By Norman P. Aquino, Special Reports Editor
and Kyle Aristophere T. Atienza, Reporter

SHERWIN DE LOS REYES, 38, sat in a wheelchair in the corridor of the Las Piñas City District Hospital near the Philippine capital for five days waiting to be treated for the coronavirus disease 2019 (COVID-19). He died shortly after.

“Sherwin never had the chance to fight for his life,” Roy R. Bayona, his business partner and close friend, said by telephone. “He might have recovered and survived had he been admitted and given proper treatment.”

This was in August last year, when more than a million doctors and nurses had warned about losing the COVID-19 battle amid record infections sweeping the Southeast Asian nation.

Nearly a year after, the pandemic is staring the government in the face. Manila and nearby cities are at the heart of a major breakdown of the country’s healthcare system that critics had long foretold.

Daily tallies and deaths are at their peak, while highly contagious variants of the COVID-19 virus are sweeping the nation as vaccines remain in short supply.

“What we’re seeing in the Philippines is the culmination of a multilayered and prolonged failure on every single dimension of governance,” said Richard Javad Heydarian, a political analyst and research fellow at the National Chengchi University in Taiwan.

“It’s a concatenation of mismanagement of the crisis on multiple levels,” he said in a Facebook Messenger chat.

The Philippines will lag behind its Asia-Pacific neighbors in terms of economic recovery as coronavirus infections continue to spike and vaccines remain in short supply, Moody’s Analytics said this week.

“The Philippines is the laggard of the entire region as a record-high number of new COVID-19 cases has led to a resumption of strict lockdowns in Metro Manila, and the country faces a severe shortage of vaccines,” Moody’s Analytics Chief APAC Economist Steven Cochrane said in a note on Monday.

Philippine authorities have blamed the surge on more contagious variants of the virus and people ignoring health protocols, but experts disagree.

“The Philippines has the longest lockdown in the world, yet the government has failed not only in saving lives, but in recognizing, admitting and learning from its failures,” said Leonard D. Javier from the Health Alliance for Democracy.

Some hospitals were running at full capacity even before the fresh surge in infections started in March, he said in an e-mail.

“Hospitals are not supposed to be inundated by patients if we contain and prevent the spread at the community level,” Mr. Javier, a doctor, said.

“Now most hospitals in the National Capital Region Plus are overwhelmed, with patients spilling over to nearby provinces,” he added.

Anabel W. Samonte, 61, got tested after experiencing high fever, body pains and other flu-like symptoms on March 27. A few days after, she tested positive for the coronavirus.

“Knowing that the hospitals were full, and with advice from our relatives who were doctors, we tried to manage her at home,” her daughter Gwendolyn Samonte said in a Facebook Messenger chat.

But they had to bring her to a hospital after her symptoms worsened. “We contacted more than 20 public and private hospitals in Metro Manila and nearby provinces but all were full.”

It took days before they found a hospital willing to admit her mother.

Gilbert Enrile, 87, was not as fortunate. He died two days after testing positive for the coronavirus, a situation described by a group of private hospital administrators as a “nightmare.”

“A village health worker advised us to just have my dad stay at home and wait until there’s an isolation facility that could take him in, which was not assured,” his son Ivan Phell said in a Messenger chat.

‘UNMANAGEABLE’
Almost a million people have been infected with the coronavirus in the Philippines, the second-highest in Southeast Asia after Indonesia. More than 16,000 people have died, while almost 800,000 have recovered, according to the Department of Health (DoH).

The agency on April 2 reported the highest daily tally of 15,310 cases since the pandemic started last year.

Active cases breached the 200,000 mark on April 17, according to DoH data, the highest in the region. The number has since gone down to 127,006 cases.

“Compared with many regions like Latin America, North America or Europe, the Philippine numbers are not as bad, but if you look at comparable cases in the region, it has not done very well,” Mr. Heydarian said.

Presidential Spokesperson Herminio “Harry” L. Roque, Jr. said the recent surge is not unique to the country but is happening worldwide.

Mr. Roque, who had tested positive for the coronaviru at least twice, added that criticisms were expected because “critics and the detractors of the administration have always something to say.”

Mr. Roque said 68% of intensive care unit (ICU) beds for coronavirus patients in the country have been used. About 49% of isolation beds have been used and more than 56% of ward beds were already occupied.

More than 80% of ICU beds in Metro Manila have been used. He added that about 63% of isolation beds and 70% of ward beds in the region were already occupied.

The command center responsible for referring patients to hospitals had been receiving an average of 399 calls daily, or almost four times the number last year, the Health department earlier said.

On-the-ground reports showed many have died without seeing a hospital or being treated by a health professional, Vice-President Maria Leonor G. Robredo said in a Facebook post this month.

“Many have already died inside tents outside hospitals, waiting to be admitted to the emergency rooms, in an ambulance while in transit, at home without receiving any medical help,” she said.

Jaime A. Almora, President of the Philippine Hospital Association, said the government had “failed to listen to the cry for help from the private hospitals.”

He said private hospitals in Metro Manila and nearby provinces had not increased their beds for coronavirus patients due to late payments from the state health insurer.

“Private hospitals had not been paid their COVID-19 claims since the start of the pandemic up to now,” he said in an e-mail. “This discouraged many hospitals in participating and expanding their capability to manage COVID-19.”

Gene A. Nisperos, a board member of the Community Medicine Development Foundation, said the state had failed to prepare the country’s healthcare system for possible emergencies such as the coronavirus pandemic.

“Government hospitals were always understaffed, poorly funded and lacked the resources to function optimally even before the pandemic,” he said in an e-mail. “The government did very little to address these issues.”

“The medical community has also learned much about handling COVID-19 patients. Management of severe cases is now more aggressive and unified. However, much needed resources, like medicine, remained in short supply,” he added.

Mr. Javier from the Health Alliance said the government had “neglected measures that matter in halting the spread of the virus: prevention through mass testing, contact tracing, isolation, quarantine and aid to those required to stay home.”

The medical community, along with civic groups, had been calling for broad-based testing since last year.

The country’s testing czar Vivencio B. Dizon has said the government could not test all Filipinos. “Testing is not the only solution to the pandemic,” he said. “We cannot test our way out of this pandemic.”

Health experts had been urging the government to test as many as 100,000 people daily in the capital region and nearby provinces, double the current rate.

“The surge became unmanageable because the fundamentals, like adequate testing and efficient contact tracing, are not even there,” Mr. Nisperos said.

‘HUBRIS’
He said the government was content in whatever it was doing for as long as hospitals were not full, people were complying with minimum health standards and vaccines were becoming available.

“The latest surge was triggered by the government’s hubris and refusal to acknowledge its own shortcomings,” Mr. Nisperos said.

“As much as we condemn vaccine apartheid around the world, Duterte had put all his eggs in Chinese and Russian vaccines,” Mr. Heydarian said. ¨But the Chinese vaccines came in late February but these were not enough,” he said, adding that Russian vaccines have yet to come.

It also did not help that state agencies led by the Health department and Philippine Health Insurance Corp. had been mired in corruption scandals, he added.

Jose Enrique A. Africa, executive director of think-tank Ibon Foundation, said the state overly relied on vaccines, which got delayed due to global supply issues.

“Its practice has evidently been a crude strategy of controlling the populace with restrictions while waiting for vaccines to come,” he said in an e-mail.

The government aims to vaccinate as many as 70 million Filipinos by year-end. It had  taken delivery of 3 million doses of CoronaVac made by China’s Sinovac Biotech Ltd. and the vaccine developed by AstraZeneca, Plc.

The government relied heavily on non-health personnel, particularly the military and police generals, instead of those in the health sector, Mr. Nisperos said.

“The Duterte government viewed the pandemic as a discipline problem, like a crime. Interventions were therefore militaristic and punitive. These are anathema to a health-based approach,” he said.

Mr. Duterte on April 15 said he could use police power to take over hotels and use their beds for coronavirus patients.

“I can order the authorities to take over the operations of hotels if there are no beds anymore. That is easy,” he said. “When we are pushed to the wall, I can always order the military and police to go there and confiscate the operation of hotels.”

During the implementation of a hard lockdown in Metro Manila, a resident of General Trias in Cavite province died after police forced him to do 300 pushups as a punishment for a curfew violation.

More than 120,000 violators of quarantine protocols have been arrested since Mr. Duterte locked down the entire Luzon island in mid-March last year to contain the pandemic.

The Presidential Palace has blamed health protocol violations for the recent surge, but government officials themselves have violated the rules.

Police Chief Debold M. Sinas reportedly skipped health screening when he visited Calapan City in the southwestern part of Luzon, the same day he announced he had the coronavirus. At the height of the first lockdown last year, he celebrated his birthday with a pre-dawn serenade.

“Public officials have the basic responsibility to be good examples to the public,” said Noreen Sapalo, a college lecturer on culture and politics and a graduate student of anthropology at the University of the Philippines.

“When they fail to do this, it leads to more distrust among Filipinos and fuels the ‘bahala na’ or fatalistic demeanor,” she said in a Messenger chat.

“We can clearly see that populism is not necessarily a recipe for competence especially in times of crisis,” Mr. Heydarian said.