Public Health at The Time of COVID-19

Public Health and Safety at the Time of COVID-19
The coronavirus disease 2019, or COVID-19, pandemic is, by far, the worst
public health crisis of the 21st century. The disease is caused by the severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first identified in
Wuhan, China in December 2019. Attempts to contain the virus from its
geographic origin failed and the World Health Organization declared it a
Public Health Emergency of International Concern (PHEIC) on January 30,
2020 and a pandemic less than two months later on March 11, 2022.
The COVID-19 virus spreads between people through close contact and via
aerosols and respiratory droplets. These droplets are transmitted when
talking, breathing or exhaling, coughing, and sneezing. The virus also tends
to spread faster in three Cs, namely crowded places, close-contact settings,
and confined and enclosed spaces with poor ventilation. Two of the most
common diagnostic tests for COVID-19 include molecular test and antigen
test. Molecular tests such as polymerase chain reaction (PCR) test, nucleic
acid amplification test (NAATs), and other molecular amplification tests
detect the genetic material from the virus and diagnose active infections.
These tests require a nasal swab, oral or throat swab, or saliva sample.
Antibody tests or sometimes called rapid tests, which detect immune
response after exposure, search for specific proteins on the surface of the
virus. Antigen tests, which are typically done using a nasal swab, are called
rapid tests because they produce results more quickly than molecular tests.
COVID-19 affects infected people in different ways, although most develop

mild to moderate illness and recover without the need for hospitalization.
The most commonly reported symptoms include fever, cough, tiredness, and
loss of taste (ageusia) or smell (anosmia). Less common symptoms include
sore throat, headache, body aches and pains, diarrhea, skin rashes,
discoloration of fingers and toes, and red or irritated eyes. Antiviral
treatments and monoclonal antibodies are administered to patients who get
very sick. Antiviral treatments, such as the oral antiviral pills Paxlovid™
(Pfizer) and Lagevrio (Merck), target specific parts of the virus to stop it from
multiplying in the infected body, thus preventing severe illness and death.
Monoclonal antibodies (mAb), such as the recombitant neutralizing human
mAb Bebtelovimab, help the infected person’s immune defense by
recognizing and responding more effectively to the virus. The United States
Food and Drug Administration have given emergency use authorizations
(EUA) to the aforementioned treatments.
The race for vaccine development was one of the most anticipated
breakthroughs at the height of the COVID-19 pandemic. The most currently
available COVID-19 vaccines in the Philippines are as follows:
1. Pfizer BioNTech COMIRNATY Manufactured by Pfizer, Inc., and BioNTech,

it is a messenger RNA (mRNA) vaccine, which injects snippets of the
virus’s generic material, called an mRNA, into human cells. This mRNA
teaches the cells to produce a protein that will trigger an immune
response inside the body. It has been given an EUA by the Philippine
Food and Drug Administration (FDA) on January 14, 2021 and an
expanded EUA on May 31, 2021, to include children aged 12-15 years
old.
2. Oxford-AstraZeneca COVID-19 vaccine Developed in the United

Kingdom and British-Swedish company AstraZeneca, it is a non-
replicating viral vector vaccine, which injects a harmless adenovirus to
deliver genetic information to human cells. The cells then follow the
information to build an immune response to COVID-19. The Philippine
FDA issued an EUA to this vaccine on January 28, 2021.
3. CoronaVac or Sinovac COVID-19 vaccine Developed by the Chinese

company Sinovac Botech, it is a whole inactivated virus COVID-19
vaccine, which uses a more traditional technology of injecting virus
particles that have been grown in culture and then killed to destroy
disease-producing capacity. It received an EUA from the Philippine FDA
on February 22, 2021.
4. Sputnik V (or Gam-COVID-Vac) – Developed by the Gamaleya Research

Institute of Epidemiology and Microbiology in Russia, it is also an
adenovirus-based viral vector vaccine against COVID-19. The Philippine
FDA issues an EUA of the vaccine on March 19, 2021 and an amended
information on the second dose interval on July 8, 2021.
5. Janssen COVID-19 vaccine or Johnson and Johnson COVID-19 vaccine

Developed by Janssen Vaccines in Leiden Netherlands and its Belgian
parent company Janssen Pharmaceuticals, it is a one-dose regimen
adenovirus-based viral vector vaccine. It received its EUA from the
Philippine FDA on April 19, 2021.
6. Covaxin or BBV152 – Developed by the Bharat Biotech in collaboration

with the Indian Council of Medical Research (ICMR)-National Institute of
Virology, it is the first indigenous COVID-19 vaccine in India. It is also a
whole inactivated virus-based COVID-19 vaccine
It received its conditional EUA from the Philippine FDA on April 18, 2021 and
an amended EUA on May 28, 2021.
7. Moderna (Spikevax) COVID-19 vaccine – Manufactured by ModernaTX, Inc.,

it is also a messenger RNA (mRNA) vaccine. It has been given an EUA by the
Philippine FDA on May 5, 2021.
8. Sinopharm BIBP COVID-10 vaccine Developed by the Sinopharm’s Beihing

Institute of Biological Products, it is one of two whole inactivated virus-based
COVID-19 vaccines. It has an EUA issued by the Philippine FDA on June 7,
2021.
The immediate worldwide response was intended to slow down the spread of
the virus. Efforts to understand the nature and behavior of the virulent
pathogen, educate people of health standards, and develop treatments and
vaccines can be understood from the lens of the Epidemiologic Triangle (ET).
ET is a model that scientists developed to understand the spread, mitigation,
and treatment of infectious diseases.
The Epidemiologic Triangle has three vertices, representing the three

elements of an infectious disease outbreak. The first vertex is the agent or
the “what” of the outbreak. It is what causes the disease. In the case of
COVID-19, it is SARS-CoV-2. The second vertex represents the host or the
“who” of the outbreak, usually humans or animals, which are exposed to or
harbor the disease. In this case, the hosts are humans, although we learned
from the previous section that the virus may have been transferred to
humans through zoonosis from bats and some intermediate animal (host).
The third and final vertex is the environment or the “where” of the outbreak,
which causes or allows disease transmission. In the case of COVID-19, the
environment includes the micro and macro human systems and interactions
which make it possible for the virus to be transmitted.
Using the ET, the goal is to break at least one side of the triangle in order to
disrupt the connection between the agent, the host, and the environment.
Needless to say, the more vertices are broken, the better because that
means less disease or a greater likelihood to stop the continuation of the
disease. Concrete strategies have been put in place which can be related to
the idea of breaking the sides of the COVID-19 Epidemiologic Triangle. To
break the agent’s vertex, treatments were developed, for the host’s vertex,
vaccines and vaccination were rolled out; and to break the environment’s
vertex, minimum health standards and protocols were required
While the world now enjoys the benefits of treatments and vaccines, which at
the onset people only hoped for, the drastic changes required to contain or
control the pandemic led to unprecedented impacts on people’s lives. In the
process, breaking the COVID-19 Epidemiologic Triangle meant required public
safety strategies, the breadth of which had never been experienced by this
generation. Especially at the onset, strategies such as staying home, using
contactless payments and contactless technologies, telemedicine, and
contact tracing using QR codes, were developed and imposed to slow down
the spread of the virus and mitigate its impacts. People were reminded to
observe physical distancing, wear a mask, keep rooms well ventilated, avoid
crowds, and wash hands properly, among other minimum public health
standards. Taking care of oneself and the community became a constant
reminder to everyone at the height of the pandemic and restrictions. Studies
show that increased physical and social distancing led to higher levels of
stress and other mental health risks. From a holistic health perspective,
people were reminded to maintain social connections and personal interests
and meaning through phone calls, video chats, picking up hobbies, finding
time to connect through social media, and other ways that could help them
cope with pandemic restrictions.

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Public Health and Safety at the Time of COVID-19

COVID-19 affects infected people in different ways, although most develop

1. Pfizer BioNTech COMIRNATY Manufactured by Pfizer, Inc., and BioNTech,

2. Oxford-AstraZeneca COVID-19 vaccine Developed in the United

3. CoronaVac or Sinovac COVID-19 vaccine Developed by the Chinese

4. Sputnik V (or Gam-COVID-Vac) – Developed by the Gamaleya Research

5. Janssen COVID-19 vaccine or Johnson and Johnson COVID-19 vaccine

6. Covaxin or BBV152 – Developed by the Bharat Biotech in collaboration

7. Moderna (Spikevax) COVID-19 vaccine – Manufactured by ModernaTX, Inc.,

8. Sinopharm BIBP COVID-10 vaccine Developed by the Sinopharm’s Beihing

The Epidemiologic Triangle has three vertices, representing the three

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