No quick fix

"Fighting smart against the virus simply means better execution."

As new cases engulf even hitherto pristine countries like Vietnam or Japan, and as our country slogs on through what is now the world’s longest lockdown, it’s sinking in among our people that we’re in for a long, long war against the virus. I personally don’t expect a vaccine to be available through this year-end into early next year. There won’t be the kind of quick fixes that Filipinos just love.

In this protracted battle, the only way to win is to hunker down and start fighting smart. This simply means better execution. And that includes embracing instead of dismissing appeals from healthcare professionals for more inclusion; immediately getting rid of officials “with just a whiff of corruption” in, of all places, our health financing system; and regularly communicating the science behind the lockdown, as well as our infrequent victories, to a citizenry that enjoys no livelihood, no mobility, and no light at the tunnel’s end.

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Amid all the gloom, it’ll be good to be reminded of the occasional bright spots. The Department of Health recently released a statement showing that the Philippines has in fact done well in some key areas, compared say to Indonesia with whom we’ve been unflatteringly compared.

In terms of testing capacity, we’re now ahead of everybody else in Southeast Asia, with 99 testing labs as of August 4 doing an average of 28,938 tests a day. This works out to 1.5 percent of our population, ahead of Indonesia’s 0.34 pct. More tests helps explain why new infections kept rising, although once we exceed 30,000, we do have a right to expect the curve to start to flatten.

Just as important, our death rate is 1.8 percent of total caseload, well below Indonesia at 4.7 percent or the global average of 3.7 percent. Most of the credit for this should go to our healthcare workers and institutions, who’ve clearly proven that they deserve the bigger seat they’ve been given at the IATF table.

Looking forward, DOH singles out as a major shift in direction a renewed focus on localized, community-centered responses to support local government units. As we’ll discuss later, though, the jury is still out on this work in progress.

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For its part, the entire IATF just released its performance summary to date. Comparing the 1st quarter (March/April) with the 3rd quarter (July/August), significant increases were posted in the number of:

• Contact tracers, from under 5,000 to 84,000

• Isolation facilities (“LIGTAS Covid”), from 2,700 to nearly 10,000

• PPE sets, from 1 million to 3.5 million

• PCR test kits, from 90,000 to 9 million

The IATF also released its entire national action plan carrying over into next year. As intimated by DOH, a major focus is carrying the fight to the grassroots. Communities are to be zoned according to severity of infection risk: critical (where cases were identified in the past week) and, radiating outward, containment, buffer, and areas outside buffer zones.

Within this zoning scheme, lockdowns are to be conducted more granularly than today’s “everybody suffers” approach. They may be imposed per barangay, per block, per block and house, per street, per house, and/or per building. Needless to say, this kind of granularity calls for highly developed data collection methods—perhaps cellphone-based—as well as a high level of competence among our barangay officials that is probably still just aspirational today.

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In the end, execution is everything, so it’s helpful to know who’re leading this charge. The first among four “czars” is the tracing czar, Baguio city mayor Benjamin Magalong, who said that he wants to improve the current tracing ratio from only four or five contacts per potential infectious case, to at least thirty per infectious. This is the most difficult job, the one where we are most backward. Unfortunately the action plan is silent about how to improve the performance of local officials, without which Magalong will simply not succeed.

The isolation czar is DPWH Secretary Mark Villar, which tells us that the perceived solution is to just build or convert more isolation centers. But what about enforcing home quarantine—again through local officials—which eases the infrastructure pressure and casts the widest possible net even among asymptomatic cases? Again the action plan is silent on this.

The treatment czar is Health Undersecretary Leopoldo Vega. With the healthcare system now reaching capacity, in terms of both physical assets and health workers, we trust that Vega will reach out more aggressively to the private sector. That will include giving private hospitals more financial and operating space, such as the suggestion from Medical City chairman Eckie Gonzales to allow balance billing to PhilHealth in order to add working capital.

The testing czar, BCDA president Vince Dizon, is doing OK with nearly 30,000 tests per day. But a key challenge for him is to go beyond clinical testing for workplace decisions about individuals, and push widespread mass testing to make public health decisions. I used to think that rapid antibody/antigen tests were useless. Now I can concede that if they’re cheap enough, easily or self administered, and frequently repeated, they too have a place in the testing technology mix.

Readers can write me at [email protected]

Topics: Gary Olivar , No quick fix , Department of Health , DOH , COVID-19 , DPWH Secretary Mark Villar
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