Philippines COVID-19 Incipient Danger Zone
The collapsing health care system in the Philippines is indeed weak as the World Health Organization Claims. “Corrupt” would be a better word than “weak”, say local doctors.
Unfortunately there are few reliable statistical data from the Philippines’ COVID-19 experience but even using the understated reported data it is clear the country is on the verge of a disaster. This article should be read as a call for help from any who can provide the assistance.
Feature by Micheal John
Unless something unforeseen happens, or our read of the data is all wrong, something like the emergency measures that Beijing applied to Wuhan may be needed in Manila. The indications are that the city of Manila is on the verge of a catastrophe.
Two of Manila’s largest government hospitals temporarily closed this past week as COVID-19 infections reduced available staff below functional levels as many came down with infections.
Community spread of COVID-19 is about to hit a new high and it is possible that an evolved or imported strain is spreading more vigorously,
Dead bodies hidden away in allies, smell. Poverty is reaching new disastrous proportions. Petty crime is on the upswing as people try to steal food. Clean water is at a premium. Masks and hygiene products are scarce and food prices are heading skyward.
Currently the healthcare system is swamped and practitioner associations are claiming their members need Manila completely locked down to try to create a break period in which to create a national plan as needed. “It sounds like reaching for straws”.
“Lock-down” meaning isolation, is impossible where millions of people live on top of each other in cramped spaces in some of the poorest ghettos on the planet. What’s worse is that these are Filipinos, some of the nicest people in the world.
Who can help?
The world now knows who can understand these words the best.
China, Taiwan, South Korea, Germany, Japan, and Singapore know how to handle this type of emergency. It’s coming.
Extra emergency rapid-build modular hospitals will be needed and a healthcare-oriented (not military search-and-seizure) canvass of Manila’s ghettos is a good idea. Keeping school closed until a vaccine is available is also a good idea. Many tactics are winning but an overall medical strategy is needed.
One hundred and nine million Filipinos are at risk. One quarter of that number are in the core cities which currently are swinging toward disaster. Not all cities, but several are in big trouble, Manila and Cebu City at the forefront.
A medical solution to COVID-19 is needed in the Philippines and the government does not know how to do that. There is no shame and no blame, some very good steps have been taken to defer the pandemic’s upsurge. Now real medical thinking is needed in a country where the best and brightest medical minds have been harvested by developed nations like the United States.
The healthcare system still has high-calibre practitioners at the clinical level but they need relevant leadership with experience in handling this type of crisis. The experience available around the world and even among near neighbours is substantial. There is no shame in not knowing how and great strength in asking for help.
The COVID-19 dead are underreported by a swamped system but an enormous extra-death dataset is being reconfirmed.
“The patient bodies are there but they died before we got a test so they are not counted as COVID-19″, one nurse practitioner told FPMag.
How many? “More than the ones who were tested and died.”
Are patients still being intubated for the ventilator? “Almost all seniors and about 85% die and that’s before we get a test back in many cases.”
COVID-19 Frontliners are “Overworked, Underpaid and marginally working in a Professional environment”
“You are not a professional if you do not have the tools of your trade skills with which to do your work,” notes one doctor, angrily.
“Our health workers are suffering burnout with seemingly endless number of patients trooping to our hospitals for emergency care and admission,” said Jose Santiago, president of the Philippines Medical Association.
“We are waging a losing battle,” notes Jose, “against Covid-19 and we need to draw up a consolidated and definitive plan of action.”
Here are the reported data.January 27, 2022
Here are the reported and estimated Philippines data.
- Country: Philippines (pop 111,880,678,)
- Reported COVID-19 Cases: 3,475,293
- Reported sum of Deaths: 53,664 (estimated:89,893)
- Reported Cured: 3,191,219
- Beta: Estimated total cases including reported plus estimated mild and asymptomatic: 17,828,253 Cases and Infection Fatality Rate (IFR) = 0.50 %. (Reported deaths and CFR are not accurate)
- 89,893 (0.0803% of population) Total deaths (estimated actual) including errors and unreported likely-cause excess deaths such as people who never went to a hospital but had COVID-19 indications but never tested.
Data collected and reported by: Civil Society Solidarity Partners against COVID-19
The Association asked the president, Rodrigo Duterte, to reimpose a strict lockdown in the country capital and nearby provinces from 1 to 15 August to give health workers a “time out”. They said the government should also use the time to “recalibrate strategies against Covid-19”.
Aileen Espina of the Philippine Society of Public Health Physicians said: “We have been in this fight since March. We feel we are nearing the end of our line. We are appealing for everyone’s help.”
The rise in COVID-19 Cases has left the trendline and heads skyward
Note: These are reported data. Death numbers and rates are known to be understated significantly. Scroll to read recent months’ data.
|Date||Cases||Deaths||% of Reported|
PH Medical workers are underpaid hence easily lured to work in other nations.
Filipino doctors and nurses have a higher-order patient-orientation hence they are desirable frontliners.
At best making the equivalent of $250.00 USD per month, Filipino nurses prefer enmasse to work in other countries, particularly in the United States and in its allied nations that the US has been propping up such as a few in the Middle East.
Trying to protect his countrymen’s health, Duterte banned Filipino nurses from working overseas many weeks ago but the ban has since been lifted without much explanation why, but for sure there would have been serious diplomatic words say sources working at 1201 Roxas Blvd. in Manila.
“Suddenly banning the tens of thousands of nurses in the USA would cause a huge problem there,” said one such embassy source who does not wish to be identified. That is true of nearly all embassy staff in Manila who consider the place ‘hot and dangerous’.
“We’ll have to look into this again,” said Duterte in early May. It has to be this week, we’ll have to meet again and consult legal: Secretary Guevarra, whether or not it would be legal for us to just stop the migration of health workers simply because they are being taken in a place where there is so much…Kawawa ang Pilipino eh (Filipinos are disadvantaged),” Duterte said.
“A more valid reason to stop a doctor or nurse or a more previous one that said, you will be deprived of workers…. Wala na ngayon (That can’t be’ [pause] no leg to stand on actually. But this one if I send you to a warfront, the enemy is the COVID [SARS-CoV-2]. Please do not misunderstand me, I am making it clear now, I do not want you to go there and come back in a coffin,” the President said.
It is more likely that a nurse or a doctor working in the Philippines would become sick and die with COVID-19 based on known statistics. What is unverified makes this much worse. Frontliners say they are poorly equipped. Inspections confirm this.
But it is not all bad. Medical workers from The RINJ Foundation came from France and Switzerland to support an indigenous team in 2017 and again in 2018 and 2019.
“They reported early in 2020 that several hospitals had made significant improvements since their recommendations were quietly presented. Most notable was Manila Doctors Hospital and the Baguio General Hospital which reportedly “morphed”.
The RINJ Foundation has been donating equipment and supplies to many hospitals in the Philippines since 2016 and does the ghosted inspections to determine viability of and need for donations. In-country workers say there is a strong and discreet relationship and that they respond to acute needs at the present time.
It’s easy to lure a Philippines frontliner medical worker to another country. They only make about $200 a month, $250 if they are longtimers.
The American side of the story is just one part of it but an enormous part. The United States built many of the nurse-training schools in the Philippines decades ago and has been ‘harvesting‘ nurses and other medical workers from the Philippines for at least 75 years. Watch the video below on the history of the Philippines from the American side (a team of journos from VOX in the USA have done an excellent job of investigative work) supplying nurses to the United States.
Watch the US Side of the Story
Watch above: The official salary of nurses in the Philippines $160 to $265 per month.
It was a letter this past week to President Rodrigo Duterte, from Philippines frontliners in Manila that complained that they can barely hold the line and would seek a another shutdown of Manila in order to regroup and make a plan for building resources.
The Philippine College of Physicians and 40 medical societies addressed Pres. Duterte, COVID-19 chief implementer Carlito Galvez Jr. and DOH Sec. Francisco Duque, through an open letter saying that the Philippine healthcare system has already reached its maximum capacity. pic.twitter.com/6aI1Vfj6d7
— The Philippine Star (@PhilippineStar) August 1, 2020
The letter stressed a losing battle against COVID-19 and a “definitive national plan of action is needed to better address the situation”.
Thus far the Duterte administration has chosen a military approach and the longest lockdown (stay-home quarantine) in the world since mid-March and currently under enforcement. That enforcement is complete with with violent shootings in the cases where Filipinos do not comply with lockdown procedures, wearing a mask when outdoors, for example.
In his televised address aired Friday, Duterte admitted that he had no national plan. He reminded viewers in his recorded address to the nation that when the China COVID-19 vaccine is available he would have the military deliver the first inoculations to the poorest of Filipinos.
The letter from the Manila medical association set out complaints about:
- Failure of case finding and isolation.
- Failure of contact tracing and quarantine.
- Hospital workforce deficiency.
- Public compliance with self-protection.
- Social amelioration.
- Transportation safety.
- Workplace safety.
But the weak health care system is nothing new. The following is a letter sent to a Manila newspaper in February 2018 saying:
“We are writing this letter to voice out the sentiments of Filipino nurses especially in light of President Duterte’s lightning action to increase the salaries and benefits of uniformed personnel and the military.
“The nursing profession faces a huge dilemma. Despite the great need for nurses in the Philippines, there’s widespread unemployment, and many have no other choice but to go abroad.
“Around 7 of 10 Filipinos die without ever seeing a health professional because of poverty. Thousands still die of highly preventable and curable diseases.
“We can no longer deny the strong demand for nurses to serve the country, yet more than 300,000 remain unemployed, and around 250,000 are underemployed or misemployed. Most nurses in hospitals and communities are contractuals and have no security of tenure. Nurse wages at P250-P350 ($5 to $7 USD) a day cannot even sustain decent family living.
The phrase “overworked and underpaid” has become synonymous to the nursing profession. The nurse-patient ratio in hospitals remains high at 1:50 up to 1:80. Nurses are exposed to verbal and physical abuse in addition to disease.
“The Continuing Professional Development Act of 2016 implemented by the Professional Regulation Commission has become an added burden, a cross to carry and bear, where nurses have to shell out from P30,000 to P50,000 to acquire CPD units and renew their licenses.
“Under this situation, many nurses are forced to go abroad to finance the needs of their families and loved ones in the Philippines. In fact, around 19,000 nurses leave every year to work abroad. “
Philippines more than 25,000 nurses short the number of nurses needed because Filipino nurses and doctors working overseas are sending millions of dollars back to PH which wants that money.
“On the matter of Ventilators, it is worth noting based on several nursing interviews that ventilators are MOSTLY CONTRAINDICATED. Do some research of your own,” suggests Dr. Anderson.
The following is an excerpt from a recent FPMag article
Dr. Cameron Kyle-Siddell, a doctor on the forefront of a USA national debate about ventilators, said “We are operating under a medical paradigm that is untrue. I fear that this misguided treatment will lead to a tremendous amount of harm to a great number of people in a very short time.”
A recent instance of high mortality among ‘vented’ Covid-19 patients at Bangalore Medical College and Research Institute (BMCRI) in India has made it increasingly clear to those doctors that ventilators are contraindicated.
Around the world, some 80+% of patients who have been intubated for a ventilator, die. Worse than that, of 90 patients who were intubated on ventilators at the India government-run BMCRI facility until 13 July, only one survived.
“Eighty per cent of the patients died within four to six hours of reaching our hospital. They had been already intubated. They had severe comorbidities like heart diseases, acute hypertension, diabetes, chronic kidney diseases, coronary artery disease and some patients were also on dialysis when they came to us,” says Dr C.R. Jayanthi, director-dean of BMCRI.
“The use of extracorporeal membrane oxygenation or high-flow nasal cannula oxygen therapy (HFNC) has cut the death rate as compared to ventilators.”
Healthcare Fraud is constantly in the news.
The most recent significant event was the resignation of three executives in the government-run health insurance program including the head of the anti-fraud division, citing excessive and pervasive corruption as being the reason for departure.
Extremely Dangerous. Do not soak your face mask in gasoline as the President has suggested.
“For people who don’t [have Lysol], drench it [the mask] in gasoline or diesel, and that son of a b**** COVID won’t stand a chance. Just find some gasoline—dip your hand with the mask in it,” Duterte said.
Days later, when challenged, Duterte stuck to his story after aides claimed he was just joking.
“What I’ve said was true,” said Philippines President Rodrigo Duterte, “If alcohol isn’t available, especially for the poor, just go to a gasoline station, and use [petrol] to disinfect.
Don’t put your hand or your mask in gasoline, says doctor.
“People should be made aware,” says Dr. Anderson of The RINJ Foundation, that gasoline is an extremely toxic and highly flammable substance. Breathing the fumes of gasoline in a face mask will in fact cause a person to be more vulnerable to the virus that causes COVID-19 if it does not kill the wearer first. Gasoline is harmful to the skin, an important organ of the body. Soaking one’s hands and mask in the gasoline presents an extremely hazard situation in which an explosive fire could be started,” said the doctor.
Typical of all Oppressive Government systems, Rape Culture in the Philippines is a bigger Pandemic than COVID-19
Rape, incest, sexually transmitted comorbid disease to Coronavirus, plus pregnant kids.
“They said there are many rape cases in Davao. As long as there are many beautiful women, there will be more rape cases, said Mr. Duterte who later pardoned military cadets for past offences. “The number one is for rape … Number two is drugs with rape with robbery … Third, multiple rape of the women of Baguio, the beautiful ones,” he said at the time.
In 2017, Duterte gave permission to soldiers to rape up to three Muslim women each in Marawi during and American/Filipino attack on Muslim gangs which claimed to be aligned with the then fractured Islamic State cult.
The president has constantly made rape jokes and created a permissive environment for rape. Courts do not hand out convictions to rapists in the vast majority of cases. Conviction rate is low.
Rape and incest are the biggest spreaders of Comorbid infections
“This has now come back to haunt the country, says practitioner Sharon Santiago.
“The victims have been locked down in quarantine with their rapists since mid-March. The outcome is more underage pregnancies and spread of HIV/HBV and other sexually transmitted diseases. These are comorbid illnesses to the COVID-19 disease and indicate the probability of a poorer outcome among younger patients.”
Secretary Francisco T. Duque III issued a statement in response to the issue of fraud surrounding the Philippine Health Insurance Corporation (PhilHealth):
“I am deeply disappointed about the recent events surrounding PhilHealth and WellMed. PhilHealth was founded with the vision of providing Filipinos with universal health coverage because it is our belief, as public health practitioners, that financial status should never hinder any Filipino from receiving quality health service. For the system to be taken advantage of and used in corruption is utterly unacceptable. These nefarious activities must end and PhilHealth should further strengthen its zero tolerance policy on overpayments.
“As the Health Secretary and ex-officio Chairman of PhilHealth, I am warning all health providers and PhilHealth officials in the strongest possible terms: do not cheat the system nor even attempt to do it. Tama na ang hocus pocus. Maraming Pilipinong may sakit ang umaasa sa tulong na ibinibigay ng PhilHealth. I will ensure that justice will be served to those who defraud the system.
“President Rodrigo Duterte has instructed for a clean slate in PhilHealth, hence I have ordered a revamp of PhilHealth’s accreditation committee. All false claims are to be investigated and when warranted, charges will be filed. Board members have also been asked to submit their courtesy resignation upon the order of the President.
“Moving forward, I have instructed my colleagues at the Department of Health to ensure anti-corruption measures are in place for the implementation of the Universal Health Care as we write the Implementing Rules and Regulations (IRR). This is to highlight the provisions in the UHC Act that were intended to improve the health financing system.
“I am grateful to President Rodrigo Duterte for his robust leadership and swift action in this matter. I call for all of us to work together — the medical community, health providers, government units in the national and local levels, and the Filipino people — to fix the system and put an end to corruption and fraud.”
‘PLEASE FIRE SEC. DUQUE’
Former senator and now Sorsogon Governor Chiz Escudero urged President Duterte to fire Department of Health Secretary Francisco Duque III after the country recorded its highest single-day increase in COVID-19 cases on Thursday. pic.twitter.com/NYBiKd2qmf
— The Philippine Star (@PhilippineStar) July 30, 2020
Taiwan, hailed globally for its efficient response to the coronavirus pandemic, counted at least 10 new coronavirus cases in July linked to travelers who came from the Philippines. https://t.co/Vm926f7koX
— Rappler (@rapplerdotcom) July 29, 2020