(This newsletter was emailed to Rappler subscribers on May 1, 2020.)

Only a few weeks ago, I could go to the roof-deck of my apartment building and watch the construction cranes and workers hustling to finish dozens of new office towers at the Cebu Business Park nearby.

The business park, which was converted from the old Club Filipino Golf Course, has been around since the early ’90s. But only in recent years has the area perked up, with more Manila-based and multinational corporations setting up operations or secondary offices here.

On March 28, that all came to a halt when Cebu City was placed under lockdown due to the novel coronavirus outbreak. Construction work was immediately stopped and companies were only given a few days’ notice to come up with plans to allow employees to work from home.

I’ve never seen the area so quiet.

We’re one and a half months into the lockdown, but I still go up to the roof-deck often at sunset. The cranes are still there in the same position they were in on March 28.

Right now it’s the only place outside of my room to get some space to breathe and think. 

It’s where I can gather my thoughts after long days of tracking numbers of confirmed coronavirus cases rising here in Cebu. Or reporting on deaths from the virus, or the contagion spreading like wildfire in the overcrowded prisons, and medical workers being marginalized, among other things. 

The information that Cebuanos are being inundated with is anxiety-inducing. And the fact that our number of confirmed cases continue to rise is certainly a legitimate cause for concern. As of Thursday evening, April 30, the number of confirmed cases in Cebu City was at 732, while in Central Visayas it stands at more than 800. (READ: Where are the coronavirus cases in the Visayas?) 

But, believe it or not, there is reason to be hopeful. And there is another context to keep in mind when reading the daily bulletin updates.

The main one is this: The rising numbers of confirmed cases is indicative of the city’s efforts in conducting widespread testing, which is something many other local government units and the national government have failed to do.  

Between May 1 and 10, the city aims to test all of its barangays through rapid testing, with confirmatory tests done with PCR swab tests. (READ: Cebu City releases mass testing schedule)

This means we must brace ourselves for the numbers to rise even more, but here are reasons why we should not panic:

1. Testing makes the virus’ presence visible. What does testing do, and what does it mean when new cases are confirmed? 

Because coronavirus cases show symptoms similar to influenza or pneumonia, or may not have symptoms at all, the only way to make make the infection “visible” is to conduct a test. 

But as the Department of Health (DOH) in Central Visayas explained at a press conference on Monday, April 27: “The test tells you that you have the virus. It doesn’t tell you when or how you got it.”

So when a report says the virus “reached” a particular area, what it really means is that it was just detected there that day. How it reached the area and when are questions the test cannot answer. And with the number of international flights, cargo ships, and domestic travel activity in Cebu City, it would probably be impossible to answer at this point.

2. Ramped-up testing began only on April 14. The biggest subnational laboratory outside of Metro Manila is the Vicente Sotto Memorial Medical Center (VSMMC) in Cebu City. 

In February, only suspected “patients under investigation” (PUIs, a term no longer being used by the DOH) were being tested. Those samples were being sent to Manila, and it was up to the specialists at the Research Institute for Tropical Medicine (RITM) whether to prioritize testing them. Some samples wouldn’t be returned for more than a week, resulting in COVID-19 positive patients dying before knowing their own results. 

About 40,000 test kits arrived in Cebu on March  20. But while the VSMMC lab got its testing kits, its capacity – or ability to run more tests – improved only gradually. It was able to push their numbers (an average of 20 to 30 tests a day at the time) to more than 200 tests a day in early April.

With an increased number of tests being run, you will inevitably have an increased number of confirmed cases.

3. Cebu City tests persons without symptoms. When 3 patients were found positive in Sitio Zapatera, a densely-populated neighborhood in Barangay Luz in Cebu City, authorities began testing anyone who lived within the proximity of the positive cases. 

This move strayed from the DOH’s guideline that only those with severe symptoms, or those with mild symptoms but have pre-existing conditions, who should be tested.  

I believe, however, that Cebu City took the right step to test those without symptoms if they lived in areas with confirmed cases. In dense neighborhoods like Sitio Zapatera, for example, where 9,000 residents live close together, contact tracing may already be a waste of time. It can already be assumed that in dense areas, all have been in contact with each other.  

Mass testing and high population density, among other factors, is what caused the spike in the city’s numbers, and not “stubborn” vagrants.

4. Its population is bigger than other cities. The population of Cebu City is about one million as of 2020 – the biggest city in the Visayas. It is the island’s economic and educational center, where many from other parts of the Visayas and Mindanao go to study and work.

The number of infected will naturally be higher here than in areas with less density and a smaller population. 

5. Disproportionate geographic distribution of tests. The VSMMC lab tests for both the Central Visayas and Eastern Visayas regions. But out of the test results released on April 27, for example, at least 300 of the 379 were from Cebu.

Cebu, because it is more aggressive in testing, has been sending more tests to the lab than other areas.

The good news. Despite the high number of confirmed cases in Central Visayas, the death rate in the region is lower than the national and global average.  

Central Visayas so far has 12 coronavirus deaths out of 636 confirmed cases, for a fatality rate of 1.8%. The national fatality rate is at 6.7%, while the global average is 6.4%.  

The threat in Cebu, as in anywhere else, is still very serious. And there is still a lot the city can improve on to contain the pandemic faster. But it’s also important that we look at the information in the proper context to guide us better in protecting ourselves and our families.

Keep safe, everyone. – Rappler.com 

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