Yellow Pad

We are now into the third week since the lockdown, otherwise known as the enhanced community quarantine (ECQ). To be exact, we are on Day 20 of the lockdown since March 15, 2020.

To date, 136 people have died and 3,018 have been found to be COVID-19 positive. This is a 12-fold rise in deaths (from 11) and 21-fold rise in positive cases (from 140) in just 20 days.

Seventeen fellow doctors – many I personally know – have fallen. Nakakalungkot. (That is so sad.)

These figures are just the tip of the iceberg. In the following weeks, we will see more and more cases detected and more deaths. This can become a deeper disaster if we don’t get our acts together NOW.

In this time of great uncertainty brought about by the disruptive COVID-19, we need adaptive responses to the challenges that don’t have easy answers.

 

We recommend the following six-point action plan:

1. Don’t lift the lockdown until the number of cases go down.

This may last for another one to two months. We have to prevent the spread of the virus. Stay home. No mass gathering. Social distancing. Wear a mask. Wash your hands. But let the supply chain flow unhampered.

Consider the following criteria in lifting or modifying the ECQ:

  •  A sharp reduction of cases as demonstrated by a consistent downward COVID-19 infection slope;
  •  Increased capacity and ability of medical facilities to treat all patients, particularly those hospitalized, which means having adequate personal protective equipment (PPEs), ventilators, testing kits, and the like;
  •  Testing of all people with COVID-19 symptoms;
  •  Effective monitoring and contact tracing;
  •  Receiving relevant information from local government units (LGUs), including those outside the Luzon ECQ, to anticipate and prevent new transmission epicenters.

2. Test Test Test!

We need to know where the enemy is. Testing is key! Given the limited availability of the testing kits, let us prioritize testing the symptomatics with co-morbidities, those in contact with positive case, and, frontline health workers

3. Heal the Sick

For those who test positive with moderate to severe COVID-19: admit them to dedicated COVID-19 hospitals.  Don’t mix COVID-19 with non-COVID-19 cases.

For those persons under monitoring (PUM), persons under investigation (PUI),  and those with mild COVID-19: they should go into home quarantine if they have enough safe space. For those without sufficient space at home, bring them to national government quarantine facilities (e.g. ULTRA, the Philippine International Convention Center, the World Trade Center) or to the community quarantine facilities of local government units (LGUs). Biosafety measures have to be in place.

4. Protect the Health Workers.

Many of our health workers get infected and die because they are not protected enough. Provide them with the necessary PPE like gowns, cover-alls, glasses, masks, and gloves. They are sacrificing their lives so that others may live. Support them with food and prayers, too.

5. Strengthen the front lines through improved community management.

Our first line of defense is not the hospital. It is our last defense. Our first line of defense is at the individual level, at our homes, in our communities and LGUs, with our barangay health workers, our city/municipal/provincial health workers at the front line.

We need to reorganize our health system from a patient-centered model of care to a community-system approach that offers solutions for the entire population, rich and poor, rural and urban.

6. Strengthen the front lines through improved community management.

The rich can take care of themselves during lockdown, but what about the poor, the unemployed, and the vulnerable sectors? Let us roll out cash transfers, food packages, health benefits, and others from all corners: national and local government, private sector and civil society. This is the time to take care more of our brothers and sisters who have less in life.

To do all of the above things, we need to unite, cooperate, and collaborate. Do not be distracted by petty ramblings, fake news, politicking. We are not the enemy. Our common enemy is the COVID-19!

To our national and local leaders: quickly implement the above recommendations simultaneously! Time is of the essence. If we act now, we will pass through this storm. If we implement these later, disaster will come. Listen also to the local government units and the cry of the people. Temper your grandstanding and greed. For once, be the real leaders you ought to be.

To our civil society: let us creatively collaborate with the national government and provide value added contributions in terms of giving sound policy directions and implementing innovative local initiatives.

To our people: have faith. The storm will surely pass but we need to be more patient, humble and kind.

It is now Lent. Let us all pray, and do simple acts of goodness and kindness with all humility.

If we all act in a unified, coordinated, and collaborative manner, we can weather the storm, prevent more deaths, and come out a better nation: more caring for one another.

Eddie Dorotan, a doctor of medicine and a three-time mayor of Irosin, Sorsogon, is a convener of the COVID-19 Action Network. He is also the executive director of the Galing Pook Foundation and a senior fellow of Action for Economic Reforms.