GOVERNMENT STILL IN DENIAL, UNREPENTANT OF ITS FAILED PANDEMIC APPROACH
OPINION | SIEGFRED D. DEDURO
On August 30, 2021 the Philippines registered a record high of 22,366 new COVID-19 cases. Cumulative figure of total positive cases is 1,976,202, of which 1,485,945 are active; 1,794,278 have recovered; and 33,330 died.
This is a slap on the face of President Duterte and his militarized Inter-Agency Task Force on Emerging Infectious Disease (IATF-EID). Instead of being self-critical and scientific, the government insists on a narrative that its Covid 19 response is the best under our circumstances and blames the people who are suffering.
The government’s response revolves around militarized lockdowns, observance of health protocol (face mask and shield, social distancing) and vaccination. After almost two years of generalized lockdown (euphemistically named as ECQ, GCQ, etcetera), millions of Filipinos are jobless, while food prices rise and government debt balloons.
The pandemic plunged the Philippine economy to its worst contraction since World War II, with gross domestic product (GDP) falling by 9.5% in 2020. It is the sharpest dip on record since available data dating back to 1947, and also the first GDP decline since 1998 (-0.5%).
Two Indian veteran infectious diseases experts — Jayaprakash Muliyal and T Jacob John, who were at the forefront of the leprosy eradication and pulse polio immunisation programmes, respectively — feel it’s time to end the lockdown, with one of them describing a long-term shutdown as akin to ‘burning the house to kill a rat’.
Indeed lockdowns should be granular, targeted at identified hot spots of infection. A glaring deficiency of government’s pandemic response is the proactive mass testing and contact tracing.
According to Emily Martin, Associate Professor on Epidemiology University of Michigan: “The purpose of surveillance tests is to monitor the current state of the epidemic. It doesn’t mean that everybody gets tested. Instead, surveillance means that we test the right samples of the population in a way that allows us to make inferences as efficiently as possible. It doesn’t mean that we test everybody because it’s important that we strike this balance between getting the information we need and saving enough tests for clinical care.”
Free mass testing to determine the extent of the epidemic is crucial in the fight against the unseen Covid19 virus. Detection, containment and treatment of Covid19 cases should be surgical, in order to lessen the economic impact of the pandemic. At present, the government has privatized the conduct of tests, which benefits private laboratory firms as the cost of RT-PCR test ranges from Php 2,500 – 5,000, way beyond the reach of ordinary Filipinos.
Related to this problem is the limited capacity in contact tracing. Contact tracing is integral in any epidemic response. However, the current capacity is only 1:3, way below the DOH target of 1:37. No wonder the current surge of infection of the Covid19 Delta variant has not been anticipated nor contained by the government.
There is a glaring lack of capacity in identifying Covid19 variants in the country. At present there is only one genome sequencing laboratory capable of identifying Covid19 variants, the Philippine Genome Center. It lags behind the need to promptly monitor these variants. There should be at least one laboratory per region to aid in the epidemiological surveillance.
The country’s health care infrastructure is overwhelmed by the continuing spread of the pandemic. Before the pandemic, our health care system is fundamentally flawed and inadequate. According to the WHO the recommended ratio of medical doctors to population is 1:1,000. World Bank data in 2017 reveals that we only have 0.6 physicians:1,000 population. From the same source, our nurses to population ratio is 4.6:1,000 while the WHO recommended ratio is 4:1,000.
It is obvious that we lack doctors, but why do we lack nurses in the hospitals if we have a surplus of them in the country? The logical explanation is that they go abroad for greener pastures because they don’t receive decent salaries and benefits compared to Duterte’s favorites – the soldiers and policemen.
In a 1990 study of the UP National Health Institute, 6 out of 10 Filipinos die without seeing a doctor. Commercialization is rife in the health sector. There are five private hospitals for every public tertiary hospital. Half (50%) of the barangays in the country do not have a Barangay Health Station (BHS), even though the Local Governments Code mandate the establishment of BHS in every barangay.
Giving sufficient aid to those affected by militarized lockdowns is necessary. It is cruel for the government not to extend sufficient aid to those affected by restrictions.
The proliferation of “community pantries” nationwide attest to the lack of support of the government to affected communities by lockdowns.
Antigen and RT-PCR tests should be free and shouldered by the government in the national agencies and LGUs, and private enterprises at the factory or shop level.
The system of the House of Representatives (HOR) is a good example. No one can enter without first undergoing free antigen test every week. If found positive, one has to take an RT-PCR test paid for by health insurance of employees. This could be done by other government offices, and private enterprises too to ensure a safe workplace for employees. Moreover, this system may be put in place in schools for the gradual return to face-to-face classes, starting in areas with zero to negligible incidence of Covid19 infection. Tests in schools should be shouldered by the government. Education of our youth is a major victim of the government’s generalized lockdowns.
The majority of poor Filipinos who rely on their daily earnings for subsistence are forced to be dishonest during contract tracing activities and shun away from testing because they are afraid to be quarantined lest they go hungry. Contact tracing and testing hesitancy is rife in poor communities.
Duterte boasts that the government can stop the pandemic with vaccines, touted as the silver bullet against the virus. Indeed, vaccines are effective in the prevention and breaking the chain of contagion if herd immunity is achieved. Though having been vaccinated is not a fail-safe guarantee from infection (breakthrough infection), data shows that almost all of the breakthrough infections incur mild illness.
Due to the incompetence of the so-called vaccine Czar and his cohorts, we lagged behind in the competition to secure sufficient vaccines from global suppliers. The first vaccines that arrived in came from the WHO COVAX facility donation. Limited supplies bought by the government is slowly arriving in trickles. “Pasang awa” is the apt description of the government vaccine roll out. With the slow pace of vaccine roll out, by the time 70% of Filipinos are vaccinated, the durability of the effect of the first ones vaccinated has already lapsed- resulting in a vicious cycle of unending vulnerability to the virus.
Vaccine hesitancy is a minor problem, the crucial problem is lack of vaccine supply because the incompetence of the government.
Does the government have sufficient funds for the aforementioned necessary pandemic interventions?
Yes! If only the government “puts its money where its mouth is”. From a budget allocation of 153.58B in 2020, DOH share in 2021 decreased by 14.2% to only 131.7B. In particular, the epidemiology and surveillance allocation also decreased, from 11.55B in 2020 to 11.26B only in 2021. On the contrary, the NTF-ELCAC (National Task Force to End Local Communist Armed Conflict) allocation increased severalfold, from only 1.08B in 2020 it increased to 19B in 2021.
In its remaining months in office, President Rodrigo Duterte’s administration asked Congress a P28.1 billion budget to fund its anti-insurgency machinery, the NTF-ELCAC in 2022.
Senators questioned Malacañang’s plan to allocate P28 billion to the NTF-ELCAC in 2022 even as it slashed the Research Institute for Tropical Medicine’s proposed laboratory services budget by P170 million.
The 2022 national budget should reflect the national priority of decisively breaking the chain of Covid19 in the coming year. Control of the pandemic is crucial in the national recovery.#