[ANALYSIS] The next normal in the Philippines: Insights from the UK

Guido David
[ANALYSIS] The next normal in the Philippines: Insights from the UK

Graphic by DR Castuciano

'The goal is not to rush getting back to pre-pandemic.... The time to throw away our masks will come in due time.'

Since the start of the coronavirus pandemic, many countries including the Philippines have introduced laws that require people to wear face masks, observe social distancing in public places, and other measures to stop the spread of the COVID-19 virus. While Filipinos are largely compliant with adhering to public health standards, citizens of many countries have resisted these protocols, as some people believed it infringed on their personal freedom.

The debate heated up in the United Kingdom after the British government announced that adhering to these protocols would become a matter of “personal responsibility” rather than a legal requirement, once COVID restrictions are removed on July 19, 2021 in what is being called “Freedom Day” in the UK.

In the UK, more than 34 million residents, or 51% of their entire population, have already been fully vaccinated. This decision to end all COVID-19 restrictions, open all businesses, and delegate the observation of health protocols such as wearing of face masks and social distancing to be a matter of personal responsibility, has been branded “dangerous and premature”  by a group of 122 scientists and doctors.

In a letter to the Lancet, they urged the government to delay the complete reopening and removal of health restrictions until everyone, including adolescents, have been offered vaccination, and mitigation measures are in place. They appealed that proportionate mitigation will be needed to avoid hundreds of thousands of new infections, until many more are vaccinated. Their concern is that instead of continuing with the inoculation of children and adolescents once vaccines become available for them, the government intends to subject the young to a form of “human experiment,” wherein they will gain herd immunity not  hrough vaccinations but through natural infection with the SARS-CoV2 virus.

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The  concerns of the scientists and doctors are further compounded by the rising number of new COVID-19 cases and infections in the UK brought about by the much more contagious Delta variant that was first identified in India. If the current surge in the UK is not mitigated, some experts believe that the country will record more than 100,000 new cases per day in the coming months.

The Philippines has thus far vaccinated more than 12 million people, with more than 3 million fully vaccinated, based on Department of Health data as of July 9, 2021. In the NCR, at least 20% of the population has received at least one dose of the vaccine.  

More vaccines are expected to arrive in the coming months, and there are already discussions regarding the next normal. We highlight some important recommendations in planning the next normal, some of which have already been brought up by Joey Concepcion of Go Negosyo, Father Nicanor Austriaco, and others: 

1. As we reach our own target levels of vaccination in the NCR and other priority cities in the Philippines, the goal is to ease restrictions even further to allow all businesses to operate at or close to full capacity. The target is the complete vaccination of at least 40% of the population (an initial phase of economic reopening may occur when complete vaccinations hit 20 to 30%). The level of restrictions will be subject to the current level of risk in the NCR, as discussed in Item 5. 

2. People, vaccinated or not, should continue to wear face masks in public areas, commercial areas, offices, public transportation, etc. The intent of this is to protect the unvaccinated individuals. The wearing of face masks may be reduced gradually especially as the level of risk of the LGU improves. Masks and health guidelines should not be abandoned hastily, particularly when the level of risk is still significant. 

In this regard, the 121 scientists and doctors who opposed Freedom Day cite the following reasons why the continued practice of minimum public health standards and proceeding with caution as far as fully opening all sectors are important: 

• COVID-19 will disproportionately affect unvaccinated children and young people.  Even with low hospitalization and mortality rates among the young, data on long COVID and post-viral complications are still limited. We risk creating a generation with chronic health problems. 

• Transmission in schools (once schools are allowed to reopen) will lead to  educational disruption. 

• Emergence of vaccine resistant variants. Allowing the virus to spread freely may allow the virus to mutate further into more transmissible variants that escape vaccines because the virus is constantly evolving. 

• Significant impact on health services and exhausted healthcare staff. The link  between cases and hospital admissions has weakened but has not been broken. An increase in the number of new cases will inevitably lead to increased hospital admissions along with people waiting for medical procedures and routine care. This will result in more deaths due to other diseases. 

• Deprived communities are more exposed. The virus disproportionately affects the most vulnerable. While the virus infects people regardless of socio-economic status, the poor will be most affected due to reduced economic mobility and the high cost of medical care. 

3. Safe spaces will be provided, particularly for vaccinated individuals. When vaccinated people come together, the need for wearing face masks and social distancing becomes less, as the risk of breakthrough infections among vaccinated people is considerably lower. Social gatherings and activities that involve vaccinated people may function normally, as it would pre-pandemic.

Offices which have achieved micro herd immunity (i.e. more than 70 to 80% vaccinated among employees) may relax the use of face masks and other health requirements within the office spaces, subject to management decisions. However, in the interest of  safety, vaccinated people displaying COVID symptoms such as coughing or fever should wear face masks, or better yet, refrain from attending such events or activities. 

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4. Children and adolescents who have not been vaccinated, when allowed to go out, should wear face masks and observe social distancing.  

5. These guidelines will be subject to the existing level of risk in the city or province, and a possible entry into community transmission by the dreaded Delta variant. If  the incidence rate or ADAR (average daily attack rate) is below 1 per 100,000 (this is equivalent to less than 140 new cases per day in the NCR), the risk of transmission is low. On the other hand, if the ADAR increases above 10 per 100,000, the risk of  transmission is significant, and people will need to comply more strictly with minimum public health practices. 

The goal is not to rush getting back to pre-pandemic. The goal is to have a merry Christmas where we can spend time with loved ones and family, giving Filipinos opportunities to work and help our businesses and economy grow, while at the same time making sure that everyone is healthy and safe. The time to throw away our masks will come in due time. –

University of the Philippines mathematics professor Guido David and Maria Patricia Agbulos are fellows of the Octa Research group.

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