By Art Jimenez
(Concluding Part)
Last week’s column ended with the more important question: “How does IATF decide if an LGU is heading towards New Normal or backsliding to MECQ, for example? What COVID-19-related criteria does it use?” Fearing I might only lose time waiting for a DOH-IATF reply, I decided to look for the answer myself.
The imposition of quarantine levels is legally backed by an IATF Resolution. However, the bases of such levels are clothed in undefined or unexplained terms, which the general public could not readily understand nor appreciate. Public appreciation is important because the quarantine level they are put under defines their lives and livelihood.
For instance, IATF Resolution No. 48 dated June 22, 2020 approved the “recalibration” of previous parameters on the “Case Doubling Time (CDT) and Critical Care Utilization Rate (CUR), for risk classification of provinces, highly urbanized cities (like Iloilo City. ARJ), and independent component cities (like Passi City. ARJ).”
The risk classifications and their corresponding community quarantine levels are:
- High-Risk Classification: ECQ and MECQ, “if with modifiers,”
- Moderate-Risk Classification: GCQ and MGCQ, “if with modifiers,” and
- Low-Risk Classification: MGCQ.
The said Resolution 48 did not define, much less explain, CDT and CUR. We, the people, basically based our understanding that we will be placed under ECQ or MECQ if we are considered High-Risk, or whatever. But as to what CDT and CUR are and their impact on risk classification, the public does not know.
Resolution 48 also enumerated four so-called “modifiers” for MECQ and MGCQ, namely: “(1) social, economic, and security factors; (2) clustering of cases; (3) health system capacity; (4) continuous trend or increasing new cases, CUR, CDT, among others.”
May I ask the reader: Which of the four modifiers are clear as crystal to you?
The IATF also listens to the voice of the LGU chief executives who may want to appeal the quarantine level they were classified under. The rationale here is pretty obvious. The governors and mayors are on the ground and are, therefore, the first to know and understand the COVID-19 situation in their respective jurisdictions.
Appellants are required to submit the following documents for possible approval of the IATF and their subsequent request for the President to change the requested quarantine classification:
“a. Daily trend of active cases, number, and percent of population;
- Percent of close contacts traced and percent of contacts in quarantine;
- Number and utilization of community isolation beds;
- Met health system capacity targets and utilization;
- COVID Special Teams investigations and results, and
- Priority areas for segmental lockdown.”
The Task Force usually allows the appealing LGU only less than a week to submit the above papers.
But here’s a better set of measures that could identify which quarantine level a certain community may be classified. Released in late September but not widely disseminated and/or known up to now, the indicators are called ADAR and 2WGR, according to Dr. John Wong who is with the IATF’s sub-Technical Working Group on Data Analytics.
ADAR stands for Average Daily Attack Rate, which refers to the number of COVID-19 cases over a two-week period divided by per 100,000 of the LGU population. The higher the ADAR, the higher the risk of infection in a given area.
Its partner is 2WGR, which measures the epidemic growth or how quickly the number of cases changes over time. The indicator compares the cases in the past two weeks with the number of cases three or four weeks ago, said the TWG. A positive (+) growth rate means the epidemic is growing. If the growth rate, however, is negative, an epidemic shrinkage is indicated.
Prior to the use of ADAR and 2WGR, however, the status of the community’s health system capacity or readiness is assessed. Among the parameters used here are the area’s testing, contact tracing, isolation, and quarantine facilities.
It is only when the results are favorable that ADAR and 2WGR are measured.
For an area to be considered “Low” risk, its 2WGR should be zero or below zero percent, “Medium” risk if 2WGR is between zero and 200 percent, and “High” risk if 2WGR is greater than 200 percent.
For ADAR, an area is “Low” risk if the number is less than 1, “Medium” if between 1 and 7, and “High” if ADAR is greater than 7.
Next is to combine the 2WGR and ADAR results in a matrix that determines whether a given community quarantine qualifies to be escalated or de-escalated.
Here is the matrix.
Let’s take a hypothetical example. The 2WGR of a community is measured at “Medium” or “Greater than 0 to 200 percent (<0-200%)” and its ADAR is determined as from 1 – 7 cases per 100,000 population. If you trace the 2WGR Medium column straight to the ADAR Medium column at the right, you will see that this particular community would be classified as “Moderate” and under GCQ.
Another example. If the 2WGR is “High” or >200% and its ADAR “High,” being >7, then the concerned community will be under ECQ.
Remember that each LGU aims for the lowest community quarantine level and attain “New Normal” status, wherein both 2WGR and ADAR are “Low,” as shown in the matrix.
The twin indicators best exemplify the acronym KISS (“Keep It Simple, Stupid”), is user-friendly, and should be brought out to the sunlight.
P.S.
Congratulations to U.S. President-elect Joe Biden! “You are fired” Trump loses his immunity from horribly numerous suits after January 20, 2021. BUT… what if he resigns before January 20?
