Loosening the lockdown

As we enter the sixth week of the Luzon-wide lockdown, not a few observers have urged the loosening of the drastic quarantine measures that have been put in place to control the spread of the coronavirus. But many, not seeing a strong enough reason for its imposition, have simply gone ahead to break quarantine rules. This has prompted President Duterte to order the mayors and the police to arrest all violators and teach them a lesson in discipline.

I personally doubt that coercion and intimidation can ensure better compliance. It’s pointless to threaten the hungry and the desperate. Detaining those who violate quarantine only compounds the problem of feeding impoverished families and preventing the spread of the disease.

The authorities must not look upon quarantine violations as willful defiance of official power. If they cannot be compassionate, they must at least keep in mind that they are not dealing with criminals.

The lockdown of entire cities and regions is, after all, an extraordinary use of state power. It suspends the fundamental rights of a vast number of citizens in the name of protecting society. Ideally, it is resorted to only when all other solutions have failed. I am not aware that the World Health Organization prescribes it as a first defense against a looming pandemic.

Three basic measures constitute the basic protocol for containing an epidemic. These are: Test, Isolate, and Trace contacts. It’s important to ask if enough effort was given to these standard responses before the government decided to lock down all of Metro Manila and Luzon. There was enough time for these benign measures in February, when there were yet no recorded cases of local community infection. Testing. We have indeed miserably lagged behind in this area. I personally understand that, given our extremely limited testing capacity, the tests could only be administered selectively. First to symptomatic persons who recently traveled to places where infections have occurred. Then to those who have been in contact with infected patients and are themselves manifesting symptoms. The lack of testing kits, in any event, would have been greatly compensated by clinical diagnosis performed by doctors at hospitals. Today, it probably makes more sense to prioritize the testing of those who may be carriers of the virus but are not showing symptoms.

Isolation. Isolation is for everyone who has symptoms or has been in contact with an infected person. Hospitalization is for those with severe symptoms (like breathing difficulty) and require urgent treatment. Those with mild symptoms are asked to isolate themselves at home, take medication, and carefully monitor their condition. I see the wisdom of staying away as much as possible from hospitals, where one can easily catch the virus. This also prevents hospitals from being overwhelmed. But where to isolate moderately sick people who live in dwellings with limited living space is an important detail that may have been overlooked in the early stages.

Contact-tracing. Consider those countries that were able to contain the initial surge of the coronavirus—Germany, Taiwan, Singapore, South Korea, Vietnam, to name a few. What they have in common is the diligent effort they put into contact-tracing. Calls were promptly made to all those who might have come into contact with an infected person. They were told to self-quarantine for at least 14 days. Someone regularly called to check their condition. Clusters of infection were, in this manner, quickly identified and contained.

In some people’s minds, the Luzon-wide lockdown may have made these basic measures, particularly contact-tracing, superfluous. But the experience of other countries shows that they remain essential to any pandemic response at every stage, and become all the more necessary after a general lockdown is lifted. The Wuhan lockdown lasted 76 days. We have not quite reached even half of that. It is gratifying to learn that, in our case, new infections and deaths are not increasing at the same exponential rate epidemiologists fear. Maybe it’s too early to tell. But until more robust testing is done, and more assiduous contact-tracing and careful documentation of COVID-19-related deaths are conducted, we are basically blind.

Rather than a total lifting of the lockdown, it may make more sense at this point to consider loosening some of the restrictive measures associated with it. People, especially the elderly and the infirm, should still be encouraged to stay at home. Physical distancing and the wearing of facial masks, together with frequent hand washing and coughing etiquette, should continue to be promoted.

But it is time we lifted the curfew and those checkpoints and barricades that prevent travel to and from Metro Manila. By the end of the month, people should be allowed to return to work and reopen their businesses. Public transport must be permitted to resume operation, guided by distancing rules for passengers. Churches, too, and other places of worship must be allowed to reopen. Schools may have to remain closed until the end of the current semester. While discouraging social gatherings especially in enclosed spaces, family and intimate friends must be allowed to hold brief wakes for their dead.

I have a sense that this great pause in our lives has already taught us many lessons. I expect that we are now more conscious of how we must live in a world we share with unknown viruses and bacteria. This can only bode well for a society where restraint is informed and voluntary, rather than imposed.