Researchers studying the coronavirus outbreak estimate infections nationwide may reach 150,000 cases by the end of August if prevailing quarantine restrictions will be implemented “strictly and effectively.”

However, the updated study from the Octa research group of experts warned that  “less effective implementation the General Community Quarantine (GCQ) may lead to an additional 20,000 cases or more.”

The COVID-19 death toll nationwide, meanwhile, may reach up to 3,000 by end-August.

The researchers said the projection was based on current data from the health department that showed the Philippines maintained a reproduction number of around 1.4. The reproduction number reflects how many people one confirmed case may infect.

To tame the runaway reproduction number, experts urge that the figure be pulled down to below 1.

“Based on the above findings, we are still in a situation where there is still very significant community transmission in the Philippines. This means that SARS-CoV2 is still spreading in the country,” the Octa research group said in its latest report on Friday, July 31.

The researchers include University of the Philippines (UP) mathematics professor Guido David, UP political science professor Ranjit Singh Rye, Maria Patricia Agbulos, and University of Santo Tomas (UST) biology professor Reverend Fr Nicanor Austriaco. 

Octa fellows including public health epidemiologist Troy Gepte, UST mathematics associate professor Bernhard Egwolf, UP College of Medicine professor Michael Tee, UP Environmental Science professor Benjamin Vallejo Jr, UP lecturer Rodrigo Angelo Ong, and Eero Rosini Brillantes also contributed research .

The group had earlier projected cases in the Philippines to reach 85,000 by the end of July. The country eclipsed that mark on Wednesday, July 29, when it posted a caseload of 85,486 infections.

By July 31, the Philippines totaled over 93,000 , pushed to new highs by an unprecedented single-day tally of 4,063 cases.

Metro Manila ‘particularly concerning’

The experts warned the situation in Metro Manila was most concerning after several factors indicated the disease was still widely spreading in the capital region.

The metropolis – which has been the epicenter of the outbreak since the crisis began – accounted for more than 60% of all cases in the Philippines. The month of July also saw a streak of 1000-plus cases tallied over several days for the first time in the outbreak. 

The researchers warned that while lags in reporting of data hindered acquiring an accurate number of cases reported daily in the past week, “it appears that the surge has not yet peaked.” 

They added Metro Manila may also see a rise in the number of deaths in the coming weeks as evidence from other countries has shown the number of deaths to lag behind the numbers of cases reported daily by at least 3 weeks. This will come on top of lags in reporting data.  

Their findings showed signs the virus was still spreading in Metro Manila. Among these was the rising positivity rate or share of people testing positive for COVID-19, which climbed above 15% for the first time since April. 

The finding is particularly troublesome, they said, as testing capacity in National Capital Region “has dramatically increased since then, to more than 15,000 tests per day.” In an ideal situation, positivity rates should drop as more people are tested. 

The World Health Organization recommends countries strive to obtain a positivity rate of 5% or less to control the pandemic. The OCTA researchers said this means that in Metro Manila, new cases reported per day should be reduced to about 350. 

The surge in new cases is also now evident and most felt in health facilities as several hospitals declared capacity in the previous weeks. 

“This surge in new cases, if left unabated, poses a real danger of the virus leading not just to exponential growth in the number of cases and deaths but also to the overwhelming of the health care system in the NCR,” they said. 

On one bright note, however, the researchers said the reproduction number in Metro Manila showed a decreasing trend, from a high of 1.8 during the first week of July to a current value of around 1.3, indicating local government strategies appeared to be working. 

But this development may still be reversed, with experts calling to further scale up in testing, tracing, and isolation to reduce transmission rates. The group said moving Metro Manila back to a modified enhanced community quarantine may bring projected cases down to 75,000 to 80,000 from 90,000 to 100,000 were it to remain in GCQ. 

President Rodrigo Duterte, however, decided to keep the metro at GCQ until August 15. With this, the group warned a less effective implementation of GCQ could lead to some 120,000 cases in NCR by August 31. 

How to respond?

For one, the government needed to focus not only on expanding health facilities and the number of beds allocated, but also in hiring more health workers to reinforce front liners who are exhausted after months of treating patients.

They cautioned against an approach that only increased hospital and critical care capacity, without increasing the number of health personnel. This move could compromise health care services for even non-COVID cases.

“If public health authorities are not careful, these critical patients will experience a lack of proper care because of lack of health care workers. This will lead to an increase in non-Covid-19 deaths,” they said. 

Aside from this, localized lockdowns that protected human rights and put forward a health-centered response, rather than a peace and order one, will be more effective. 

“For local lockdowns to be effective, they must always be implemented in a manner that is protective of the rights and the welfare of citizens,” they said. 

This should not come at the expense of strengthening the country’s test, traced and treat strategy which remained “the front and center of the strategy against COVID-19.” 

“The testing, contact tracing, isolation and treatment capabilities that we have now will not be enough if we continue to loosen restrictions without a marked and sustained decline in the number of new cases and positivity rate,” they said. 

“While many are hurting at this point, this is a bitter pill that we all need to swallow sweetened by the thought that we are doing this as one nation believing that every single life matters.” – Rappler.com