Locking-down our priorities

COVID-19 PH4, Carlo L. Navarro, a 48-year-old tax lawyer, visited Japan in February with his wife, Evie and only daughter, Gia. Throughout their trip, they wore protective masks, gloves, and incessantly used alcohol on their hands. Seven days after returning home, Mr. Navarro showed mild signs of COVID-19. A responsible citizen and father, he immediately insisted on being tested for the virus at a private hospital. His infection was confirmed within two days. He was the first Filipino to be found positive in the country. He was quickly confined to prevent its spread. His family, household members, and contacts have all tested negative.

Mr. Navarro was in hell for eight days at the Research Institute for Tropical Medicine (RITM) and for another week at a private hospital. He was discharged after a CT Scan showed that his hospital-acquired pneumonia did not consolidate.

He was allowed home quarantine without the benefit of two confirmatory negative tests for the virus. RITM has been flooded by requests for COVID-19 testing from Persons Under Investigation (PUIs) and from prioritized asymptomatic “very important persons,” to whom the Health Secretary has decided to accord “courtesy.”

According to the Department of Health tracker, as of this writing, the Philippines has 636 confirmed cases with 84 new cases, 38 deaths, and 26 recoveries.

The prognosis is very grim. With a very weak healthcare system and late lockdown, the scoreboard is expected to continue bleeding red. It is only recently that the Philippines received a good number of test kits mostly from other countries. Those under the radar would be flushed out, and the statistics of infected Filipinos is likely to surge. There is hope in Mr. Navarro’s message put out by the South China Morning Post, that getting COVID-19 “is not a death sentence.” It can be controlled.

Until the passage of the “Bayanihan to Heal as One Act” last Tuesday, for weeks there was little coherence in the public response to the virus. We experimented in incrementalism: from simple monitoring to “community quarantine,” to “enhanced community quarantine,” to “extreme enhanced community quarantine,” to lockdown. The experiment in incrementalism has failed.

Hospital facilities including the medical complement cannot cope. Heroes are falling from their ranks. The lack of PPEs (Personal protective equipment) and masks are being addressed by private donations or do-it-yourself-taped-up garbage bags and acetate shields, while a Senator calls out the medical-supply scarcity as “fake news.” Some local government units have decided to establish makeshift tent cities with flimsy partitions to accommodate potential COVID-19 patients.

Incrementalism is sensible only when one advocates good governance and expects meaningful changes in public policy. But during a health crisis like the COVID-19 pandemic, the perspective of competent health practitioners should guide public policy decisions and subsequent implementation. We urgently need decisive leadership with the best interest of the general public foremost in their hearts.

What do we expect from the Bayanihan Act?

Constitutional and legal issues aside, the Bayanihan Act compensates health workers infected with COVID-19 or those who perish upholding their Hippocratic Oath. PhilHealth is mandated to shoulder the medical expenses of public and private health workers in case of virus exposure or any work-related injury or disease. It allows the Executive to engage temporary health workers to support the regular force. Good.

The Act however, does not rectify the previous reduction of the Health Budget, and those of RITM, PGH (the Philippine General Hospital) and other public hospitals. We hope this is addressed by leveraging on Section 3 of the Bayanihan Act. It ensures “sufficient, adequate and readily available funding to undertake… measures that will prevent the overburdening of the healthcare system.”

We highlight the healthcare system because the virus piggybacked on it to propagate itself.

Because it is weak, our healthcare system has failed to readily test cases; establish contact tracing; and undertake mitigation to those affected. A half-hearted lockdown aggravated the tragedy. Both public and private healthcare systems are bursting at the seams. Sufficient funding is absolutely needed to avoid unbridled spread of the virus.

Some epidemiologists hope that “the virus mutates and dies out.” Be that as it may, there is no substitute for funded vigilance. The virus can be proactively controlled. This is displayed by policy actions with good results in Singapore, Taiwan, South Korea, and Hong Kong.

The social and economic costs cannot be dismissed. In the Philippines, as in other jurisdictions, the virus has prevented daily wage earners and ambulant vendors from sustaining their lives through their modest earnings. The Bayanihan Act addresses this issue by providing subsidies ranging from P5,000 to P8,000 a month to some 18 million low-income households. This is admittedly inadequate by any standard. It is good the Executive is also authorized to implement an expanded and enhanced conditional cash transfer program.

To secure the welfare of both individuals and businesses, the Act rightly protects the general public from “hoarding, profiteering, injurious speculations, manipulation of prices, product deceptions, and cartels, monopolies or other combinations in restraint of trade, or other pernicious practices” affecting the supply, distribution and movement of products and services.

What about the economy?

The Act is silent as to any assistance to businesses at this time. We agree: first things first. Since we are just catching up with COVID-19’s deadly spread, focus on the healthcare system and insurance for social protection are the imperatives.

What of Government’s initiatives prior to the pandemic? The Build, Build, Build program must be sustained subject to normalization of business. If a project is too ambitious to be completed within the year, it would be prudent to freeze it. Meanwhile, the budget can be realigned to augment public healthcare.

In this, Finance Secretary Sonny Dominguez assured that the Government is “willing to do as much as it takes.” He acknowledges the need to prioritize. After a good stocktaking of economic damage, further stimulus programs can be considered. Previous fiscal and monetary measures have been announced by the National Government and the Bangko Sentral ng Pilipinas.

So far, the public has broadly adhered to the quarantine.

But what about the quarantine call endorsed by a Senator of the Republic, a call strongly decried by Makati Medical Center as “merely rhetoric,” which “he himself violated,” virtually assaulting the hospital, its frontliners, and in the process, the integrity of the whole healthcare system?

Diwa C. Guinigundo is the former Deputy Governor for the Monetary and Economics Sector, the Bangko Sentral ng Pilipinas (BSP). He served the BSP for 41 years. In 2001-2003, he was Alternate Executive Director at the International Monetary Fund in Washington, DC. He is the senior pastor of the Fullness of Christ International Ministries in Mandaluyong.