Living with the virus

Even if a vaccine becomes available by early next year, the pace at which people could be immunized would not be fast enough to permit a return to some semblance of pre-COVID-19 times. And even assuming the discovery of a cheap and effective vaccine, experts doubt that this will spell a quick and total end to the disease. We will have to learn to live with this novel coronavirus, in much the same way we have lived with the common cold, influenza, and pneumonia.

This change in mindset compels a corresponding change in our approach to the pandemic. This is already happening in many countries. Here are 10 lessons we might consider as we gradually resume our lives while avoiding the dreaded second or third wave:

First, countrywide and regional lockdowns such as we have borne in the last 100 days must give way to targeted and localized responses that are fast, precise, and adjustable. These measures must be indexed against the maximum number of new cases a town or barangay can manage at any given time. Beyond a certain level, an increase/decrease in new cases must trigger adjustments. Every resident must be encouraged to keep watch over these trigger points.

Second, greater attention must be paid to keeping track of clusters of new infections. This means being alert to where they are coming from—something that can only be done with robust testing and diligent contact-tracing. This is already evident in China, where the Wuhan-style lockdown is giving way to targeted closures, mass testing, and rapid treatment in outbreak areas.

Third, every province or major city has to have its own testing facilities and personnel, capable of being deployed to the remotest barangay or wherever there are outbreaks. It is now known that, apart from the fact that the virus can be transmitted by asymptomatic carriers, 80 percent of those who test positive for the coronavirus show only mild symptoms. Without widespread testing, most of these cases will go undetected and unreported, even as they remain contagious.

Fourth, the new approach shifts much of the responsibility for containing outbreaks to the local government units—notably, the barangays and municipalities. At this level, there are, as we have seen, wide variations in leadership capability, available resources, and civic-mindedness. Far from relieving the central government of any responsibility, however, the turn to the local will require national agencies to ensure tighter coordination and sharing of information and resources.

Fifth, a targeted approach also means that establishments where the risk of viral transmission is highest must take responsibility to keep their places safe. These are venues that exemplify what have been called the “three Cs”—covered/confined, crowded, and close-contact. They should commit themselves to shutting down at the shortest notice when an outbreak occurs in their space.

Sixth, the importance of wearing a mask cannot be overemphasized. Though its protective value was initially doubted by the World Health Organization, the facial mask has now become an integral part of the pandemic culture, a tangible reminder of the need to regularly wash one’s hands and observe physical distance. In South Korea, where strict lockdowns have been avoided, people are advised to use heavy-duty masks in crowded places and reserve the ordinary surgical or cloth mask for everyday use.

Seventh, the novel coronavirus has exposed the limits of existing knowledge about the management of pandemics. This is even more so in societies like ours that had been spared from the ravages of past epidemics like SARS and MERS. Without this experience, we failed to recognize the threat or what it signified. Out of arrogance or lack of humility, the government showed no interest in tapping the nation’s best minds in what should have been a collective effort to understand the virus, track the course of its transmission, and control the unintended consequences it has spawned. This is the bane of authoritarianism.

Eighth, every large barangay or municipality must have its own quarantine and isolation facilities, to be staffed by volunteers headed by trained health personnel. Residents manifesting serious symptoms must be promptly identified and brought to the nearest designated COVID-19 hospital. They must be assured that government will take care of the cost of treatment of all COVID-19 patients. Only with this firm assurance will poor families feel confident about reporting cases from their households.

Ninth, guidelines must be simple, clear, and flexible. The longer it takes to bring the pandemic threat to a manageable level, the greater the need for government to rely on normative compliance rather than coercive enforcement. The unnecessary use of force only breeds resentment and distrust. The advent of the new normal must not bring with it the virus of authoritarianism.

And tenth, the past 100 days have shown us the many uncounted costs of total lockdowns. The most obvious have been the loss of income and livelihood, the looming starvation in impoverished communities, and the collapse of many businesses. There is a need to pay equal attention to the pandemic’s hidden consequences: the neglect of non-COVID-19 related health emergencies, the rise in domestic violence, depression and suicide, the growing despair among the elderly, the confusion and anxiety among the youth, etc. No government can hope to solve these by itself. We are all called to become each other’s counselor—this is the most basic meaning of solidarity.