"Without aggressive testing-isolation, the epidemic will come back even with maintained social distancing."
"Without aggressive testing-isolation, the epidemic will come back even with maintained social distancing."
A big online forum was held last Friday, attended by over 120 invited stakeholders who were given the opportunity to hear experts from the health, academe, government and private sectors sharing insightful views on overcoming the complex challenges of this global pandemic sparked by the virus from Wuhan, China.
The virtual round table discussion (vRTD) that was hosted by the Stratbase ADR Institute. Its theme was “The Philippine Health Care System: Emergent and Pressing Issues, Approaches and Perspectives Amid the COVID-19 Crisis.” It was the first in a series of forums in using the digital platform.
Prof. Dindo Manhit, President of Stratbase ADR Institute, opened the discussion by reiterating his call for a whole-of-society approach. He acknowledged the outpour of donations and support from businesses, organizations, foreign governments, and private individuals.
“What we need are courageous and thinking leaders who will set aside ambitions and hidden agendas for the sake of the Filipino constituents; leaders who are ready to take a stand and provide solutions in the face of a global health crisis,” Manhit said.
Prof. Ronald Mendoza, PhD, Dean of the Ateneo School of Government cited valuable lessons from Asian neighbor countries who have been most effective in dealing with the pandemic.
Vietnam implemented a low-cost strategy of communications through technology platforms and systemic tracing, strong trust of citizens in sharing personal health information, and transparency by sharing information about the virus online. This proved successful despite its proximity to China.
Taiwan’s early intervention with its flexible command structure, comprehensive epidemic prevention strategy, integrated medical data, and proactive information disclosure combined with its experience with SARS outbreak in 2003 and having the world’s best health insurance with nearly 100-percent coverage worked well in protecting its inhabitants.
South Korea, also learning from MERS infection in 2015, mobilized resources for massive and systematic Trace, Test and Treat measures with no lockdowns, or local and international transportation bans but had strong public support on social distancing.
Mendoza stressed the need to focus on the health sector and that health systems must also recover together with the economy underpinned by test, trace and treat capabilities designed to prevent a relapse of the contagion. Investing in the Philippine healthcare system will also offer growth opportunities as a driver of economic growth. The importance of a health ecosystem wherein inclusive healthcare and social protection systems, more effective crisis response rather than draconian policies and social cohesion and trust in the state are the key ingredients of resilience.
Dr. Sherwin Ona, Senior Researcher of the Jesse Robredo Institute of Governance and Chairperson of the Department of Political Science of the De La Salle University, espoused the need to shift from a highly “securitized” to “desecuritizing” of the current situation. The first bucket is a reexamination of national security policies such as classifying pandemics as a non-traditional threat, making the manufacturing of medical supplies and equipment as a strategic industry, and reviewing of modernization programs of the AFP, PNP and PCG. The second bucket focuses on building strong communities and agile institutions by reviewing possible amendments to the Disaster Risk Reduction Management and Disease Surveillance laws, expanding the Research Institute for Tropical Medicine and establishing the Philippine Center for Disease Control and Prevention, pursuing digital transformation through Ease of Doing Business and National ID Laws, and promoting research and development. The last bucket calls for the forging of international cooperation particularly with the ASEAN for humanitarian assistance and disaster relief to pandemics and participation in WHO initiatives related to COVID 19.
Dr. Eduardo “Dodo” Banzon, Principal Health Specialist of the Asian Development Bank, champions moving towards Universal Healthcare wherein all people are covered with population and personal health services, primary care accessed thru local-wide health systems. To achieve this, government needs to harness the private sector, institute financial protection measures, and shift from silos to a whole-of-government and whole-of-society strategy.
Dr. Banzon compared 12 scenarios on phased shifts from ECQ to GCQ and new normal conditions wherein there will be sustained social distancing, restrictions on risks for some sectors, reduced proximity, work-from-home arrangements, face masks required in crowded areas, prohibition of mass gatherings, and protection for vulnerable individuals (elderly and persons with pre-existing health conditions). All who are sick must stay home. Levels of tracing, testing and isolation must be expanded and there will still be varying degrees of school closures.
He clarified that results show that going back to business as usual after the lockdown just delays the peak by five months. Without aggressive testing-isolation, the epidemic will come back even with maintained social distancing.
“ECQ/GCQ contribution is to buy time to prepare for ‘new normal.’ The fundamental feature of the new normal is the ability to conduct aggressive tracing and testing and isolate. The largest gains in terms of benefit-cost ratios come from ability to test and trace. There should be a mechanism to ensure that symptomatic persons must stay at home (e.g., explore paid sick leave for daily wage earners). There must be massive investment in tracing, testing and isolation capacity. Daily test should peak to over 75,000 per day by December, contact tracing of over 50,000 individuals, isolation facilities, and the ability to return nearly all test results in less than 2 days,” Banzon said.
Other stakeholders from the government, pharmaceutical industry, patient groups, civil society, and information technology companies complemented the presentations with a wealth of constructive recommendations relevant to the distinct concerns of their sector which I shall feature in succeeding columns.
In closing, Prof. Manhit said, “As we enter the new normal, we need to sustain government-business coordination to win the war against COVID-19. The challenge therefore is to strengthen the policy framework and conduciveness of the environment to expand and deepen a dynamic public-private sector collaboration. By working together and enabling the private sector to flex its potential, we can heal faster.”