Community-based approach needed to handle pandemic – former DOH secretary
MANILA, Philippines – Coronavirus disease (COVID-19) control measures should trickle down from the national to barangay levels, in order to ensure the physical and mental well-being of Filipinos during the coronavirus pandemic, according to a former health secretary.
Former health secretary and current chairperson of Health Futures Foundation, Jaime Galvez Tan discussed the need for a "whole of government, whole of society" master plan in a webinar hosted by the Institute of Philippine Culture on Friday, April 3.
Tenfold testing, timetable needed
Tan said that the reason the pandemic is so anxiety-inducing is because there is lack of knowledge of the extent of the enemy. This can be addressed by a massive increase in testing capacity. "Alam natin ang COVID, pero nasaan siya? (We know what COVID is, but where is it)"
As of April 2, 4,726 patients under investigation (PUIs) have been tested. Tan recommended that testing must be increased by a "tenfold" – around 20,000 to 40,000 tests a day. Known hotspots of the disease should be the cities for prioritization for mass testing.
The Department of Health (DOH) should also present a timetable with target dates. For instance, the timetable could say that by April 15, 5 more hospitals will effectively be exclusive for COVID-19 patients. By April 30, there would be 10 additional hospitals, and so on.
As of 2017, the Philippines has a total of 40,775 doctors, 90,308 nurses, and 13,413 medical technologists. Tan said if 150,000 personal protective equipment (PPE) sets are used every day by health workers nationwide, then it 1 million PPEs would be used up in just one week. (IN NUMBERS: What hospitals need to treat COVID-19 patients)
With the whole world facing the pandemic, PPEs are in demand everywhere. Tan said that the Philippines needs to establish local production of PPEs. (EXPLAINER: The PPE keeping our healthcare workers safe)
Vice President Leni Robredo has begun such an initiative of tapping local designers to produce PPEs. However, Tan said that the government needs to mobilize more than medium-scale enterprises in helping out.
"Lahat ng may makina, dapat makagawa (Every company that has a machine should be able to produce)," said Tan.
Health workers are also vulnerable to fatigue, sickness, and even death. The government must prepare to hire reserves, or "locum," in ensuring frontlines are always filled up. (READ: Left in the dark: Little protection for government's coronavirus frontliners)
"DOH can't say walang tao, walang pera. May pera. Hindi ko tatanggapin na walang pera (DOH can't say there is not enough manpower, not enough money. There is money. I won't accept that there is no money)," he said.
"Never in the history of the Philippines have we had so much money. Even now with the President's special powers, we have even more funds," said Tan. The Department of Health's budget for 2020 is P100.56 billion.
The Bayanihan to Heal as One Act also allots P209.9 billion lump sum allocation in the 2020 budget as additional funding to deal with the pandemic.
Levels of risk, locations of PUIs, and circumstances of citizens must be classified in the most local levels possible. These are some of the classifications Tan suggested every local government should have:
- Barangays should classify citizens into asymptomatics, persons under monitoring (PUMs), PUIs, or COVID-19 positive;
- Barangays should have a COVID-19 map that classifies home according to capacity: only one room, one bedroom, or with more than one bedroom. This will help the barangay understand how well physical distancing can be done in a home;
- Barangays should be classifications by high risk (more than 10 cases), medium risk (less than 10 cases), and low risk (no cases at all at present);
- Provinces and cities should be classified as epicenters (more than 50 COVID-19 cases), with less than 50 cases, and with no cases at present.
"My whole framework is on the whole government and whole society together. The most urgent action for me is the return of inspired leaders across all sectors," said Tan.
These sectors not only include national to local government leaders, but also civil society organizations and business leaders. All of these must be involved in effective community-based caring systems.
"While we have an Inter-agency Task Force [for Emerging and Infectious Diseases], nasaan ang civil society voice 'nun (where is the voice of the civil society in it)? Is there representation of the poorest of the poor?" (READ: 'Walang-wala na': Poor Filipinos fear death from hunger more than coronavirus)
Leaders should also promote positive communication and mindsets among citizens that the nation will get through the pandemic. This can be further strengthened with a "global alliance" against COVID-19, where Tan recommended for world leaders to convene in online conferences and speak of worldwide solutions.
The Philippines is under a state of calamity due to the COVID-19 pandemic. As of April 3, there have been 3,018 confirmed cases in the country, with 136 deaths and 52 recoveries. – Rappler.com