MANILA - The Philippines is seeing the start of a surge in coronavirus infections, with cases in about a dozen cities in the capital region rising, health officials warned on Thursday (Dec 17).
"There has been a continuous growth of cases in Metro Manila, signalling the start of a surge... It is not a question any more of if a surge will happen, but when and by how much," Health Undersecretary Rosario Vergeire told reporters.
She said people are increasingly gathering in thick crowds and flouting safety protocols to mark the Christmas holidays.
Data experts estimate that Covid-19 cases could spike, up to 4,000 a day, from a current average of less than 1,500, by end-January.
"That's on the higher end if things get really bad," said Dr Guido David, head of the Octa Research Group based in the state-run University of the Philippines.
He said hitting 4,000 cases a day would be "very critical". He said if that happens, the health system will be overwhelmed, necessitating a return to a sweeping lockdown.
The Philippines went through one of the longest and strictest lockdowns in the world early this year, shutting down nearly all businesses and keeping millions stuck inside their homes.
With infections retreating to below 1,500 a day and a death rate of less than 2 per cent in recent months, the government has been moving to revive a crippled economy, put people back to work and get them to spend once more.
Tens of thousands of factory workers are back in economic zones in the suburbs that ring Metropolitan Manila.
People are flocking back to restaurants, public markets, gyms, spas and salons, and churches. Malls are seeing a noticeable jump in foot traffic, from nearly zero during the lockdown. Public transport is back up to 50 per cent.
But all these have led to an uptick in cases in the past two weeks, especially in Metro Manila, as people let their guard down and make more frequent social forays, meeting in restaurants and holding gatherings in homes without masks or face shields.
The Healthy Ministry reported that while nine in 10 people wear masks in public, only one in three uses them along with face shields.
The Philippines currently has the second-highest number of Covid-19 cases in South-east Asia, after Indonesia. Nearly half of the 452,000 cases - some 204,000 - are in Metro Manila, home to about 13 million, with the big cities of Quezon City, Manila, Caloocan, Taguig and Makati accounting for a large share of the total.
The government and health advocates are now telling the public to ease back on the socialising.
President Rodrigo Duterte urged the public during a Cabinet meeting on Wednesday to forego plans to hold Christmas parties and large gatherings.
"Make it a sacrifice... We have suffered enough, and to suffer more is not acceptable any more. Please continue to obey protocols," he said.
Father Nicanor Austriaco, a microbiologist and research fellow with Octa Research, said: "Whether the wave will be a ripple or a tsunami depends on what people will do over the next several weeks."
The situation in the Philippines is not unique in the region.
The World Health Organisation (WHO) said on Thursday that Covid-19 infections have lately been more prevalent among young adults who, in a sign of quarantine fatigue, have been ignoring mask mandates and social distancing rules as they insist on returning to normal routines.
That marks a reversal from an earlier trend when the coronavirus hit the elderly more, said Dr Takeshi Kasai, WHO's director for the Western Pacific.
Addressing those below 40 years old, he said: "I know how tired you are of this pandemic, and I understand the anxiety, fears and uncertainties you're feeling. Some of you may not even feel particularly vulnerable to this disease. You might think even if you get infected, you won't get very sick. But the truth is, you can."
Dr Kasai added that a vaccine "is not a silver bullet", and the fact that nations have started giving millions of shots should not induce complacency.
"No one nation is safe until everyone is protected," he said, and that could take years.