Do not panic.

Do not panic.

Do not panic.

Chances are, the one who nervously warns against panicking might be the one wetting his pants. The mischievous Greek half-god, half-devil Pan would be laughing shrilly after bellowing loudly to frighten those who unfortunately found themselves lost in his forest lair. Demonic laughter rouses the adrenaline of fear and the cauldron bubbles in the ensuing pandemonium. (Note the “demon” in pan-demon-ium.) Fear is contagious. Pretty soon so many are caught in the contagion of fear — transmitted person to person or “airborne,” as in the ambience — and there is a pandemic. (Note the “pan” in pan-demic, where “Pan,” the god who strides both the upper and the lower worlds, has been made the prefix for things universal or worldwide.)

So much for etymology and the play of words. Sorry, there is the luxury of time and space in this “expanded community quarantine” (ECQ) for the idle mind. But wait, here’s yet more “double-speak” in the “New Now” of the novel coronavirus world experience:

The World Health Organization (WHO) had first issued a warning about the coronavirus, renamed “COVID-19” on Dec. 31, 2019.  It was declared to be a Public Health Emergency of International Concern (PHEIC) by the WHO on Jan. 30, which noticeably avoided calling it a pandemic, as other previous widespread contagions or plagues have been rationally labeled. Precisely, world pandemonium over a pandemic must be avoided. Do not panic, world leaders exhort their fearful people. The leaders are panicking, perhaps over bubbling cauldrons of other pandemics in politics, economics, and societies within and outside their countries.

While outwardly repeatedly preaching “Do not panic” to constituents, world leaders in their respective regimes must, for their own sakes and, of course, for their country and people, look at the confluence of effects of the world shutdown in this time of COVID-19. The feisty socialist Bulgarian President Roumen Radev called down his government, and with them, world leaders who have been in denial about the “parallel crisis” of survival during and after the coronavirus pandemic. Radev initially did not want emergency powers, but eventually agreed to the State of Emergency Measures bill, after refining the freedom of speech and profiteering clauses in the bill, according to the Sofia Globe of March 22. How different Radev has been, from some PR-seeking politicos who seem to have taken shameless advantage of the pandemic to take unto themselves “emergency powers” purportedly to handle the situation better, when their sworn duty to their people was simply to do their jobs, and do their jobs well.

As of yesterday morning, April 5, there were 1,201,591 total confirmed COVID-19 cases in the world, with 64,703 deaths and 246,198 total recoveries. The US still tops the list at 246,198 confirmed cases, 8,476 deaths and 14,694 recoveries; Spain follows with 126,168 cases, 11,947 deaths and 34,219 recoveries; and third is Italy with 34,219 cases, 15,362 deaths and 20,996 recoveries. The Philippines, according to the same Johns Hopkins Hospital tally, has 3,094 confirmed cases, 144 deaths and 37 recoveries. With the varying numbers of confirmed cases versus corresponding death and recovery percentages, it can be seen that the coronavirus cannot yet be contained and controlled, much less reasonably prevented, regardless of the economic standing of the country in the world, or its state of medical technology and skills.

The more technologically advanced countries, led by the US and China, are working feverishly to cool the COVID-19 fever, but no vaccine is yet in sight to give confidence to the world that it would be fully restored to economic and social freedom of movement and interaction quo ante to the pandemic. The panic is now for the lack of testing kits for even the PUIs (persons under investigation) and the PUMs (persons under monitoring) so that they can remain in quarantine while the uninfected can resume “normal” life with relaxed social-contact restrictions vis-à-vis the identified sources of infection. Then there is the overwhelming lack of facilities (hospitals, equipment, specially ventilators and PPEs — personal protection equipment like masks, gloves, and gowns) and medical staff (the brave front liners, some of whom have already succumbed to the virus).

The top three countries suffering most from COVID-19 — the US, Italy and Spain —  have bungled their handling most, according to doctors interviewed in the Atlantic Daily of March 25. They blamed the denial of the leaders of these countries, or maybe the ignorance that the coronavirus was stealthier and more virulent, more immediately fatal than any other coronavirus (like the 2003 SARs). The slow reaction and bad planning, exacerbated by the lack of hospital facilities brought the world to its knees before the taunting coronavirus.

The quarantines around the world might not be lifted by Easter Sunday, most Health Departments say. Lockdowns have been extended by governments tentatively until the end of April, and some until the end of May. Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, said in the USA Today of March 16 that the outbreak will get worse before it gets better.

Meanwhile, the “parallel crisis” of world economics petulantly vies for attention. Those hopefully not infected by COVID-19, and those who would have survived the contamination must have the wherewithal to continue to live, with a quality of life above Maslovian survival.

“The global economy is already in a recession as the hit to economic activity from the coronavirus pandemic has become more widespread, according to economists polled by Reuters amid a raft of central bank stimulus actions this week,” Reuters reported on March 20. “The evolving news on COVID-19 has triggered ‘forecast leap frogging’ with economists and strategists repeatedly lowering their forecasts. Among the big three economies, the US and the Euro area will see negative growth, while Chinese growth is expected to come in at a paltry 1.5%,” Reuters reported.

“Recession” is a dirty word, a virtual virus that can cross-contaminate nations and cause a pandemic as life-threatening as the coronavirus. And perhaps technology, with its tempting fruit of information-sharing and high-speed accessibility has brought the world to this now unshakable togetherness of commerce and trade, even diplomacy, in globalization. What affects the countries of the world will affect the little developing country of the Philippines.

“The main downside risk to (Philippine) GDP (gross domestic product) growth in 2020 comes from COVID-19 and is therefore highly unpredictable. The impact on the economy will be larger than currently assumed if the global outbreak is prolonged beyond the first half, or if there is a sustained local transmission in the Philippines,” the ADB said in its Asian Development Outlook 2020 report. Luzon, home to half of 105 million+ Filipinos, locked down since March 24, accounts for more than 70% of national GDP and is the center of the COVID-19 outbreak.

 Ernesto Pernia, director general of the National Economic Development Authority (NEDA) now says, “Gross domestic product could register negative growth of 0.6% to an expansion of 4.3%, depending on how long the lockdown of Luzon will last (ABS-CBN News, March 24). “But we still hope to recover by fourth quarter this year,” Pernia said, indicating the possibility of ending just somewhere 1% below the target 6.7% before the Luzon lockdown.

In a phone interview by Cathy Yang of ANC yesterday morning, Bangko Sentral Governor Benjamin Diokno said we are OK, no need to panic about the economy. There have to be two successive quarters of negative GDP growth before a technical recession, and we were at 2.9% in January, 2.6% in February, and 3.25% in March. We have the fiscal space, with 40% public debt to GDP ratio, which we can even increase to 45%, Diokno said. Reserves are good for eight months. We have the $2 billion assistance from the World Bank and its affiliates. And we have the continuing stream of OFW remittances, increasing 2% this year, dampened only slightly by the world quarantines situation from the previous 3% expected growth.

No need to panic over the pandemic.

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.