Despite a dire warning from Health Secretary Francisco Duque III, former Department of Health officials and several other medical experts said on Tuesday that evidence from several studies support the gradual reduction of social distancing inside public transportation vehicles.
In a meeting with President Rodrigo Duterte and several Cabinet members, Duque had warned that the plan to reduce the distance between passengers from one meter to 0.75 meter alone would result in 686 new COVID-19 infections a day—or more than 20,000 a month.
But a group of experts, including former Health secretaries Manuel Dayrit and Esperanza Cabral, said that the World Health Organization’s (WHO’s) recommendation of keeping at least one meter of distance from others “allows for adjustments based on context.”
“Given our other recommended health interventions, we propose the gradual reduction of the physical distancing norm during transit to 0.5 meters or lower… We believe the evidence shows physical distancing can be maintained below 1 meter, so long as other health measures are also implemented,” they said in a statement.
The other signatories included National Task Force Against COVID-19 advisor Ted Herbosa, University of the Philippines Manila officials Vicente Belizario Jr. and Michael Hernandez, Philippine College of Surgeons Cancer Commission Director Manuel Roxas, Eye Bank Foundation of the Philippines founder and CEO Ma. Dominga Padilla, and infectious diseases specialist Rontgene Solante.
The medical experts said the economy cannot bounce back without increasing the capacity of public transport, which has long been on limited operation to avoid possible transmission of COVID-19.
They also pushed for the strict implementation of the “seven commandments” for all public utility vehicles:
· Wearing of proper face masks
· Wearing of face shields
· No talking and no eating
· Adequate ventilation
· Frequent and proper disinfection
· No symptomatic passengers
· Appropriate physical distancing.
“By imposing these strict measures, we believe we can gradually relax social distancing rules, in order to double or even triple our current public transport capacity, without compromising public health,” they said.
The experts cited several studies that support the reduction of social distancing in public transport.
“A recent study from Duke University, for example, shows that surgical masks reduce droplet transmission by up to 99 percent, and that the simple act of not talking can reduce droplet counts by up to four times,” the experts said.
“A meta-analysis published on June 22, 2020 in The Lancet, a leading international medical journal, shows that face masks and face shields can independently reduce the chance of viral transmission by up to 5-fold and 3-fold, respectively,” they also said.
They also said that COVID-19 infections remain “manageable” in China, Japan, Korea, Singapore, Taiwan, and Vietnam, even though passengers sit side-by-side in trains.
“We believe that there is a way forward that carefully balances a careful reopening of public transport capacity, with public health, while allowing purposeful flexibility to re-adjust measures based on actual and evolving data from the ground,” they said.
The government earlier approved a proposal to gradually reduce physical distancing in public transport from 1 meter to 0.3 meters by October.
After the adjustment took effect on Monday, Cabinet officials publicly debated the decision to loosen restrictions on social distancing.
Defense Secretary Delfin Lorenzana on Tuesday said he supports measures to reduce the physical distance between passengers in public transport as long as certain health and safety protocols are observed.
Health groups and various sectors expressed concern over the measure, claiming that it may lead to increased transmission of COVID-19.
Over the weekend, Cabinet Secretary Karlo Nograles said the move to adjust physical distancing in public transportation was a "carefully calibrated" decision to address the gap brought by the reopening of the economy.
But Duque said shortening the required physical distance between passengers in public transportation will lead to a higher number of COVID-19 infections.
Citing studies by the Asian Institute of Management (AIM) and the Healthcare Professionals Alliance Against COVID-19 (HPAAC), Duque said in a briefing with the President that the reduction alone of the required distance between passengers to 0.75 meters from one meter is likely to result to 686 additional new infections daily.
“Ata 50 percent ridership, new cases will reach 686 per day. If you multiply that by 30 days, you will have about 20,580 cases,” Duque said.
"If you multiply that by 1.6, which is our case mortality rate, meaning the number of deaths over the number of total infection, you will get 3,951 deaths a year,” Duque added.
Duque said he will recommend the studies of AIM and HPAAC to the Inter-Agency Task Force (IATF).
As the new policy took effect earlier in the day, Malacañang said the IATF would consult medical professionals Tuesday.
Duterte has yet to approve the distancing reduction, but Cabinet officials have already approved the policy in response to the need of the country to re-open the economy, Presidential Spokesman Harry Roque said Monday.
A healthcare workers alliance appealed on Tuesday to the IATF to reject the reduction of the physical distancing standard in public transport amid the COVID-19 pandemic.
In an interview on Unang Hirit, Dr. Carmela Kasala, of Healthcare Professionals Alliance Against COVID-19 (HPAAC), said the reduction can cause an increase in COVID-19 cases.
Kasala said her group will have a meeting with the IATF to discuss the matter on Tuesday.
She said they will present a model to show the possible impact of the reduction on the number of cases and death rate.
Kasala said the protection given by face mask and face shield is not absolute and would work better with social distancing.
A party-list lawmaker on Tuesday criticized the Department of Transportation's (DOTr) directive to reduce social distancing on public transport from one meter to 0.75 meter.
"Instead of re-calibrating social distancing weekly, why not listen instead to the call of many PUVs to open more routes?" said Rep. Ronnie Ong of Ang Probinsyano.
Ong, vice chair of the House committee on rural development, said he sees no harm in the immediate re-opening of all previously-available routes of jeepneys and buses as long as the scientific-backed one meter of social distancing and wearing of face masks and face shields for each passenger and the PUV driver and conductor are followed.