150 words essay about philippine covid 19 response

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The Philippines’ COVID-19 Response Has Left the Most Vulnerable Behind

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Far from being a “great leveler,” the pandemic is much more likely to impact socioeconomically disadvantaged communities.

A vaccination center established on a basketball court in Las Pinas, Metro Manila, Philippines, April 2021.

­­­­Since early 2020, health experts have emphasized the need to support fragile countries during the pandemic to prevent the further spread of COVID-19 across the world. In response, the G7 nations last year affirmed their commitment to provide “affordable and equitable access to vaccines, therapeutics and diagnostics” globally.

Despite this rhetoric, wealthy nations continue to put their needs and interests over those of lower income countries. They are hoarding vaccines from poorer countries (with some countries like the United States and Canada now offering their citizens third and fourth booster shots) and as a result, around 78 percent of the population in high and upper-middle income countries have received at least one dose of the COVID-19 vaccine in contrast to only 11 percent of people in low-income countries. Even the targets for COVAX , the global initiative to send vaccines to lower and middle-income countries, have been repeatedly cut back due to production issues, export bans, and vaccine hoarding by wealthy nations.

Consequences of Vaccine Inequity on the Philippines

The Philippines is one of the many countries dealing with the effects of vaccine inequity. Despite being one of the hardest hit countries in Southeast Asia in 2021, the Philippines has had to wait for vaccines from wealthy countries. The country now has over 3.5 million confirmed cases of COVID-19 and around 54,003 deaths. While its daily infection numbers had reduced significantly by the end of 2021, the rapidly spreading Omicron variant is concerning. The country’s vaccination rate remains relatively low, with only 52 percent of the population fully vaccinated, and recent evidence suggests that vaccines like AstraZeneca and Sinovac, used in low-income countries like the Philippines, provide less protection against Omicron than the mRNA vaccines produced by Pfizer and Moderna.

However, not all Filipinos have been impacted equally by vaccine inequity and the pandemic in general. In November 2021, 93 percent of residents in the capital region had been fully vaccinated in comparison to only 10.9 percent of people in the predominantly Muslim regions in southern Philippines. More broadly, research shows that the government has ignored the unique needs and vulnerabilities of marginalized groups in the Philippines such as the poor , Indigenous Peoples , and disabled people , which has affected their access to food and income, among other issues, throughout the pandemic.

Although the Philippine government is aware of the necessity of supporting vulnerable groups in order to curb the spread of the virus, it has repeatedly chosen to scapegoat and criminalize the poor who have to pursue their livelihood outside the home (due specifically to insufficient government assistance ) for “violating” lockdown measures. Just like wealthy countries’ attempts to “ boost [their] way out of the pandemic ,” the Philippine government’s solution to fighting the pandemic through criminalization is both unethical and ineffective at actually mitigating the spread of the virus.

Lack of Adequate Support for Typhoon Victims

Another group that has been heavily impacted by the COVID-19 pandemic in the Philippines are the over 75,000 residents of resettlement sites in Tacloban City, homes that were built for the hundreds of thousands of Typhoon Haiyan survivors. Our June 2021 study on the impact of COVID-19 on 357 households in these resettlement sites found that participants did not receive sufficient support from the government to get through the pandemic. Specifically, over a third of participants found the national government’s response to the pandemic to be somewhat inadequate or very inadequate and very few felt that any level of government could protect them from COVID-19 in their community.

Financial problems and lack of livelihoods were cited by participants as the most serious problems they were facing during the pandemic, both of which have been worsened by the government’s pandemic response. For example, though 91.6 percent of participants received financial assistance from the government, 47 percent said it was insufficient. Specifically, the participants, the majority of whom make 15,000 pesos (around $300) or less monthly on average, noted that they did not have sufficient financial resources to buy food, maintenance medicine, and other necessities.

Many participants also said that as a result of COVID-19, they had lost their livelihoods or made a lot less money from their work, as they mostly work in-person. One participant noted that without a livelihood, they could not “support [their] big family and… cope with daily living.” Other issues mentioned by participants include the inadequate amount and quality of food, the lack of running water at home, and the inability to participate fully in online learning (particularly due to poor internet connections).

These findings reinforce yet again that the pandemic is no “ great leveler .” In large part due to their financial and living conditions, socioeconomically disadvantaged communities are more likely to be affected by the pandemic. And by not addressing the specific needs of resettlement site residents, the Philippine government’s inadequate response has directly impacted their ability to meet their basic daily needs. As such, a group that was already vulnerable before the pandemic is now even more so, both financially and in terms of getting COVID-19.

How does the government solve this issue? In the above study, residents offered a variety of recommendations for how the government could better meet the challenges facing them, from providing more sustainable livelihood programs and offering sufficient financial assistance to the stricter implementation of COVID-19 health and safety protocols.

Ultimately, national and local governments in the Philippines must include marginalized groups when developing and executing their pandemic responses, specifically to understand their needs and the best ways to address them. This is necessary because, as a research study on community engagement found , “marginalized people living through the experience of COVID-19 have embodied knowledge, skills, and experience to inform equitable public policy.”

Wealthy nations must also support vulnerable nations by actually adhering to their commitments of sharing vaccine supplies as well as by sharing patents for vaccines so that countries in the Global South can produce them.

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COVID-19 Response in the Philippines

20 January 2022

The Philippines has been severely affected by COVID-19. According to latest WHO figures , as of 17 January 2022, the Philippines had recorded over 3 million confirmed cases of COVID-19 with over 52,700 deaths. Since March 2020, the country has taken strict measures to halt the spread of the virus, including lockdowns such as Enhanced Community Quarantines.

The impact of COVID-19 has especially been significant on TB and HIV. In 2020, the National TB Control Program recorded a marked decrease in TB testing as well as notification for TB and drug-resistant TB (DR-TB). In 2021, COVID-19 cases surged again as the Delta variant spread.

In 2021, through our COVID-19 Response Mechanism (C19RM), the Global Fund supported the Philippines with over US$37.7 million to fight COVID-19, including to expand COVID-19 testing capacities and support the COVID-19 case management strategy. In addition, interventions focus on COVID-19 mitigation measures for HIV, TB and malaria programs. This includes telemedicine, mobile clinics, bidirectional testing, digital tools to help patients adhere to their treatment, improving TB case finding and transportation networks to transport samples, supporting differentiated service delivery approach to providing HIV services, and integrating information campaigns for COVID-19 and malaria. The programs also support social protection interventions, community-based organization strengthening, addressing human rights barriers to health care and services, and HIV mitigation measures addressing community needs like mental health support and gender-based violence prevention. The Philippines was one of the first countries to develop a strong comprehensive TB adaptive plan to the impact of COVID-19.

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Supporting the Philippines’ COVID-19 Emergency Response

Beneficiaries

For Vilma Campos , a Quezon City resident and mother of five, life has improved since her family received their vaccinations. “My daughter has resumed working, so has my husband,” she said. “Life is no longer that difficult.”

Before COVID-19 hit, Vilma’s job was taking care of children. When the authorities started implementing quarantine restrictions, she, her daughter, and her spouse lost their jobs. Vilma said her family was always wondering where to get the next meal.  “What gave us hope was the arrival of vaccines,” she said. “Things have improved and I really wish we can all overcome this pandemic.”   

The Philippines was one of the countries hit hardest by COVID-19 in the East Asia and Pacific region. To manage the spread of the virus, authorities implemented strict quarantine restrictions and health protocols, restricted mobility of people as wells as the operational capacity of businesses. As a result, the Philippine economy suffered. In 2020, GDP contracted 9.5 percent, driven by significant declines in consumption and investment growth, and exacerbated by the sharp slowdown in exports, tourism, and remittances. Many Filipinos lost jobs and experienced food shortages and difficulties accessing health care. Due to global shortages, procurement of COVID-19 vaccines, medical supplies, personal protective equipment (PPE), reverse transcription polymerase chain reaction (RT-PCR) test machines, and test kits proved challenging in the early phases of the pandemic.

The project supported the country’s efforts to scale up vaccination across the national territory, strengthen the country’s health system, and overcome the impact of the pandemic especially on the poor and the most vulnerable. Besides vaccines, the project supported procurement of PPE, essential medical equipment such as mechanical ventilators, cardiac monitors, portable x-ray machines; laboratory equipment and test kits; and ambulances. The project also supported construction and refurbishment of negative pressure isolation rooms and quarantine facilities, as well as the expansion of the country’s laboratory capacity at the national and sub-national levels for prevention of and preparedness against emerging infectious diseases. It funded retrofitting of the national reference laboratory – the Research Institute for Tropical Medicine (RITM) – as well as six sub-national and public health laboratories in Baguio, Cebu, Davao, and Manila, and the construction and expansion of laboratory capacity in priority regions without such facilities.

During year1 to year 2, the following results were achieved:

• The project supported the procurement and deployment of 33 million doses of COVID-19 vaccine across the country. The project supported pediatric vaccination for 7.5 million children. With the support of development partners including the World Bank, Asian Development Bank, and Asian Infrastructure and Investment Bank, the Philippines administered more than 137 million vaccines (more than 126 million first and second doses, and more than 10 million booster doses) by March of 2022.
• The project helped scale up testing capacity from 1,000 RT-PCR tests per day to 24,979 per day.
• The project supported the procurement of 500 mechanical ventilators, 119 portable x-ray machines, 70 infusion pumps, 50 RT-PCR machines, and 68 ambulances.
• As a result of the strong vaccination rates and strengthened health response capacity, the Philippines is now much better able to manage the pandemic.

The Philippines COVID-19 Emergency Response Project supported the procurement and deployment of 33 million doses of COVID-19 vaccine across the country. The project also supported pediatric vaccination for 7.5 million Filipino children.

Bank Group Contribution

The World Bank through the International Bank for Reconstruction and Development (IBRD) provided $900 million of funding in total for the emergency response project. The project provided $100 million for medical and laboratory equipment and supplies; $500 million for primary vaccine doses, ancillaries, and end-to-end logistics; and $300 million for boosters and additional doses, and end-to-end logistics.

The World Bank collaborated with the Asian Development Bank (ADB) and the Asian Infrastructure and Investment Bank (AIIB) on project preparation and vaccines financing. The Bank worked with the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), and the United States Agency for International Development (USAID) on the Vaccine Introduction Readiness Tool (VIRAT) and Vaccine Readiness Assessment Tool (VRAF) Tool 2.0, which is used to assess status, gaps, and issues in four domains: planning and management, supply and distribution, program delivery, and supporting systems and infrastructure. Australia, through the AGaP Trust Fund, provided a US$300,000 grant to support implementation. The World Bank also collaborated with UNICEF to address vaccine hesitancy and with the WHO to procure RT-PCR machines and test kits.

Looking Ahead

The Philippine government is considering additional support for scaling up testing capacity. Equipment has been acquired and civil works commissioned through the project are now in use. An action plan is being developed for continued implementation of environmental and social safeguards employed in the project, such as COVID-19 waste management and assessment of accessibility of vulnerable groups to health care services. These will be institutionalized using the manuals developed and through directive issuances by the Department of Health. The project also supports the development of National Action Plan Towards Increased Accessibility of Health Care Facilities for Vulnerable Groups. The World Bank is also supporting the Department of Health and priority LGUs in strengthen local health systems for Universal Health Coverage.

Philippines Covid-19 Emergency Response Project

Philippines Covid-19 Emergency Response Project Additional Financing

Philippines COVID-19 Emergency Response Project – Additional Financing 2

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Department of Health Covid-19 Updates on Covid-19 Vaccines

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Analysing the Philippines' health and economic response to Covid-19

The Philippines | Economy

The Philippines reported its first Covid-19 case on January 30, 2020, and confirmed its first coronavirus-related fatality three days later. The country was officially placed under a state of calamity for a period of six months on March 17, mandating that national and local authorities mobilise the resources needed to respond to the health crisis. The state of calamity was extended for an additional 12 months in September, facilitating one of the world’s longest, most stringent lockdowns. In March and September of that year the government passed two wide-ranging stimulus packages aimed at helping to mitigate the economic impact of the crisis and aid in the health response.

Movement Restrictions

Covid-19-related restrictions varied, with the government designating each region or metropolitan area one of four quarantine phases, based on contagion figures and in consultation with health officials and local authorities. These labels were re-evaluated every two to four weeks, and local officials had the autonomy to tighten restrictions within their area. The entire island of Luzon – home to over half of the population – was placed under the most stringent grade of restrictions, enhanced community quarantine, on March 16. This remained in force until May 12 across some areas – including the National Capital Region, which accounts for more than one-third of GDP.

By early November 2020 total confirmed cases exceeded 380,000, with over 7000 fatalities. Within the ASEAN region, only Indonesia had officially reported higher case and fatality counts. The Philippines had, however, ramped up testing by this time, with the Department of Health reporting that the country had performed the highest number of tests in South-east Asia as of early August. A curfew remained in place in many areas throughout November and all of the country retained some degree of quarantine restrictions.

Relief Funding

Two weeks after the World Health Organisation officially declared the pandemic, in late March 2020 President Rodrigo Duterte signed the Bayanihan to Heal as One Act – known as Bayanihan 1 – into law. Among the measures included in the stimulus package were economic assistance for disadvantaged families and displaced workers; protocols for coordination between the central government and local government units; a mandate for the public health insurance provider to shoulder the treatment costs for any medical centre employees who contracted the coronavirus; and measures to limit the hoarding and profiteering of essential food, fuel and medical supplies.

Bayanihan 1 was followed by the Bayanihan to Recover as One Act, or Bayanihan 2. Signed into law on September 11, 2020 and valid through December 19 of that year, the P165.5bn ($3.3bn) package included almost P39.5bn ($785.6m) for loans targeting small businesses; P24bn ($477.3m) for the agriculture sector; and P13bn ($258.6m) to assist displaced workers. Bayanihan 2 also mandated the extension of grace periods and zero-interest staggered instalments for rental payments and utility bills incurred by residential occupants and micro-, small and medium-sized businesses during the two strictest lockdown phases.

Recovery Priorities

The administration reinforced the importance of its flagship Build, Build, Build infrastructure development programme throughout the pandemic period, both as a strategy to create jobs in the immediate term and as a means to accelerate economic growth into the future (see Transport & Infrastructure chapter). Meanwhile, efforts to strengthen the digital economy gained momentum, providing an opportunity to grow value added in key segments and broaden financial inclusion. Supplemented by ongoing support for vulnerable groups and targeted strategies that aim to enhance food security and health care, these developments are expected to create a more resilient economy. These shifts will not only help to drive the post-pandemic recovery, but also pave the way for ongoing economic expansion in the years to come.

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100 days of COVID-19 in the Philippines: How WHO has supported the Philippine response

9 May 2020 marked 100 days since the first confirmed COVID-19 case was announced in the Philippines. Here is how WHO has supported the Philippine response.

Last 9 May 2020, exactly 100 days had passed since the first confirmed COVID-19 case was announced in the Philippines on 30 January 2020, with a 38-year old female from Wuhan testing positive for the novel coronavirus. On the same day, on the other side of the world at the WHO headquarters in Geneva, WHO activated the highest level of alert by declaring COVID-19 as a public health emergency of international concern. The Philippine government mounted a multi-sectoral response to the COVID-19, through the Interagency Task Force (IATF) on Emerging Infectious Diseases chaired by the Department of Health (DOH). Through the National Action Plan (NAP) on COVID-19, the government aims to contain the spread of COVID-19 and mitigate its socioeconomic impacts. The Philippines implemented various actions including a community quarantine in Metro Manila which expanded to Luzon as well as other parts of the country; expanded its testing capacity from one national reference laboratory with the Research Institute of Tropical Medicine (RITM) to 23 licensed testing labs across the country; worked towards ensuring that its health care system can handle surge capacity, including for financing of services and management of cases needing isolation, quarantine and hospitalization; and addressed the social and economic impact to the community including by providing social amelioration to low income families. The World Health Organization (WHO) has been working with Ministries of Health worldwide to prepare and respond to COVID-19. In the Philippines, WHO country office in the Philippines and its partners have been working with the Department of Health and subnational authorities to respond to the pandemic. The country level response is done with support from the WHO regional office and headquarters.

Surveillance

Surveillance is a critical component and is used to detect cases of COVID-19 as well as to understand the disease dynamics and trends and identify hotspots of disease transmission. The Department of Health included COVID-19 in the list of nationally notifiable diseases early in the outbreak to ensure that information was being collected to guide appropriate response actions. Existing surveillance systems were capitalized upon to speed up identification of cases as well as identify unusual clusters. Laboratory confirmation is a critical component of the surveillance system but cannot be the only sources of information. The non-specific symptoms and the novel nature of the disease means that the DOH, with support from WHO, are looking at all available information sources to guide response decision making. WHO also provided technical assistance to selected local government units to strengthen field surveillance for timely data for action at the local level.

Contact tracing

Contact tracing is crucial to the response. It is a system to detect and isolate cases and identify close contacts who will be advised for quarantine. It allows the investigation the system to tracjk the chain of infections as well as the settings, places, events or other avenues that where transmission have occurred or may have been amplified. A major bottleneck to doing this is the availability of timely and complete information from the hospitals for suspected, probable and confirmed COVID-19 cases. WHO assisted the DOH Epidemiology Bureau in developing  COVID KAYA , a case and contact tracing reporting system for epidemiology and surveillance officers, health care providers and laboratory-based users, expanding the capacity of the previous COVID-19 information system. WHO also continued to support the government to establish the system and improve capacity for contact tracing at the city and municipal levels.

Infection prevention and control

Patients and health workers must be protected from the possible transmission of COVID-19 inside health facilities. Infection prevention and control (IPC) is vital in minimizing the harm caused by the spread of infection in these facilities. In the early part of the response, WHO supported the DOH with the provision of personal protective equipment (PPE) for health workers. To strengthen IPC, WHO and DOH developed modules and conducted online IPC training of trainers for frontline health workers in health care and community settings. The training has since been rolled out more widely by partners USAID-MTaPS and UNICEF to cover over 5,500 health workers to date.

Laboratory and therapeutics access

Laboratory testing for COVID-19 is critical to be able to rapidly identify, treat and isolate the positive patients, and be able to see the bigger picture of how many people are infected and ultimately stop the transmission of the virus. Since the beginning of the response, WHO provided support to the DOH’s Research Institute for Tropical Medicine with laboratory supplies and extraction kits. WHO also assisted the DOH in the accreditation of COVID-19 testing laboratories. To date, 23 real-time reverse transcription polymerase chain reaction (rRT-PCR) laboratories nationwide are now conducting COVID-19 diagnostic tests. The Philippines has also  recently joined the WHO Solidarity trial  to find effective COVID-19 treatment.

Clinical care

With a new disease, there are a lot of unknowns regarding the proper clinical management of suspect and confirmed cases. But when clinicians are armed with the necessary knowledge and skills to care for sick patients, the more the patients are likely to recover. WHO supported the frontline health workers through a webinar series on clinical management, providing up-to-date WHO clinical perspectives. At the same time, WHO also supported the DOH and the Department of Interior and Local Government in preparing policies to form health care provider networks for COVID-19, from primary care that includes telemedicine and community management, to tertiary care linking to referral hospitals.

Non-pharmaceutical interventions and mental health

Non-pharmaceutical interventions (NPIs) refer to public health measures, which are not related to medicines or vaccines, that people and communities can do to prevent the spread of infections like COVID-19. These interventions involve personal protective measures, environmental measures, physical distancing measures and travel-related measures. WHO supported the DOH in the development of a policy on NPIs as well as assisted in rapid assessment on local government capacity on NPIs and policy-gap analysis. In times of extreme experiences brought by COVID-19, it is likely that people feel fearful and anxious. Providing mental health and psychosocial support (MHPSS) during the time of COVID-19 pandemic is important. WHO assisted the DOH in developing policy guidance and advice on integrating MHPSS within health and social services and increasing access to care to these services.

Risk communication and community engagement

Effective communication and engagement with communities is essential for people to understand the situation, know the situation and practice protective measures to protect their health, their family and the larger community. WHO supported and amplified DOH messaging by releasing various communication materials on the risk of COVID-19 and how people can protect themselves through social media and traditional media. WHO also worked with partners such as UNICEF and OCHA in reaching vulnerable groups, getting their feedback and understanding their information needs.

Logistics support

With lots of moving equipment and supplies required for COVID-19, logistics support is an important part of the response. WHO provided technical support to the DOH in the recalibration of PPE requirements by using WHO projection tools, provided cost estimates, and advised on streamlining the distribution flow of PPEs and other essential supplies. WHO also supported DOH in the development of a commodities dashboard that provides real-time PPE stocks at the facility level, as well as assisted in building an information system for tracking essential COVID-19 commodities.

Subnational operations support

Aside from national support to the DOH, WHO is also providing subnational support in the Philippines by working with the DOH Field Implementation and Coordination Team (FICT) and the Centers for Health Development (CHDs) at the regional level. WHO conducted scoping missions in 10 out of 16 regions outside the National Capital Region to assess the needs and capacity of CHDs in responding to COVID-19. WHO staff have also been deployed in specific high-risk subnational areas in the country to provide technical support for the response. At the same time, contact tracing in subnational areas is also being strengthened with WHO, DOH Epidemiology Bureau, and UP College of Nursing developing a training programme and learning resource materials on contact tracing to build the capacity of epidemiology and surveillance officers and local contact tracing teams.

Responding to outbreaks in high risk areas

Closed settings like prisons and hospitals have seen clusters of confirmed cases. WHO, the DOH Epidemiology Bureau and the International Committee of the Red Cross (ICRC) worked with prison authorities and hospitals in joint contact tracing and infection prevention and control investigations. The teams provided them with guidance to prevent the further spread of infection to ensure the protection of persons deprived of liberty, hospital patients and people with mental health conditions.

WHO also supported the strengthening of community-based interventions and social support and addressing the needs of specific populations such as people with pre-existing mental and substance use disorders.

Moving forward with the response

Much more needs to be done to break the chain of COVID-19 transmission. Some of the challenges that the Philippines continues to face are containing transmission of infection, mitigating the impact in high risks communities and confined settings, as well as ensuring the uniform enforcement of non-pharmaceutical interventions that are already in place. The continuation of the community quarantine will have substantial social and economic impact and thus a heightened effort to control  transmission of infections through rigorous contact tracing, isolation of cases, quarantine of contacts while ensuring timely and adequate treatment to save lives will continue to be the primary public health measure. In addition, while the government is exerting all its efforts in this current situation, it also needs to prepare its health systems for surge capacity in the event that a wide-scale community transmission occurs.

In the next few days, the government will carefully consider the next steps, especially on deciding whether or not the communty quarantine will be lifted or levels of quarantine will be differentiated based on the situation of provinces. WHO strongly recommends that when the government considers  adjusting public health and social measures in the context of COVID-19  the following requirements must be in place:

• COVID-19 transmission is controlled through two complementary approaches – breaking chains of transmission by detecting, isolating, testing and treating cases and quarantining contacts and monitoring hot spots of disease circulation
• Sufficient public health workforce and health system capacities are in place
• Outbreak risks in high-vulnerability settings are minimized
• Preventive measures are established in workplaces
• Capacity to manage the risk of exporting and importing cases from communities with high risks of transmission
• Communities are fully engaged.

View an infographic on WHO Philippines' support to the COVID-19 response in the Philippines  here.

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The Philippines’ Response to the COVID-19 Pandemic: Learning from Experience and Emerging Stronger to Future Shocks

• Celia M. Reyes
• COVID-19 pandemic
• whole-of-government approach
• COVID-19 policy responses
• macroeconomic response
• public health shock
• Philippine economy
• crisis response
• food security
• overseas Filipino workers
• human development
• income distribution
• basic education
• crisis communication
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• COVID-19 recovery
• local government units
• fiscal response to pandemic

The coronavirus disease 2019 (COVID-19) pandemic hit the Philippine economy and society unprecedentedly. To protect the people, the government had to act decisively and identify solutions to contain the rapid spread of the virus and the devastating economic and social disruption caused by the pandemic.  This book compiles papers assessing the strategies, policies, and recovery efforts that the government had implemented during the first year of the COVID-19 pandemic. It discusses the challenges that the country had experienced and the government's responses in the areas of health, macroeconomy, food security, labor, social protection, poverty, education, digitalization, fiscal policy, and crisis and risk communication. Learning from these experiences, this book provides recommendations to help the Philippines recover from the current crisis and build better resilience to future shocks.

This publication has been cited 4 times

• Alviar, DC. 2023. Sapat ba ang teknolohiya upang epektibong magturo? Mga aral mula sa PIDS . Tutubi News Magazine.
• Daily Guardian . 2024. COVID-19 school closures led to significant learning losses – expert . DailyGuardian .
• Manila Standard Business. 2023. PIDS: Technology key to learning amid crises . Manila Standard.
• Nazario, Dhel. 2023. NAST PHL set to introduce new members, recognize outstanding Filipino scientists . Manila Bulletin.

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Fighting COVID-19 in the Philippines

8 ways usaid reachhealth supports pandemic response.

As COVID-19 swept the world in 2020, the Philippines became Southeast Asia’s most affected country.

RTI International has been supporting the COVID-19 response in the Philippines through ReachHealth , a five-year United States Agency for International Development (USAID) project that strengthens and improves access to family planning and maternal and child health services.

Building on 14 years of RTI experience working with local governments in the Philippines to improve health outcomes, the USAID ReachHealth Project supports the COVID-19 response in 15 priority local government units across the country. Working closely with the Department of Health (DOH), the Department of Interior and Local Governance, UN agencies, the private sector, and civil society organizations, we strengthen the government’s emergency and ongoing response at all levels.

Our support has included operationalizing nationwide COVID-19 policies, rolling out vaccines, helping facilities access national COVID-19 financing and testing kits, strengthening the capacities of health workers on infection prevention and control and case management, improving contact tracing, and supporting risk communication and community engagement efforts. Most recently, ReachHealth has helped the country prepare for the roll out of child vaccines and the safe reopening of in-person schools.

Since ReachHealth began supporting the Philippines' pandemic response, we have trained over 20,000 people and reached nearly 37 million people with messages on preventing gender-based violence and COVID-19’s spread.

Here are eight of the important ways we have and continue to respond to COVID-19 in the Philippines:

1. Strengthening community health and support systems

Barangay Health Emergency Response Teams, or BHERTs, usually connect community members to health facilities — but during times of emergency their work becomes more important than ever. These neighborhood-based teams formed the frontline of efforts to delay COVID-19’s spread and locally contain the pandemic by communicating risk, facilitating contact tracing and vaccination, and connecting communities with broader local health systems. ReachHealth works to ensure BHERTs in hotspot communities are active, effective, and trained on critical elements of the COVID-19 community response, including essential behaviors to prevent the virus’ spread, infection prevention and control, vaccination and testing protocols, contact tracing, and quarantine and isolation. ReachHealth has helped train over 7,800 people on contact tracing and rapid response so far.

2. Increasing vaccine coverage

In 2021, ReachHealth collaborated with the DOH and local actors to plan for vaccine rollouts. We developed public messaging for local governments to spread the word, updated FAQs for community health responders like BHERTs, and supported health facility planning and preparation. Once vaccines were available, ReachHealth also helped speed up the roll out by deploying 28 mobile vaccine teams across the country to ensure even the most remote communities got access. ReachHealth has established or supported over 200 vaccination sites in the Philippines. More than 2.8 million Filipinos have been fully vaccinated with ReachHealth’s support.

Grace Jose receives a COVID vaccine at a vaccination site in Caloocan City. Photo by Christian Rieza/USAID ReachHealth

3. Strengthening health and testing facilities

Throughout the pandemic, the science on COVID-19 and how to address it has evolved. To help health facilities keep up, ReachHealth provided training to over 5,000 people on case management and over 3,000 people on infection prevention and control. We also partnered with local governments to establish 10 additional mobile testing units and four community testing centers in vulnerable areas. As COVID-19 testing increased, so did the demand for accredited labs that could process tests quickly. By providing support , ReachHealth helped increase the number of accredited labs across the country and reduced testing times to just a few hours in eight labs in Mindanao and Luzon. 

Vilma Cabral gets tested for COVID-19 at a USAID-supported community-based testing center in the Philippines. Photo by Rosana Ombao for USAID

4. Supporting a data-driven response

The DOH collaborated with the World Health Organization to launch a mobile application, COVID KAYA , that supports frontline responders with contact tracing and case monitoring. The introduction of any new, centralized data system across regions with varying needs and infrastructure can be challenging and uneven. Our team provided technical assistance to help local governments roll out the application, and directly trained officials, health workers, and personnel from health epidemiology units on its use.

5. Addressing gender-based violence

In the Philippines, 1 in 20 women and girls aged 15-49 have experienced sexual violence. COVID-19 lockdowns and quarantines brought extended periods of restricted movement and home confinement for millions of people — an unprecedented situation that worsened violence against women and children at home. ReachHealth supported the continued functioning of gender-based violence (GBV) services, such as a 24-hour helpline, while a messaging campaign, Hindi kailangang magtiis! (You don’t need to suffer in silence!), sought to prevent GBV and to let people know about available services. Since October 2020, this campaign has reached over 9 million Filipinos on Facebook alone.

6. Distributing essential equipment and supplies

Frontline health workers needed personal protective equipment (PPE) to care for their patients safely. In partnership with the Armed Forces of the Philippines, ReachHealth supported the distribution of PPE donated by the US Defense Threat Reduction Agency to 109 hospitals, rural health units, and quarantine facilities in vulnerable areas across the country. We also partnered with Proctor & Gamble to distribute more than 700,000 face masks. ReachHealth is now providing PPE and communication materials to local schools to aid in the safe reopening of in-person classes.

Boxes of personal protective equipment destined for health facilities during the COVID-19 pandemic in Cebu City, Philippines. Photo by Robyn Lacson/USAID ReachHealth

7. Prioritizing water, sanitation, and hygiene

Although water, sanitation, and hygiene (WASH) was not a focus area for ReachHealth, our team recognized that good sanitation and hygiene are critical to slowing the spread of COVID-19. We developed a tool to assess and prioritize sites for handwashing stations and installed these facilities in more than 200 quarantine centers, shelters, and public spaces. We also incorporated WASH messaging into our trainings and messaging campaigns and partnered with the DOH and Procter & Gamble to procure and distribute 70,000 hygiene kits to adults and young people. We have reached over 2.5 million Filipinos with WASH support so far, and our team continues to collaborate with local WASH organizations to bolster their ongoing work.

U.S. Ambassador Sung Kim uses one of the 16 handwashing stations installed in facilities and communities around the city. Photo by Rosana Ombao/USAID ReachHealth

8. Keeping our focus on family planning

Family planning (FP) continues to be an essential health service, especially in times of social and economic uncertainty. While our team stepped up to contribute their expertise to the COVID-19 response, they remain committed to expanding access to quality FP services across the Philippines. In March 2020, 25% of surveyed health centers reported a disruption in FP services and 81% saw a decline in people seeking FP care. From creating online resources to helping service providers improve their teleconsultation abilities, our team rapidly adapted approaches to accommodate the new normal and ensure all Filipinos could continue to access FP care. More than 2,000 teleconsultations on family planning have occurred since.

A team of "Nurses on Wheels" delivers family planning supplies to neighborhood health stations in Cainta. Photo by Mon Joshua Vergara/Cainta Municipal Health Office

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• Global Health
• Global Health Security
• COVID-19 Research + Response
• Health Systems Strengthening
• Primary Health Care in Low- and Middle-Income Countries
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ReachHealth: Strengthening Access to Critical Services for Filipino Families

Assessing the availability of essential family planning services during covid-19 in the philippines, from hotspots to bright spots: fighting covid-19 in the barangays of the philippines, hope on wheels: delivering vaccines to remote communities, stopping the spread: making covid testing accessible for filipinos.

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Journalism, public health, and COVID-19: some preliminary insights from the Philippines

In this essay, we engage with the call for Extraordinary Issue: Coronavirus, Crisis and Communication. Situated in the Philippines, we reflect on how COVID-19 has made visible the often-overlooked relationship between journalism and public health. In covering the pandemic, journalists struggle with the shrinking space for press freedom and limited access to information as they also grapple with threats to their physical and mental well-being. Digital media enable journalists to report even in quarantine, but new challenges such as the wide circulation of health mis-/disinformation and private information emerge. Moreover, journalists have to contend with broader structural contexts of shutdown not just of a mainstream broadcast but also of community newspapers serving as critical sources of pandemic-related information. Overall, we hope this essay broadens the dialogue among journalists, policymakers, and healthcare professionals to improve the delivery of public health services and advance health reporting.

Introduction

In this essay, we reflect on how COVID-19 has brought to our attention the often-overlooked relationship between journalism and public health. We draw initial insights from critical analysis of media and public health ( Henderson and Hilton, 2018 ) to suggest that health reporting in the country during the pandemic can be connected to journalistic practices, technological changes, and structural constraints. For journalism to advance public health, it needs to contend with the pandemic and the context into which it is uniquely situated – both of which are moving targets and difficult to predict. In this essay, we pay attention to the Philippines not just because it has one of the highest COVID 19-related cases and deaths in the world but also because the country is at the crossroads of changes in digital media and shrinking space for media freedom, as evidenced by the shutdown of the country’s biggest media network, closing or suspension of community newspapers, and passage of laws that may restrict free speech. In doing so, we hope to broaden dialogue among journalists, policymakers, and healthcare professionals to improve the delivery of public health services as well as advance health reporting.

Similar to other countries, the public health system in the Philippines was unprepared for and overburdened by COVID-19. The first case was reported on January 30 when a Chinese woman reached the country from Wuhan, China, and then a few days later her male companion died of the virus – making it the first recorded death outside of China ( Department of Health (DOH), 2020b ; Ramzy and May, 2020 ; World Health Organization (WHO), 2020a ). By March 7, the first case of local transmission was confirmed ( DOH, 2020a ; WHO, 2020a ). To date, there are 112,593 confirmed cases, 6,263 new cases, and 2,115 deaths in the country ( WHO, 2020b ) – making the Philippines as one of the most highly impacted in Southeast Asia and the Western Pacific Region. Equally alarming is the number of doctors, nurses, and other hospital staff who get infected and die of COVID-19 ( CNN Philippines, 2020a ; McCarthy, 2020 ). Recently, professional medical and allied medical associations have called for a unified and calibrated response and temporary quarantine of the country’s capital to avoid a total collapse of the healthcare system ( Batnag, 2020 ). Critical but seldom discussed are the challenges of journalism in making sense of the rapid spread and devastating impact of COVID-19 in the Philippines and how the pandemic is also gradually transforming journalism in the country.

Journalism and public health work together to broaden health information sources, facilitate public understanding of health, and mobilize support for or against public health policy ( Henderson and Hilton, 2018 ; Larsson et al., 2003 ; Vercellesi et al., 2010 ) and this relationship is magnified during pandemics. The relationship between journalism and public health has mostly been explained based on journalistic roles and news framing. During the 2009 H1N1, for instance, Klemm et al. (2017) found that journalists shifted from ‘watchdogs’ to ‘cooperative’ roles. Holland et al. (2014) further argued that the 2009 H1N1 enabled journalists to be reflexive of their roles especially with conflicts of interest among experts and decision makers. News framing has likewise informed the conversations between journalism and public health. For example, Krishnatray and Gadekar (2014) found that fear and panic dominated the frames used by journalists in their news stories about the 2009 H1N1. In this essay, we hope to engage with ongoing discussion about journalism and public health by reflecting on how health reporting during COVID-19 in the Philippines relates to broader, emergent, and interconnected issues of journalistic practices, technological changes, and structural constraints in the country.

Reporting from home

COVID-19, along with the ensuing quarantines, poses challenges to existing journalistic practices that typically require fieldwork, but it also encourages journalists in the Philippines to reimagine news production. We observe that access to information has generally been limited because government offices have not been in full operation while virtual press briefings do not allow for a more open discussion between journalists and officials. To illustrate, Ilagan (2020) reported that most routine requests for information have not been processed since March 2020 when government offices were wholly or partly closed due to the ongoing quarantine. The Philippines is among many governments in the world that had to suspend the processing of freedom-of-information (FOI) requests because of the pandemic ( McIntosh, 2020 ). FOI officers working from home could not address requests because they lacked Internet connection, laptop computers, and scanners, including digital copies of files. They also found it difficult to coordinate remotely with record custodians. While some national agencies have been proactive in providing information on COVID-19, the same cannot be said for many local government units. Ilagan (2020) further noted that ‘[un]like frontline agencies at the national level, local governments do not proactively publish data on their websites’. Information about plans to combat the impact of the virus are usually available, but more prodding is needed to find out how these plans are being implemented and funded. Camus (2020) also reported that journalists were prohibited from covering what is happening in hospitals and other high-risk areas. More and more press briefings have thus taken place online, but reporters have found it harder to demand answers because officials and their staff often screen questions. For instance, Camus (2020) wrote that some questions from journalists were ignored while official reports from the government were consistently discussed.

Moreover, we observe that the pandemic has taken a toll on both the physical and mental well-being of journalists. Reported cases of journalists experiencing high levels of stress, undergoing self-quarantines, and at least one news anchor contracting the virus point to the need for broader safety measures at the organizational level of news outlets. The National Union of Journalists of the Philippines (NUJP) lamented the limited mental health support for journalists by saying that ‘there are hardly any readily available and sustained support systems for colleagues experiencing mental health issues’ ( Adel, 2020 ). Safeguarding the physical and psychological well-being of journalists during pandemics or any type of crisis does not rest on individuals alone but should be demanded from news organizations and advocated for by professional associations. Yet some journalists have been able to navigate the consequences of COVID-19 on the profession by reimagining newsgathering, taking advantage of online resources as well as doing collaborations.

First, journalists have been coping with the challenge of limited access to information by interviewing sources through phones and attending webinars with experts to learn more about the pandemic ( Tantuco, 2020 ). Bolledo (2020) said that journalists had to adapt in light of the global health crisis changing media operations. By adapting, he referred to Reuters’ approaches to comprehensive newsgathering, which focus on open-source and non-mainstream techniques such as ‘citizen and collaborative journalism’ and ‘social journalism’. In practice, this set of methods includes monitoring Facebook and Twitter feeds, joining Facebook groups created for a specific cause or geographical area, following hashtags and using keywording to find leads and sources. Bolledo (2020) also emphasized the need to fact-check information gathered using these methods, highlighting the importance of news values and the 5Ws and one H in reporting. Second, to address the barriers in online press briefings, journalists organized themselves to raise their unanswered questions in media group chats of government organizations ( Ilagan, 2020 ). Third, the NUJP organized peer support networks critical for minimizing stress and trauma among journalists who reported about and during COVID-19. Finally, in an effort to prevent contracting and spreading the virus among co-workers, journalists are maintaining records of their activities and a list of sources whom they interacted for purposes of contact tracing ( Camus, 2020 ). The new methods employed in health reporting, as creative responses to the constraints brought upon by COVID-19, partly illustrate how an emerging practice may turn into professional norm ( Henderson and Hilton, 2018 ) in health reporting during pandemic.

Double-edged sword

At the onset of COVID-19, journalism in the Philippines has struggled with ongoing technological changes that bring about double-edged consequences. On one hand, digital media has enabled journalists to help Filipinos make better sense of the pandemic – from reporting infections and deaths regularly to covering press conferences organized by agencies at the frontlines of COVID-19 response. Through Facebook live videos, Zoom , and other video conferencing applications, journalists are able to talk about their lived experiences in covering COVID-19. Various groups inside and outside of the Philippines have been hosting a series of webinars on how to cover the pandemic. Media groups in the Philippines meanwhile have also organized press briefings that tackle the state of news reporting in the country. In the forum titled ‘Intrepid Journalism in the Time of Corona’ organized by This Side Up Manila , two journalists discussed the state of news from the early stages of the pandemic to the declaration of enhanced community quarantine (ECQ). Early in the live video, they shared their frustrations about the consequences of COVID-19 on fieldwork and storytelling. According to the reporters, covering COVID-19 is different from reporting about natural disasters or conflict zones because they felt that there was no end in sight to the pandemic. As a result, they reminded themselves and their colleagues to find a balance and slow down as the pandemic may be prolonged and even put the lives of their families at risk. These webinars, which are in theory accessible to anyone in the world, also allow journalists to share their experiences with and learn from their counterparts in other countries. For instance, Hivos organized a webinar titled ‘Data Driven Reporting During Covid-19’ with journalists from the Philippines, Kenya, and Mexico to find out how they have been affected by and coping with the pandemic. The journalists said they have found collaboration or working with other journalists and members of the academe and civil society as key in reporting when fieldwork is not possible. Like the Philippines, too, Kenya and Mexico also experience barriers in accessing and reporting information while their governments too are also mandating policies that could restrict press freedom ( Hivos, 2020 ).

On the other hand, digital media has complicated the work of journalists as they had to deal with the spread of health mis- and/or disinformation. To partly explain the diffusion of online fake news (e.g. mass testing and vaccines), we engage with Tandoc et al. (2018) who emphasized the characteristics of technology and the role of audiences. For instance, social media made it challenging for journalists to delineate information sources from each other, especially given the evolving science of COVID-19. Because science is evolving, journalists tend to rely heavily on expert opinion, without verifying the experts’ assumptions. Correcting mis- and/ or disinformation about the pandemic was likewise difficult because journalists had limited understanding of what counted as fake news among Filipinos. Another problem that journalists had to contend with while working during the pandemic is the recent ‘data breach’ that used Facebook profiles of real people ( Robles et al., 2020 ). The rise of fake Facebook accounts is counterproductive not just to fight against health mis- and/or disinformation but also places the identities of journalists at risk. To a large extent, the proliferation of health mis- and/ or disinformation is inextricably connected to the social context not just of COVID-19 but also the Philippines. As Tandoc et al. (2018) pointed out, ‘fake news needs the nourishment of troubled times in order to take root. Social tumult and divisions facilitate our willingness to believe news that confirms our enmity toward another group’ (p. 149). While it created new issues, COVID-19 has also reinforced existing problems in the country and one of those is the shrinking space for free speech.

Shutdowns, suspensions, and shrinking spaces

The pandemic is also laying bare pre-existing conditions hounding the Philippine press in a supposed democracy. For instance, the government passed ‘The Bayanihan to Heal as One Act’ (Republic Act No. 11469) to give the president emergency powers that would enable him to quickly respond to COVID-19. Human rights and media advocates criticized this law as it included a provision penalizing ‘fake news’, which can easily be used and abused by those in power to file complaints against individuals, including journalists ( Freedom for Media, Freedom for All Network, 2020 ). Again this posed another challenge to journalists and the audience who both use social media as a means to get and share information. In similar vein, the passage of the ‘ Anti-Terrorism Act of 2020 ’ (Republic Act No. 11479) received pushback for its broad provisions. Human rights groups also say that the law has essentially also criminalized intent, which could send a chilling effect especially among journalists who might be working on stories critical of the government.

On 5 May 2020, ABS-CBN, the country’s largest media network, went off-air after its broadcast franchise expired. The House of Representatives, which oversees the granting of franchises, refused ABS-CBN’s bid for a renewal, which ultimately led the media giant to close its broadcast operations and lay off thousands of employees. This development comes after the conviction of Rappler executive editor Maria Ressa and former researcher-writer Reynaldo Santos Jr for supposedly violating the Cybercrime Prevention Act of 2012 (Republic Act No. 10175). The shutdown is seen as the latest in a series of attacks and threats against news organizations deemed as critical of the current administration ( Gutierrez, 2020 ; Pago, 2020 ). Community journalism is neither spared. At least half of some 60 community newspapers have suspended or ceased printing due to economic losses caused by the quarantine, according to estimates from the Philippine Press Institute, the national association of newspapers. The NUJP also raised economic difficulties confronting many freelance journalists, especially those who work on contract in broadcast, since the start of the lockdown. Suspension of operations means that contractual media workers would not be able to earn because work is not available. The halt in the production of news by ABS-CBN and various papers across the archipelago means that people, especially those in far-flung areas, have fewer sources of news at a time when getting information is most crucial. Again, these developments point to how pandemic reportage may be tied to political landscape in the country ( Henderson and Hilton, 2018 ).

COVID-19 is transforming the practice and business of journalism. On one hand, the pandemic and the ensuing quarantine restrictions have prompted news organizations and journalists to adapt and take advantage of digital media to continue gathering and presenting news. On the other hand, the pandemic has also exposed journalists and audiences alike to further mis- and/ or disinformation as well as to government’s new efforts to stamp out ‘fake news’. These developments run in parallel with threats to press freedom and journalist safety. In a pandemic, journalists are not mere observers or mere reporters as they also face the same risks everyone else is exposed to ( CNN Philippines, 2020b ). By laying out the current media environment in this essay, we hope to expand and deepen the conversation between and among journalists, policymakers, and healthcare professionals about public health reporting. In line with Larsson et al. (2003) , we encourage further conversations between journalists and healthcare professionals to collectively identify gaps in health reporting and broaden understanding of ‘fake news’ and how it thrives in social media. Consistent with Tandoc et al. (2018) , we also recommend that journalists and healthcare professionals listen to their audience to help understand what counts as health-related ‘fake news’ for them. Moreover, we invite policymakers to protect democratic spaces that enable journalists, healthcare professionals, and citizens alike to gather and share information related to COVID-19. At a time when disseminating reliable information and holding the powerful to account have never been more critical, we deem it necessary to understand where journalists are coming from to understand both the long-standing and emerging issues they have to grapple with in a pandemic.

Authors’ note: The views provided in this essay do not represent the official views of the authors’ institutional affiliations.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

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• Tantuco V. (2020) How the COVID-19 pandemic is affecting the media . Rappler , 7 May . Available at: https://rappler.com/newsbreak/in-depth/how-covid-19-pandemic-affecting-media
• Vercellesi L, Minghetti P, Di Croce M, et al. (2010) Recommendations for health reporting: proposal of a working paper . Health Education Journal 69 ( 1 ): 48–62. [ Google Scholar ]
• World Health Organization (WHO) (2020. a) Coronavirus disease (COVID-19) in the Philippines , 20 May . Available at: https://www.who.int/philippines/emergencies/covid-19-in-the-philippines
• World Health Organization (WHO) (2020. b) WHO coronavirus disease (COVID-19) dashboard , 5 August . Available at: https://covid19.who.int/region/wpro/country/ph

• Feature stories /

100 days of COVID-19 in the Philippines: How WHO supported the Philippine response

Exactly 100 days have passed since the first confirmed COVID-19 case was announced in the Philippines on 30 January 2020, with a 38-year old female from Wuhan testing positive for the novel coronavirus. On the same day, on the other side of the world at the WHO headquarters in Geneva, WHO activated the highest level of alert by declaring COVID-19 as a public health emergency of international concern. The Philippine government mounted a multi-sectoral response to the COVID-19, through the Interagency Task Force (IATF) on Emerging Infectious Diseases chaired by the Department of Health (DOH). Through the National Action Plan (NAP) on COVID-19, the government aims to contain the spread of COVID-19 and mitigate its socioeconomic impacts. The Philippines implemented various actions including a community quarantine in Metro Manila which expanded to Luzon as well as other parts of the country; expanded its testing capacity from one national reference laboratory with the Research Institute of Tropical Medicine (RITM) to 23 licensed testing labs across the country; worked towards ensuring that its health care system can handle surge capacity, including for financing of services and management of cases needing isolation, quarantine and hospitalization; and addressed the social and economic impact to the community including by providing social amelioration to low income families. The World Health Organization (WHO) has been working with Ministries of Health worldwide to prepare and respond to COVID-19. In the Philippines, WHO country office in the Philippines and its partners have been working with the Department of Health and subnational authorities to respond to the pandemic. The country level response is done with support from the WHO regional office and headquarters.

Surveillance

Surveillance is a critical component and is used to detect cases of COVID-19 as well as to understand the disease dynamics and trends and identify hotspots of disease transmission. The Department of Health included COVID-19 in the list of nationally notifiable diseases early in the outbreak to ensure that information was being collected to guide appropriate response actions. Existing surveillance systems were capitalized upon to speed up identification of cases as well as identify unusual clusters. Laboratory confirmation is a critical component of the surveillance system but cannot be the only sources of information. The non-specific symptoms and the novel nature of the disease means that the DOH, with support from WHO, are looking at all available information sources to guide response decision making. WHO also provided technical assistance to selected local government units to strengthen field surveillance for timely data for action at the local level.

Contact tracing

Infection prevention and control

Laboratory and therapeutics access

Clinical care

Non-pharmaceutical interventions and mental health

Risk communication and community engagement

Effective communication and engagement with communities is essential for people to understand the situation, know the situation and practice protective measures to protect their health, their family and the larger community. WHO supported and amplified DOH messaging by releasing various communication materials on the risk of COVID-19 and how people can protect themselves through social media and traditional media. WHO also worked with partners such as UNICEF and OCHA in reaching vulnerable groups, getting their feedback and understanding their information needs.

Logistics support

With lots of moving equipment and supplies required for COVID-19, logistics support is an important part of the response. WHO provided technical support to the DOH in the recalibration of PPE requirements by using WHO projection tools, provided cost estimates, and advised on streamlining the distribution flow of PPEs and other essential supplies. WHO also supported DOH in the development of a commodities dashboard that provides real-time PPE stocks at the facility level, as well as assisted in building an information system for tracking essential COVID-19 commodities.

Subnational operations support

Responding to outbreaks in high risk areas

Moving forward with the response

Much more needs to be done to break the chain of COVID-19 transmission. Some of the challenges that the Philippines continues to face are containing transmission of infection, mitigating the impact in high risks communities and confined settings, as well as ensuring the uniform enforcement of non-pharmaceutical interventions that are already in place. The continuation of the community quarantine will have substantial social and economic impact and thus a heightened effort to control  transmission of infections through rigorous contact tracing, isolation of cases, quarantine of contacts while ensuring timely and adequate treatment to save lives will continue to be the primary public health measure. In addition, while the government is exerting all its efforts in this current situation, it also needs to prepare its health systems for surge capacity in the event that a wide-scale community transmission occurs.

In the next few days, the government will carefully consider the next steps, especially on deciding whether or not the communty quarantine will be lifted or levels of quarantine will be differentiated based on the situation of provinces. WHO strongly recommends that when the government considers adjusting public health and social measures in the context of COVID-19 the following requirements must be in place:

• COVID-19 transmission is controlled through two complementary approaches – breaking chains of transmission by detecting, isolating, testing and treating cases and quarantining contacts and monitoring hot spots of disease circulation
• Sufficient public health workforce and health system capacities are in place
• Outbreak risks in high-vulnerability settings are minimized
• Preventive measures are established in workplaces
• Capacity to manage the risk of exporting and importing cases from communities with high risks of transmission
• Communities are fully engaged

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Philippines: Rodrigo Duterte’s Response

The COVID-19 Crisis: Voices From Asia This post is part of a series from Asia Unbound. This post is authored by  Richard Heydarian, a Manila-based academic and author of The Rise of Duterte: A Populist Revolt Against Elite Democracy. 

As of this week, the Philippines has one of the worst COVID-19 outbreaks in Southeast Asia. The country also has among the highest fatality rates in the region, underscoring the weakness of its increasingly strained public health system. The numbers are even more troubling when one considers that the country has yet to implement mass testing of any kind. The actual numbers of infected could be in tens of thousands, if not higher, making the Philippines one of Asia’s biggest hot spots.

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COVID-19 is doing economic damage to the Philippines as well. The Philippine GDP growth has averaged around 6 percent annually for the past decade, but it could actually contract this year. As many as 1.2 million Filipinos could lose jobs as the economy dives, and as a lockdown limits economic activity. A $23 billion rescue package is being hurriedly put together, but even this relatively large amount may not be sufficient to avoid serious economic damage.

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Cfr fellows and other experts assess the latest issues emerging in asia today.  1-3 times weekly., eyes on asia, insights and analysis from cfr fellows on the latest developments across asia.  monthly., daily news brief, a summary of global news developments with cfr analysis delivered to your inbox each morning.  weekdays., the world this week, a weekly digest of the latest from cfr on the biggest foreign policy stories of the week, featuring briefs, opinions, and explainers. every friday..

During a recent national address, the usually tough-talking President Rodrigo Duterte admitted that the “government is desperate now. I am desperate now.” In many ways, this tragic outcome was far from surprising. Across the world, Duterte’s fellow illiberal populists have bungled the initial phase of the crisis, the period when they had time to listen to medical experts and put measures into place to reduce the spread of the virus.

A common thread among illiberal populists has been a reckless initial dismissiveness towards the crisis, with Brazilian President Jair Bolsonaro as an extreme case of obstinate denialism . In the case of Duterte, his dismissive folly extended well into mid-March. During a March 11 speech at the Malacanag presidential palace, the president told the audience : “I’ve been told masyado naman takot itong corona na ito ,”—“you folks are too scared of this coronavirus epidemic.” “ Naniwala pala kayo. Sus ”—“fools, don’t believe it.”

Meanwhile, Duterte moved slowly to implement travel restrictions on people coming to and from China, likely because of the Philippine leader’s worry about alienating Beijing, a key strategic patron , and concerns about affecting the inflow of hundreds of thousands of Chinese citizens working in the online casino industry in the Philippines. Even when many Philippine legislators pushed for such travel restrictions, Duterte moved slowly on them, and still allowed some incoming flights from China.

Duterte even personally also ignored a strict “no touch” policy —meaning no one was supposed to touch the president—introduced by his security team to protect the seventy-four-year-old president, who has multiple underlying health conditions . Duterte even quipped that he prefers to hug, rather than shake hands, with females visiting the palace.

Meanwhile, many Philippine health authorities questioned the necessity of conducting mass testing, claiming it is “ unrealistic ”. They also failed to establish a robust nationwide infrastructure to combat the spreading epidemic—through pro-active testing, large-scale contact-tracing, and targeted quarantines of most affected areas—in the first three months of the year.

Only days after mocking those who took the crisis seriously, Duterte announced a month-long lockdown (March 15 to April 14) across Metro Manila and surrounding regions. For days, the exact contours of the lockdown—initially dubbed as “community quarantine,” then later upgraded to “ enhanced community quarantine ”—remained unclear. But panic buying ensued as soon as twelve million residents of Metro Manila realized that there would be restrictions on entry and exit from the national capital region and large parts of the country’s economy—including malls, restaurants, and public parks—would be shut down under a strict social distancing regime.

While many welcomed the lockdown as an effort to contain an epidemic outbreak, the Duterte administration bungled its initial implementation , as varying agencies made contradictory statements on curfews and travel restrictions in the national capital region and beyond. To be fair, the government’s struggles are not entirely of its own fault, given the country’s weak public health system. But Duterte didn’t help the situation by cutting the health budget in recent years.

Is this bungling of the initial COVID-19 response having an impact on Duterte’s popularity, or on his legacy? According to polls conducted prior to the lockdown, Duterte remains widely popular . Under current circumstances, conducting polls may have been logistically difficult, so it is difficult to tell for sure where public opinion stands on the issue. Online, Philippine netizens are expressing rising impatience and discontent with the Duterte administration’s response. Although Duterte has worked hard to silence dissent in the country, doctors are now publicly complaining about the lack of protective equipment , middle class Filipinos are openly complaining about the lack of financial support for certain sectors hit hard by the lockdown, and some poorer Filipinos are complaining about their desperate struggle to survive the lockdown with dwindling resources. Following small-scale protests by mostly poor residents in Manila about Duterte’s COVID-190 response, Duterte greenlighted “shoot to kill” orders to law enforcement and soldiers implementing the lockdown.

With the government extending the lockdown until the end of the month, public discontent and impatience is bound to increase, especially if the government fails to reassure the public that it is in control, such as by rolling out mass testing, showing a credible decline in infections, or extending policies that help poor Filipinos meet their basic needs during the lockdown. As the crisis continues, Duterte’s popularity and legacy could well suffer major damage.

While his position as president will likely remain secure for the foreseeable future—he is limited to one term and it is unlikely that anyone will try to bring him down before his presidency ends in 2022—the ongoing crisis has chipped away at Duterte’s claim to competence and of being a man of the people. If his popularity falters, it could dramatically affect his ability to shape, if not choose, his successor ahead of the 2022 elections. In recent years, the president has been grooming his daughter, Sara, as well as long-time assistant and current senator, Bong Go , as his potential successors.

Shaping the 2022 election is important in a country where in recent years many outgoing presidents face hostile successors, and—like former presidents Joseph Estrada and Gloria Macapagal-Arroyo—have wound up under house arrest or in jail after leaving office for crimes allegedly committed back when they were president. Duterte’s controversial rule, which has coincided with thousands of extrajudicial killings and intense cleavages between him and the country’s leading businessmen, has created no shortage of enemies for him. If Duterte leaves office with his legacy in tatters, he could be extremely vulnerable to political persecution if not legal prosecution at home. Thus, the ongoing COVID-19 crisis in the Philippines, the economic shocks of which will echo for years to come, will impact not only Duterte’s legacy but also the post-2022 scenario in the Philippines’ rapidly evolving political landscape.

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Philippines

100 days of COVID-19 in the Philippines: How WHO supported the Philippine response

Exactly 100 days have passed since the first confirmed COVID-19 case was announced in the Philippines on 30 January 2020, with a 38-year old female from Wuhan testing positive for the novel coronavirus. On the same day, on the other side of the world at the WHO headquarters in Geneva, WHO activated the highest level of alert by declaring COVID-19 as a public health emergency of international concern.

The Philippine government mounted a multi-sectoral response to the COVID-19, through the Interagency Task Force (IATF) on Emerging Infectious Diseases chaired by the Department of Health (DOH). Through the National Action Plan (NAP) on COVID-19, the government aims to contain the spread of COVID-19 and mitigate its socioeconomic impacts.

The Philippines implemented various actions including a community quarantine in Metro Manila which expanded to Luzon as well as other parts of the country; expanded its testing capacity from one national reference laboratory with the Research Institute of Tropical Medicine (RITM) to 23 licensed testing labs across the country; worked towards ensuring that its health care system can handle surge capacity, including for financing of services and management of cases needing isolation, quarantine and hospitalization; and addressed the social and economic impact to the community including by providing social amelioration to low income families.

The World Health Organization (WHO) has been working with Ministries of Health worldwide to prepare and respond to COVID-19. In the Philippines, WHO country office in the Philippines and its partners have been working with the Department of Health and subnational authorities to respond to the pandemic. The country level response is done with support from the WHO regional office and headquarters.

Surveillance

Surveillance is a critical component and is used to detect cases of COVID-19 as well as to understand the disease dynamics and trends and identify hotspots of disease transmission. The Department of Health included COVID-19 in the list of nationally notifiable diseases early in the outbreak to ensure that information was being collected to guide appropriate response actions. Existing surveillance systems were capitalized upon to speed up identification of cases as well as identify unusual clusters. Laboratory confirmation is a critical component of the surveillance system but cannot be the only sources of information. The non-specific symptoms and the novel nature of the disease means that the DOH, with support from WHO, are looking at all available information sources to guide response decision making. WHO also provided technical assistance to selected local government units to strengthen field surveillance for timely data for action at the local level.

Contact tracing

Contact tracing is crucial to the response. It is a system to detect and isolate cases and identify close contacts who will be advised for quarantine. It allows the investigation the system to tracjk the chain of infections as well as the settings, places, events or other avenues that where transmission have occurred or may have been amplified. A major bottleneck to doing this is the availability of timely and complete information from the hospitals for suspected, probable and confirmed COVID-19 cases. WHO assisted the DOH Epidemiology Bureau in developing COVID KAYA , a case and contact tracing reporting system for epidemiology and surveillance officers, health care providers and laboratory-based users, expanding the capacity of the previous COVID-19 information system. WHO also continued to support the government to establish the system and improve capacity for contact tracing at the city and municipal levels.

Infection prevention and control

Patients and health workers must be protected from the possible transmission of COVID-19 inside health facilities. Infection prevention and control (IPC) is vital in minimizing the harm caused by the spread of infection in these facilities. In the early part of the response, WHO supported the DOH with the provision of personal protective equipment (PPE) for health workers. To strengthen IPC, WHO and DOH developed modules and conducted online IPC training of trainers for frontline health workers in health care and community settings. The training has since been rolled out more widely by partners USAID-MTaPS and UNICEF to cover over 5,500 health workers to date.

Laboratory and therapeutics access

Laboratory testing for COVID-19 is critical to be able to rapidly identify, treat and isolate the positive patients, and be able to see the bigger picture of how many people are infected and ultimately stop the transmission of the virus. Since the beginning of the response, WHO provided support to the DOH’s Research Institute for Tropical Medicine with laboratory supplies and extraction kits. WHO also assisted the DOH in the accreditation of COVID-19 testing laboratories. To date, 23 real-time reverse transcription polymerase chain reaction (rRT-PCR) laboratories nationwide are now conducting COVID-19 diagnostic tests. The Philippines has also recently joined the WHO Solidarity trial to find effective COVID-19 treatment.

Clinical care

With a new disease, there are a lot of unknowns regarding the proper clinical management of suspect and confirmed cases. But when clinicians are armed with the necessary knowledge and skills to care for sick patients, the more the patients are likely to recover. WHO supported the frontline health workers through a webinar series on clinical management, providing up-to-date WHO clinical perspectives. At the same time, WHO also supported the DOH and the Department of Interior and Local Government in preparing policies to form health care provider networks for COVID-19, from primary care that includes telemedicine and community management, to tertiary care linking to referral hospitals.

Non-pharmaceutical interventions and mental health

Non-pharmaceutical interventions (NPIs) refer to public health measures, which are not related to medicines or vaccines, that people and communities can do to prevent the spread of infections like COVID-19. These interventions involve personal protective measures, environmental measures, physical distancing measures and travel-related measures. WHO supported the DOH in the development of a policy on NPIs as well as assisted in rapid assessment on local government capacity on NPIs and policy-gap analysis.

In times of extreme experiences brought by COVID-19, it is likely that people feel fearful and anxious. Providing mental health and psychosocial support (MHPSS) during the time of COVID-19 pandemic is important. WHO assisted the DOH in developing policy guidance and advice on integrating MHPSS within health and social services and increasing access to care to these services.

Risk communication and community engagement

Effective communication and engagement with communities is essential for people to understand the situation, know the situation and practice protective measures to protect their health, their family and the larger community. WHO supported and amplified DOH messaging by releasing various communication materials on the risk of COVID-19 and how people can protect themselves through social media and traditional media. WHO also worked with partners such as UNICEF and OCHA in reaching vulnerable groups, getting their feedback and understanding their information needs.

Logistics support

With lots of moving equipment and supplies required for COVID-19, logistics support is an important part of the response. WHO provided technical support to the DOH in the recalibration of PPE requirements by using WHO projection tools, provided cost estimates, and advised on streamlining the distribution flow of PPEs and other essential supplies. WHO also supported DOH in the development of a commodities dashboard that provides real-time PPE stocks at the facility level, as well as assisted in building an information system for tracking essential COVID-19 commodities.

Subnational operations support

Aside from national support to the DOH, WHO is also providing subnational support in the Philippines by working with the DOH Field Implementation and Coordination Team (FICT) and the Centers for Health Development (CHDs) at the regional level. WHO conducted scoping missions in 10 out of 16 regions outside the National Capital Region to assess the needs and capacity of CHDs in responding to COVID-19. WHO staff have also been deployed in specific high-risk subnational areas in the country to provide technical support for the response. At the same time, contact tracing in subnational areas is also being strengthened with WHO, DOH Epidemiology Bureau, and UP College of Nursing developing a training programme and learning resource materials on contact tracing to build the capacity of epidemiology and surveillance officers and local contact tracing teams.

Responding to outbreaks in high risk areas

Closed settings like prisons and hospitals have seen clusters of confirmed cases. WHO, the DOH Epidemiology Bureau and the International Committee of the Red Cross (ICRC) worked with prison authorities and hospitals in joint contact tracing and infection prevention and control investigations. The teams provided them with guidance to prevent the further spread of infection to ensure the protection of persons deprived of liberty, hospital patients and people with mental health conditions.

WHO also supported the strengthening of community-based interventions and social support and addressing the needs of specific populations such as people with pre-existing mental and substance use disorders.

Moving forward with the response

Much more needs to be done to break the chain of COVID-19 transmission. Some of the challenges that the Philippines continues to face are containing transmission of infection, mitigating the impact in high risks communities and confined settings, as well as ensuring the uniform enforcement of non-pharmaceutical interventions that are already in place. The continuation of the community quarantine will have substantial social and economic impact and thus a heightened effort to control transmission of infections through rigorous contact tracing, isolation of cases, quarantine of contacts while ensuring timely and adequate treatment to save lives will continue to be the primary public health measure. In addition, while the government is exerting all its efforts in this current situation, it also needs to prepare its health systems for surge capacity in the event that a wide-scale community transmission occurs.

In the next few days, the government will carefully consider the next steps, especially on deciding whether or not the communty quarantine will be lifted or levels of quarantine will be differentiated based on the situation of provinces. WHO strongly recommends that when the government considers adjusting public health and social measures in the context of COVID-19 the following requirements must be in place:

• COVID-19 transmission is controlled through two complementary approaches – breaking chains of transmission by detecting, isolating, testing and treating cases and quarantining contacts and monitoring hot spots of disease circulation
• Sufficient public health workforce and health system capacities are in place
• Outbreak risks in high-vulnerability settings are minimized
• Preventive measures are established in workplaces
• Capacity to manage the risk of exporting and importing cases from communities with high risks of transmission
• Communities are fully engaged

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