When the novel coronavirus (Covid-19) emerged and spread earlier this year, the seemingly endless movements of people suddenly came to a halt and took over normal routines worldwide.
Now, people are mandated to wear face masks, physically distance themselves at least six feet, and have no other choice but to stay indoors. Flights were grounded, concerts were canceled, schools suspended classes, and for the first time in nearly 500 years of Christianity in the Philippines, churches temporarily shut its doors during the Holy Week to protect its followers. Social distancing measures have no doubt become more stringent, all to avoid further contagion.
Even New York City, “the city that never sleeps,” is now sleeping.
WHERE IT ALL BEGAN
On December 31, 2019, as the world prepared to welcome the new year, China alerted the World Health Organization (WHO) of an unknown virus that caused several cases of an unusual case of pneumonia in Wuhan, a port city of around 11 million people in the central Hubei province.
Most of the infected individuals worked at the city’s Huanan Seafood Wholesale Market, which was then shut down the following day, January 1, 2020.
A week later, officials identified and announced that a novel coronavirus had been discovered, identified as Severe Acute Respiratory Syndrome Coronavirus 2 or SARS-CoV-2.
More infected cases emerged, and on January 11, China announced its first-ever death from the said virus. Two days later, Thailand reported its first case, the first country outside China to have contracted the novel coronavirus.
The number of cases in China continued to rise from dozens to hundreds in a span of weeks. Especially with the Chinese Holiday on January 25, the spread outside the epicenter was inevitable, and soon countries such as Nepal, France, Australia, Malaysia, Singapore, South Korea, Vietnam, Taiwan, and the United States each recorded their confirmed cases.
Since then, people around the globe halted and have shifted their eyes as the world witnessed the threat and terror of the novel coronavirus unravel.
What is COVID-19?
Coronaviruses, as defined by the WHO, are a large family of viruses that may cause illness on both animals or humans.
In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes, which is then called, the coronavirus disease (COVID-19).
Like its relatives MERS and SARS, COVID-19 can spread through from one human to another by inhaling droplets, generated when coughing or sneezing, from an infected individual. It can also be passed on by touching a surface where these droplets landed and then touching one’s face or nose. Although the virus is not airborne, having to breathe in these microdroplets coming from a sick individual within a meter away, can potentially pass on the virus to another person.
To better explain the microdroplets, WATCH Japan’s experiment below:
Symptoms & prevention
Those who will contract COVID-19 commonly exhibit the following symptoms: fever, tiredness, and dry cough. Some people may even have aches and pains, nasal congestions, sore throat, diarrhea, or shortness of breath. These symptoms are usually mild and begin gradually, between 2-14 days after infection.
WHO said that most people (about 80 percent) recover from the disease without needing hospital treatment, and only around 1 out of every 5 people who get COVID-19 becomes seriously ill. Under this are those who are older people or with underlying medical conditions like high blood pressure, diabetes, heart and lung problems, or cancer.
However, WHO noted that anyone is susceptible to contracting COVID-19, and can become seriously ill. Likewise, people with very mild symptoms can transmit the virus. Moreover, some people may not even show any symptoms at all, which are then classified as asymptomatic.
To prevent infection, authorities are urging people to practice regular hand washing, proper cough, and sneezing etiquettes, and to avoid close contact (considering asymptomatic individuals).
TIMELINE OF INFECTION IN THE PHILIPPINES
“Today, the DOH is confirming that the 38-year-old female Chinese patient under investigation or PUI is positive for the novel coronavirus 2019-nCoV,” Philippine Health Secretary Francisco Duque announced on January 30.
Dubbed as PH1, a 38-year-old woman traveled into the country from Wuhan, China. A couple of days later, two more cases were confirmed, and by February 2, the first-ever death in the country was reported. Identified as PH2 and husband of PH1, the 44-year-old Chinese man was the first recorded death outside China.
The news caught every Filipino’s attention, and some started voicing out their concerns and demanded travel bans from incoming flights from the hot zone areas, which were yet to be placed.
Around the same time, the WHO declared a Public Health Emergency of international concern as the number of infections rose to 14,000 and killed at least 305 people globally.
Here’s a quick recap and timeline of COVID-19 in the country since its emergence on January 30:
January 30 – First case recorded by the Department of Health.
February 2 – First death recorded in the country, a 44-year-old Chinese man coming from Wuhan.
February 11 – WHO announced the official name of the novel coronavirus, COVID-19.
March 7 – DOH confirmed the first Filipino confirmed case, affirming COVID-19 is now locally transmitted. Thus, the declaration of Code Red Sublevel 2.
March 8 – Duterte signed Proclamation No. 922, placing the entire country under State of Public Health Emergency. Consequently, the president mandated all government agencies and local government units to cooperate and mobilize necessary resources against COVID-19.
March 11 – WHO declared COVID-19 as a pandemic. Accordingly, stringent social distancing, as well as travel bans, were implemented to severely infected countries were highly advised. Nonessential travels and mass gatherings such as concerts and church masses were also discouraged to reduce contagion.
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March 12 – The Philippines reported over 50 cases with five deaths and one recovered patient. Nevertheless, with the continuing rise of Persons under investigation (PUIs) especially in the capital region, home to around 12.8 million people (14.5 daytime population), President Rodrigo Duterte placed the capital under ‘soft lockdown’, also known as community quarantine, starting Monday, March 16.
March 13 – With a total of 64 confirmed cases and the impending soft lockdown, most of the residents at the capital rushed to bus terminals to get out of the city. Meanwhile, grocery stores and supermarkets were packed with hoarders and panic buyers who were ‘preparing’ for the lockdown. By then, alcohol and face masks were both out of stock.
Classes were also suspended and church-goers were discouraged to visit the churches by suspending masses. The sea, air, land travel entry in the NCR were limited, while mass transportation such as trains continued to operate with the strict observance of social distancing.
March 15 – A day before the implementation of community quarantine, commuters who were trying to get out from the capital grew frustrated and tired, waiting in long, crowded lines at the borderline checkpoints. By evening, a strict implementation curfew from 8 PM to 5 AM began.
March 16 – Day one of the Community Quarantine implementation. But the congestion at checkpoints continued to mount. Social distancing advisory was completely ignored by frustrated commuters in and outbound of the capital. Later that evening, Duterte decided to place the entirety of Luzon under Enhanced Community Quarantine (ECQ), which would further limit the movement of people.
March 17 – Duterte signed Proclamation No 929, placing the entire Philippines under the State of Calamity.
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March 25 – Duterte signed the “Bayanihan to Heal as One Act of 2020”. With this, the president has been granted 30 additional powers, including the protection of the aftermath of the pandemic.
March 31 – The total number of cases in the country reached the 2000-mark after 538 new cases were added, the highest by far in one day.
April 7 – After considering the recommendations from the Inter-Agency Task Force for Management of Emerging Infectious Diseases (IATF-EID), Duterte extended the ECQ until April 30 instead of April 12.
April 14 – The Philippines surpassed Malaysia as the Southeast Asian country with the most number of cumulative COVID-19 cases.
April 24 – Along with the IATF recommendation, Duterte announced to further extend ECQ in high-risk areas. Meanwhile, moderate and low-risk areas will be placed under General Community Quarantine (GCQ) until May 15.
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“Land, domestic air, and domestic sea travel to and from Metro Manila shall be suspended beginning March 15, 2020, and to end April 12, 2020,” Duterte announced in a state address last March 12.
But after some reconsiderations and reassessment, Malacañang further widened the scope and shifted to ECQ, which now includes the entirety of Luzon.
Other cities and municipalities across the country also imposed the appropriate community quarantine measures, depending on the number of confirmed cases in their respective areas.
These stringent measures taken by the government in terms of containing and keeping the healthcare system afloat may be commendable, another issue that is now in need of immediate attention and action—the financial assistance to all affected Filipinos.
While some Filipinos have diligently followed the stay at home order, many—especially those who are in the poorest of the poor sector—were left in the streets unsheltered. Most of these street dwellers heavily rely on foot traffic when it comes to sustaining their basic needs. But now, with the empty streets would also mean empty stomachs for many of them.
Shortly after the implementation of ECQ, thousands of Filipinos lost their jobs since a lot of non-essential businesses and industries in the country have either temporarily suspended their operations or shut down permanently.
Both the public and private business sectors offering essential services, on the other hand, were urged to apply social distancing at the workplace through skeletal force or work from home options. Through this, operations may resume without sacrificing the health of the workers.
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“No one at this time can estimate the fallout in terms of possible job losses except to state the obvious, that we fear it may be deep and enduring,” Luis Corral, Vice President of the Associated Labour Unions-Trade Union Congress of the Philippines, said in an interview. He pointed out that the government must urgently help those who were out of jobs.
Last month, the National Economic and Development Authority estimated that up to 60,000 people working in the tourism industry alone would lose their jobs.
With this, the cry for financial assistance from the government gradually increased.
“Magugutom talaga kami ‘pag hindi kami bumiyahe dahil wala kaming pera, wala kaming pambili bigas. Mahirap eh… mahirap ‘pag mahirap, walang pagkukunan… ang kailangan pagkain,” Reynold Alcala, a taxi driver interviewed by ABS-CBN last March 17.
To address the nation’s concern on financial assistance, the national government has so far approved several cash disbursements through its agencies, including the Department of Labor and Employment for affected employers and businesses, Department of Social Welfare and Development for the vulnerable sectors, and Overseas Workers Welfare Administration for the returning and stranded Overseas Filipino Workers (OFWs), to name a few.
But the question is, will this be able to sustain the country’s economy in the long run?
Global PPEs shortage
Three weeks after the local outbreak began in the country, panic buyers immediately hoarded most of the medical supplies including face masks and rubbing alcohols.
The severe and mounting disruption to the global supply of personal protective equipment (PPE), caused by rising demand, panic buying, hoarding, and misuse, put lives at risk from the new coronavirus and other infectious diseases, WHO warned.
Healthcare workers have always been relying on PPEs to protect themselves and their patients from being infected and infecting others.
Accordingly, the WHO estimated that the industry must increase the manufacturing of the needed supplies by 40 percent in order to meet the rising global demand. So far, the agency shipped nearly half a million sets of PPEs to 47 countries, however, supplies are rapidly depleting.
In the Philippines, the IATF mandated local manufacturers to double the production to keep up with the demand. In the meantime, the task force urged the public to use improvised face masks like handkerchiefs or DIY face masks instead, so as not to draw any more supplies from the health workers.
In response to the cry for the depleting supplies, celebrities, known public figures, and even regular citizens have gone out of their way to help replenish hospital supplies, as well as affected individuals due to community quarantine.
From buying and donating millions of test kits to mass-producing PPEs to thousands of DIY face masks and face shields, down to meal packing and distributions—everyone in their own little way helped and supported frontliners, who remain to brave the threat of the contagious fatal disease.
One prime example is actress and philanthropist Angel Locsin, together with her fiance, Neil Arce. The couple has been volunteering on putting up isolation tents, as well as leading donation drives for PPEs and other needed medical supplies.
Heart Evangelista is also notable for sending out money to those who are in need, which she would personally scout via Twitter.
Rubbing alcohol shortage in the country continues despite efforts in consumption control. This is why the Philippines’ largest liquor makers pledged to produce and donate thousands of liters of 70 percent ethyl alcohol and hand sanitizers.
Call for mass testing
The government has been criticized for being too slow with testing. But since the procurement of more test kits and laboratory capacity since the start of April, the testing has been accelerated.
“Our strategy is Metro Manila first because this is the epicenter,” Carlito Galvez said in a radio interview. “When we test Manila, we can win this battle against COVID.”
Dr. Emmanuel Baja from the Institute of Clinical Epidemiology, UP Manila said that it would be better to mass test at the barangay level.
“It would be nicer sana if the Department of Health could give up to the barangay level kung saan na infect yung case. Kasi at the barangay level, yung privacy clause o yung data privacy mawawala na doon. So ma propotectahan mo yung person who is infected with COVID-19,” Baja said.
According to Dr. Baja, it would be more efficient and wise to focus on testing starting at the barangay level. There would be much more focus on monitoring confirmed cases, at the same time, the task force in each LGUs will be able to concentrate on their respective area.
Meanwhile, LabX founder Thomas Navasero said that the country is already late in the game, hence the urgency to have more people tested.
“If we need to test a million Filipinos within 30 days during this quarantine, we’ll have to do at least 25,000 to 30,000 tests per day,” he stressed in an interview with CNN Philippines. “And we are presently about 3,000 to 4,000.”
Navasero further explained that the two tests must be combined, the Reverse Transcription Polymerase Chain Reaction or RT-PCR and rapid antibody tests. The rapid test, he said, is the primary test, while the gene test serves as the confirmatory test.
The following persons under monitoring (PUMs) or persons and healthcare workers, who have no flu-like symptoms and no history of travel, will be prioritized to be tested using the rapid antibody test kits:
- Healthcare workers with no symptoms but have “unprotected exposure” can be tested using the rapid test kits if RT-PCR kits are unavailable. They can be tested using the rapid kits to get clearance to go back to work;
- Asymptomatic close contact of a known or suspected case can be tested if there is no stock of the RT-PCR test. However, regardless of the test result, they need to remain isolated;
- A close contact of a COVID-19 patient, but not showing any symptoms;
- Filipinos returning from another country can be tested using the rapid test kits when they arrive at a quarantine facility. The rapid test kits can also be used before they are discharged after fulfilling their mandatory 14-day quarantine;
- People who are not showing symptoms but are residing in areas with suspected community-based COVID-19 transmission. Testing can be performed at the household, sitio, and barangay level with proper sampling methodology upon coordination with the epidemiology bureau and local health officials.
Test Trials in the country
DOH announced on April 17 the participation of the Philippines to the WHO Solidarity trial which the Single Joint Research Ethics Board (SJREB) approved.
WHO launched an international trial dubbed as “Solidarity Trial” in finding help in researching for an effective treatment for COVID-19.
The Solidarity Trial will compare four treatment options against standard of care, to assess their relative effectiveness against COVID-19. By enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence.
However, the WHO warned physicians and medical associations on recommending or administering unproven treatments until there is sufficient evidence. Instead of curing, these unproven treatments may further jeopardize patients’ health like reports the agency received wherein some individuals self-medicated using hydroxychloroquine.
Another clinical aid doctors around the world started using is the convalescent plasma. However, health experts clarified that plasma therapy is not a cure but rather an immune-booster to aid newly infected patients. One of the recent clinical aids doctors administer to severely ailing patients is the convalescent plasma from donors who are patients who have recovered.
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Social distance IS the new norm
When is the need for social distancing going to end?
Like previous outbreaks, however, we can be assured that this will be gone too, that this is going to be a passing challenge that this generation can defeat.
But while we are still working on that part, immediate actions from the government and world leaders should be more visible than ever, along with the cooperation and participation of everyone through social distancing and practicing good hygiene. Although wearing face masks does decrease the chance of contracting the virus, it is not a hundred percent guarantee.
Moreover, thorough planning and consideration for creating long term solutions should be prioritized, as lessons from this pandemic highlights for us to be more mindful when it comes to infectious diseases, as well as how a person’s action may affect millions of lives.
For now, our best option is to apply social distancing measures and avoid mass gatherings, and accept that this is currently our new normal—or at least until we find and mass-produce the vaccine.
As of Tuesday, April 28, the Philippines has recorded 7,958 confirmed COVID-19 cases, including 530 deaths and 975 recoveries. Meanwhile, the total number of confirmed cases worldwide has already surpassed the 3 million mark, at 3.12 million cases, with more than 200,000 deaths and 900,000 recoveries.
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