Report in May 2021 ①

COVID−19: Philippine Situation

April 14, 2020

Coronavirus Disease−19 (COVID−19), caused by the virus severe acute respiratory syndrome　coronavirus 2 (SARS−CoV−2), is a highly contagious respiratory disease of man that have originated from City of Wuhan, Hubei Province, China. It has been said that the disease have originated in bats. The disease has been characterized as a pandemic by the World Health Organization (WHO) on March 11,　2020, infecting more than 200 countries and 1.7M people globally.

The Philippines has encountered its first COVID−19 infection on January 30, 2020. A 38−year−old female Chinese patient that came from Wuhan and arriving in the country last January 21, 2020 tested positive for the disease after seeking consultation for mild cough (1). A day after confirmation, the Philippine government has imposed travel ban from people coming from Hubei Province, China, (2) and widened this ban on February 2, 2020 to include Mainland China, Hong Kong and Macau (3).

The first COVID−19 related death was reported on February 2, 2020. It was a 44−year−old male Chinese patient who also had a travel history from Wuhan, China and arrived on January 21, 2020 in the Philippines. He was admitted in a hospital in Manila due to fever, cough and sore throat until his untimely death on February 1, 2020 (4).

On March 7, 2020, the Department of Health (DOH) has confirmed the first case of local transmission in the country. The patient, a 62 year old male and the 5 th COVID−19 positive case in the Philippines, has no recent travels abroad. Due to this, the DOH has raised the COVID−19 alert system to Code Red sublevel 1 (6),(7) meaning that there is evidence of local transmission in the country, and subsequently, on March 8, 2020, the Philippine Government declared a state of Public Health Emergency (8). The declaration would facilitate easier access to financial resources to control the spread of the disease in the country and faster procurement of needed medical supplies (9).

In lieu of the increasing cases especially in Metro Manila, the Philippine Government has declared COVID−19 alert system to Code Red Sublevel 2, which is raised "when there is evidence of community transmission and prevalence of cases beyond what the government can address" (10), and has declared an "enhanced community quarantine" of Metro Manila starting on March 15, 2020 until April 14, 2020 (11).

Under the guidelines of the community quarantine, work in the government shall be suspended, with assigned skeletal workforce or frontliners that shall continue essential services of government agencies, and all health and law enforcement shall continue their duties. The private sector was encouraged to adapt flexible work arrangements for their employees. Domestic land, air and sea travel to and from Metro Manila was restricted. Suspensions of classes are left to the discretion of the Local Government Units. Foreigners from countries with localized COVID−19 transmission are prohibited to enter the country (11).

The imposition of community quarantine starting March 15, 2020 was announced on March 12, 2020, resulting in the exodus of people from Metro Manila to their respective provinces (12). With the start of the quarantine on March 15, there was confusion on its guidelines. Private sector employees were still reporting for duty, and given many have their homes in provinces outside Metro Manila, they were allowed to enter and exit Metro Manila as long as they present proof of employment (13).

Shopping centers, most restaurants, churches and other religious services and leisure activities were ordered closed. Only grocery stores, pharmacies, banks, and some restaurants were allowed to continue operation (14).

On March 16, 2020, the government has declared a state of calamity for the whole country for a period of six months, allowing the use of Quick Response Fund or the calamity fund (15). The government has also widened the enhanced community quarantine to include the whole island of Luzon (16).

Novel guidelines in the new memorandum include suspension of school activities, prohibition of mass gatherings, imposition of strict home quarantine, adoption of work from home arrangement by the executive government branch except for law enforcement and health services, and restriction of land, air and sea travel until April 14, 2020.

On March 25, 2020, the Republic Act No. 11469, or the Bayanihan to Heal as One Act, was enacted into law, granting special powers to the President and Executive department in the control of the COVID−19 outbreak. Among the new special provisions of the law are: a subsidy of Php5,000 (approx. USD 100) to Php8,000 (approx. USD 160) to low income households per month for 2 months; additional hazard pay and special compensations to health workers; and utility of private establishments and enterprises by the government when required in the interest of the public (17).

Last April 7, 2020, the enhanced community quarantine was extended until April 30, 2020 as per memorandum from the Executive Department (18).

As of April 15, 2020, the Philippines have 5,223 confirmed cases based on RT−PCR. 3,151 are currently admitted to hospitals, 335 have died, 295 have recovered, and 1,442 is currently being validated by the DOH (19).

As of today, mandatory quarantine measures are strictly being implemented. In most areas, families are given one quarantine pass. This quarantine pass can be used by only one member of the family in order to leave their homes and purchase necessary goods. Supermarkets, wet markets, pharmacies, and select food establishments continue to operate albeit with strict quarantine measures such as social (physical) distancing of 1 meter from person to person, mandatory wearing of masks, disinfection of hands upon entering establishments, and checking of temperature. Some local government units started "market−on−wheels", wherein trucks goes to certain areas to sell goods to prevent people to congregate in large markets.

In cases of low income families and to prevent people leaving their homes, local government units also distributes relief goods consisting of canned goods and rice. Informal / Contractual workers or those with no−work no−pay work arrangements such as public transportation workers will also be receiving monetary subsidy from the government.

The first weeks of the quarantine were marred with skeletal personnel such as health workers walking long distances to be able to report for work. The government has then provided vehicles for transportation of these personnel. Some public and private entities have also offered temporary accommodation and donated food to health workers and front liners. Some toll ways have also temporarily stopped collection of fees and gas stations provided free fuel for front liners.

Amidst the call of government for help, big businesses in the Philippines have already donated approximately Php 6 Billion (USD 120 Million) that includes cash and in kind donations for medical equipment and test kits.

There are still selected international flights available to either repatriate stranded foreigners or to receive overseas Filipino workers. Domestic flights are allowed on per need basis, especially to repatriate stranded foreigners.

The government has also started converting government and private buildings and even shipping vessels into COVID−19 quarantine and treatment facilities to supplement the capacity of hospitals.

Shortage of necessary goods such as food was foreseen because of conflicting quarantine rules in each province, city or municipality. The government then issued guidelines that mandate unhampered movement of goods through quarantine checkpoints.

The Philippines government mandates that people stay at home and that their basic needs be provided in order to prevent congregation of people and the spread of the virus. Future actions of the government involve the mass testing of people for COVID−19, and the continued provision of basic goods and services until the lifting of quarantine.

Due to this outbreak, the common Filipino people started to learn basic epidemiology of diseases, such as the assignment of "Suspect, Probable and Confirmed" to patients, the importance of testing and knowing the difference in confirmatory and screening tests. Basic hygiene is now being strictly practiced and internalized by the people. Biosecurity measures like mandatory disinfection procedures are now being practiced nationwide, such as in entry to establishments and even in some households. This may result in the increased appreciation of the people in the strict biosecurity protocols of animal farms.

The people has also started to appreciate not only medical personnel but also other front liners such as garbage collectors, security guards, delivery workers, grocery and pharmacy workers, among others, more due to this outbreak, many revering them as heroes in this situation. Appreciation and support of local farmers and fisherfolks and locally produced goods have also risen, with some advocating for increased support for them after the quarantine has been lifted.

Also, online meetings and other technological means as a solution for work from home arrangements has also been extensively used.

Personally, the quarantine measures changed my personal life and my daily routine drastically. I have continued rendering service as a government official, having availed frontline service and work from home arrangements. The services of our agency have been very limited and we have only done essential services as of the current situation. As a silver lining, my daily commute has been very quick lately as traffic was almost nonexistent. With the availability of work from home arrangements, I have been able to catch up with tasks and commitments such as writing and preparations of documents. I was able also to be able to spend plenty of time with family and friends.

Masks and alcohol have been very essential in my daily routine. I have also started mandatory hand washing every time I go outside and interact with other people. Prior to coming home, I practice spraying of disinfectant in my clothes and my things.

My personal opinion is that this outbreak will not be resolved in the near future, and that there would be changes needed in the routine and behavior of the populace. By April 30, 2020 on the lifting of the quarantine, the economy and transportation will gradually be opened albeit with maintained measures on the prevention of disease spread.

Hopefully, the government, financial, business, and health sectors learn from this situation and craft laws and preparedness plans in the future since the population will continue to increase and the risks of outbreaks in the future is more likely to occur. Also, hopefully, lessons learned in this outbreak are entrenched in the populace as this will not be the last outbreak the Philippines will experience.