No curve to flatten

By Uriel C. Quilinguing .

 FOR over three months, the pandemic brought by coronavirus disease (Covid-19) has introduced words and phrases many have started using in day-to-day conversations.

One of these is “flatten the curve” which should be clearly understood even without looking at a graphic material. This refers to the epidemiological curve which represents the number of cases over time and flattening that curve means preventing a huge surge of new cases in a very short time.

Ideally, epidemiologists should do the explaining since they are the experts. But their hands are full from the time the pandemic was declared last March 11 this year.

They have been trying to figure out what this novel contagion is, taking stock of their knowledge on infectious and reemerging infectious diseases, and reviewing lecture notes from clinical studies on severe acute respiratory syndrome (Sars) and middle-east respiratory syndrome coronavirus (Mers-Cov).

Not only that. They have been stretching their working hours and days to assume the role of disease detectives in the rigorous contact tracing, aside from suggesting interventions and containment measures to policy and decision-makers to combat the elusive invisible enemy.

Aside from the graphical illustration and discussion by medical experts on international television networks, MediaKonek has yet to hear talks from experts on the epidemiological curve, the how and when is the peak is reached, the period of flattening which some call plateauing or leveling, and the fall.

To visualize the epidemiological curve, it is prudent for one to plot on a graph the daily confirmed cases of Covid-19, based on figures from the Department of Health.

For February and March, one could visualize an exponential rise in Covid cases, almost all of these from the confirmed Covid-19 cases in Metro Manila and Luzon. These peaked when 538 confirmed cases were recorded in a single day and that was last March 31. The second highest was 445 last April 3.

But relatively high numbers were not posted in succeeding days. Numbers were down the first and second weeks of April. The lowest was 76 last April 3.

A total number of new cases were falling, deaths were decreasing and double-digit recoveries observed—all encouraging signs, yet some think these are not reflective of real situations on the ground primarily due to lack of tests and many continue to defy the stay-at-home orders.

There might be a semblance of an epidemiological curve but not quite. The succeeding days in April as well as the initial days of May, if plotted on a graph, would show an erratic trend of rise and fall, an irregular pattern.

These were the days when figures from the regions have started coming in, those from Davao City triggered by infections from those who were in a six-cock derby on three occasions from March 7 to 12. Just lately, numbers were up largely due to a surge of cases in Cebu City, after over a hundred tested positive.

Just when the numbers were dropping to double digits and just over a hundred cases in a day, figures went up again to over 200, as shown in the daily DOH Covid-19 case tracker.

Yesterday, there were 295 new cases and the figure is highest since April 2 and that 90% of this number of confirmed Covid-19 comes from Cebu City.  

We’re on the 13th week since the first case was confirmed in the Philippines, way beyond the nine-week viral infection period, and of total lockdown in Wuhan, China after which businesses were reopened.

The war against the virus is far from over in the regions and such may even get worse due to community transmissions. An epidemiological curve for the entire country may not be possible at all. If it can, it’s reflective of how infections on a nationwide scale occurred.

The Philippines is an archipelago, geographically unique compared to China, Italy, Spain, and the US and even to Japan, Singapore, and Vietnam.

As such viral transmissions were somehow suspended, depending on how fast a carrier could travel either by land, water, or air, and the restrictions imposed midnight of March 14, this year, delayed such. For the central government to impose the level of restrictions for the regions and the provinces does not augur well since this country is not in a single landmass.

In Northern Mindanao or the entire Mindanao, plotting all daily new cases of confirmed Covid-19 patients, suspects and probable cases in a graph may not show an epidemiological curve at all, for now. But if slowing down the spread of the virus so that the capacity of the health care system doesn’t become overwhelmed, then the curve has been flattened.

That, if there is a curve.

(Uriel C. Quilinguing is a former president of the Cagayan de Oro Press Club who had been editor in chief of Cagayan de Oro-based newspapers. For almost a decade, he led the Media Health Advocates Group in Northern Mindanao. For reactions, email them to uriel.quilinguing@yahoo.com.)