Uganda is now battling an outbreak of the Ebola virus, which causes a severe and often fatal hemorrhagic fever in humans and other mammals like monkeys. The latest outbreak was said to be caused by the “Sudan strain,” which reportedly has no approved vaccine or drug treatment, the New York Times (NYT) reported. Scientists are beginning clinical trials only now.
In Zimbabwe, the NYT also reported, a measles outbreak killed more than 700 children and infected thousands of others. There is also a cholera outbreak, reportedly spreading fast, in Syria, and a similarly fast-moving outbreak of syphilis in Texas and the UK. Also in the UK, an outbreak of avian influenza or bird flu has been reported.
Meantime, polio, a disease once almost eradicated, continues to linger in New York State. While presently contained, the virus is seen as staying. Over in Ohio, the third known death of a person in the US with monkeypox was reported. And in Colonie, New York; and parts of Minnesota, Wyoming, Utah, Indiana, and Montana, outbreaks of bird flu have been reported.
In the Philippines, COVID-19 remains a problem, although the spread of the virus seems somewhat contained. However, the threat of monkeypox, polio, and other viruses remains. Moreover, dengue continues to be a major public health issue. Luckily, the Department of Health (DoH) bureaucracy continues to function effectively even without a permanent Secretary.
Nobody knows what the future holds. And no one can predict with certainty what the next pandemic will be and when. Crucial are the types of public health systems the world is putting in place for scientists to recognize early what and when new viruses arise, the threats they pose, the ways to mitigate their threats, and their treatment options. As with any viral outbreak, there is simply no way to avoid them. But the damage can be mitigated.
And this is where I call on our public officials to consider bigger public investments in biosurveillance systems, perhaps even to call on the private sector for urgent assistance. We need to further improve our situational awareness before and during public health emergencies, and this requires better monitoring of what is happening not only here but also abroad.
It takes only one sick patient on a plane, or a ship, to travel to the Philippines for a deadly virus to quickly spread. The COVID-19 virus proved this to be the case. And while effective monitoring at borders and ports of entry helps control the spread of disease, it is also question of knowing way ahead what to look out for and how. This way, appropriate systems and interventions can be put in place.
Knowing ahead, and thus allowing for time for preparation, is the crucial advantage given by effective biosurveillance. Delays in detection and response can mean life or death. After all, poor monitoring results in inadequate information, which can delay initial detection of a possible outbreak. Poor or delayed monitoring also prevents officials from making an informed decision on control efforts or interventions.
What hinders most control efforts is the simple lack of understanding about the underlying epidemiology of emerging or spreading viruses, noted a memo on US Health Security by public health expert Jennifer B. Nuzzo. In her memo to the US Congress, she noted that biosurveillance systems must “1.) rapidly alert and inform decision makers of potential incidents of national significance; 2.) continually provide critical updates as circumstances evolve; and, 3.) access information that answers decision makers’ questions about probable impacts of an event and the consequences of action/inaction.”
It is in this line that I take exception to the back-to-school mandate of the Department of Education (DepEd). Beginning this month, schools have started adding more face-to-face classes. And by November, all schools are seen shunning hybrid or flexible learning and going back to full-week face-to-face schedules.
With this back-to-school mandate, I will be less concerned with vehicular traffic and more worried about the risks to our children. Why the DepEd insists on making physical attendance mandatory for all escapes me, considering that the pandemic is far from over. While I understand that many children, particularly in public schools, lack facilities for online learning and thus find themselves falling behind, why insist on applying the same rule even to schools that have successfully adopted hybrid or flexible learning programs? This, I believe, is a step backward both for education and public health.
Exposure to the virus grows exponentially with back-to-school as it puts more people — students, teachers, parents, school administration and staff, among others — on the road and in public places and in public transportation daily. Physical distancing and disease surveillance becomes more difficult as more people troop to and from school five to six days weekly.
Moreover, monitoring already indicates to us the possibility of a new subvariant of COVID. “We’re not sure why there’s a resurgence in cases in Metro Manila. It could be a new subvariant because we’re also monitoring new subvariants in other parts of the world,” the Philippine Star quoted OCTA fellow Guido David as saying in The Chiefs over Cignal TV’s One News on Monday night. “In fact, in the UK (United Kingdom), they’re starting to see an increase again in cases. There could be a new subvariant causing that.”
He also noted that some schools had to go back to online classes because of clustering of COVID cases. “And when they get infections from schools, usually they bring it back to their households where the rate of transmission is very high. So, it could be partly an effect of the -ber months or face-to-face classes,” David added in a mix of English and Filipino.
The Star also reported that based on DoH data, about 4,000 COVID-19 cases could be reported daily by the end of October, or even higher if people will be less compliant with minimum public health standards. And this is from an average of just 2,288 cases daily for the period of Sept. 26 to Oct. 2. With this projected increase in cases, why go back-to-school now?
DepEd admits that some schools across the country have reported cases of students, teachers, and school personnel getting sick with COVID-19. But the DoH says COVID-19 transmission in schools is still manageable, even while it admits that it does not have the data on how many COVID-19 cases in schools have been reported since face-to-face classes resumed in August. And yet, while it projects the number of cases to rise yet again by the end of this month, it remains supportive of the DepEd’s back-to-school mandate.
Why fan the flames, so to speak, by insisting on returning to “normal” for all schools while the pandemic remains? As the DoH noted, it would “rethink” the policy only “if it comes to a time that cases will surge and hospital admission will be overwhelming.” Really? Should we still wait for that? Meantime, as we send all our children back to school physically, as required by DepEd, are we not deliberately putting them in harm’s way? They are school children, not the Marines.
Marvin Tort is a former managing editor of BusinessWorld, and a former chairman of the Philippine Press Council