Thursday, April 16, 2020

Wake-up call: PH doctors in dire need of PPE


PERRYSCOPE
Perry Diaz

Early in the novel coronavirus outbreak, presidential spokesman Secretary Salvador Panelo defended President Rodrigo Duterte on his decision to allow the Chinese to travel to the Philippines.  “No need to ban our Chinese friends,” he said. “You just need to boost your immune system.”  That was on January 23, 2020, three weeks after the pandemic broke out.
A week later, on January 30, 2020, Sen. Christopher “Bong” Go commented, “China is not the only country hit by the virus.”  He said, “Other countries, too.  It’s hard to single out China.”         
               On Feb. 3, 2020, President Duterte declared: “Everything is well in the country.  There is nothing to be extra-scared of that coronavirus thing.”
With President Duterte and his two close allies rooting for the Chinese, it left the doors wide open for Chinese tourists – untested of the virus -- to come to the Philippines, exposing the country to the virus.
As the novel coronavirus (a.k.a. COVID-19) spread in Manila, Duterte – who had refused to impose a travel ban then -- abruptly imposed ground, sea, and air travel ban to and from China for a month through April 14, 2020.  By the time he had imposed the travel ban, the COVID-19 virus had already spread in Manila.
He ordered 40,000 police officers deployed to checkpoints on roads that lead to Manila.  Each vehicle was stopped to check the IDs of the passengers and purpose of their travel. The officers also looked for people with symptoms of COVID-19, such as fever and coughing. 
Duterte then authorized sweeping quarantines in Metro Manila to fight the COVID-19 virus.  He also banned large gatherings in the metropolitan area, suspended most government work, and extended the suspension of classes by a month in new restrictions announced in a nationwide TV address.  He warned that violators and officials who refuse to enforce the restrictions would face possible imprisonment.
“This is not martial law,” Duterte said, stressing that the restrictions are only aimed at fighting the COVID-19 virus.  He himself was tested for the COVID-19 virus and has self-quarantined although he has no symptoms of COVID-19.  He only wanted to make sure he was healthy and could continue to engage with the public.
At least nine Cabinet members said they were exposed separately to COVID-19 patients and decided to self-quarantine. Several mayors and senators have also gone on home quarantine after coming into contact with patients.  
It’s interesting to note that prior to imposing the travel ban, Duterte had allowed flights from China to the Philippines.  The total number of Chinese tourists allowed to enter the Philippines at the time of the outbreak was around 4,500. He had resisted calls and pleas for travel restrictions, saying “Not yet” and reasoned that there had been no proven case off human-to-human transmission of the virus.
“If there is the slightest possibility that a contamination could occur in the Philippines, then we will have to take measures,” Duterte said. “At this time there is no known protocol which we can follow to combat the disease. What we can do is to limit the people entering [the Philippines]. It could include China but at this time, I am not for it. It would not be fair [to China].” But would it be fair to allow people suspected of having COVID-19 from China to enter the Philippines?
Health Secretary Francisco Duque reluctantly recommended banning Chinese nationals from entering the country.  He said the government is looking at the ban as an option; however, he raised the issue that China might question why the Philippines is not imposing the same restriction on other countries?  But Mr. Secretary, the virus originated in China; there were no other countries where the virus was found in large numbers at that time.
Total ban
The first case was a Chinese national who arrived in the Philippines on January 21.  The man tested positive for COVID-19.  It prompted Duque to immediately recommend a temporary ban on all travelers from Hubei province in China, where Wuhan is.  But some experts urged the president to go even further.  Dr. Anthony Leachon, former president of the Philippine College of Physicians, recommended a “total ban.”  “China is the main source of the coronavirus and with the most deaths and cases globally. Protecting our people from an epidemic is paramount,” Leachon said. “The deaths and cases are mounting – we need to do something.”
“It is hard to say that you suspend everything because they are not also suspending theirs and they continue to respect the freedom flights that we enjoy," Duterte told reporters in an ambush interview.  Once again, Duterte implied that he didn’t want to antagonize Chinese President Xi Jinping whom he was kowtowing to.
               But Duterte needs to realize that China is not banning travel between China and the Philippines because Filipinos traveling to China are not considered high risk for carrying the virus.  
Eventually, the Philippines suspended all flights from Wuhan and the issuance of visas upon arrival for Chinese nationals, albeit a little bit too late to stop the coronavirus from spreading in the country.
Lockdown
Leachon had told the media the only way to contain the virus was a lockdown of Metro Manila and its 12.8 million people.                 “If we will not avert the epidemic through a lockdown like in Italy, then our private and public hospitals will be swamped with patients and risk the lives of our health care professionals,” he said.
On March 12, Duterte ordered the lockdown of Metro Manila.  Overnight, checkpoints were set up in every exit to and from the 16 cities and one municipality that comprise Metro Manila.  The month-long lockdown was from March 15 to April 14. 
However, Leachon said, “It is likely this won’t go away in the next two or three months based on the China experience.” 
He warned that the outbreak would get worse before it gets better after a few months.  “It’s unfortunate that the government did not accurately project the need for more test kits.  But with lockdown and social distancing we will be able to contain the epidemic,” which is now a pandemic of global proportion.
The pandemic has so far claimed the lives of 17 doctors who died while in the frontline battling the highly infectious COVID-19 virus.  The Philippine Medical Association (PMA) has been critical of the government on its handling of the fight against the COVID-19 pandemic.  PMA Commission on Legislation chairman Dr. Oscar Tinio believes that the deaths could have been prevented if there was enough supply of personal protective equipment (PPE) for the health workers.
Further, Tinio pointed out that many practicing doctors with various specialties want to help in the war against COVID-19.  But they are hesitant because of the lack of protective gear, which would expose them to the virus while treating patients.
This is a wake up call.  The number of frontline doctors and workers is dwindling.  The doctors and workers are in dire need of PPE.  Unless Duterte does something fast, he will be left with nobody to care for the growing number of COVID-19 patients. 


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