Metro Manila on MECQ again – and 4 Covid protocol errors that might have led to it

Although until now Philippines has had a good hold on containing the Covid-19 outbreak, after infections began to rise across the National Capital Region in July, the government announced it is reverting Metro Manila back to the stricter modified enhanced community quarantine (MECQ).

Just a few days ago, medical frontliners called for a 'two-week-back-to-ECQ' course of action as top doctors warn the coronavirus outbreak will truly spiral out of control and weaken the health system.

As the country breached the 100,000 mark in the number of Covid cases and after registering its worst day on record with 5,032 infections yesterday, MECQ restrictions are now in back in place as public transportation, group gatherings, dining in at restaurants and many businesses will close once more –– including gyms, barber shops, sports grounds and resto bars. 

If you’re left feeling a little confused by the sudden changes to the rules, here are four reasons that might have contributed to the rise of Covid infections in the metropolis. 

1. RELAXING OF QUARANTINE MEASURES

In June, Metro Manila’s coronavirus outbreak seemed largely under control. Expanded testings were conducted daily, and contact tracing seemed a success, the general consensus was to place NCR to an eased general community quarantine (GCQ). In the midst of a more relaxed background, the reins were let loose and the public – nearly all of whom wore face masks—stood shoulder-to-shoulder on crowded MRT trains, markets and workplaces.

The government allowed most of the city’s businesses, even those that has little to none social distancing like barber shops, salons, and most recently the gyms, to open. Dine-in services also became available.

It was a celebration of sorts, and some public officials thought Metro Manila had gotten it right. 

But in an Inquirer news report, Dr. Rabindra Abeyasinghe, World Health Organization (WHO) representative in the country, said 'the proportion of positive cases is very slowly increasing,' from a positivity rate of 6.5 percent in June, it rose to 7.7 percent or 7.8 percent in July. The ideal positivity rate is 5 percent. 

When asked whether Metro Manila should be placed under lockdown, Abeyasinghe said the surge in infections followed the easing of quarantine restrictions to reopen the economy.

2. WEAK CONTACT TRACING

One of the main concerns right now is that people are not being contact traced in time and that leads to more people contracting COVID-19. 

More important than maintaining the ideal positivity rate of 5 percent, Abeyasinghe said, 'is that a country’s testing capacity is matched by its contact tracing and suppression capacity is matched by its capacity to manage patients.’

He said the government had used the long lockdown it imposed on Metro Manila, the epicenter of the outbreak, to expand its testing capability and treatment facilities. 'But unfortunately,' he said, 'the contact tracing and suppression capacities did not keep pace with what was happening on the testing and treatment care pathways … This aspect of the response was a little weak.'

3. QUARANTINE EXEMPTIONS

Metro Manila was also generous with quarantine exemptions. Certain groups have been excluded entirely from the city’s quarantine rules, including thousands of locally stranded individuals (LSIs) who’ve arrived at the Rizal Memorial Stadium to board buses to their provincial destinations. In early July, some LSIs who arrived in their respective hometowns were discovered positive for coronavirus. On July 30, 48 more LSIs tested positive in COVID-19 rapid tests. After a public outcry on the conditions of the people packed at the stadium, the Department of Health (DOH) said this was considered a mass gathering violating guidelines against the pandemic. 

Drivers transporting goods and workers employed across the whole of Mega Manila (NCR, Rizal, Calabarzon) were exempt from quarantine too. People in these groups are only required to wear masks and report their temperature daily to their destinations, but they do not need to self-isolate when they go home to their families everyday.

Some public officials have always maintained that the average workers are essential to maintain the necessary operation of the economy and to ensure an uninterrupted supply of daily necessities.

4. AT-HOME QUARANTINE

In an effort to decongest Covid-populated hospitals, probable or suspected COVID-19 patients were allowed to quarantine in their own homes, but the people they live with are not subject to quarantine and can move freely—a loophole that some experts consider one of the possible sources of infection.

In mid-July, a Philippine Star reportsaid that according to DOH Undersecretary Maria Rosario Vergeire, there are 12,684 probable or suspected COVID-19 cases on home quarantine in different areas of the country. But even if this is one of the possible factors driving coronavirus infections, Vergeire clarified the DOH 'does not discourage' home quarantine as long as the requirements for it are strictly met to prevent the spread of COVID-19.

Otherwise, it is 'best' to place these suspected cases at the temporary treatment and monitoring facilities, just like the asymptomatics and those with mild coronavirus infection.

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