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Thursday, April 25, 2024

COVID-19: How prepared are we now?

After two and a half months of
lockdown, the public healthcare system remains unequipped with the necessary
weapons to fight COVID-19. The Philippine government imposed a total lockdown
dubbed as the “enhanced community quarantine” or ECQ last March 16 after there
was a confirmed local transmission of COVID-19. The announcement was totally
unprecedented and ill-planned. It caused a lot of confusion among Filipino
citizens and even among implementing agencies and local government units.

The basis for this lockdown was to
stall the spread of the coronavirus while preparing the needed facilities to
fight the disease. Ideally it should be the government’s opportunity to equip
the health system with enough facilities and health workers to brace for the
second wave of COVID cases. But has the lockdown been truly beneficial in
preparing the public health system for the worst of the pandemic that is yet to
come?

Under-capacitated

According to a Philippine
Institute for Development Studies (PIDS) discussion paper
released last
April, the country will need a total of 182,000 hospital beds during the peak
month in the best case scenario. But as per a recent Department
of Health (DOH) situationer
, the overall bed capacity of the public health system
is only 13,565 which only covers about 7% of the total hospital beds needed.
Currently, there are only 2,005 mechanical ventilators available, very far from
the estimated 30,000 ventilators that the country will need during the peak of
the disease.

When it comes to the health
workforce needed, the country will require a total of 88,000 doctors and
118,000 nurses for COVID patients. There are just 52,000 doctors and 351,000
nurses available for all diseases and care, and we cannot of course assume that
they should be dedicated to only attend to COVID patients. Again, these
estimates are just for the best-case scenario which will only happen if 70% of
total symptomatic cases will be isolated. This seems unattainable with the
current status or practical non-existence of mass testing and contact tracing.

Unfortunately, the government has failed
to maximize its imposed lockdown to fill the existing gaps.

Mass
arrests instead of mass testing

Instead of acquiring the necessary
equipment and building additional facilities, the government has focused more
on restricting people’s mobility and using military forces in enforcing the
quarantine. The government has not only been slow – it has also made poor
decisions.

Instead of prioritizing mass
testing to identify and isolate affected individuals and infusing funds for
this, government chose to fully restrict economic activity, which has disrupted
people’s livelihoods and incomes.

There was even a time when there
were more individuals apprehended and arrested than tested for COVID. According
to the Coalition for People’s Right to Health, as of May 3 there were a total
of 158,353 quarantine violators, with 42,138 arrests made. Meanwhile, there were
only 106,520 unique individuals and 120,736 tests conducted overall.

Plans for checkpoints are more precise
than plans for mass testing. There are more checkpoints than testing centers.
As of May 29, there were 4,398 quarantine checkpoints
and 115 dedicated checkpoints and the police are still planning to add more. As
of May 31, there were only 38 licensed reverse transcription-polymeraise chain
reaction (RT-PCR) laboratories and 11 licensed GeneExpert laboratories, while
130 laboratory applications are still waiting for approval.

Now as
economic activity is slowly opening after a long period of lockdown, citizens’
call for free mass testing has become even louder. But instead of addressing
this, the government has only played with semantics – clarifying that it would only
conduct “expanded targeted testing” instead of mass testing because it does not
have enough capacity for testing the WHOLE Philippine population. This has sparked
further outrage among the Filipino people hence the louder call for free mass
testing and government accountability.

While government is busy with its vocabulary
enrichment games, the Makabayan bloc in the House of Representatives (HOR) filed
on May 28 House Bill 6848, the “Free Mass Testing Act of 2020”. But the
super-majority Duterte-allied HOR has prioritized the approval of the
Anti-Terrorism Bill instead of more COVID-urgent legislative proposals. Apparently,
the Duterte government is more concerned now with its critics than the
pandemic.

Forgetting
the frontliners

The government has prioritized arming
the military and weaponizing laws to target activists and critics who have
grown disgusted with the lack of government response to COVID. And it has
practically neglected the medical frontliners.

Protecting health workers and
non-medical frontliners is another area of failure. Massive shortages in personal
protective equipment, mask, and other equipment and facilities at the beginning
of the outbreak resulted in a huge number of our frontliners being infected by
the disease. But now that there are allegedly enough protective covers, the
slow bureaucratic process of distribution (plus a hint of corruption) is unjustly
affecting our frontline medical workers.

As per latest DOH report, there
are 2,606 health workers infected by the disease with 1,172 active cases and a
total of 32 casualties. Recent reports even have it that some health workers
have not received any of the mandated aid to them, and relatives of health
workers who died of COVID have not received the death benefits.

A mere ‘thank you’ will not help
our frontliners. The government should do aggressive mass testing – this is also
for the sake of our frontliners. Our health workers should be the last ones
standing, but what is happening now is without protection they are the ones
being sacrificed in the fight.

Ready
or not?

The government declaration of
lockdown was premature – it lacked a clear plan on how it really intended to
contain the spread of coronavirus. It also lacked foresight on how to address
the socioeconomic impact of such lockdown on the people. Now, businesses all
over the country are pressuring the government to lift the ECQ since the two
months of lockdown have entailed huge profit losses.

But more importantly, the poor cannot
afford the lockdown anymore. The people should not choose between dying from
hunger and dying from the virus – the government must give everything for the
people to live. But the government has not even given enough support. The poor are
going hungry, they have already endured too much, and their rumbling stomachs
are becoming hard to ignore. It is a rumbling social unrest.

On the other hand, the health system was already weak before COVID, but the pandemic only bared how bad the system is. And now that there is urgency to improve it, the government still sticks to its sick policy of relying on the private health system and defaulting on state responsibility. Government action has not only been slow and meager, but the bureaucracy has not prioritized what the people need. And now that the majority of the Filipino working class are getting back to work, government has no clear plan and support on how the workers and low-income earners shall be protected from COVID.

The activists are right after all – we need mass testing, and more so now that economic activity has resumed. It is government responsibility to isolate and treat infected individuals and let the rest of the healthy people be productive. Government should remove the undue stress and anxiety that this disease is giving to the population, let them work with peace of mind that they are fully protected from this disease and from the harsh socioeconomic impact of the lockdown.

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