Coronavirus disease 2019 is a new type of coronavirus that even the first-world countries had difficulty handling the rapid spread of infection.
Cagayan de Oro City recorded its first coronavirus disease (COVID-19) infection back in March—over a month after the Department of Health (DOH) announced the country’s first-ever COVID-positive patient.
Tagged by the DOH as PH 597, the 71-year-old male, residing in one of the city’s numbered barangays, had a travel history abroad. Unlike the first case admitted at Northern Mindanao Medical Center (NMMC) who succumbed to the disease, the man successfully recovered.
Since then, the COVID-infection count in the city rose gradually.
Almost six months following the first case recorded in the city, let’s recap what the city has done so far in fighting the novel coronavirus.
City Health officials have been keeping a close eye on persons under monitoring (PUMs) and persons under investigation (PUIs) as early as February.
But it wasn’t until the news on the first COVID-positive case in Mindanao broke that sent most city citizens into a frenzy.
Many rushed to supermarkets, pharmacies, and grocery stores to grab boxes of surgical face masks, alcohol bottles, and other disinfectant products. Even Vitamin C’s were out of stock. Panic became a common scenario not just in the city but also in different regions and countries, where people hoarded supplies after supplies.
To further control and prevent this, city officials urged the public to calm down, while simultaneously issuing a city ordinance on price freeze and control.
Precautionary measures taken
The main goal of every city is to contain—if possible, not to let the virus in. But that seems inevitable to happen either way, so city officials now have the task to control and slow down the number of positive cases as much as possible and not let its healthcare system get overwhelmed.
The Moreno administration started preparing and strategizing in containing the virus along with the guidelines from the national government and collaboration with the DOH Region 10.
Days following President Rodrigo Duterte Public Health Emergency declaration, Mayor Moreno launched a LIVE press briefing (which eventually turned into a daily briefing) to raise awareness and give city citizens access to information about the strategies the local government will take.
City officials also strongly urged the public against going out to crowded places, especially attending public events that could converge a massive number of attendees in one area.
These means concerts, festivals, general assemblies, cockfighting, and attending mass were all advised to cancel and shut down until further notice.
The DOH and the Department of Labor and Employment (DOLE) in Region 10 also advised both the public and private sectors to apply health and safety measures to contain the virus’s spread in workspaces. Skeleton forces were introduced for essential businesses to continue operating amid quarantine measures.
Likewise, Moreno started issuing different relevant city ordinances and executive orders (EO) to support the necessary actions on the containment of the virus. Notably, EO 48 and 49.
See the Latest City Executive Orders here
EO 48 mandated the closure of certain establishments, including malls, shopping centres, cinemas, and other significant recreational and entertainment places effective March 17, 2020, until further notice. However, businesses that offer essential goods and services are permitted to operate, including groceries, pharmacies, 24/7 convenience stores, bakeshops, pet shops, hardware stores, health clinics & diagnostic centres/laboratories, and restaurants (take-outs).
Meanwhile, EO 49 placed the entire city together with the whole province of Misamis Oriental under general community quarantine starting March 19, 2020, until further notice.
Accordingly, the issuance of community quarantine left the bustling streets of the thriving city almost empty for weeks.
Most city citizens showed disagreement when city officials decided to include the entire province of Misamis Oriental and the nearby municipalities of Bukidnon in its community quarantine coverage.
But the inclusion of these neighbouring areas meant giving them quick access to the primary referral centre for COVID-19 in Northern Mindanao, the NMMC. Moreover, Cagayan de Oro is the central hub and gateway of Mindanao, making it a vital part of the entire region.
See the Latest City Guidelines and Ordinances here
With this, the city has taken more steps in strengthening its health screening around different entry points.
The LGU has allocated budget to acquire additional temperature scanners and thermal scanners, and strategically placed these pieces of equipment at the Laguindingan Airport, Cagayan de Oro Port, and bus terminals.
Different teams were also created, playing different roles that would ensure the health and safety of city citizens, like the disinfectant teams, active surveillance teams, relief operations teams, and contact tracing teams, also known as the ‘Retuya’s Army’.
Apart from this, Moreno also imposed a city-wide curfew from 10:00 PM to 5:00 AM applicable to all ages and gender as additional movement restrictions. People who will leave their homes are tasked to take precautionary measures such as wearing masks and observances of physical distancing in public places.
Later on, the City Mayor also issued a Barangay Exit Pass to impose more movement restrictions. With the issuance of the exit pass, only one person per family was allowed to go outside strictly for essential transactions only.
Immediate isolation for new arrivals
As residents from all over the region with local transmissions started coming back home to the city, Moreno has anticipated a possible rise in infection rates.
To prevent unidentified COVID-positive returnees from infecting the city locals, the City Mayor has ordered all new arrivals to submit themselves for a mandatory 14-day quarantine upon arrival.
Aside from designating isolation areas in different barangays and across the city, the local government has further reached out to hotels, inns, and pension houses, converting them to additional isolation units. Moreover, health officials will have to check and review the area first for those who opt for a home quarantine to ensure the health safety of the household and its surrounding neighbours.
A Temporary Treatment and Monitoring Facilities (TTMFs), on the other hand, were prepared to take in COVID-positive patients exhibiting no to mild symptoms. Not only that, City Health officials introduced teleconsulta, a free online consultation that will cater to medical consultations and checkups without having to visit the hospitals physically. Regular birth deliveries were also transferred to barangay health centers.
With this, the NMMC and other hospitals will be unclogged and reserved for severe and critical patients.
Investment on testing capacity
Besides the isolation units, the local government has also invested in expanding its testing capacity as early as the first week of March.
Moreno endorsed to Regional DOH-10 Director Dr. Adriano Suba-an a letter of request to Health Secretary Francisco Duque III, asking that a COVID-19 testing facility be set up in the city or within Region 10.
Consequently, the city will not have to send the specimens of other towns and reduce the results’ waiting time.
In preparation for the upcoming testing facility, the LGU has acquired two Reverse transcription-polymerase chain reactions (RT-PCR), two automated extractor machines, Gene Xpert testing, and BioRad polymerase chain reaction (PCR). These pieces of machinery were then lent to NMMC.
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PCR and RT-PCR are two techniques used on detecting specific genetic material in any pathogen, and in this case, the SARS-CoV-2 the coronavirus that causes COVID-19. Since the novel coronavirus only contains RNA, RT–PCR is mostly used for detecting it. The machine is also highly sensitive and precise and can deliver a reliable diagnosis in at least within three hours. Nonetheless, most laboratories take on an average between six to eight hours.
Likewise, RT–PCR is also significantly faster and has a lower potential for contamination or errors, compared to other available virus isolation methods.
It is important to note, however, that the machine cannot detect past infections. (2020, Jawerth)
Automated RNA (ribonucleic acid) extraction machines, on the other hand, can help ease the job of overworked medical technologists by acting as a medium during the virus extraction process. Manual extraction put lab personnel at risk, exposing them to more viruses.
By using an automated machine, it allows them to operate robots instead of extracting the genetic material. It creates an effective shield from the virus’ exposure. Moreover, it will prevent health workers from being overworked and exhausted.
Lastly, Gene-Xpert is widely known as a rapid diagnostic test for Tuberculosis (TB). But it has been reconfigured to detect COVID-19, which both the US and the Philippine Food and Drugs Administration (FDA) has approved in March.
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Likewise, medical technologists underwent biosafety training at the Research Institute for Tropical Medicine (RITM) for handling COVID-19 testing facilities.
Then on May 27, Moreno revealed that the city will allocate around P25 million from the P156 million ‘Bayanihan to Heal As One’ fund granted by the national government to construct an Emerging and Re-emerging Infectious Disease (ERID) Facility in Barangay San Simon.
ERID will be used for disaster preparedness, among others. They will also put up a Biosafety Laboratory 2, which includes laboratories that work with agents associated with human diseases such as pathogenic or infectious organisms that could pose a moderate health hazard.
The city’s latest machine procurement is high-pressure oxygen humidifiers dedicated to COVID-19 patients with early mild symptoms, which will allow the NMMC to reserve its mechanical ventilators for critical cases.
Despite the previous backlash received by its local government, Cagayan de Oro City has managed to keep its COVID-19 cases relatively low and contained through the stringent measures mentioned above.
Isolation and Contact Tracing
Once again, identifying who these patients are and separating them from the rest makes a massive difference in infection rate. While we cannot still fully eradicate the deadly disease without a vaccine, having to control it puts relief on our healthcare system.
Consequently, all returning residents, both locally stranded individuals and returning overseas Filipino workers, are brought to different isolation units to comply with the 14-day quarantine period upon arrival.
LGU deployed teams to greet new arrivals and transport them to their respective quarantine units. Swab tests are then conducted for free to identify whether or not the isolated individual contracted the virus. Once cleared, they can then return home and complete another set of the home quarantine period.
Simultaneously, contact tracing teams conduct immediate tracing on the whereabouts of COVID-positive patients.
However, the city’s efficiency rate in contact tracing is by far the weak spot of the local government’s COVID-19 response. According to Baguio City Mayor Benjamin Magalong, the city’s contact-tracing rate fell below the national standard.
Magalong said Cagayan de Oro’s performance was only 1:4 or four persons traced for each COVID-19 patient, the same ratio achieved in neighbouring Iligan City. The ideal national benchmark, he said, is around 1:37 or 37 persons for each COVID-19 patient (lowest is at 1:20) for the program to be considered as successful.
He added the low-efficiency rate means that in 10 days, the city would have several potential COVID-19 carriers walking around, unknowingly infecting other people.
Magalong added that only five percent of the city’s 500,000 residents underwent RT-PCR tests due to the high testing cost. Nonetheless, the DOH will help address this by sending more RT-PCR test kits.
Re-opening the Economy
Moreno has underscored the tricky balancing act between health and economy since the beginning as COVID-19 covers so many angles.
While health is of paramount concern, the economy should not be sacrificed.
That is why, when community restrictions were slowly easing up, minimum health protocols such as wearing masks, physical distancing, and frequent disinfection, were strictly mandated to the public. Meanwhile, businesses such as malls and restaurants were ordered to strictly implement these health protocols to protect the health of customers and employees.
Mass gatherings, on the other hand, remained discouraged, including leisure and recreational activities.
To ensure protocols are followed, inspectors checked malls for health protocol compliance, and authorities remain deployed around the city.
Along with the directive from the national government and the national task force for COVID-19, the city was able to kickstart its economy flow back through focus containment programs. With this, only a specific portion of areas will be locked down for at least two weeks upon the detection of infection, letting other parts of the city continue operating.
Lauded by the National Government
The proactive strategy and efforts of the city did not go unnoticed.
Through Peace process Secretary and the Chief Implementer of the National Action Plan on COVID-19 Carlito Galvez Jr., the national government has recognized and lauded the COVID-19 response of the city, describing the region’s ‘proactive’ strategies to keep the cases down as ‘exemplary.’
The National Task Force Against COVID-19 and Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) visited the city to assess the current situation last Wednesday, August 19.
Galvez cited Cagayan de Oro’s “balanced approach” to manage the infections while keeping the economy open.
He described Cagayan de Oro as “one inspiring city” that other local government units can emulate in managing COVID-19 cases, including its approaches to localized transmission.
Presidential Communications Operations Office Secretary Martin Andanar also agreed, saying the city government’s “proactive response and the way it balanced the flow between the economy and public health would be a fine model for other local government units.”
Furthermore, Galvez commended the city government’s initiative to assist neighbouring Iligan City by admitting many of its COVID-19 patients under its patient care centres, saying this reflected the Filipinos’ “Bayanihan” values.
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Moreno explained by helping Iligan City manage its own cases is also a practical approach, noting that the two cities are important economic hubs in the region.
Also, Andanar cited the region’s best practices, noting that the Regional Inter-Agency Task Force (RIATF) has campaigned to accelerate efforts to establish more testing laboratories and came up with a regional recovery program with considerations to health and economy.
In response, Galvez said at least 16 engineers from the Philippine Red Cross, who will arrive in the region soon, will survey existing medical facilities and install more testing laboratories that can test more than 2,000 samples daily.
A Long Way To Go
Like everyone else in the world, the local government still has a lot to learn about handling and managing the pandemic properly. We should keep in mind that while this is new, it is nevertheless not an excuse to not take immediate action.
Admittedly, the local government’s actions weren’t exactly a smooth sailing process even with the already established COVID-19 response system they have today. It still has a lot to learn and improve to strengthen its response against the deadly virus.
On the other hand, taking steps should be taken thoughtfully, ensuring the whole picture has been thoroughly examined because mistakes can be crucial and could trigger a domino effect.
People should also understand that officials have to consider many things, mainly the economy, because killing it off will indeed affect the rest, including the testing capacity. Without funds, monitoring and isolating infected patients would be impossible.
Keep in mind that the goal here is not to overwhelm the region’s healthcare system. That’s why citizen participation is imperative. We are the basic unit in the city, and what small violations one of us make could affect many lives.
Always Remember: Continue to practice physical distancing as much as possible. Wear a mask every time you step outside your homes, ensuring to cover your nose and mouth, and wear a face shield when using public transportations or going to public places. Lastly, don’t forget to wash your hands, sanitize, and practice good hygiene to keep yourself and your companions at home away from contracting the deadly coronavirus disease.
What are your thoughts on the COVID-19 response of Cagayan de Oro City so far? Let us know in the comments!