Dr. Mary Jean Loreche, the chief pathologist of the Department of Health (DOH) Region 7 claims that there is no pressing reason to place the Province of Bohol on a lockdown status.
She was among the members of the delegation from the DOH Region 7 and the Office of the Presidential Assistant to the Visayas (OPAV) who visited Bohol on Friday, April 23, 2021.
Loreche and companions attended the weekly Bohol mayors’ meeting to discuss the Coronavirus disease (Covid) vaccination rollout program, among other topics related to Covid.
The DOH-7 chief pathologist said, “You can’t be on [Enhanced Community Quarantine] ECQ forever. You have to learn from our experience in Cebu. Sometime in January, February and mid of March, we had our 2nd wave of our cases. But we never agreed that we would be on lockdown and be placed in ECQ. Never again are we going to be on lockdown. I believe that the best way to handle this [situation] is actually to put in the containment and control measures [in place].”
Her assertions came after she was informed that some Boholanos suggested to the Bohol Inter Agency Task Force (BIATF) to impose ECQ status in the province following a spike in Covid cases here.
As of yesterday, Apr. 24, 2021, the BIATF reported at 8 am a total of 594 active Covid cases in Bohol.
Moreover, she said, “The source of the fear is the unknown, when you don’t know where Covid-19 is and you wouldn’t be able to find it. But believe me, once you have the right test protocol, the isolation, and the treatment, then you have nothing to fear. I speak before you as an expert.”
BOHOL’S COVID MANAGEMENT IS IMPRESSIVE
Dr. Loreche bared to the Bohol mayors and to the members of BIATF that Bohol’s Covid infection management is impressive.
Despite the fact that a surge of cases was recorded, where the number of cases doubled in just two weeks, Loreche said the situation is still not alarming based on the available data.
She asserts that from Jan. 1 to April 22, 2021, Bohol’s total cases are at 1,436 and the age ranges of those infected are from 3 days to 95 years old with a median age of 33 years old.
The most affected age group by Covid is the one that includes those aged 21 to 30 years old, Loreche continued.
Furthermore, Dr. Loreche said, “Bohol’s case fatality rate [CFR] is almost zero except for morbidity week 5, that is 1.82, but other than that, you have almost zero deaths.”
Morbidity week refers to the specific time a report is generated to serve as a weekly epidemiological digest or weekly health index, according to Capitol’s Provincial Information and Media Relations (Primer) office.
She added that there is a need to be alarmed when the CFR surges because it is a reflection of how intense the health care utilization is at a given moment in time.
In Bohol’s case, the data is showing that the Covid situation is properly handled, Loreche quipped.
She asserts, “We congratulate Bohol province, Gov. [Arthur] Yap’s administration because that means you are properly taking care of your Covid-ill individuals.”
THE POSITIVITY RATE
The DOH-R7 chief pathologist said that Bohol’s positivity rate is not yet alarming even if it went up to 11% last week from the 0 to 2% in the previous week.
However, she emphasized that the rise in the positivity rate is due to continued contact tracing of new cases.
Positivity rate refers to the number of confirmed positive cases versus the number of samples taken.
ATTACK RATE
On the other hand, the attack rate is calculated as total number of new cases divided by the number of people at risk of the illness, according to Primer.
According to Dr. Loreche, Tagbilaran City registered the highest average daily attack rate (ADAR) at 13.52% from March 21- April 17, 2021.
There are towns with an ADAR of 4% as some towns even having an ADAR of less than 1%, she revealed.
AREAS WITH HIGH COVID CASES
Based on the data presented to the Bohol mayors on Friday, the DOH-7 identified the top 5 localities with the highest Covid cases from Jan.1 – Apr. 22, 2021 with Tagbilaran City topping the list with 461 cases. Ubay and Dauis had 89 and 88 cases, respectively, followed by Inabanga and Baclayon which had 61 and 50 cases, respectively.
SYMPTOMATIC VS ASYMPTOMATIC
Based on the data from the Regional Epidemiologic Surveillance Unit (RESU), only 5% of the total number of confirmed Covid cases in Bohol are symptomatic. About 95% of Covid cases here were asymptomatic and got detected because of the massive contact tracing efforts.
TEST, TRACE, TREAT
The DOH-R7 top pathologist reminded the Bohol mayors to strictly implement the national strategy in addressing the pandemic. The containment strategy is critical in order to keep the infection rates at bay.
Loreche said that once a person has been identified to have a close contact with a positive case, the former must be isolated and quarantined immediately.
Moreover, the timing of conducting the test is also critical, Loreche underscored.
She added, “[Testing] for asymptomatic individuals who may be exposed to a known positive, confirmed person should be on day 5 to day 6 because if you’re going to test too early, then you may miss [detecting the virus] based again on the science of how the virus [works] inside our body. But for those persons who are symptomatic, meaning to say, meron na pong simptomas, may ubo, may lagnat, may masamang pakiramdam ng katawan, and then especially with the history of contact with a positive confirmed individual, your testing would be not counted on the day of exposure but rather on the day when the symptoms appeared. Meaning to say, kung ako po sa araw na ito ay naging symptomatic, meron po akong nararamdaman, at sa aking history ay positive po ang aking exposure sa isang tao na Covid-positive, [testing] should be conducted immediately. Because once you have already the symptoms, the probability of retrieving the virus is already 30 to 40%.”
NO TO LOCKDOWN
According to Dr. Loreche, critical care utilization is the total reflection of how Bohol is addressing the challenges of the pandemic.
The management of public hospitals and those at the helm of private hospitals must include a system of constant communication with one another to help contain the the situation, Loreche emphasized.
“Hospital bed allocation for Covid patients must be raised at any point when the time calls for it. It must also with complimented with additional manpower to man the stations”, she said.
She noted that at the onset of the pandemic, that the Provincial Government has proactively solicited advice and recommendations from the members of the local medical community.
Health care facilities, through their respective chiefs of hospitals, were also consulted and in constant communication with proper authorities, she added.
Loreche continued, “Categorically po, sasabihin ko sa inyo, hindi kailangan kayo mag-ECQ. To see a number of cases of 122 or 125 in a day, tapos wala kayong namamatay na pasyente, at meron pa naman kayong mga kama sa mga hospital ninyo, bakit po tayo magsasara? Fear is not going to bring us anywhere.”
Loreche emphasized, “Why would a beautiful place like Bohol, shut down because of the 5% of the active cases being symptomatic? Let us do it scientifically, logically and with bases and then let us also balance it with the economics.”