In response to the exponential growth of COVID-19 infected patients since the first confirmed case in the Philippines, the Zuellig Family Foundation held a virtual round table discussion (RTD) to talk about the local government units’ (LGUs) role in combating the threats of COVID-19.

Under Proclamation No. 922, all government offices and LGUs are mandated to “render full assistance and cooperation and mobilize the necessary measures in a timely manner to curtail and eliminate the COVID-19 threat.”

“As bridging leaders, local chief executives should be fully informed of what is happening, target the cooperation and trust of constituents, and come up with new institutional arrangements to address the emergency,” said ZFF chairman and president Ernesto Garilao in his discussion of ZFF’s Leadership Framework for COVID-19.

Department of Health (DOH) Undersecretary Maria Rosario Vergeire, a resource person during the RTD, pointed out the roles of the LGUs.

Vergeire encouraged each LGU to align their mitigation initiatives with DOH’s four-point strategy of contact tracing, physical distancing, diagnostics, and medical management to fight COVID-19. Accordingly, surveillance and epidemiology units shall be mobilized to do contact tracing.

Another resource person, ZFF trustee and former DOH Secretary Dr. Manuel Dayrit, reiterated that contact tracing is a crucial stage as it is the key to identifying community members displaying symptoms of the disease, tracking people who have been in contact with patients under monitoring and investigation (PUMs and PUIs), and identifying patients who need critical care.

Dayrit cited Metro Manila’s experience to explain why early detection is fundamental, saying, “We were not able to do early detection in February. What eventually happened, many of our countrymen went home to provinces. As we can see, from DOH reports, there may already be transmission in the provinces –some of them may be carrying the virus.”

Meanwhile, municipal and city mayors as well as barangay captains are expected to enforce and monitor the implementation of social or physical distancing in their jurisdiction. This is the measure to reduce close contact between people in order to prevent the spread of contagious diseases. Hence, it is the LGU officials’ mandate to ban mass gatherings, suspend classes, and enforce mandatory community-based quarantine.

As COVID-19 spreads quickly and new protection measures are implemented, people are constantly seeking information. Here, government officials again play a crucial role to make sure effective communication is in place, where, according to another RTD resource person Vikki Luta, EON-Engage business unit head, advised local authorities to conduct social listening or taking note of the public’s opinions, questions, and complaints. Then, the government can respond appropriately. LGU officials must also be responsible for addressing false information to avoid further panic and other social disturbances.

While the DOH has already set up a centralized communication chat where all announcements are posted, LGUs are encouraged to use necessary platforms to reach their constituents, especially those in geographically isolated and disadvantaged areas. In Salcedo, Eastern Samar, Mayor Melchor Mergal uses radio and text blasts in disseminating the latest developments about the virus.

“People are confused because of many news items about COVID-19 on TV and social media. Access to correct, clear, and regular information will help government in identifying right intervention,”shared Mergal. LGUs are encouraged to tailor their communication strategies and channels—print, traditional, or new media—with the communities they serve.

In terms of diagnostics, city mayors and provincial governors are likewise given the task of mapping out primary health care facilities, which can accommodate mild and asymptomatic cases. This is to avoid congestion in hospitals that must prioritize severe and critical cases.

Bataan Governor Albert Garcia shared they are already preparing more facilities like stadiums and coliseums that can accommodate more patients. They are also looking into the possibility of using elementary schools as temporary facility for PUMs and PUIs.

To assist the national government in medical management, the DOH encourages LGUs to establish their own mechanism to collect and send samples of patients to designated laboratories while the national government is arranging the setting up of testing laboratories in each region. Vergeire also points out that LGUs can help provide transport means to health workers and essential personnel especially during the community quarantine period and take lead in designating funeral homes in handling COVID-related casualties.

Moving Forward

While COVID-19 is the urgent health concern, patients with other illnesses should not be neglected. Hence, the DOH provided a set of guidelines to help LGUs implement telemedicine while the enhanced community quarantine is in place. Telemedicine is the distribution of health-related services through electronic information and telecommunication technologies. It minimizes face-to-face interactions between patients and health workers, thus, complying with the mandate of DOH to observe social distancing.

On top of these health concerns, LGU officials should also consider the present situation as public order and security concern. Threats of riots, looting, and other social disturbances must also be managed, taking into consideration children, pregnant women, senior citizens, and people with underlying conditions as most vulnerable sectors.

ZFF recognizes that all initiatives, however big or small, require participation among the people. Combating COVID-19 is not the sole responsibility of a single sector but requires everyone’s cooperation. As Cagayan de Oro Mayor Oscar Moreno said, “The best way to handle this problem is to look beyond our boundaries. The key is teamwork at all levels, all the way to the barangay level.” The mayor had begun coordinating with mayors from neighboring towns so they work together in addressing the pandemic.

The RTD, held last March 25 and entitled “Working Together for LGU Preparedness and Response,” is part of ZFF’s efforts to continue its mission of being catalyst of better health outcomes especially now that the whole world faces a pandemic. For over a decade now, ZFF has been helping improve capacities and knowledge of local chief executives in health leadership and governance. Its interventions have been introduced to health leaders in 774 municipalities, 25 cities, and 27 provinces.

For more information about the roundtable discussion, you may email kmg@zuelligfoundation.ngo.

Coronavirus transmissions have slowed down in Bataan, Aklan, and Agusan del Sur, according to the Zuellig Family Foundation (ZFF), which has been helping those three provinces establish their own COVID-19 response system.

In a statement issued on Monday, ZFF attributed the decline in those provinces to “an integrated COVID-19 response with increased testing capacity, enhanced hospital and isolation facilities, and improved contact tracing.”

According to the statement, the effective reproduction number of COVID-19 — or Rt — in the three provinces in the first week of November was below the threshold level, which is set at 1.

The foundation pointed out that the low Rt numbers were not due to a lack of testing.

“The test per capita — or the number of individuals tested for every 100,000 population—has increased by 7% in Bataan, 11% in Aklan, and 19% in Agusan del Sur. Swab test results are released within two days of testing,” ZFF said.

Those provinces also implemented other measures that would limit the spread of the virus.

“With the biggest population among the three provinces and the closest, geographically, to Metro Manila, Bataan has begun using a QR code to monitor the movement of people to and from the province,” ZFF said.

“With these interventions, the case fatality rate (CFR) — or the proportion of deaths among infected patients — in Agusan del Sur and Bataan are kept below the global average (2.8%). Bataan’s CFR is at 1.9% and Agusan del Sur’s is at 1.6%. Aklan is still striving to bring down its 5.2% CFR,” it added.

Recent data from the Department of Health (DOH) show that COVID-19 cases nationwide have started to dwindle, with the lowest number of active cases being recorded in the last three months.

A lot of observers warned, however, that this may just be brought by the recent calamities — typhoons that forced some testing sites to temporarily suspend operations.

Aside from that, DOH itself warned that crowding in evacuation centers — which were set up in schools with the recent onslaught of three typhoons Quinta, Rolly, and Ulysses — may trigger an increase in COVID-19 cases in affected areas.

To date, the country has a total of 409,574 COVID-19 patients — of whom 27,369 are considered active cases while 374,336 have recovered. The death toll stands at 7,839.

Local government play a key role in fighting the pandemic, according to the ZFF chair and president, Ernesto Garilao.

“The success of the COVID-19 response depends on the capacity of the local government units (LGUs) to identify, contact trace and test and provide quarantine facilities for the COVID-19 positives, as well as hospital care for severe cases,” Garilao said.

“Without an integrated COVID-19 responsive system, the virus will make its way to the non-infected,” he added.

Still, he believes there is more to do to ensure that the battle against the pandemic will be won.

“Investments in the local health system must be sufficient to have the following: adequate health manpower for the population, sufficient resources for the different health services, a reliable health information system, adequate medicine supply, adequate financing,” Garilao said.

“Total investments will be high but that is the price to pay for resiliency,” he added.

(This story was published in Inquirer.net on Nov. 17, 2020)