The Urgent Tasks for a Unified and Coordinated Action
We, namely the Covid19 Action Network, the Stop COVID-19 coalition, the Sin Tax Coalition, and the Right to Know, Right Now! Coalition (R2KRN) submit this position paper to the Inter-Agency Task Force (IATF) and the Department of Health (DOH).
We, the medical and health community, the civil society organizations, youth groups, and people’s organizations, the business sector, and other non-government actors will take collective action together with government partners. We recognize the multiplicity of tasks, and here we focus on what we view are the most critical areas.
1. Decisions to lift or modify the enhanced community quarantine (ECQ) should be guided by the following conditions or criteria, namely:
• 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 (PPE), ventilators, testing kits, and the like;
• Testing of all people with COVID-19 symptoms;
• Effective monitoring and contact tracing at the community level;
• Relevant epidemiological information from local government units (LGUs), including those outside the Luzon ECQ, to anticipate and prevent new transmission epicenters; and
• Monitoring of socio-economic indicators, particularly on jobs and food security.
2. Protect the Health Workers. • Our health care workers (HCWs) have to be provided with life-saving PPEs, but lack of information or scattered information and logistical problems have led to delayed or inefficient distribution. One way to make the distribution efficient and transparent is by having a central database for real-time stock of PPE from all health facilities.
• Strengthen the logistics chain for PPE through simplified rules that eliminate arbitrariness and discretion. Allow parcel deliveries of PPE to hospitals (especially the small ones). There are reports of parcel deliveries having been blocked because of a rigid interpretation that only bulk cargo deliveries are allowed.
• Simplify the rules and processes in the Bureau of Customs (BOC). Ensure that transactions on medical or pharmaceutical supplies like PPE, masks and ventilators are completed within the day. Impose the stiffest punishment on Customs personnel who are engaged in kotong or “ransom.”
• Step up sustainable local production of medical-grade PPE, and find ways to recycle used PPE.
3. Strengthen the frontlines through improved community management
Our first line of defense is not hospital care. 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 frontline. 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.
• Adopt the Philippine Society of Public Health Physicians (PSPHP), the Alliance for Improving Health Outcomes (AIHO), and the Foundation for Family Medicine Educators (FaMED) Recommendations on Community-based Management on COVID-19, and the Unified Algorithms on community management. These guidelines rationalize the identification, admission, and referral protocols for probable and confirmed COVID-19 cases.
It also provides a clear roadmap for LGUs, communities and households on how to apply preventive measures to fight the virus.
• Set up a website that serves as the information hub in the fight against COVID-19. The website should cater to all audiences: the general public, health workers, and local government units.
• Use SMS tele-health solutions for doctor consultations that do not require visits to medical facilities. Free social media applications such as Facebook may also be used for this function. This helps unburden health facilities and reduce the number of people who otherwise would leave home for consultations.
4. Test, Test, Test.
• Given the limited availability of the testing kits at present, let us prioritize testing to symptomatic patients with co-morbidities, those in contact with positive cases, and frontline health care workers.
• To increase testing capacity, explore the technology of pooled testing. This is a method used by the Israel Institute of Technology and Rambam Health Care Campus wherein simultaneous testing of dozens of samples is done.
• Explore community COVID-19 seroprevalence testing to determine the impact of mitigating strategies after we have addressed the more urgent testing needs of currently infected individuals.
5. Heal the Sick.
• Augment the health workforce; enlist more healthcare workers (HCWs).
• Implement the province-wide and city-wide health systems as mandated by the Universal Health Care (UHC) law. Through this, the DOH can realign province-wide and city health systems to set up a wide net of surveillance for influenza-like illness and a secondary line for SARI (severe acute respiratory infection or atypical pneumonia).
• Designate separate areas for COVID-19 and non-COVID-19 cases, to prevent non-COVID-19 patients from being infected by the virus.
• Set up isolation facilities for suspect, probable, and confirmed COVID-19 positive patients with mild symptoms who do not have sufficient spaces at home.
• Assign an epidemiological surveillance unit (ESU) at the provincial and city levels. These units can anticipate where the next outbreaks will be and act on information regarding new cases.
• Direct all hospitals to disclose their accommodation capacity in real time. Have a central data base of available hospital accommodation and services, which is updated in real-time. This is to allow the efficient trafficking of patients in need of care.
• Adopt the national strategy of ventilatory support in hospitals which the civil society Stop COVID-19 coalition has submitted to the DOH and the IATF.
6. Take care of the poor and the vulnerable
For the immediate and effective implementation of social amelioration measures we support the following:
• Utilize the National Household Targeting System (NHTS) as the baseline for the rapid deployment of assistance to poor families. Although imperfect, the NHTS has already incorporated variables from the Family Income and Expenditures Survey and the Labor Force Survey in the identification of 4.2 million Filipinos enrolled in the Pantawid program. Cash transfers to Pantawid households can be automatically done utilizing the payout system that is already in place
• Merge the NHTS with the LGUs’ recommended list for inclusion, using the application for the Social Amelioration Card (SAC), This should cover non-Pantawid households, including persons with disability (PWDs), single parents, informal workers, teen parents, senior citizens, and poor migrants trapped in localities because of the ECQ. The non-Pantawid households should immediately get cash assistance and issued cash cards as soon as they accomplish the SAC application form. Gathering completed SAC application forms must be a combined house-to-house effort of the Department of Social Welfare and Development (DSWD) and LGUs, with DSWD fielding enumerators to hasten the process of generating the list of additional recipients. Encode the data from the SAC forms as soon as possible, to clean the list for the next round of assistance and thus have a more reliable database for social protection measures.
• The cash transfers should not be conditioned on completion of encoded data of beneficiaries, as this will take longer to do. There is a need to expand the support currently mandated to address exclusion and cover remaining gaps.
• Use electronic money transfers towards a swift release of the assistance. Loop in conduits that offer zero to minimum transaction fees like GCash, PayMaya, Palawan Express. and the Land Bank of the Philippines card for beneficiaries. This reduces the burden of the barangay and reduces human interaction. But fund transfer arrangements should be flexible, depending on the condition of the locality. There might be instances where it would still be easier to funnel it through the barangay especially in areas where money transfer facilities are in the población and the recipients are in far-flung barrios.
• Make public the list of beneficiaries. This will minimize suspicions of politicizing the transfers, favoritism, and corruption. This is allowed under Section 4-c of RA10173 or the Data Privacy Act of 2012. The file formats shall be disclosed in an open and machine-readable format, so the public can create better dashboards
• Immediately establish the grievance mechanism for citizens. The grievance mechanism, can address problems of unjustified exclusion. This can be facilitated by making public the list of beneficiaries.
• The local government should draw up the list of non-Pantawid beneficiaries without requiring them to present an identification card. These non-Pantawid households should immediately get cash assistance and issued cash cards as soon as they accomplish the SAC application form. We propose the same for fisherfolks and farmers who were not covered by the RSBSA survey or BFAR’s municipal fisherfolk registry. The implementing enumerator can consult with community leaders who can vouch for that person, too. Guidelines for cash transfer must aim for maximum coverage of the vulnerable sectors and should err on the side of inclusiveness.
• Allow limited public transport operations that will serve all essential trips of frontline workers and ordinary citizens who need mobility to access healthcare, medicines, food and other essential items. To make this possible without veering away from the health objectives of the quarantine, we need to have skeletal public transport routes, provided that health and safety measures are strictly observed. These public transport services may include buses and jeepneys, and should serve main transit corridors.
• Transport operators who will render limited service must be subsidized through fixed-fee contracts for their operations to be viable, given the need to reduce passenger load to observe social distancing in vehicles.
• Active transport modes, walking and cycling, should be prioritized through the creation of a protected bicycle lane network and clearing and widening of sidewalks.
• There should be unhampered production and delivery of basic commodities. LGUs and their barangay officials should be fully aware that farmers, farmworkers and fisherfolks are front liners as well. So long as they are healthy, they should be allowed to go to their farms or fishing grounds. Barangay checkpoints in areas outside NCR should also be dismantled and have the AFP man inter-municipal/provincial checkpoints.
7. Guarantee access to information.
A key to winning the war against COVID-19 is transparency. The complaints, pleas, cries and rants we are hearing from the medical community and the general public stem from their lack of information or their lack of access to information. When information from establishment sources fails, confusion, hysteria, anger and demoralization will prevail.
• For the IATF, demand from all agencies the public disclosure of all information and data that the Executive Order on freedom of information covers. Disclosure should include medical monitors and the status of implementation of RA 11469 or the Bayanihan to Heal as One Act of 2020
• For government agencies like DOH, have a temporary lifting of the non-disclosure agreements with concerned parties who hold or produce data and studies that the scientific community and the public will need to fight COVID-19. This serves the public interest at a time of national emergency.
• Public health and safety prevail over confidentiality of medical data. This means that suspect/probable/confirmed COVID-19 patients must waive the confidentiality of their medical condition and inform those they have been in close contact with immediately. Also, the government must prudently use and promptly share this medical information to enable concerned authorities, institutions and persons to effectively take precautionary and remedial measures.
• Include in the President’s Report a Budget of Expenditures and Sources of Financing Tables for COVID19.
The tasks are aplenty; the tasks are complex and challenging. By grasping and implementing these urgent tasks through our collective action, we shall overcome.
SIGNED,
Organizations: COVID-19 Action Network Stop COVID-19 Coalition Sin Tax Coalition Right to Know, Right Now! Coalition (R2KRN) Action for Economic Reforms (AER) Akbayan Youth Aksyon Kabayanihan Para sa Organizadong Pagbabago (ANGKOP) Alyansa Tigil Mina (ATM) AltMobility PH ANG NARS Asosasyon ng Nagkakaisang Magsasaka sa Philseed. Ayos na Gamot sa Abot Kayang Presyo (AGAP) Bagumbayani Initiative Balay Mindanaw Buklod CSSP Cambuga Farmers Credit Cooperative. (CFCC) Consolidated Council of Health and Allied Profession (CCHAP-PSLINK) COVID19PH Citizens’ Budget Tracker (bit.ly/holdpowertoaccount) Economics Research Society Fair Trade Alliance Focus on the Global South FOI Youth Initiative (FYI) Galing Pook Foundation GoodGovPH Health Justice Philippines JCI-Lakambini Davao Kaisahan ng Magniniyog sa Mulanay (KASAMA MU, COINDEV) KALikha UP Diliman Kanlungan, Damayan at Agapay ng Magsasaka Para sa Agrikultura (KANLUNGANG DAMPA) Lingap Para Sa Kalusugan ng Sambayanan (LIKAS) Move Metro Manila National Public Workers Congress (PUBLIK) Philippine Legislators’ Committee on Population and Development (PLCPD) Philippine Pediatric Society Philippine Rural Reconstruction Movement (PRRM) Public Services Labor Independent Confederation (PSLINK) PUP College of Social Sciences and Development Student Council PUP SEED PUP Sociology Society PUP Viva Voce RIGHTS, Inc. Rotaract Club of Raha Sulayman Sentro ng mga Nagkakaisa at Progresibong Manggagawa (SENTRO) Sikhay EDUK United Federation of Service Workers United Healthcare Organization of the Philippines UP Alyansa ng mga Mag-aaral para sa Panlipunang Katwiran at Kaunlaran (UP ALYANSA) UP Business Administration Council UP College of Education Student Council UP College of Music Student Council UP College of Social Sciences and Philosophy Student Council UP Economics Towards Consciousness UP Law Student Government UP National College of Public Administration and Governance Student Council (UP NCPAG SC) UST Lakas ng Diwang Tomasino – College of Nursing (Lakasdiwa Nursing) UST Lakas ng Diwang Tomasino (Lakasdiwa) WomanHealth Philippines Women Action Network in Development (WAND) Youth Advocates for Economic Progress Youth Strike 4 Climate Philippines Y’s Men’s Club of RAHA Paranaque
Individuals: Dr. Anthony Leachon Joseph Lim, PhD Clarissa Militante Dr. Charl Andrew Bautista