UP proposes graduated activation of ECQ beyond April 30

MANILA, Philippines – The University of the Philippines (UP) COVID-19 Pandemic Response Team is proposing for the implementation of graduated activation of Enhanced Community Quarantine (ECQ) depending on the level of risk in certain areas beyond April 30.
UP proposes graduated activation of ECQ beyond April 30

The modified community quarantine to contain the spread of COVID-19 aims not to paralyze local economies over a long period of time.

"It is important to tackle this question at this time because LGUs rely upon national directives for policy and decision-making. Crafting of guidelines for an extended ECQ requires foresight, one that is informed by scientific data on estimates of the effectiveness of pandemic control strategies," UP said in its report.

Under this set-up, provinces (or even lower-level LGUs) may be put under ECQ depending on how close or far they are to an estimated outbreak threshold.

"This suggestion is made based on our analysis on the trajectory of spread and the severity of its impacts across LGUs, which varies depending on the onset of local transmission, population density, and age-group distribution," the report said.

probability of cases/outbreak threshold Philippines COVID-19 cases
Example map showing the probability of cases/outbreak threshold (with reproductive number of 2) of the Philippines computed per province from best available data as of 9 April 2020. Map layout by Feye Andal of UPRI Youth Mappers.

Example of a Decision Matrix for Graduated Community Quarantine Implementation.

Originally set until April 12, President Rodrigo Duterte ordered for the extension of Luzon-wide lockdown until end of the month. Luzon is home to more than 57 million people. It is where Metro Manila, the country’s political and economic nerve center, is located.

Is the Luzon-wide ECQ effective?

Based on time-series analysis, it now takes a little longer for the number of confirmed cases to double in number. UP noted of relative success of the ECQ–along with other interventions–in containing the spread of the virus.

"Based on the trends, one can estimate about 9,000 to 44,000* possible cases reported by the end of April 2020," it said.

typical trends in the DOH reported positive COVID-19 cases
Simple time-series analysis showing typical trends in the DOH reported positive cases (latest data: 10 April 2020). The current trend shows that the number of reported cases doubles about T2 = 6 days, while there has been a linear trend for the past 10 days (since 01 April). The color bar represents the data range used to estimate the linear projection.

Another metrics, the fatality rate (5.38% as of April 10) and reproduction number (0.6398) show that the ECQ has been effective. "The goal is to keep bringing the reproductive number down to lower than 1 through continued medical and non-medical interventions."

Time-Dependent Reproduction Number Rt of the Philippines
Time-Dependent Reproduction Number Rt of the Philippines, Singapore, and South Korea, with 95% Confidence Intervals for March 9 to April 10, 2020.

UP said quantifying the effectiveness of the ECQ, however, is highly dependent on efforts in discovering new cases.

"Specifically, there are situations in which countries were able to bring their reproduction numbers down close to 1, but later testing pulled the number up, such as the case of Singapore. In the case of Korea, consistent increased testing coupled with contact tracing facilitated the detection and management of the epidemic, lowering the reproduction number of COVID-19."

However, UP emphasized that decision-making depends entirely on the quality of official reports, testing accuracy, monitoring, and faithful accounts of fatalities, among others.

"There have been reports of discrepancies between the official fatality count and those reported from the ground and must be addressed to ensure quality and timeliness of data used in any analysis."

They also recommend the employment of an automated LGU data collecting system for real-time and barangay-level COVID-19 related data.

You may read the full report here.

— The Summit Express

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