With an enemy unknown, the Department of Health (DoH) was blindsided, just like all national health agencies in other countries. The protocols were there, but it needed a redefinition in terms of capacities from supplies to laboratories, to data and data analytics, to operational definition and hopefully localization because, technically, there is a health care provider network already in the country.
Note: This column originally appeared in The Manila Times on April 28, 2020.
No country was prepared to face the coronavirus disease 2019 (Covid-19). All relied on the World Health Organization (WHO) for guidance. There were countries that won against the severe acute respiratory syndrome (SARS) in 2003, and the Philippines did with two deaths and 14 cases recorded. One should take note, though, that SARS-CoV-2, the virus that causes Covid-19, and the SARS-CoV, also known as SARS-CoV-1, are both coronaviruses, genetically related to each other but different in one trait: SARS is more fatal and deadly, but less infectious than Covid-19. Even if the country has existing protocols dating back to the 1960 cholera outbreak, Covid-19 tested capacities in vulnerable areas (high population density), population (senior citizens with compromised health issues and frontliners in hospitals) and swiftness of action since the virus was mutating fast and spreading exponentially.
At the early rise of Covid-19, the common reasons forwarded were difficulty in breathing, flu-like symptoms and body aches, among others. Filipinos rarely take themselves to the hospital if they feel like the flu bug is hitting them. So, the moment one goes to the hospital, not knowing one is already a carrier, the front liners are exposed. Some might not even say anything because they do not know that they were already exposed. The initial days were bad both for our medical professionals and the country’s health system.
In a previous column, an issue was made about frontliners — that they should not be the medical professionals simply because they should be the last defense of any country. That is why in war, you don’t see medics being all in the frontlines. Imagine the situation where we are in the thick of war and we do not have our last line in place because we failed to recognize that battling Covid-19 was a primary health battle at the communities and the barangay (villages).
Barangay health workers (BHW) should be the frontliners, together with the local disaster risk reduction and management (DRRM) councils. BHW know primary healthcare; they can locate, isolate and cure. Local DRRM are trained in anticipating hazards from floods and earthquakes and with Covid-19, it is now managing multihazards. These networks are all set up at the local level, the national would just need to define the minimum standards and allow innovation and adaptation be done locally in rolling out the minimum.
With an enemy unknown, the Department of Health (DoH) was blindsided, just like all national health agencies in other countries. The protocols were there, but it needed a redefinition in terms of capacities from supplies to laboratories, to data and data analytics, to operational definition and hopefully localization because, technically, there is a heath care provider network already in the country.
When the Senate called for the “immediate” resignation of the secretary of Health, solely blaming (seven sins, as presented in an online publication) his office for certain predicaments in the country, the Senate was acting true to form. It just like in ancient Rome — needed a sacrificial lamb to assuage the cry for blood by the spectators in the arena.
Interestingly, behind the scenes were key incidents that happened, in which the Health secretary needed to be firm: the news about VIP testing; the incident involving Sen. Aquilino Martin Pimentel 3rd; the ruling against misting, a huge contract cornered by a former official where almost all local government units in Metro Manila, as well as huge malls, secured equipment and supplies; the long-delayed barangay health station units now being offered by Triple A contractor as Covid-19 response centers; and the supply of personal protective equipment (PPE) and rapid testing kits, among others.
A lot has been written about the VIP testing (eight of the 14 authors of Senate Resolution 362) and the reckless behavior of Pimentel. On the issue of misting, the DoH has come out stating that “spraying and misting with disinfectants does more harm than good.”
JBros Construction Corp., the contractor of the previous administration’s project building barangay health station (BHS) units in “every barangay, using public schools as sites, was the product of a 2015 tripartite memorandum of agreement signed by DoH (under then-Health Secretary Janette Garin), the Department of Education and the Department of the Interior and Local Government, with the DoH as the procuring entity for the project.” The project was supposed to construct 5,700 BHS units — 3,200 units under Phase 1 (supposedly awarded Dec. 29, 2015) and 2,500 units under Phase 2 (awarded on March 22, 2016). The cost to Filipino taxpayers was P3.5 billion.
Per Health department records, of the 5,700 units to be constructed, JBros claims to have completed only 570, but the DoH technical team has validated only 270 units as completed. The contracts for “both Phases 1 and 2 are under court litigation and investigation by concerned agencies.” There are other entanglements in this contract because J.D. Legaspi Construction, owned by the father of the owner of JBros Construction has a pending project with DoH, the new Fabella Hospital, which remains unfinished.
On March 23, JBros offered to President Rodrigo Duterte the use of the BHS as Covid-19 response centers. The Health department registered its opposition because of the standards on infection control. Further, it appealed to DoH for the “release of P1.043 billion awarded by CIAC (Construction Industry Arbitration Commission) in 2019,” while the matter is under litigation. JBros even proposed to “waive P2.4 billion” out of the P3.5 billion under the letter of credit issued for Phase 1 of the BHS project to be reallocated for the Bayanihan to Heal As One Act. Who is pushing for these creative ways out during the pandemic?
We were already battling the pandemic on March 23 when JBros wrote to the Pressiddent,and the Senate resolution was filed April 20. And in between those key dates, pressure was exerted from suppliers of PPEs and the rapid testing kits to their respective political muscles. The PPEs were coming in, but since the Bureau of Customs didn’t have a skeletal staff or was quite slow in processing importations, the supply tanked out. Request were made for “clients to advance their 50 percent lagay…” Then there was the prioritization of “reefer and frozen ahead of dry containers, where food have expiry dates, chemicals included.” United Staates suppliers were also saying that “they cannot book containers with final destination of Manila. Ports abroad are not accepting bookings because Manila and Batangas ports were closed.” When politicians and people in government secure major supplies of PPE and rapid testing kits, we will help a problem in terms of allocation and distribution.
For rapid testing kits, the pressure was to make it the acceptable device for testing because some heavy lifter cornered the supply in the market. Legislators have means. They have networks. They can order, buy and bring the same to their districts or chosen provinces, for the senators. But the Health department said: “The rapid antibody test kits can produce false positive or false negative results; thus it should be coupled with the PCR-based testing method.” The DoH went further, saying “PCR (polymerase chain reaction)-based test remains the ‘gold standard’ in testing for Covid-19.”
When a political institution calls for an immediate resignation during a pandemic, try looking where the dots are and connecting these and you will end up with a huge transaction cost. The bamboo has a way of making noise, especially when the wind blows strong.BLOG COMMENTS POWERED BY DISQUS