When Dr. Lei Alfonso learned that her father had symptoms of COVID-19, she traveled to Pampanga while she was in the Metropolitan Area of Manila.
“If I am already a doctor myself, I have felt this helplessness, how many people?” told INQUIRER.net.
That’s in March, when coronavirus cases in the country reached hundreds. At the time, she and her colleagues at the Philippine Society of Public Health Physicians (PSPHP), of which Alfonso is a founding member, were preparing modules to help prepare local government ensembles (LGU) to manage the crisis.
PSPHP, together with Alliance for the Improvement of Health Outcomes (AIHO) and Foundation for Family Medicine Educators, Inc. (FAMED) are Version 1 of the modules titled “4-Part Recommendations for COVID-19 Community Management (CBMC).
“We worked there as if our lives depended on it, the lives of our dependents,” he recalls.
After sleepless nights, the teams were able to publish the 1st edition of the LGU toolbox on March 29. Version 2 of the recommendations was later published on June 25, after AIHO tested the documents in 3 provinces, South Agusan, Aklan and Bataan through a partnership with the Zuellig Family Foundation (ZFF). The updated toolkit can be found on the PSPHP website.
The 4 main themes of the toolkit are the strategy of preparation and reaction, case search and contact localization, the creation of network isolation sets and the provision of recommendations to families in the prevention and control of COVID-19.
Alfonso, in an interview with INQUIRER.net, gave a recommendation on how to use the toolkit and how the country’s UGLs should prepare for the virus, even with limited resources.
“I think the first thing that local government prioritizes is a transparent understanding of what the challenge is and how to solve it,” he said.
If it was not already clear to Filipinos who have been under lockdown since March, Alfonso said, “The enemy works by transmission.” In effect, the solution is on how LGUs can stop the disease from being transmitted.
“The challenge with this pandemic is that the genuine interventions they paint are simple, confusing us all,” he said. “These are the strict measures of public fitness: hand washing, physical distance, social etiquette, masks.”
There are no vaccine left for the virus, which had inflamed more than 160,000 people in the Philippines as of August 18.
The bet is prevention, because Alfonso clarifies that “hospitals are the last line of defense”.
“Hospitals fill up as a symptom that you don’t catch up with [your patients] early enough that they don’t end up in the hospital,” he said.
It is also a challenge to clarify, especially in the face of a virus that has affected countries on an unprecedented scale.
“Things are about to be done when there is a transparent view and everyone sees the bigger picture and everyone knows where to contribute,” Alfonso said.
Tip 2: Examine your resources
“When we communicate about public fitness in general, you don’t have unlimited funds. You have to make sure your interventions are worth each and every weight,” he said.
Alfonso and the module team ensured that their recommendations were realistic. With input from the Ministry of Health (DOH) and professionals in the field, the modules have principles that apply to any UGL.
The first module is based on crisis response governance structures such as Operation Ready and Barangay Health Emergency Response Teams (BHERT).
“A UGL that has these interventions in place, in a position to respond to disasters, will have to be prepared for everything that is happening,” he said.
Local leaders will have to embark on a “game of choice” on the resources to invest in to better combat the public fitness crisis. For example, Alfonso stated that from an operational point of view, mass testing is not feasible because of its costs. In addition, this “does not result in a behavior replacement”.
“What you want to do is treat patients,” he says. “We prefer to focus on this management. We have to stop other people from getting it. We will have to protect communities, families and individuals.”
Tip 3: Focus on human behavior
Public fitness measures such as staying at home and wearing a mask have been repeated incessantly. But how can barangay leaders point out to a governor that their constituents are constantly complying?
“Does the pandemic have the way other people behave properly? If other people trust that they will be taken care of, there is a transparent address, they are more likely to comply. That’s what we’ve seen,” Alfonso said.
“It’s not just a behavioral problem, however, there are structural problems that need to be addressed and it’s the environment that drives them to behave in a safe way,” he said. “We have families that cannot conform to quarantine. For what? Because they want to eat.
“We can’t quarantine other people for the next two weeks without food. This is where social improvement comes in, for targeted quarantine,” Alfonso added.
He also noted that for some, being in the crowd is “inevitable,” as is the case with the use of public transport. In such cases, LMU wonders why there is congestion in the first place.
For others, non-compliance can only be a matter of communication. He cited a case in which he caught the attention of an older user because his mask had been “careless”.
“[They may not understand, or perhaps] that the messages that succeed in them do not resonate,” he said.
Alfonso also commented that despite the “pasaway” label, knowledge showed that Filipinos have reduced their time outdoors and that most wear a mask when they leave home.
Tip 4: Note the effect of the solution
But when it gets the coronavirus, what happens then? You will need to follow the insulation and repair, but making an investment in this also requires prudent decisions in the leadership component.
The 3rd recommendation module provides the operational direction for the structure of an isolation unit and its operation with appropriate procedures.
He noted that most or about 90% of COVID-19 are mild, which was supported by the latest DOH data.
“For example, if I’m going to send all my mild instances to the hospital, it means I have to spend on my PPE on each and every shift of fitness workers,” he says.
“However, the amount I spent building the hospital to admit mild cases [could] actually be [used] to buy a cell phone from an isolation unit where I can remotely monitor those mild cases that usually work,” he said. “There is a commitment to prioritization.”
A cost-effective measure that Alfonso cited Tacloban’s efforts to locate contacts through a QR code for the electorate and visitors to the city, which began to be implemented on July 16. He noted that it is available to the poor, they can only encode QR into a published identifier given through their barangays if they do not have a phone.
Government and non-governmental offices, as well as advertising establishments, must have the city’s touch search app to scan the QR code. The application will turn on if a person is allowed to enter or if it is a COVID-19 case. It will also record U.S. entries for study purposes.
Tip 5: Communicate effectively
In Alfonso’s experience, the real “illness” of public aptitude is the lack of communication.
“I’m a doctor, but my patients are not individuals. My patients are fitness systems, so some of the diseases I treat are the most important, other people don’t communicate with each other,” he said. “Policies exist, but if other people don’t communicate, they don’t get implemented, so we make it easier.”
He said that countries that have done a smart task to flatten the curve, such as New Zealand, which was “without COVID” for months before a recent epidemic, are “those who continue to involve their population … countries that accept as true with systems and leaders. Array »
She says public fitness messages target other segments of society.
“For the segment, you have to take other people where they are. What appeals to me … possibly not please another mother,” she says.
Accessibility to classified ads is important.
“I think it’s vital that local governments say, “Okay, it’s not enough to have a Facebook page because not everyone has the Internet.” Not everyone can watch ad videos because they only have Facebook [free].
And the camp has been a constant appeal for citizens, Alfonso warned that “Philippine values” deserve to be used as well.
“If you know that your movements have an effect on the protection and well-being of your family, of others, chances are you will do it not by discipline, but by your malasakit (sympathy), pakikipagkapwa (to be one with others.”
Benefits for the action of the provinces
The fate of the provinces that piloted the module on how they implemented what they learned from these guides, depending on their situation, according to Alfonso.
“What they gave us is that it helped them prepare. They didn’t fully engage in it, but they would locate tactics to tailor the implementation to their context,” he said.
Alfonso said that even when the province had no instances and far from COVID-19 hotspots such as Manila, his local government, led by Governor Santiago B. Cane Jr., strengthened BHERT’s capacity and took a step forward in Internet connectivity.
The media was made for all barangays in early March and a COVID-19 hotline was established, according to the ZFF report in May that he quoted Momville.
The landlocked province also strictly monitored those entering its borders, as it surrounded provinces with cases.
Agusan del Sur showed its first two instances on May 31. He reported instances and no deaths as of August 18. Jb
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