By Gene Alzona Nisperos, MD / Community Medicine Development Foundation

The extension of the enhanced community quarantine (ECQ) should not be a mere repeat of the month-long lockdown that was bereft of elements necessary to make containment measures effective and more palatable to Filipinos.

Saving lives remains the overarching objective in the fight against COVID-19 but, thus far, the actions taken by government lack both the transparency and comprehensiveness that express its serious intention towards this goal. Instead, there are issues of trust and credibility.

Even as the Department of Health (DOH) relented to the call for mass testing, the reported numbers do not add up, causing more confusion. The conflation between number of tests done and number of individuals tested does not help any. There is severe under-reporting, including those for persons under investigation (PUIs) and persons under monitoring (PUMs), that needs to be seriously addressed.

Further, local quarantine centers outside Metro Manila must also be established. The capacity of the healthcare delivery system under local government units (LGUs) should be raised to prepare for more COVID-19 cases. Enhancing the capacities of the barangays and the mobilization of barangay health emergency response teams (BHERTs) should go together with setting up local quarantine centers. The government should utilize all of its resources in health and create a more centralized command that will work closely with LGUs.

The DOH should protect health workers while actively recruiting and hiring more. Adequate health human resources are central in this campaign, being both the first and last lines of defense. Providing health workers with sufficient resources and personal protective equipment (PPEs), ensuring work safety, and monitoring their well being, including periodic testing, are absolutely essential.

As health personnel are dwindling, the DOH should actively recruit more to supplement the health workforce. The call for volunteers is inappropriate given the amount of money mobilized in the name of COVID-19. It will cost the government around 7.2 billion pesos to hire 10,000 doctors and 20,000 nurses for the next six months, and this amount represents just half of the Department of Tourism allocation. The least that this government can do for the health workers willing to put themselves on the line is to protect them and provide them with adequate remuneration.

As the war against COVID-19 is waged, patients who do not have COVID-19 but likewise need medical care must not be forgotten. Diseases like renal failure requiring dialysis or cancer that need chemotherapy will not wait. Yet these patients, especially the poor, have even less access to health services now. This too must be addressed.

Sadly, the DOH and the Duterte administration have shown no sense of urgency. Amidst a public health crisis, this is unacceptable and must change. The current extension must do more if the ECQ is to be meaningful and effective in saving lives.  

The urgent social imperatives experienced by the poor have not been addressed and the provision of adequate safety nets and social support has largely failed. People are experiencing hunger because the relief assistance did not come on time or was not enough for their families. 

Again, the government should take a more active role in ensuring that the food packs being distributed are sufficient. Government should also ensure access to basic utilities like water, which is needed to ensure hand washing and overall hygiene. Economic relief for those who lost income or were economically displaced must be given. This is the social determination of health. 

Most importantly, fundamental human rights must still be recognized and respected.

The ECQ is a health measure. It should not be used as an excuse to further impose repressive measures against the people. There should be no curtailment of basic freedoms and civil liberties. Rather than stifling dissent through threats, the government would do well to focus its energies on gaining the trust of the people.

The authoritarian behavior of the current dispensation should always be challenged. After all, it is a lockdown for health, not a political crackdown. The virus is the enemy, not the people. 

The containment of COVID-19 is a means to save lives. The extension of the ECQ should be towards this end. At this juncture, public health interventions are essential, social and economic aid is imperative, and resistance to tyranny necessary. #

–The author is a professor of community medicine at the University of the Philippines College of Medicine.