By Joseph Anthony Lim
First of two parts
Responding to the urgent health aspects
The Covid-19 pandemic, its health and economic impact, and strong social distancing policies, will continue at the very earliest up to the end of the year. Most likely, the health and economic crisis will last up to 2021 or beyond, until a vaccine and cure are discovered. We must therefore immediately and carefully prepare a bigger and longer-period social protection as well as economic rescue and stimulus program and budget. It is likely that after May 15 most of the country will be under some kind of a general community quarantine. Under GCQ, most businesses will be allowed full or partial operations except schools, leisure activities, amusement, gaming, fitness, “kid” industry, and tourism. Under GCQ, all gatherings, including religious and conferences, are also disallowed, but small religious groupings practicing social distancing may be allowed.
Comparing the Philippines with 14 other East and South Asian countries in relation to Covid-19 responses, its number of tests per million population at 1,211 (as of May 6, 2020) is still low compared to more successful countries. Also, it has the highest deaths per million population at 6 as compared to 1 for India and 3 for Indonesia. It shows the limitations and under-capacity of our hospitals, health workers and health-care system. Likewise, the World Health Organization (WHO) sounded the alarm that the Philippines has a high rate of infection of health workers, with 16 percent of health workers infected. Hence, significant improvements in health responses must be continuously undertaken.
In this regard, more and more tests in designated laboratories and approved rapid test kits must be accelerated. This has been done rather satisfactorily starting April. But the results of the 17 or 18 designated laboratories and rapid testing kits (where data are with the LGUs) still have to be integrated and their results stored in a central repository in DOH. Cases reported are only those from the laboratories.
The Department of Health announced in early April that, with the help of the Department of Trade and Industry, it has tapped the Confederation of Wearable Exporters of the Philippines, a group of Philippine-based firms exporting garments for top global brands, to start the local production of 10,000 personal protective equipment coveralls daily. However, the project seems to have not been producing enough. The shortage of PPEs, face masks and protective devices still haunt our hospital workers. The Chinese experts sent by China to help the Philippines found that health workers’ face masks and PPEs are worn repeatedly, due to shortages. Hence, it is strongly recommended that DOH and DTI ensure the fast-tracking of this project, and if needed, search for other quick sources of PPEs including imports or donations from our neighbors China, South Korea, Hong Kong, Taiwan and Vietnam—countries that have successfully flattened the curve, and reduced their Covid-19 infections.
Another worrisome problem in DOH is the slow process in achieving the full operation of out-of-hospital quarantine facilities to house Covid-19 patients exhibiting mild or no symptoms. These facilities should have been operational in early April, and fully operational by mid-April. Although the quarantine facilities are slowly being filled up, limited equipment, personnel and supplies, as well as a slow contact tracing process, continues to slow down the full operations of these facilities. This again was brought up by the Chinese experts who said it is urgent that positive Covid patients with mild symptoms, or asymptomatic, should be isolated and quarantined in these quarantine centers so that their illnesses will not worsen, and so that Covid-19 patients will not infect family members, who in turn will not infect neighbors and other people. This, they said, was a crucial component of Wuhan’s success in defeating Covid-19.
Contact tracing to identify people who have been exposed to positive patients should be intensified simultaneous with rapid testing and expansion of quarantine facilities. It seems the success of contact tracing varies from one local government units to another. DOH has had problems in contact tracing cases from China early on in the first month of the pandemic because of poor coordination between DOH and the airlines. Now that domestic transmission is the main way of infection, efficient coordination among DOH, LGUs and the police must be achieved in contact tracing activities in all LGUs, neighborhoods, workplaces and prisons critically affected by the pandemic.
Since these are urgent tasks, government should pour resources on these and if it needs more, it is suggested that funds be requested from the multilateral agencies such as World Bank and the Asian Development Bank in the form of long-term loans given at concessionary rates, on top of what they already approved for the country.