“We cannot fight without knowing the extent of the enemy.”
By RONALYN V. OLEA
MANILA – Two doctors from public hospitals are pushing for mass testing as a way to combat coronavirus disease 2019 (COVID-19) pandemic.
In a video conference last March 21, Dr. Gene Nisperos, a faculty member of University of the Philippines College of Medicine, said that community quarantine should be complemented by identification of COVID-19 cases and isolation.
“It is easier to implement appropriate measures if there is mass testing,” he said.
A barangay task force frontline doctor, Dr. Leonard Javier, agreed with Nisperos. “Quarantine without testing only puts burden on the people under quarantine. It strains resources and we are fighting [the pandemic] blindly,” Javier told Bulatlat in an online interview. “We cannot fight without knowing the extent of the enemy.”
As of this writing, the Philippines has 307 COVID-19 cases and 19 deaths. The country has a high case fatality rate (CFR), which is 6.2 percent, as against the world’s CFR of four percent.
Nisperos lamented how the national government is addressing the health emergency. He maintained that COVID-19 cases are under-reported as test kits remain limited and contact tracing remains inefficient.
“Instead of increasing the number of diagnostic test kits, the DOH [Department of Health] opted to revise its protocol,” Nisperos said. “The government abandons its responsibility of providing enough test kits.”
As of March 10, the DOH protocol states that persons under investigation (PUI) with mild symptoms and without other co-morbidity or underlying illnesses may be sent home after testing. By March 16, the DoH revised it, stating there is no need to test PUIs who are non-elderly and considered mild cases.
So far, the DOH has conducted 1,399 tests for COVID-19.
Nisperos criticized the DOH’s double standards. “[Test kits are] limited for those who are sick but not for politicians.”
President Rodrigo Duterte and his family members, several senators and Health Secretary Francisco Duque III, although asymptomatic, availed of COVID-19 testing.
He said all PUIs, frontline health personnel especially those exposed to COVID-19 patients, all individuals in clusters of infection must be tested.
Nisperos prefers Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test kit or diagnostic test for accurate results to rapid testing, which he said yields 40 to 50-percent false negative. False negative means that an individual may get a negative result even if he or she is COVID-19 positive.
Javier said that while prolonged quarantine is a likelihood, it should be coupled with mass testing and increasing the capacity of hospitals and communities.
As of March 20 though, the DOH said it sees no need for mass testing yet.
Nisperos said the country should learn from South Korea, which he said has drive-through virus testing centers. According to a report, South Korea has a daily capacity of over 10,000 tests, the most of any country, and the results are reported by text message within 24 hours.
“They were able to identify the clusters of infection, then they focused on those areas, undertook appropriate interventions and they were able to flatten the curve,” Nisperos said. Flattening the curve means slowing the virus’ spread.
Both Nisperos and Javier fear that COVID-19 cases in the provinces are not at all monitored.
“PUIs in provinces have been reported dying or escaping untested or with pending results,” Javier noted.
With the new DOH protocol, the spread of the virus in the provinces is likely, Nisperos said.
Still missing in the national approach to COVID-19 is the social determination of health, Nisperos said.
“The inability of the poor, the informal sector, and the working class to comply with the demands of the enhanced community quarantine underscores their vulnerabilities,” Nisperos said, adding that the current fight against COVID-19 must be both medical and social.
Javier said social safety nets such as food distribution, moratorium on collection of utilities, subsidy for the unemployed should be undertaken.
Nisperos called on the national government to deal with the pandemic in a comprehensive manner. “If the Duterte administration had been proactive, we would not have come to this situation.”