A cluster of pneumonia cases of unknown cause was first reported from Wuhan, a city in the Hubei Province of China on December 31, 2019. It was later recognized to be a new coronavirus which was named as novel coronavirus 2019 (2019-nCoV). The disease, now named as coronavirus disease (COVID-19), has been confirmed in 24 countries outside of China including the Philippines (WHO, 2020).
World Health Organization (WHO) has been working with governments to build preparedness and response capacities in every country to contain the outbreak and prepare for possible community transmission. Such approaches are critical to reduce surge capacity needs during the outbreak, ensure that health systems can cope, and prevent hospital care units and ICUs from becoming overwhelmed (WHO, 2020). Thus, countries had developed and implemented strategies to contain the transmission based on the technical guidance on the COVID-19 response which WHO has issued. The paper aims to present how the country dealt with the pandemic.
Government Analysis of Data
On April 13, 2020, the Department of Health (DOH) launched a COVID-19 tracker and Data Collect App which facilitates tracking of reports between their offices.The DataCollect App collects daily data such as essential resources and supplies, hospital beds, isolation rooms, mechanical ventilators, and human resource needs from hospitals (Data) and stakeholders which is mandatory under RA 11132 known as ‘Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act’. The data gathered in daily case tracker every 1 PM is calculated and interpreted into a daily situational report after press briefing then is released and featured on COVID-Tracker not only as the epidemiology of COVID-19 in the country but also COVID-19 testing, health facilities, and availability of personal protective equipment or PPE (Information).
With this information, the public gains awareness of the health system’s capacity and update of COVID-19 cases. Also, the information is used to calculate the projected needs of supplies and develop guidelines such as management of person under monitoring (PUM) suspected with COVID-19, expanded testing, step-down care, contact tracing, and many more together (Knowledge). In response, the office works with the government agencies and private sectors to garner supplies and deliver it to different healthcare.
The DOH has also deployed teams to conduct an epidemiologic investigation and contact tracing activities such as but not limited to reviewing patient records and interviewing patients, relatives, healthcare providers, and other concerned personnel of the facility to gather a validated profile and travel or exposure history, obtain updated information on the daily status of the cases, track and identify people who may have been exposed to the case, and recommend necessary actions and measures accordingly. Also, the external agencies shall comply with the specific roles and corresponding operational guidelines provided by the DOH and National Task Force in response to COVID-19 (Wisdom).
Presentation of Data
The events and circumstances surrounding COVID-19 have brought about much panic and confusion to the public mostly due to the conflicting, inaccurate, and unverified reports around several media outlets and social media platforms (DOH, 2020). The Department of Health (DOH) in commitment to protect and promote public health and enhance transparency and accountability through freedom of information and open governance regularly publish, print and disseminate in an accessible form true, accurate and updated information through the website under Republic Act No. 9485, Anti-Red Tape Act of 2007 (DOH, 2020). This is to encourage the public to take action to prevent the spread of the disease, inform stakeholders on the government’s response in the protection of the health of the public and concerned individuals, and to correct misconceptions. In ensuring that only official and verified information is disseminated to the public, DOH follows the Reporting and Information Dissemination Protocol. This is a process wherein surveillance reports are sent to Usec Domingo who will inform Secretary Duque, who also directly receives the laboratory results before the cut-off time which is 12 PM.
The report then is disseminated to concerned offices wherein Health Promotion and Communication Service (HPCS) and Media relations Unit (MRU) drafts the press release/ statement. Secretary Duque then announces the updates to the public through press conference. After the official announcement, HPCS and MRU sends a copy to the regional directors and post on the official DOH website and social media platforms (DOH, 2020). The DOH COVID-19 tracker utilized a Tableau Public visualization with the help of Thinking Machines Data Science, the leading data science company in the country together with Nel Jason Haw, a faculty of the Health Sciences and Development Studies Programs of the Ateneo de Manila University and holds a Master’s of Science degree in Global Health from Georgetown University, USA and is an incoming Ph.D. student in Epidemiology at the Johns Hopkins Bloomberg School of Public Health, USA.
The tableau shows the total cases, deaths, recoveries, and active cases which contain asymptomatic, mild, severe, critical, and either pending in admission status, home quarantined, and admitted. New cases added can be seen below the classifications. The detailed case information shows total cases, new cases, total admitted, total deaths, new deaths, total recoveries, and new recoveries of different regions and province/city. Age and sex distribution of confirmed cases, active cases, deaths, and recoveries are also provided. Aside from providing accurate, reliable, and timely information, DOH also provides Information, Education, and Communication resources and materials. These include FAQs, Inter-Agency Task Force (IATF) resolutions, Interim Guidelines, Screening Tool for COVID-19, Public Advisories, Gabay sa Publiko, and Infographics.
Evidence-based Practice Implementation
One of the prevention measures that can limit the spread of certain respiratory viral diseases, including COVID-19 is wearing masks. However, the use of a mask alone is not enough to provide an adequate level of protection. Whether or not masks are used with other measures is critical to prevent human-to-human transmission of COVID-19.
According to WHO (2020), medical masks and respirators should be reserved for healthcare workers. Healthcare workers should use a medical mask when entering where patients with suspected or confirmed COVID-19 are admitted and use a particulate respirator when performing or working in settings where aerosol-generating procedures, such as tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, and bronchoscopy are performed. In line with this, the PICO question would be P- Healthcare workers, I- Use of respirator, C- Use of cloth mask, O- Infection Protection.
Quality Improvement Tools
Severe and mounting disruption to the global supply of personal protective equipment (PPE) is caused by rising demand, panic buying, hoarding, and misuse which puts lives at risk from the new coronavirus and other infectious diseases (WHO, 2020). Healthcare workers are relying on PPE to protect themselves and their patients from transmission of infection. However, supply shortage leaves the health workers insufficiently equipped to care for COVID-19 patients.
The use of cloth face covering is recommended by the Centers for Disease Control and Prevention or CDC (2020) so that medical masks and respirators would be reserved for health care workers. In addition to that, simple cloth face coverings slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. According to Cheng, Lam & Leung (2020), the use of cloth masks is adequate if everyone uses a mask. Homemade cloth mask has become prevalent as it is easy, simple, and cost-effective. It can be made through the sew method or non-sew method. Non-sew method includes quick cut t-shirt face covering and bandana face covering. According to CDC (2020), the use of homemade face masks can be an additional and voluntary public health measure.
Besides, a study was carried out for several common fabrics including cotton, silk, chiffon, flannel, various synthetics, and their combinations due to limited knowledge on the performance of different fabrics used in cloth masks to evaluate filtration efficiency. The study showed that filtration as a function of aerosol particle size improved when multiple layers were used and when using a hybrid combination of cloths such as high threads-per-inch cotton along with silk, chiffon, or flannel. With this study, cloth mask design could be enhanced and made available for protection against the transmission of particles in the aerosol size range.
Change in Learning Modality
On March 11, 2020, the World Health Organization (WHO) has characterized COVID-19 as a pandemic due to the exponential increase in the number of cases in more than 100 countries. Under Republic Act No. 11332, the President issued Proclamation No. 922, s. 2020 declaring a State of Public Health Emergency throughout the Philippines, and consequently, Proclamation No. 929 s. 2020 placing the entire Luzon under Enhanced Community Quarantine or ECQ (DOH, 2020). Mayor Benjamin Magalong announced suspension of classes at all levels until May 31, 2020 under Executive Order No. 78, series 2020.
In line with this, the education system must adapt to online classes. However, online classes have posed challenges to the students. Students come from very different backgrounds and have very different resources, opportunities, and support outside of school (Mineo, 2020). Some students will be fine during the pandemic because they have adequate resources for learning opportunities. Conversely, other students will not have access to anything of quality, and as a result will be at an enormous disadvantage. A survey conducted by Supreme Student Council (SSC) showed that more than half of the respondents (511) use smartphones for learning, 259 use both smartphones and laptops, and 8 do not have any device for learning. It also showed that most of the respondents have access to the internet but 191 do not have access to the internet at home. Additionally, 543 of the respondents have a slow internet connection. These became hindrances to online learning.
Rogers Diffusion of Innovative Theory examines the pattern of acceptance that innovations follow as they spread across the population of people who adopt it. Students despite their economic status understand the rapid transition to online learning due to the pandemic. Due to economic differences, it has garnered different opinions and concerns. However, the students were left with no other choice but to adapt to the demands of online classes to prevent delays in the academic level. While adapting to the demands of online classes, the students further enhance their technological skills. Setting aside the number of tasks to be done, students develop flexibility in finishing academic tasks at their own pace getting used to online classes. However, the continuation of utilizing online classes by the students after the pandemic might only be integrated but not fully implemented as the educational system is used to the traditional classroom setting, not prepared for virtual learning, and is a part of adjusting to the change brought upon by K-12 (ABS-CBN, 2020).
SLU Students’ Response to SLU Advisory
In line with the Luzon-wide ECQ, the SLU Administration has announced its decision regarding the continuation of online learning for the rest of the semester through its Supplemental Advisory No. 2. In line with this, the SLU students expressed their disappointment through social media platforms such as Facebook and Twitter with the hashtag (#) WalangIwananLouisian. The concerns of the students include lack of access to internet and technology, lack of quality education, determination of doable and lenient work, and recently tuition fee 8% discount.
Upon the release of SLU Advisory, the students responded differently. Some have expressed their concerns in a good way. But some expressed offensively. This event has shown the students’ manners and behaviors online. It showed how they represent themselves in public. Not only that, their actions reflected their professionalism in communication and handling emotions. As John Powell said, “Communication works for those who work at it”.
Fever is a common symptom of COVID-19, typically appearing 2-14 days after exposure. The clinical electronic thermometers are an important screening and diagnostic tool to assist in the identification of those individuals who may be infected with COVID-19 (FDA, 2020). Electronic thermometer particularly infrared thermometer guns are used in various hospitals and checkpoints to measure temperature. This minimizes the risk of cross-infection since it does not require physical contact with other person’s skin.
The government has enforced social distancing, ban mass gathering, and temporary closing of non-essential public places. This is to prevent human-to-human contact. Public health and safety officials, therefore, use drones to monitor people’s movement in public places and facilitate front liners. Drones are used to broadcast information and lockdown measures. It is also used to carry out tasks like spraying disinfectants to reduce exposure of sanitation workers to the virus and disinfectant. It can also be used to deliver medical supplies and transport samples from hospitals to laboratories. Drones equipped with infrared were also used to carry out large-scale remote temperature measurement (Sharma, 2020).
DOH has also boosted the use of telemedicine services for the public. This allows people to seek medical advice without leaving their homes. Examining a patient with COVID-19 symptoms or other medical conditions limit the risk of infection exposure of other people in a face-to-face consultation. Telemedicine is free of charge until the ECQ is lifted.
The NI applications are of great use during this pandemic. It facilitates monitoring at the same time limits human-to-human contact to prevent further spread of diseases. Proper usage of the applications would prevent errors and maximize the functions of NI applications in the promotion of health.