After a month and a half into the enhanced community quarantine (ECQ), the Department of Health (DOH) reported in a media forum Tuesday that the country is starting to flatten the COVID-19 curve.

Health Undersecretary Dr. Maria Rosario Singh-Vergeire, reported that the country is starting to experience a flattening of the COVID-19 curve. However, she warned of a resurgence of cases when the ECQ is lifted and people start being complacent about social distancing.

Sana matulungan nyo kami na hindi pa rin dapat maging complacent,” she appealed to media during the forum.

While reiterating that the decision on lifting the ECQ still lies with the Interagency Agency Task Force (IATF) for the Management of Emerging Infectious Diseases, the DOH remains adamant in pushing for behavioral changes to slow down a possible resurgence of infections once the ECQ is lifted and eased to a general community quarantine (GCQ).

The Health Spokesperson was also joined by epidemiologist Dr. John Wong of Epimetrics Inc. Dr. Wong is an Associate Professor of the Ateneo School of Medicine and Public Health, a member of the IATF’s technical working group on data analytics, and a Roux Prize Winner from the Institute for Health Metrics and Evaluation.

In his presentation, Dr. Wong explained how we know the country is flattening the curve based on the measuring of the doubling time or duration in days for cases or deaths to double. According to him, although the rise in cases and deaths started fast, the ECQ has significantly slowed down the speed of transmission, hence flattening the curve.

“When April 1 came around, when the ECQ took effect, you’ll see that the curve has started to flatten. From doubling every less than three days, now it is doubling around four days,” Dr. Wong explained as he presented a graph of the case doubling time in Luzon.

In measuring the case doubling time, lower numbers mean faster outbreaks, while higher numbers mean slower outbreaks. For Luzon, except for NCR and neighboring provinces, Dr. Wong reported, “There has been flattening in a more dramatic way, very near the seven-day line.”

He also reported an optimistic case-doubling time outlook at the regional level. “Because of the transport network between the National Capital Regional (NCR) and its neighbors, we consider this as one unit. So you see, where maybe about 70% of the cases are focused or concentrated, the flattening is even more evident compared to the graph of the national level, especially for mortality” Dr. Wong said about the flattening of the curve in the NCR and its neighboring provinces.

He added that NCR listed only a few additional deaths and noted that most deaths are from outside of the region. Generally, however, “deaths are approaching the seven-day level, so they’re slowing down,” Dr. Wong continued.

Luzon has greatly improved during the ECQ. While it has a very slow outbreak to begin with, it has also exceeded the seven-day line for deaths. Dr. Wong further stated, “The biggest improvement was in Mindanao. Although it started with a very fast outbreak, they slowed down considerably by about three days.”

Dr. Wong specified that the country generally has a case doubling time of 4.6 days, which indicates that cases double almost every 4-5 days. Excluding NCR and its neighboring provinces, the rest of three regions placed under ECQ—Luzon, Visayas, and Mindanao—all recorded at least seven days mortality doubling time.

Another good indication of the readiness of the country to have the ECQ lifted is the country’s health capacity. “Right now, we only have 25% utilization for mechanical ventilators and about 40% each for ICU beds and isolation beds. So, we still have a lot of reserve capacity,” he noted.

While there are still backlogs in the outcome of samples from the tests, current measures taken to flatten the curve were not hampered. Though the results reported now were taken about 10 days ago, collective data still showed that case doubling time is slowing down.

In expediting data encoding in different laboratories, the Department deployed some of its staff to different laboratories. New encoders have also been hired while the department continues its call for more applicants.

Singh-Vergeire also reiterated that properly categorizing positive cases—asymptomatic, mild, severe, and critical—has helped in the quick isolating and treating of patients.

Building on Singh-Vergeire’s pronouncement, Dr. Wong added that the country has more asymptomatic and mild cases. For instance, in each test sample, only 10% tested positive.

“In spite of this backlog, hindi po nito napigilan na i-flatten ang curve natin. Maganda ang indication natin,” the DOH Spokesperson announced. While evidence points to the Philippines flattening the curve, Usec. Singh- and Dr. Wong called on the public to remain vigilant for a possible resurgence.

“There have been lots of focus on capacity and testing, but we should also focus on how to manage the 99% who are uninfected,” stressed Wong, who added that teaching behavioral changes and motivating them to follow these changes will help in delaying a resurgence.