Thread by @jasonhaw_

It's going to be difficult to determine whether the surge we are seeing in cases is driven by a variant (whether it's B.1.1.7, B.1.351, P.3, or P.1) but there are some key differences in the country's surveillance capacity between the July/Aug surge and the one happening now

1/ The narrative last July/Aug was that the government was struggling to expand laboratory capacity. Mayors and senators were posturing how they were ready with their labs but DOH regulatory bodies were taking forever to inspect and approve. Now, labs have been underutilized.

2/ Laboratory tests have been hovering around 20-30k daily, but I can easily imagine laboratories ramping up to surge capacity and doing 50k tests daily. It's going to be a question of affordability, as nat'l gov't gave up on enforcing the free testing policy of PhilHealth.

3/ This means that when looking at the lab positivity values, it is important to look at both positivity rate AND absolute number of tests. Also important to look where testing is happening since all regions have labs now so the positivity values by region reflect regional cases

4/ This also means that the daily reports of DOH are TIMELY. No more nonsense with fresh and late cases. Almost all cases reported daily had their specimens collected within the past 14 days. That's a level of timeliness unheard of in any of our disease surveillance systems.

5/ So the 5000+ numbers we are seeing are a much higher surge than what we saw last August. Nat'l gov't cannot hide behind late reporting anymore. This also means that we will reach a peak with new cases when labs are all operating at surge capacity again and backlogs are present

6/ What is the same, or probably even worse, is the government neglect of fundamental and essential pandemic response measures. Contact tracing is still a mess, and all nat'l gov't can do is to blame LGUs who are already fatigued, and individuals who are also fatigued.

7/ I still hate the policy question of lockdown or no lockdown because it didn't have to be this way. A lot more could have been done. Stimulus payments to help families and small businesses survive. Enforcement of COVID-19 benefit packages and timely payments to health providers

8/ But the sad reality is that the only question nat'l gov't will consider is stricter lockdown or status quo. Our urban cities are some of the most densely populated in the world so it was going to take more than acting on our own to practice these individual behaviors

9/ For now, it seems like nat'l gov't wants to open up the economy (what economy?) despite rising cases until some untenable point where hospitals are filled again & they will announce a stricter lockdown at 2 AM because the half-dead president can't be bothered to do it earlier

10/ It's truly heartbreaking to say the only thing we can all do is take care of ourselves, our family, our friends. The current administration has neutralized almost all checks and balances and 2022 can't come any sooner. But take this surge seriously because nat'l gov't won't.