The collective action of the health professionals

We have read and heard — and we have written — that beating COVID-19 is a collective action problem. It is in the common interest of the whole of society to get together and take united action against the pandemic. But getting together, despite having an indisputable common objective, is hard to do.

Collective action requires a good organization, but the majority of our people are not organized. The masses simply do not have the extra resources and spare time to take part in a collective effort. The unorganized would just let the few active ones take up everyone’s cause.

Among the population, the doctors and other health professionals are at the forefront of fighting COVID-19. They screen or diagnose the patients. They treat and heal the sick. They conduct medical research, provide advice, and educate the public. (The word “doctor” is derived from the Latin verb docēre, which means “to teach.”) This set of tasks can be done individually and per se, does not constitute collective action.

But the nature of the pandemic threatens the health professionals themselves. Moreover, the health crisis has an incalculable impact on society’s economic, social and political fabric. The risks and costs to self and society thus motivate and compel the health professionals to take collective action. The doctors feel and understand the necessity of collective action. No amount of medical intervention they do can succeed without having the appropriate or responsive institutions and public policies.

As an agent of change, as a force for collective action, the doctors are influential and powerful. They are organized nationwide in medical associations or societies. They relate with different people. They have vast networks, and it goes without saying that their patients include the policy makers, the influencers, the politicians, and the technocrats.

Above all, the whole of society trusts the health professionals. A global survey conducted in October 2018 by Ipsos, a global market research and public opinion company, shows that scientists, doctors, and teachers are the most trustworthy professions, with scores of 60%, 56% and 52%, respectively. (Other professions have a score of less than 50%. The survey covered 23 countries, but excluded the Philippines.) To explain the high level of trust that society accords to doctors, I quote a blog authored by Laura Smith titled “Why Do We Trust Doctors?” (Oct. 2, 2019): “So why do we trust doctors now? We trust doctors because most of us have agreed to trust science and evidence-based conclusions. We trust doctors when they time and again heal us. But perhaps, we also trust doctors because they appear unified, a surprisingly recent development in medical history offering a cautionary tale useful in our own professional and public divisions.”

I hasten to add that the matter of doctors being unified is not only limited to their thoughts and knowledge; such unity applies to their actions as well.

The united action of health professionals in the time of COVID-19 has taken different forms. In the United States, the medical workers have joined the ranks of protestors. They have manifested their indignation over the killings of black Americans like George Floyd and Breonna Taylor. The slogan “white coats for black lives” says it all. After all, the credo of health professionals is to protect lives, save lives.

In Peru, about 10,000 doctors have mounted a nationwide strike to protest the government’s handling of the pandemic and to demand better compensation for the front-line medical workers. Peru has one of the highest per capita COVID-19 fatality rates in the world.

In Madrid and Barcelona (Spain), hundreds of doctors and nurses have protested against a shortage of human resources and inadequate supplies and have demanded better working conditions.

In the Philippines, the collective action of the health professionals has taken the form of an alliance that has pressed forward a coherent and fairly comprehensive package of interventions to contain COVID-19. This coalition is called the Health Professionals Alliance against COVID-19 (HPAAC), consisting of 163 medical associations, representing 100,000 doctors and a million nurses and other allied health professionals. Precisely because of their reach and influence and the trust that they enjoy, the whole nation is listening to them.

The government has acknowledged the recommendations of the HPAAC. Some of these recommendations are now being implemented, and others are being studied.

The government responded to the call of HPAAC and other civil society networks for a “timeout” with respect to the lifting of quarantine measures, in order to prepare the necessary measures, medical and non-medical, for the safe opening of the economy. The HPAAC and civil society organizations, armed with the scientific evidence, have likewise prevailed upon the government to reverse the policy of easing physical distancing on trains and public utility vehicles.

The gains from collective action include the following:

• Unified clinical and public health algorithms (or protocols) to avoid confusion and inconsistency in policy implementation.

• Activation of the health technology commission to ensure that the technology and medicines that the government will purchase and use are effective and cost-efficient.

• Establishment of a “one hospital command.”

• Adoption of workplace and transport safety guidelines or measures.

• Introduction of service contracting in the transport sector, whereby the government will contract the services of public utility vehicles to ensure adequate transportation that will follow the essential health and safety standards.

Still, much more has to be done. As government is opening up the economy, the HPAAC and an array of civil society organizations want to put in place measures that will:

• Strengthen and improve contact tracing through a defined gateway and clear pathway (an enterprise hub).

• Create and consolidate a broad referral network (which transcends geographical or jurisdictional boundaries) for testing, contact tracing and treatments.

• Provide support for public transportation, including active transport (non-motorized transport).

• Provide financial support and other incentives for isolated and quarantined workers.

• Increase and enhance digital connectivity.

• Accelerate the implementation of the Universal Health Care law.

To be sure, the task of attaining these proposed measures cannot be confined to the health professionals. These measures are of paramount public interest. We, the citizens, are the ultimate beneficiaries of the proposed medical and non-medical measures to beat COVID-19. Let us then join our doctors, nurses and health workers in collective action.

 

Filomeno S. Sta. Ana III coordinates the Action for Economic Reforms.

www.aer.ph