A radical shift in the COVID-19 response

COMMENTARY

A radical shift in the COVID-19 response
By: Bobby M. Tuazon - @inquirerdotnet
Philippine Daily Inquirer / 04:15 AM August 15, 2020

President Duterte’s response to the COVID-19 pandemic started on the wrong foot. It was bound to fail. After five months of lockdowns—the world’s longest—the number of confirmed cases is surging by leaps. COVID-19-dedicated facilities are overwhelmed and frontliners are demoralized.

The response to COVID-19 would be better off by retooling the Inter-Agency Task Force for the Management of Emerging Infectious Diseases leadership and applying lessons in social engagement by countries that have succeeded in containing the coronavirus.

In true strongman style, Mr. Duterte handpicked ex-generals to lead the IATF. Trained mainly to fight wars, the IATF enforcers naturally rolled out a top-down, command and control approach to the pandemic—a public health issue where the role of medical experts and scientists with strong community support is crucial.

People were expected to cooperate as lockdowns were enforced, sans public consultation, especially in high-risk barangays. The Department of Health publicly airs safety protocols, but its media strategy has been drowned out by the APCs, combat troops, and SAFs projecting a message of fear to make people obey the measures. That proved to be futile especially in the National Capital Region where repeated lockdowns in many barangays did not prevent the contagion from raging back.

To begin with, government was unprepared, with no mechanisms set up to cope with the pandemic despite decades of disease outbreaks in the country that should have armed authorities with summed-up lessons and prepared them for the worst. With the DOH hobbled by budget slashes, public health services remained fragile and public hospitals understaffed.

With government losing the battle on COVID-19, it’s high time to let credible medical experts and scientists into the driver’s seat, giving them a greater say in restrategizing the anti-COVID-19 response. The Palace should replace its top-down approach with a unified, bottom-up strategy that harnesses the expertise of NGO community leaders whose track record in disaster response, environment protection, and other social causes is known among the local government units (LGUs).

Good practices and narratives from three developing countries in fighting the pandemic prove this point.

Driven by its “health above economy” policy, Vietnam mobilized grassroots organizations for aggressive and cost-effective control measures such as extensive contact tracing. Testing targeted only high-risk and suspected cases, but for every one confirmed case, 1,000 others were immediately tested—the highest ratio in the world. By end-April, Vietnam had only 352 confirmed cases and 0 deaths.

Trained since the 1960s, Cuba’s local primary care providers, medical workers, and volunteers conducted door-to-door screening drives with fast contact tracing and hospital treatment. Cuba’s primary health care system and free medical treatment have been instrumental in its COVID-19 response. Battling a 60-year US economic embargo, Cuba has limited positive cases to 2,532 and 87 deaths.

Except for small infection clusters, China has largely contained the pandemic after a short hard containment and suppression strategy to buy time for strengthening immunity and developing vaccines. The control of the virus in China, where it first broke out, relied on broad community solidarity and engagement with millions of community workers acting as the first line of defense.

Government should now radically rethink its mindset in treating local communities as mere proselytes in a fight where social participation and cohesion are pivotal. Drawing from global health guidelines, the prestigious Lancet medical journal says communities, including vulnerable and marginalized groups, can identify solutions and devise collective responses. The journal cites grassroots movements as crucial in curbing HIV/AIDS, SARS, the Ebola virus, and now COVID-19.

In fact, many of the country’s people’s organizations and NGOs with extensive community networks are engaged in livelihood, food distribution, and popularization of indigenous treatments like essential oils in mitigating the impact of the coronavirus. In true “Bayanihan heal as one” spirit, LGUs should harmonize with grassroots civil society instead of just using their barangays for partisan electoral ends.
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Bobby M. Tuazon is policy director of CenPEG and teaches at the University of the Philippines Manila.

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