4/1/2020 | by Vicente Gomez, MD
Philippine experience on COVID and the lockdown
I am presently the Director of the Philippine Childrens Medical Center, the largest pediatric hospital under the Department of Health (700 beds). We are the referral center for all COVID suspect patients under the age of 18 within our quarantined area of Metro manila (25 million). Presently we have and evaluated 531 cases and sent home most of them after diagnosis and monitoring. NONE of our patients has turned in a positive result. We have one mortality but the child had so many other co-morbid problems with underlying blood dyscrazia and her test result is still pending. We have now 20 patients being monitored but they all are getting better and may be only community acquired pneumonia.
I would just like to share the Philippine experience regarding the COVID pandemic. When the news from Wuhan came in as early as late February that there was an epidemic of the Coronavirus, the government started monitoring visitors from China, Hong Kong, Taiwan and South Korea as to the possibility that they had a fever or cough upon arrival in the International Airport. As the numbers increased, the Department of Health advised an Expanded Community Quarantine program. This identified areas like Cities and major towns and blocked traffic in and out of these areas with the exception of Health Care workers and food and medicine suppliers. As it reached Pandemic proportions, on March 13, the government declared a national quarantine limiting mobility of all citizens advising people to stay home. Each household was issued ONE quarantine pass for that person to go out and buy food and medicine and essentials. All stores were closed, inlcuding restaurants, bars and the like. The exceptions are markets, groceries and drugstores and their working hours were from 8 AM to 3 PM only. There is a curfew on the roads from 11PM to 5AM except for those with passes for essential travel. If anyone is caught on the street by the police or paramilitary, they are sent home and risk confiscation of their pass if the reasons for being out are not valid.
So, my being in Manila now means I cannot get out of the City until after Easter.
Public gatherings including weddings and even wakes are not allowed. Churches are closed and all services are over the TV or online. All deaths are cremated and the family is given the ashes. The population is advised to hold services after the "all clear" is raised by the Department of Health.
Several hospitals have been identified for all suspect COVID patients and the non COVID cases are managed in other hospitals after they have been tested and found to be negative. This concentrates the patients in only specific places in the different regions of the country. The DOH has strict guidelines regarding the use of PPE's, Hazmats and other precautions.
Everyone now wears a mask and gloves when they go outside. entry into supermarkets is limited to a certain number at a time. Senior citizens have special lines so they do not have to queue. if you don't have a mask, you cant't go out even if you are in your car. Temperature is measured on everyone who enters a facility and even the police can stop you and take your temperature, and compel you to go to a health facility if you have a fever.
These measures have drastically reduced the number of mortalities. New cases that appear receive early treatment and the number of recovered cases is overtaking the deaths on a daily basis. Unfortunately, 20% of the mortalities are doctors who are in their 50's and 60's and these came in early on in the epidemic before we could identify COVID as the cause of the deaths. Despite aggressive measures, they did not pull through due moslty to irreversible multiple organ damage.
Another thing, our government is testing people suspect of having the disease or contact with a known patient for free. All care is free and if a pateint is confined for Monitoring, this is also covered by a special budget release by Congress and the President.
Volunteers receive a hazard "allowance" and free accomodations and food if they are from out of the main cities to encourage them to stay in the vicinity of the health care facility since public transportation has also been limited. For the rest of the population, there are free groceries being given on an every other day basis, more so in the cities since the people in the provinces can grow their own food. All hospital and health care expenses are covered by the government and we receive daily supplies of PPEs and medicines for both the patients and out health care workers. Families with a COVID death are given money to cover cremation expenses and other necessities. Our sporting arenas and other large areas are converted into field hospitals for patients under monitoring. I believe due to the very aggressive early treatment with medication, our number of patients that have required pulmonary support is dropping daily.
Though these measures may be considered draconian by some and a violation of one's "human rights", it has worked. Our country with few medical centers as well equipped as the US is on its way to controlling this disease. One factor is Filipinos are very social media savvy and very concerned about affecting their own family members so there is a lot of personal and social pressure for people to cooperate. Our national motto now is: We Work as One, We Heal as One.