"There is no mission impossible when people work together to make the right things happen."
"There is no mission impossible when people work together to make the right things happen."
A few weeks ago, the Department of Health and the IATF National Task Force convened the Task Force T3, which stands for test, trace and treat, in an effort to expand the government’s testing capability for COVID-19 to at least 30,000 tests per day by May 30, 2020. Early on the COVID-19 pandemic, there were already calls to accelerate massive testing. Sadly, the seeming dearth in resources has diverted much of the attention on the clinical management of those already infected with the coronavirus disease, and on efforts to “flatten the curve” to overwhelming the already limited capacity of our hospital system.
But for the authorities and policymakers to determine a calibrated public health response, having an accurate and updated baseline data is of critical importance. Unless we can identify and confirm how individuals many are actually infected with the disease, it would be difficult to craft and implement an effective and sustained strategy in preventing the spread of COVID-19. In fact, a COVID-19 response strategy without massive testing would be like going to fight blindfolded.
This was exactly the reason why as early as the second week of March, Tingog Party-List began exploring the need to establish a COVID-19 testing center that will cater to suspected COVID-19 cases in Eastern Visayas. At that time, not much attention was given to COVID-19 testing. There was even an impression at that time that the Department of Health was limited to the designation of the Research Institute for Tropical Medicine as the primary testing center and the establishment of only three subnational laboratories in Baguio, Cebu and Davao.
Eastern Visayas had every reason to worry. With its population of more than four million, it has a limited hospital capacity of fewer than two thousand beds and worse, fewer than a hundred ICU units and fewer than ten ventilators. God forbid, an outbreak could easily overwhelmed our hospital system in the region.
Fortunately, the local chapter of the Philippine Association of Medical Technologists shared Tingog Party-List’s concern about the need for our own testing center in Tacloban City. Although by then, DOH has not yet issued the guidelines for the accreditation of COVID-19 testing centers, PAMET and Tingog partnered with the local DOH regional office to form a technical working group that will plan and spearhead the establishment of a COVID-19 testing center for Eastern Visayas.
Admittedly at first, it seemed to be quite an ambitious plan. A COVID-19 test center required a biosafety level III molecular laboratory – there was none in Tacloban. Even local hospitals were not too confident about the feasibility of having one in the region – considering the huge financial and manpower requirement, not only in starting but more so in operating one. But given the exigency, the technical working group was left with only one choice – to do whatever it takes to start a biosafety level III molecular laboratory from scratch. With the lives and health of the people at stake, the tall order was to make it happen.
Rolling their sleeves, the technical working group began to work on setting up the laboratory. PAMET and EVRMC focused on finalizing the laboratory’s standard protocols and operating procedures. The regional DOH coordinated with RITM and DOH central office on complying with the accreditation process and loaned laboratory equipment from other facilities to complete the requirements. Tingog Party-List, on the other hand, took charge of retrofitting and renovating the laboratory facility, which for years was left unused ever since the hospital was relocated to the northern area of Tacloban.
The restrictions due to the community quarantine in effect in Tacloban posed a lot of challenges. With most of the hardware stores closed, it was difficult to source out construction supplies. Trainings had to be done with social distancing, and many of the medical technologists and laboratory staff had to deal with the limited transport available when going to meetings and trainings. But with a lot of determination and a little ingenuity, the technical working group was able to overcome all these challenges.
The biggest hurdle to the project was procuring a reverse transcription polymerase chain reaction (RT-PCR) machine for the laboratory. The group initially thought of loaning the machine from a nearby university, but there were compatibility issues. When Leyte First District Rep. Ferdinand Martin G. Romualdez learned about the predicament, he and his wife Tingog Party-List Rep. Yedda Marie K. Romualdez readily purchased the P2.7-million worth machine out of their personal funds. This is such a generous gesture in a time of need will surely never be forgotten.
The preparation of the COVID-19 test center was in full swing when DOH finally released the accreditation guidelines for COVID-19 test centers. The TWG had to take a step back to align itself with then new guidelines, but with everything almost in place, it was immediately assessed to be on Stage III as soon as the guidelines came to effect. After the on-site assessment conducted by the composite team from DOH, RITM and the World Health Organization, the final proficiency training of the laboratory staff followed. In less than two weeks, the proposed test center successfully completed Stage IV of the accreditation process.
The final requirements were submitted morning of May 8, and the TWG was hoping to receive the results of the proficiency assessment. However, they were surprised to learn that DOH has already announced the accreditation of the Eastern Visayas Regional COVID-19 Test Center and has certified that the test center was now ready to conduct independent COVID-19 RT PCR detection tests.
The Eastern Visayas Regional COVID-19 Testing Center has significantly increased the region’s capability to address COVID-19. Massive testing of suspected cases can now be done more effectively. With the right and accurate baseline information, our government and health authorities are now more capable of preventing the further spread of COVID-19 and of carrying out a more calibrated and responsive public health care strategy for the region.
Credit is due to everyone who worked together to help realize this project – Majority Leader Rep. Ferdinand Martin Romualdez and Tingog Party-List Rep. Yedda Marie Romualdez, DOH Eastern Visayas led by regional director Dr. Minerva Molon, TWG chair Dr. Exu Sabalbarino and overall coordinator Lila Ballila; PAMET represented by Clive Ivan Mercado and Carlo Chris Apurillo; Tingog Party-List chair Mark Gimenez, president Glenn Capucion and secretary-general Rachel Rodeles-Santiago; EVRMC pathology unit led by Dr. Kae Parilla and the laboratory staff; the City Government of Tacloban under Mayor Alfred Romualdez and city health officer Dr. Gloria Fabrigas. Special thanks to our partners Health Secretary Francisco Duque, the Research Institute for Tropical Medicine, OPAV Secretary Mike Dino, the Office of Civil Defense, the Philippine Air Force, the Philippine Coast Guard, RTR Hospital, St. Scholastica’s College, Manila Realtek, DPWH Eastern Visayas Regional Office, Tacloban Host Lions Club, Dr. Raul Destura of UP Institute of Health and Dr. Aileen Riel-Espina of the Philippine Academy of Family Physicians.
From the very start, it was clear to us that we cannot win this fight against this invisible enemy without knowing who is infected – that is why the objective has always been to test, test, test. As the Eastern Visayas Regional COVID-19 Test Center starts operation on May 11, it is now possible to ramp up testing, trace, isolate and treat those infected, and to save many more lives in the region.
If there is any lesson learned from the successful realization of the project is that there is no mission impossible when people work together to make the right things happen. This is not a time to point fingers and assign blame, nor it is the moment to be complacent and to wait for others to do the task already in front of us. We must be ready to help ourselves and the only way out and moving forward is to lock our arms and pull each other out of the danger zone. Once more, this experience reaffirms that to fully control and defeat this pandemic, cooperation and solidarity is absolutely essential.
