing what the government is doing. It is trying to balance economy and health,” Herbosa said.

According to Herbosa,  the movie houses are being reopened to provide income not just to cinemas but for the people who make films such as the cameramen and others from production outfits who have not been working for almost two years. “They’re the ones who lost jobs,” Herbosa added in Filipino.

“That’s the more important basis of why we’re slowly reopening, and this is risk-based. The moment that outbreaks occur, that can be rethought. That can be corrected. That has been our stance ever since. We are risk-based in making sure that we can work but we are safe,” Herbosa said.

Herbosa also thinks that the health system is opening up since COVID cases in NCR are decreasing. “We're able to take the risk but we minimize the bad effects of opening up the economy. So it’s really a balancing act,” he said.

Malacañang announced on Wednesday  that quarantine restrictions in NCR will be relaxed to Alert Level 3 from Oct. 16 to Oct. 31. Under Alert Level 3, cinemas may be allowed to operate at 30% indoor venue capacity for fully vaccinated individuals, and at 50% outdoor capacity. Cinemas will reopen after 19 months since the start of the pandemic.

Read More: Cinemas, Spas, Gyms Allowed To Reopen At Limited Capacity As Metro Manila Is Placed Under Alert Level 3

Medical experts, such as former NTF special adviser Dr. Anthony “Tony” Leachon, said that the move to reopen is “very risky.”

Herbosa said he expects moviegoers to abide by protocols once cinemas reopen, and that the vaccination rate in NCR is almost at 80%.

 “I think if the moviegoers will behave and will not violate protocols, there will be a minimal risk of infection. And remember the vaccination rate of NCR is 78.7% fully vaccinated. So most likely the one beside you is already vaccinated...You have to show your vaccination card,” he said.

Alert Level 2?

Asked if NCR could further shift to Alert Level 2 after Oct. 31, Herbosa said it is possible if people still practice minimum public health standards and have themselves vaccinated.

“If you remember last year, we didn't have vaccines yet but the people followed minimum public health standards. Christmas was OK all the way to January and February. It was only in March when cases started rising. We can do that again especially with the vaccination rate of NCR,” Herbosa said.

No more quarantine

Concerning the removal of mandatory facility quarantine for those coming from “Green” or low-risk countries, Duque said he will raise the matter with the IATF.

Duque said he was not in the meeting when the IATF decided to remove the mandatory facility quarantine. The health chief said he has always supported mandatory quarantine at facilities.

“I was told that in some countries, they’re doing this now. But those countries can afford to do it because their national vaccination coverage is more than 70%, whereas we are only at 30%,” Duque explained.

Sen. Imee Marcos said that while quarantine restrictions are getting relaxed due to declining cases in Metro Manila, the people should not let down their guard.

“We cannot be slaves to fear. Honestly, lockdowns are not for the poor. This is only for people who have no problem serving food at their tables,” Marcos said. “But let us remember that we are still far from the so-called level for herd immunity that used to be 70% of the population and now 90%, because of the Delta variant.”

She called on every Filipino’s sense of civic responsibility to ensure the health of all. “Discipline is very important in simply wearing face masks and distance, amigo,” she said.

Moderate risk

As the NCR begins to ease quarantine restrictions, OCTA Research said all local government units (LGUs) in Metro Manila are now classified as moderate risk based on indicators and metrics.

Citing data from the DOH, OCTA said on Thursday the region recorded an average of 1,847 cases per day from Oct. 7 to 13, down 30% from the 2,638 daily new cases recorded in the preceding week.

The reproduction number, which indicates the number of persons a positive individual can infect, further decreased to 0.60 from 0.62 on Wednesday.

While still “high” at 13.05 daily new infections per 100,000 people, the region’s average daily attack rate (ADAR) had already dropped from critical levels during the peak of the surge last month.

According to OCTA, only San Juan has a critical ADAR at 28.68, although its average daily new cases continued to drop over the past week.

Eleven Metro Manila LGUs have “high” ADAR of over 10 but less than 25 daily new infections per 100,000 people: Mandaluyong, Pateros, Taguig, Marikina, Makati, Quezon City, Pasig, Parañaque, Pasay, Valenzuela and Las Piñas.

The remaining five LGUs have a “moderate” ADAR of less than 10 but more than five daily new infections per 100,000 people: Muntinlupa, Manila, Malabon, Navotas and Caloocan.

No LGU has critical hospital bed utilization rate, with Muntinlupa, Las Piñas and Quezon City at moderate and the rest within safe levels.

In terms of ICU utilization, Muntinlupa and Taguig are still at critical capacity at 85% and 100%, respectively.

Tagged as having high utilization were Las Piñas, Quezon City, Makati and Mandaluyong.

OCTA earlier said that the number of new cases in the region may further decrease to 1,500 to even below 1,000 per day by the end of the month if the current trend holds.

Meanwhile, the average number of new COVID-19 cases in the country has fallen to less than 10,000 for the first time since August.

OCTA said an average of 9,648 daily new cases were recorded from Oct. 7 to 17, with the 7,181 recorded on Oct. 13 the lowest since Aug. 3. – With Janvic Mateo