Philippines poorly prepared to deal with

COVID-19, report says

Despite an early coronavirus disease (COVID-19) response against the severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2), the Philippines continues to grapple with skyrocketing cases,
which have reached over 1.3 million total cases as of June 15, 2021.

Researchers at the College of Medicine at the University of the Philippines Manila, along with
collaborators at the School of Medicine and Public Health at the Ateneo de Manila University,
described the challenges and early response of the Philippines to COVID-19. To this end, the
researchers focused on travel restrictions, community interventions, risk communication, and testing
between January 30, 2020, which was when the first case in the country was reported, and March
21, 2020.

In this peer-reviewed study, which was published in the World Health Organization (WHO)’s Western
Pacific Surveillance and Response Journal (WPSAR), the authors discuss the surveillance of and
response to public health events in the Western Pacific Region. Ultimately, the researchers
concluded that the Philippines’s initial response to the COVID-19 pandemic lacked organizational
preparedness.
 Public health emergencies in the Philippines
As a developing country, the Philippines experienced some improvements in its healthcare system
over the past decade. Despite this, the country continues to face various challenges in its response
to public health emergencies.

It is estimated that the Philippines has about 10 hospital beds and six doctors per 10,000 people
which, taken together, amounts to only 2,335 critical beds nationwide. Mainly, the available
healthcare resources are focused in urban areas, while rural areas experience a lack of available
physicians. Within these rural areas, only one physician is available for a population of 20,000
people, with only one bed available for a population of 1,000.

Although community health centers and local healthcare workers comprise the primary care system
in the nation, they are often poorly resourced with limited surge capacity. Furthermore, while local
government has disaster preparedness plans, these plans are designed for natural calamities, which
the country often experiences, rather than for disease outbreaks.

Travel restrictions
The first COVID-19 case in the Philippines was reported on January 30, 2020. By March, the cases
rose significantly, which prompted the government to put the northern part of the country, Luzon, in
an enhanced community quarantine (ECQ) or lockdown by March 15.

The Philippine government implemented travel restrictions as early as January 28, 2020. While this
prevented the spread of the virus, travelers from areas that were not included on the list of restricted
countries were not subject to stringent screening and quarantine protocols. Meanwhile, those from
restricted countries were subjected to a 14-day quarantine, testing, and contact tracing.

In the first few weeks after these restrictions were put in place, the COVID-19 spread was delayed.
However, as time passed, COVID-19 cases began to rise due to viral transmission within
communities, particularly from people who had no prior travel history.

Community interventions
Related Stories

 SARS-CoV-2 infection and severity are strongly associated with nasal microbiota
 Structure of monoclonal antibody that can potently neutralize SARS-CoV-2 and variants of concern
 Comparison of Pfizer, Moderna, J&J, AZ vaccines for neutralization titer, against Delta and other
variants

When the lockdown or ECQ was implemented in Luzon, which included Metro Manila, families were
placed on strict home quarantine. This quarantine consisted of strict home quarantine in all
households, with the exception of when individuals needed to acquire essential food and health
services.  

Additional measurements that were implemented during this time included work-from-home
schemes, suspension of classes and distance learning instruction, closure of public transport and
non-essential business establishments, as well as physical distancing and the prohibition of public
gatherings.

These measures successfully slowed the spread of the virus; however, it was difficult for the
government to enforce these restrictions for extended periods of time because of their severe
economic impacts.

Though the lockdown order was just for Luzon Island, health systems were not overwhelmed. In fact,
the quarantine regulations gave the Philippines the opportunity to mobilize resources and organize its
pandemic response.

Risk communication
During the lockdown, the Philippine government ensured that all plans and information about the
COVID-19 pandemic would be distributed to all residents and citizens. The government also
strengthened its national risk communication plans through press briefings, internet advertisements,
health-related television advertisements, and infographics on social media.

Despite these efforts, misinformation and conspiracy theories about COVID-19 emerged in the
Philippines.

Testing
Many countries that were successful in containing the COVID-19 pandemic implemented widespread
testing. While testing is key to controlling the pandemic, the Philippines only performed COVID-19
testing on a small scale. More specifically, the authors of the current paper found that by March 19,
2020, fewer than 1,200 people in this nation had been tested for COVID-19, with the Research
Institute for Tropical Medicine in Metro Manila being the only institution that was capable of
 performing these tests. Due to the limited capacity of the healthcare system to conduct mass testing,
the Department of Health (DOH) recommended rationed testing, wherein strict protocols were
implemented.

Study takeaways
The authors of the current study concluded that the Philippines was not ready for a pandemic. The
disease surveillance system could conduct contact tracing and, for several months at the beginning
of the pandemic, only one laboratory was available for COVID-19 testing. Furthermore, the primary
healthcare system did not serve as a primary line of defense, which led infected people to flock to
hospitals in cities, thus overwhelming the healthcare system and critical care capacity.

“The lack of pandemic preparedness had left the country poorly defended against the new virus and
its devastating effects. Investing diligently and consistently in pandemic prepared.”

Taken together, the researchers noted that the lack of pandemic preparedness had left the
Philippines poorly protected from the effects of SARS-CoV-2. The pandemic, therefore, taught the
Philippines, as well as many other nations around the world, that increasing its investment in the
modernization of hospitals and clinics is crucial for protecting its citizens against disease outbreaks in
the future. This investment should also be accompanied by the development of adequate
surveillance, testing, and contact tracing services.

Journal reference:

 Amit, A.M., Pepito, V.C., and Dayrit, Manuel. (2021). Early response to COVID-19 in the
Philippines. World Health Organization (WHO)’s Western Pacific Surveillance and Response Journal
(WPSAR) 12(2). doi:10.5365/wpsar.2020.11.014. https://ojs.wpro.who.int/ojs/index.php/wpsar/
article/view/725.