Officials of the Inter-Agency Task Force on Emerging Infectious Diseases (IATF) are divided on the easing of physical distancing rules in public transport, President Rodrigo Duterte's meeting with them on Monday night revealed.
On one hand, National Task Force Chief Implementer Secretary Carlito Galvez sided with the Department of Transportation, which on Monday reduced the recommended distancing inside public mass transport like trains and buses from one meter (3.3 feet) to 0.75 meter (2.5 feet).
However, Interior Secretary Eduardo Ano sided with the Department of Health, which said the one-meter distance should stay even as it urged the public to just stay at home if they don’t really need to go out.
Health Secretary Francisco Duque III warned the plan to shorten the physical distancing requirement in public transportation could lead to an additional 686 coronavirus cases every day.
Galvez Jr., however, warned against risk aversion, noting that virus transmission will remain low for as long as passengers will not remove their masks and will avoid talking and eating.
Duque cited a study conducted by the Health Professionals Alliance Against COVID ,which showed that reducing the one-meter requirement to 0.75 meter, at a 50 percent ridership capacity, will lead to 20,580 additional cases per month.
"If you multiply that by 1.6 percent, that's our case fatality rate, that will be 3,951 (additional) deaths per year," the Health chief added.
Presidential spokesman Harry Roque, however, reminded Duque that when the proposal was being discussed during a previous meeting of the IATF, the representative from the Department of Health registered no objection when it was adopted by the body.
Roque said the belated warning from the DOH made it appear that two departments — health and transportation — were in conflict over the proposal.
The President, in the meeting with the task forced televised nationwide, noted that face shields would only be able to protect people wearing them from a direct hit of a cough from someone carrying the coronavirus.
However, air conditioning in an enclosed vehicle like a train or bus would allow the virus to be circulated and even seep into face masks, Duterte said.
The President then said the IATF will discuss the proposal further on Wednesday, as he asked the task force for a visual diagram of the proposal.
The IATF, tasked to handle the country's COVID-19 response, will meet today to discuss the concerns on easing the physical distancing rules in public transport, Malacañang said earlier.
“We will not play deaf to the opinions of our medical frontliners, so we will reopen the discussions on this issue," Roque said in a televised briefing. “We will listen to them [on Tuesday].”
Reducing the distance required between public transport passengers is a move local doctors said could trigger a resurgence in coronavirus cases.
Experts from the University of the Philippines (UP) also advised the Duterte administration to reconsider cutting the distance between seats in public transport from at least one meter (three feet) to 0.75 meters (2.5 feet).
UP-OCTA Research Team Professor Ranjit Rye and Dr. Guido David discouraged the change in protocol in a television interview, saying they believed it would only lead to a rise in the transmission of the coronavirus.
Mayors in Metro Manila were likewise apprehensive over the move, with the group's spokesman saying health protocols should not be sacrificed for the opening of our economy.
Parañaque Mayor Edwin Olivarez, chairperson of the Metro Manila Council, told ABS-CBN’s TeleRadyo: "We have apprehension that physical distancing won’t be implemented. We know that our coronavirus curve has yet to flatten so we have to sustain our physical distancing."
The Department of Transportation on Monday implemented the 0.75 meter physical distancing inside public mass transport like trains and buses. It could be further reduced to 0.5 meters after two weeks and to 0.3 meters after another two weeks.
The department said this was to increase ridership in public transportation.
But Health Undersecretary Maria Rosario Vergeire said their agency values “the protection of lives and livelihoods” as well as the need “for spurring economic recovery.”
“The DoTr, being the lead agency, shall be responsible for issuing and enforcing transport guidelines to ensure that the public’s health and safety shall not be compromised,” Vergeire said, reading a DOH statement during a virtual briefing.
“Stay at home when you don’t need to go out,” she said, and appealed to senior citizens and those who are immunocompromised or ill to heed the advice.
The DOH did not categorically state if reducing the distance between passengers to less than a meter was advisable, but it asked “all Filipinos to be extra vigilant in situations where distancing cannot be practiced, and if possible choose to participate in activities or use transport options that can afford at least one meter distancing.”
Asked for DOH’s stand on the public transport policy, Vergeire said discussions were still ongoing.
She reminded the public to wear masks and face shields, and to continue practicing hand washing and physical distancing. “Based on evidence, the level of protection increases when the practices are combined.”
In a tweet, former adviser of the national task force on COVID-19 response Dr. Tony Leachon said: “There’s no categorical statement from DOH to oppose the DOTr on these flawed public transport guidelines. The DOH statement is weak, confusing and arbitrary, and sends wrong and mixed messages to the community.”
Leachon earlier told ANC that the government’s decision to reduce the distance of passengers from each other to 0.75 meter is “a risky and confusing and counter-intuitive measure.” It is also against the World Health Organization guideline of one meter.
Leachon pointed out that other health institutions abroad even recommend distances of up to two meters.
“Nowhere in the world literature that I went around to read that less than one meter would be beneficial in terms of risk reduction for prevention of COVID,” he said.
An infections disease doctor at the Philippine General Hospital agreed.
"The proposal to decrease the distance in public transport to less than one meter is problematic,” said Dr. Edsel Salvaña. “If there is a single COVID-19 positive person in the transport, anyone less than one meter from him or her after 15 minutes becomes a close contact who will need to quarantine and can potentially spread disease.”
Leachon warned that the public transport policy was reckless and could increase the number of COVID-19 cases in the country.
“This will be risky, reckless, counter-intuitive and will derail the flattening of the curve in the National Capital Region which will…affect the entire Philippines. We have flattened the curve, but that is not completely irreversible. We will cause resurgence of cases if we are reckless in our measure,” he said.
Leachon said that the one-meter physical distance between individuals is the bedrock of preventing virus transmission, and that wearing a face mask or face shield is just a complement to this basic preventive measure.
“The one-meter social distancing is backed by international safety standards. You cannot bend the rules to perk up the economy,” he said.
Instead of reducing the one-meter physical distance between individuals, Leachon suggested the government deploy more jeeps and buses and require government offices to provide shuttle services for their emplyees while the pandemic rages.
“There will be no reopening of the economy unless you reduce the virus transmission. That is a basic tenet in epidemiology. We always welcome the opening of the economy, but not at the expense of health standards,” he also said.
The Department of Health (DOH) issued a statement on Monday calling on the public to follow one-meter physical distancing protocol.
Interior Secretary Eduardo Año also said providing additional mass transport vehicles for commuters is better than reducing the physical distancing between passengers.
The government earlier approved a proposal to reduce social distancing in public transport vehicles from 1 meter to 0.3 meters by the end of September.
Transportation Secretary Arthur Tugade said the reduced social distancing will begin on Monday, Sept. 14.
A group of doctors also warned that the government’s decision to ease restrictions in public transportation could trigger a surge in COVID-19 cases.
“It's too early to do this now and cases might increase further and recovery might slow down,” said Dr. Antonio Dans, of the Healthcare Professionals Alliance Against COVID-19 (HPAAC).
The Philippines had nearly 50,000 active cases out of a total of 261,216 cases as of Sunday, raising concerns that allowing more passengers in public utility vehicles could lead to more infections.
The HPAAC urged commuters to use face masks and face shields and avoid talking while taking public transportation. They should also open windows and pick low-traffic periods during the day whenever possible.
“If there are few passengers, continue observing a physical distance of 1 meter or even farther. Observe proper etiquette when coughing or sneezing. Cover your mouth.,” Dans said in Filipino.
Dans said the group had submitted a model to the government task force to help predict how the reduced physical distancing in public transportation could affect the rate of COVID-19 transmission.
“I can tell you that cases will increase, for sure. But the question is, by how much?” Dans said.
Dr. Edsel Maurice Salvaña, an infectious diseases specialist from the Philippine General Hospital, said the government should have tried the reduced physical distancing policy in pilot areas first.
"I do not think a broad rollout with ever decreasing distances in a matter of weeks is prudent," he said in a Facebook post.
"We need to wait at least two to four weeks from initial pilot implementation to properly see any spikes in cases since we know it takes time for people to develop disease,” he said.