Strength, Weakness, Opportunity, Threat (SWOT)

Analysis of the Adaptations to Anatomical Education

in the United Kingdom and Republic of Ireland in
Response to the Covid‐19 Pandemic

The coronavirus (Covid‐19) pandemic is an unprecedented emergency that has affected all
global industries, including education (Ayittey et al., 2020). With the widespread
implementation of social distancing and self‐isolation policies, it is not feasible for educators and
students to attend lessons or assessments as they have previously. The Covid‐19 pandemic has
disrupted our long‐standing educational practices and has precipitated an urgent need for many
institutions to rapidly implement alternative educational and assessment strategies.

Historic pandemics, such as the severe acute respiratory syndrome (SARS) also saw changes to
educational practices and important lessons were learned. During the SARS epidemic, Chinese
and Canadian medical schools were forced to cease their clinical clerkships and electives
(Ahmed et al., 2020). Chinese medical schools supplemented their students learning experiences
with the introduction of online problem‐based learning (Ahmed et al., 2020). At the same time
in Hong Kong, university policies decreed that the external examiner must be present for final‐
year medical distinction examinations (Patil and Yan, 2003). These examinations traditionally
took place as viva voce examinations; however, because the external examiner could not be
present, these examinations took place by phone call. Due to concern regarding the stability of
the phone connection, the first part of the examination was conducted by an external examiner
and no interruptions were reported (Patil and Yan, 2003). These solutions could similarly be
utilized by anatomists in addressing the challenges that have arisen due to the Covid‐19
pandemic.

Educators across the globe have been forced to replace traditional learning modalities with
distance and blended learning approaches. Distance learning has been described as an
information delivery mechanism where the educator and learner are separated in both time and
space (Billings, 2007), whereas blended learning combines traditional classroom methods of
learning with online learning modalities (Green and Whitburn, 2016). Neither approach is novel,
and both have been used successfully as part of anatomy education (Pereira et al., 2007; Ferrer‐
Torregrosa et al., 2016). However, these approaches are usually implemented after strategic
planning, collaboration with other academics, and careful consideration of the pedagogical
evidence. In order to utilize online approaches, educators must invest considerable time up‐
front to learn how to create online learning material. In many cases, academics are required to
develop these new skills and create or adapt resources in parallel with a time frame that reflects
the normal progression of student learning.

Lectures
Universities opted to replace lectures with recorded presentations and accompanying
audio that was uploaded to the Virtual Learning Environment. The most common lecture
recording platform used was “Panopto” (Panopto Inc., Seattle, WA), with 50% of
universities citing its use. Thirty‐six percent of universities also provided live sessions
and tutorials via platforms such as “Zoom” (Zoom Voice Communications Inc., San Jose,
CA), “Collaborate Ultra” (Blackboard Inc., New York, NY), and “Big Blue Button” (Big
Blue Button Inc., Ottawa, Canada).

1
Practical sessions
All bar two universities in the sample group used cadaveric material to teach anatomy
prior to the pandemic. Universities replaced practical sessions by supplementing Virtual
Learning Environments with additional resources. 

=============================================================================

Why SWOT is essential for a successful COVID-19 recovery

What worked before the crisis for your dental practice may not work post–COVID-19. Dr. Roger
Levin shares a new twist on the basic SWOT formula to help dental practices as they reopen to a
new world.

Roger P. Levin, DDS

May 22nd, 2020

A SWOT analysis is not new to the business world. SWOT stands for strengths, weaknesses,
opportunities, and threats. Good companies engage in an annual SWOT analysis to better
understand their companies and their futures. Levin Group has been doing this in strategic
planning sessions for clients for many years. It is a tried and true traditional business technique
that allows companies to perform at the highest possible level.

Then came this crisis, and it is a crisis. It will end. It may be back. There’s a great deal we don’t
know.

So, we need to focus on what we do know and that is your SWOT. But this is not as easy as it
sounds. It is not difficult or unpleasant, but it does require a process and some thought time in
order to determine what your strengths, weaknesses, opportunities, and threats will be in the
COVID-19 era.

Weaknesses

In any crisis the weaknesses change and, unfortunately, sometimes expand. Perhaps pre-
coronavirus your weaknesses were needing an office manager, inadequate time for the team, an
absence of step-by-step documented systems, not running on time, and others. Following the
COVID-19 crisis you will have a different set of weaknesses. These may include patients who for
safety reasons are afraid to come back to the practice; limited financial options in a time when an
economic recession is causing severe financial challenges for many patients; attracting new
patients using traditional marketing if the practice fees and options do not change; not
participating with dental insurance in a fee-for-service practice (which was not necessarily a
weakness in the past but may become one post COVID-19). These are just examples of what may
lay ahead.

Opportunities

In any crisis there are opportunities. Perhaps you’ve heard the quote “Never let a crisis go to
waste.” Well, having a crisis may be good for certain businesses, but not for most. Unless you were
about to manufacture gloves, masks, and ventilators there is not much about this situation that’s
good for dental practices. But you can shift the curve. Opportunities could include expanding
hours, adding weekend hours, hiring highly trained team members who were not able to remain
with other practices, reducing labor costs, reducing supply costs, reevaluating all expenses with
companies that are soliciting business, and being willing to except lower fees or prices.

Threats

This coronavirus has awakened dentists to the reality of threats. It will probably never be
business-as-usual again. Threats include patients who will no longer go to the dentist unless they
have an emergency; patients who cannot afford or choose not to afford treatment and forego
regular preventive care; or patients who leave the practice because they do not participate with
any insurance plans. Other threats include the return of coronavirus, the lingering recession from
the crisis, loss of income, higher taxes to pay for all of the loan and bailout programs, increased
regulation of dental practices for safety concerns, and others that we have not even thought of yet.

2
Take some time to think about your SWOT from a post–COVID-19 perspective. You won’t have all
of the answers yet, but this is the time to get realistically prepared for the most effective recovery
you can achieve.

Roger P. Levin, DDS, is the CEO and founder of Levin Group, a leading practice management
consulting firm that has worked with over 30,000 practices to increase production. A recognized
expert on dental practice management and marketing, he has written 67 books and over 4,000
articles and regularly presents seminars in the US and around the world. To contact Dr. Levin or
to join the 40,000 dental professionals who receive his Practice Production Tip of the Day,
visit levingroup.com or email rlevin@levingroup.com.

Editor's note: To view DentistryIQ's full coverage of the COVID-19 pandemic, including original
news articles and video interviews with dental thought leaders, visit the DentistryIQ COVID-19
Resource Center.

https://www.dentistryiq.com/covid-19/article/14176510/why-swot-is-essential-for-a-successful-covid19-
recovery

=============================================================== 

 International Journal of
Environmental Research
and Public Health
Review
Strengths, Weaknesses, Opportunities and Threats
(SWOT) Analysis of China’s Prevention and Control
Strategy for the COVID-19 Epidemic
Jia Wang and Zhifeng Wang *
Department of Health Policy and Management, Peking University School of Public Health, Beijing
100191,
China; wangjiawst@163.com
* Correspondence: zhfwangwf@163.com; Tel.: +86-(10)-82805017
Received: 15 February 2020; Accepted: 23 March 2020; Published: 26 March 2020


Abstract:
This study used the Strengths (S), Weaknesses (W), Opportunities (O) and Threats (T)
(SWOT) analysis method, drawing on our experience of the response to the 2003 SARS epidemic,
the 2019 China Health Statistics Yearbook data, and changes in China’s policy environment for the
pneumonia epidemic response relating to the novel coronavirus (COVID-19) infection, to perform
a systematic analysis of the COVID-19 epidemic prevention and control strategy S, W, O, and T,
with a further analysis of a strategic foundation and to determine a significant and relative strategy.
We assessed and formulated strength-opportunity (SO), weakness-opportunity (WO), strength-threat
(ST), and weakness-threat (WT) strategies for the prevention and control of the COVID-19 epidemic.
We conducted an in-depth analysis and identified the highest-priority policies. These are: reshaping
the emergency system (SO1); adding health emergency departments to universities and other
institutions (WO2); adjusting the economic structure and strengthening international and domestic
linkages (ST2); and strengthening public intervention in responding to public health emergencies
(WT1).
Keywords: COVID-19; coronavirus; strategy; SWOT analysis
1. Introduction
In December 2019, a new outbreak of pneumonia caused by a novel coronavirus began in Wuhan
(Hubei Province, China). It subsequently spread to many countries around the world. The World
Health Organization (WHO) announced that COVID-19 is a public health emergency of international
concern (PHEIC) on January 30, 2020.
Background of the Pneumonia Epidemic in China
On December 31, 2019, the Wuhan Municipal Health and Health Committee of Hubei Province,
China issued the “Notice of Pneumonia in Wuhan”, after 27 cases of pneumonia had been reported [
1
].
On January 7, 2020, a China CCTV News Release reported that an expert group had preliminarily
identified the “viral pneumonia of unknown cause” as a new type of coronavirus (CoV) [
2
]. On January
12, 2020, WHO temporarily named the newly discovered CoV “2019-nCoV”. This virus is the seventh
identified CoV that can infect humans [

3
3
]. On January 25, 2020, the Chinese Communist Party
Central Committee designated a group of leaders to manage the response to the epidemic, in order
to comprehensively strengthen measures for prevention and control of the virus. On January 31,
2020, WHO announced that 2019-nCoV was a PHEIC [
4
]. On February 11, 2020, WHO announced
that the novel CoV disease was to be named “coronavirus disease-2019 (COVID-19)”, and that the
virus that caused the disease was to be named severe acute respiratory syndrome coronavirus 2
Int. J. Environ. Res. Public Health 2020, 17, 2235; doi:10.3390/ijerph17072235
www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020, 17, 2235 2 of 17
(SARS-CoV-2)” [
5
]. As of 11 March 2020, the COVID-19 epidemic continues to spread. There are more
than 80,000 confirmed cases in 34 provinces (regions) of China, and cases have been confirmed in 106
countries, including South Korea, Iran, Japan, Italy, and the United States [6].
This article discusses the rapid spread of the COVID-19 epidemic. Based on our experience of the
response to the SARS epidemic in 2003, the 2019 China Health Statistics Yearbook data, and changes in
China’s policy environment for the response to COVID-19, herein we present a systematic analysis of the
advantages, disadvantages, opportunities, and challenges relating to the current COVID-19 epidemic
prevention and control strategy. In addition, we provide suggestions to aid further development of
epidemic prevention and control strategies, and scientific decision-making.
2. Opportunity Window: SWOT Analysis of COVID-19 Prevention and Control Strategies
in China
SWOT analysis refers to the assessment and evaluation of various strengths (S), weaknesses (W),
opportunities (O), threats (T), and other factors that influence a specific topic. It comprehensively,
systematically, and accurately describes the scenario in which the topic is located. This helps to
formulate the corresponding strategies, plans, and countermeasures, which are based on the results
of the assessment [
7
]. This method can be used to identify favorable and unfavorable factors and
conditions, solve current problems in a targeted manner, recognize the challenges and obstacles faced,
and formulate strategic plans to guide scientific decisions. This study used the SWOT analysis method,
and drew on our experience of the response to the 2003 SARS epidemic, the 2019 China Health Statistics
Yearbook data, and changes in China’s policy environment for the COVID-19 response, to perform a
systematic analysis of the COVID-19 prevention and control strategy.
2.1. Strength Analysis
2.1.1. The Medical and Health System is Gradually Improving
According to data from the China Health and Health Statistics Yearbook 2019 [8], the amount of
medical resources in China has been steadily increasing.
The gross domestic product (GDP), the number of medical and health institutions, the number of
beds in medical and health institutions, and the number of health technicians per 1000 of the population,
have all been increasing year-by-year; therefore, the medical and health system is gradually improving
(Figures 1–4)

2.1.2. Comprehensive Advancement of China’s Health Emergency System

In 2003, the SARS epidemic had a huge impact on China’s economy and society, especially
the lives of ordinary people. At the time of the SARS outbreak, there were no specialized health
emergency agencies, established plans, systems, mechanisms, or applicable legal framework. Faced
with severe challenges, the Chinese government responded by developing a health emergency system
based on a “one plan, three systems” strategy, and continued to strengthen basic health services [
9
].
“One plan” refers to the emergency plan, and “three systems” refers to establishing and improving
(1) emergency response systems, (2) mechanisms, and (3) legal systems. In the face of the rapidly
advancing COVID-19 epidemic, the Chinese health emergency system can play a role in the guiding,
coordination, prevention, and control of this epidemic (Table 1)

resilience. The public health system and basic security facilities are lagging behind and have not

kept up with the level of economic development, including the lack of early public health emergency
prevention and control plans; uneven data sharing and transformation application channels; weak
wildlife market supervision; a lagging legal framework that is difficult to implement; weak health
emergency resources census database; lack of specialized emergency personnel for major public
health emergencies; lacking composite rescue teams; insufficient emergency rescue teams; insufficient
professional emergency rescue funding; and a serious shortage of human resources. The COVID-19
epidemic in China provides a major opportunity for the reform and development of a public health
emergency management system.
The core competency of public health emergency management is the health emergency response
system. However, the strategic positioning of the core competency of public health emergency
management and the improvement in planning and construction are not clear. In recent years, the

4
Chinese government has proposed developing a health emergency system and improving emergency
response capabilities. The process of the progression from the emergence of the pneumonia to the
rapid spread of the COVID-19 epidemic in China is a major test of the national governance system
and governance capabilities. From the perspective of theoretical research, there is still no formal and
authoritative definition of the connotation and extension of the core competence of public health
emergency management in China. From the perspective of practical challenges, China’s public
health emergency management has revealed much inconsistency, and gaps in awareness, philosophy,
governance, command, coordination, and action. The COVID-19 epidemic in China revealed a limited
degree of response during the early stages of the outbreak; the performance of the authorities in
different regions in the prevention and control of the epidemic was variable across regions, and the use
of material donations caused public doubts and social response; Ineffective measures by individual
local governments resulted in ineffective control of local epidemics.
In summary, to implement the above ideas in concrete terms, we must answer a series of questions:
What major deficiencies have emerged in the public health emergency management system in the
face of major public health emergencies, such as the COVID-19 epidemic in China? What is the core
mandate of the public health emergency management system? In the process of improving the national
public health emergency management system, what foreign experiences can we learn from? What
is the core competency of public health emergency management? What are the key processes for
improving public health emergency management core capabilities?
The national health emergency system needs continuous development and remodeling.
In particular, we recommended exploiting the core capabilities of public health emergency management,
clarifying its strategic position and planning, developing and upgrading processes related to the fate
of the country and its people, and the current and future systems are in urgent need of long-term
strengthening. The establishment of a professional team of university health emergency teachers,
discipline construction, and a personnel training system should be included in the scope of the
national health emergency system. Restructuring organizations can lead to the establishment of
health departments where required. Establish a series of square cabin hospitals with different medical
or technical support functions to ensure emergency rescue tasks for public health emergencies by
Health administration [
30
]. Emergency management positions could be used to play a better role in
communicating and coordinating the joint prevention and control strategy; the system plan should
include prevention and control plans for major infectious diseases during special periods such
as the Spring Festival and ban wildlife trade. The quarantine institutions, detection technologies
and treatment options all require further improvement. Hazard risk assessments, hazard grading
systems and corresponding response mechanisms among different departments for major public health
emergencies also require improvements. Market supervision must also be strengthened, and online
as well as offline wildlife trading must be banned by State Administration of Market Supervision.
The production capacity of domestic health emergency protection materials is insufficient, and the
international and domestic health emergency material standards are inconsistent; thus, it is difficult to

Int. J. Environ. Res. Public Health 2020, 17, 2235 12 of 17

“benchmark” the quality of these materials. The Ministry of Industry and Information Technology
should formulate applicable standards for materials. Transportation of protective materials should
also be improved. There is an urgent need to reshape the national health emergency system in the near
future and to address these issues in the reshaping.
3.1.2. People-Oriented and Value Policy Orientation
The construction of overall management systems should be “people-oriented” with regards
to the level of protection of medical and epidemic prevention personnel. After a large number of
medical and health and epidemic relief teams have been put in place, the overall management of food,
accommodation and protection needs to be enhanced. One should be more humane and pay attention
to policy orientation. For example, more public interests should be considered in the aspects of refunds
and reissues of civil aviation and railway tickets. Many individuals have expressed their demands
through the internet, and many have already responded to national policies for refunds. The refund
fees amount to thousands of yuan.
3.1.3. Integration and Upgrade of the Health Emergency Information System
The health emergency information system needs to be integrated and upgraded, to strengthen
the national-level surveillance of major infectious diseases, and to formulate a centralized reporting
and information release system for new or unknown infectious diseases. The epidemic situation
must be reported and released in a timely and accurate manner to avoid concealment, duplicate
reports, omissions, and misreporting. In addition to publishing dynamic information on the epidemic,
information platforms should allow the development of statistical analysis functions.
3.2. Weakness-Opportunity (WO) Strategy
3.2.1. Formulate a Health Emergency Response System for Major Infectious Diseases during Holidays
When the occurrence of a major infectious disease epidemic coincides with a statutory holiday,
preparations should be made to respond to public health emergencies over holidays, and the statutory
holiday or series of holidays should be terminated temporarily in advance.
3.2.2. Establish a Health Emergency Department in Universities
There are only a few universities in China, such as Jinan University, Henan Polytechnic University,
and Jiangsu University, which have undergraduate emergency courses, and there are very few
professionals qualified to lecture or conduct scientific research in the health emergency field. Regardless
of improvements in national health emergency awareness, professional training of national health
emergency administrative personnel, or from the improvement of national health emergency scientific

5
research level, setting up health emergency disciplines in colleges and universities, and training
professional health emergency teachers. It is one of the countermeasures for long-term sustainable
development. The COVID-19 epidemic may provide the catalyst needed to take action to develop
public health emergency management infrastructure. Not only medical schools, but other universities
may also consider setting up health emergency disciplines and forming a team of health emergency
teachers. All universities have the educational obligation of cultivating students to learn emergency
and establishing emergency awareness. Educational channels for school health emergency can also
strengthen publicity for social health emergency.
From the perspective of long-term development, with the special needs of the country as the
guide, additional health emergency majors have been established in universities, the number of
health emergency professional teachers has been increased, and the development of health emergency
disciplines is imminent. Scientific research on health emergencies can be strengthened to reinforce
the country’s scientific research output for health emergencies, to support the capacity of health
emergencies, and to popularize the basic knowledge of public health emergency prevention and
Int. J. Environ. Res. Public Health 2020, 17, 2235 13 of 17
control for students, as well as providing basic guarantees for universities to respond to public health
emergencies. In addition to the establishment of independent health emergency departments in health
departments, medical and health institutions, disease prevention and control agencies, and health
supervision agencies, health emergency management departments should also be established within
other joint health emergency prevention and control agencies.
3.2.3. Construction of the Health Emergency Culture and Code of Conduct of the System
It is important for emergency health education to be conducted, as well as the formulation of
a “Code of Conduct for Health Emergency Response”. Training exercises should be carried out on
community health emergency knowledge, field training of health emergency professional teams, long
distance training as well as quality development, and promote health emergency awareness through
banner slogans and display boards. Through the cultural construction activities of health emergency
communities and departments, such as “health emergency team song collection activities”, “telling
health emergency stories” and “remembering emergency training diaries”, the content of health
emergency culture is enhanced, health emergency awareness is established, and health emergency
personnel are stimulated. Furthermore, a sense of honor and achievement can form an effective
spiritual motivation. Attention should be paid to the coordination of urban governance and health
emergency policies, and it should not be controlled by public opinion, in order to avoid excessive
interference in urban governance.
3.3. Strength-Threat (ST) Strategy
3.3.1. Authoritative Departments Releasing Accurate Information in Time
A national unified platform for the release of epidemic information should be established.
Authoritative departments should publish accurate information in a timely manner. At the same
time, an epidemic information release and review system should be formulated. The provinces
should centrally report epidemic information by infectious disease direct reporting system. National
authorities should respond to public concerns immediately.
3.3.2. Timely Adjustment to the Economic Structure and Strengthening of International and Domestic
Regional Linkages
The COVID-19 epidemic spreads rapidly around the world. The epidemic triggered not only the
global public health crisis, but also global public crises that penetrated into many fields such as politics,
economics, culture, and health. In responding to COVID-19 epidemic, the shortcomings of public health
emergency management systems have become fully exposed in multiple countries. The epidemic
has exposed the insufficient knowledge of major public health emergencies, limitations in prevention
measures, and limitations in core competencies in public health emergency management. The global
public health emergency management system cannot meet the needs of the current complicated and
severe epidemic situation.
Iran was the first country in the Middle East to experience an outbreak of COVID-19. The Iranian
economy has been subject to economic sanctions for a long time, and the government cannot easily
impose a shutdown in the country. If the outbreak in Iran continues to grow, it may cause more serious
health incidents in the Middle East as a whole; Japanese domestic enterprises and local governments
are in a state of emergency. The Japanese government has taken measures to start budget reserves to
help small and medium-sized enterprises to manage their financial shortfall.
To adjust the economic structure in a timely manner, people-intensive production enterprises
should strengthen the impact assessment, strengthen communication, and linkage with international
organizations and other countries. They should also share information, actively respond to adverse
measures of international organizations and other countries and strengthen entry-exit inspection and
quarantine. Efforts will be made to control population flow in epidemic-stricken areas, strengthen
Int. J. Environ. Res. Public Health 2020, 17, 2235 14 of 17
the sharing and release of epidemic information internationally, and to establish an international
cooperation and coordination mechanism for health emergency rescue.
3.3.3. Enhance Scientific Research and Transformation of Major Infectious Diseases
The long-term accumulation of basic research on the pathogens of major infectious diseases will
provide the theoretical basis and supporting technology for the detection, diagnosis and control of
major infectious diseases. Strengthening of the scientific research capabilities for infectious diseases,
laboratory construction, timely conversion of production capacity, and strengthen the linkage and
upgrade of upstream and downstream scientific research institutes and enterprises, are all necessary.
Research institutions and institutions of higher education should continue to support studies exploring
the etiology of important pathogens, pathogenic mechanisms of infection, animal models, antiviral
drugs and vaccines, as well as research on detection and monitoring technologies, and control
technologies for severe and foreign pathogens. Support is also crucial for research into mechanism and

6
control technology. Research on prevention and control strategies and measures, technical support,
and drug reserves for responding to public health emergencies is also vital.
3.3.4. Develop the Health Emergency Function of the Medical and Health System
It is necessary to fully develop the functions of the medical and health system, invest in health
emergency reserve funds, optimize the allocation of medical and health resources, set up full-time
emergency departments and positions in medical and health institutions, increase basic training for
medical personnel on major infectious diseases, and enhance pathogen detection in medical and health
institutions. The ability to increase the importance of medical personnel on major infectious diseases
is required, as is an improvement in the ability to identify and judge early, and strictly regulate the
system of surveillance, early warning, and reporting of major infectious diseases. Investment in health
emergency reserve funds to enhance defense capabilities is crucial.
3.4. Weakness-Threat (WT) Strategy
3.4.1. Strengthening the Public’s Psychological Intervention in Responding to Public
Health Emergencies
The COVID-19 epidemic is identified as a Class B infectious disease in China, and measures for
the prevention and control of Class A infectious diseases are adopted. Class A infectious diseases
include plague and cholera. Class B infectious diseases include infectious atypical pneumonia, AIDS,
viral hepatitis, and polio. Patients will experience varying degrees of stigma during the epidemic, and
this will cause anxiety, depression, hostility, and other mental and psychological symptoms requiring
timely intervention to avoid the emergence of mental and psychological disorders such as long-term
post-traumatic stress disorder. With the implementation of the COVID-19 epidemic prevention,
control, and governance measures, problems in public health ethics and psychology have become
apparent. Public health ethics is to establish reasonable boundaries and standards for citizens to make
the necessary sacrifices. Volunteers entering the community and actively conducting psychological
assistance can help the public to prevent and control infectious diseases. It is a key strategy to solve
public psychological problems.
Based on the monitoring and information management of major infectious diseases, it is important
to establish and improve a social psychological early warning system, to strengthen the public’s
psychological health education, to open a psychological counseling hotline, unite health emergency
professionals and psychological counselors, and provide psychological counseling and emergency
interviews to the public. Other interventions, such as cognitive therapy, behavioral therapy, and other
professional psychological interventions, are also of crucial importance.
Int. J. Environ. Res. Public Health 2020, 17, 2235 15 of 17
3.4.2. Formulate Return to Work Plans for Different Industries
According to the characteristics of individual industries, plans for returning to work in different
industries should be formulated. Non-life security service industries and consumer entertainment
service industries can postpone the return journey; however, economic pillar industries should
formulate effective response plans to avoid excessive impact on the wider economy.
3.4.3. Increase Support for Health Emergency Education
Guided by the national health emergency manpower demand, one should consider increasing
professional emergency health education support, fully developing the role of health emergency
employment guidance, adjusting the professional settings and enrollment plans of universities, creating
health emergency unified recruitment and sub-specialties, and increasing health emergency professional
employment. A system for targeted employment in health emergencies should also be developed.
3.4.4. Implementation of Mobile Offices during Major Infectious Diseases
At present, most enterprises and institutions have postponed work, and the implementation of
mobile offices can reduce economic losses and the spread of major infectious diseases caused by contact
with people in the workplace A mobile office plan for major infectious diseases should be formulated,
and qualified units should equip staff with internet-enabled smartphones or tablets. Scientific research
institutions should provide free data and virtual private network (VPN) access in order to minimize
the disruption to office work during major infectious diseases.
4. Conclusions
In conclusion, the strength-opportunity (SO) strategy includes the continuous reinvention of the
health emergency system, emphasis on people-oriented policies, and upgrading of the health emergency
information system. The weakness-opportunity (WO) strategy includes the formulation of a health
emergency response system for major infectious diseases during the holidays, the establishment of health
emergency specialty and emergency management departments at universities, and the development of
a public health emergency management system and code of conduct. The strength-threat (ST) strategy
includes authoritative departments releasing real information through a centralized system with a
timely review system, the timely adjustment of economic structure, strengthening of international and
domestic regional links, enhancement of scientific research relating to major infectious diseases, and
facilitating full development of the functions of the medical and health system. The weakness-threat
(WT) strategy includes strengthening the public’s psychological interventions in response to public
health emergencies, formulating plans for returning to work in different industries, increasing support
for health emergency education, and promoting mobile work during major infectious disease epidemics.
There is still much work to be done for the prevention and control of COVID-19.
In short, based on the SWOT analysis of the COVID-19, we have integrated the relevant factors that
are currently scattered, and have a more systematic and intuitive strategy for the prevention and control
of COVID-19 in China. We combed SO, WO, ST, and WT strategies. We performed an in-depth analysis
of the policy’s highest-priority areas that we identified, and the highest-priority policies are as follows:
continuing to reshape the health emergency system; establishing health emergency departments in
universities, and health emergency management departments in all institutions; adjusting the economic
structure and strengthening international and domestic linkages; and strengthening public intervention
in responding to public health emergencies. From the perspective of continuously responding to

7
the global public crisis, the continuous reconstruction of the health emergency system should attract
sufficient attention from countries around the world.
Author Contributions:
J.W.—Data curation, Formal analysis, Writing—original draft; Z.W.—Supervision.
All authors have read and agreed to the published version of the manuscript.
Funding: This research received no external funding.

https://www.researchgate.net/publication/340332312_Strengths_Weaknesses_Opportunities_
and_Threats_SWOT_Analysis_of_China's_Prevention_and_Control_Strategy_for_the_COVID-
19_Epidemic

============================================================================

How to bring maximum benefit to your twice-yearly marketing update.

Strategic planning demands realistic and objective assessment. At least
twice each year, use the SWOT analysis to discover key internal and
external issues and refresh the strategies and tactics of your marketing
plan. Understanding where you are today is fundamental to achieving
your future goals.

The well-known SWOT analysis appears disarmingly simple. But avoid

the temptation do it quickly or casually. Taking this valuable analysis for
granted would be downright unfortunate.

Thoughtfully listing the STRENGTHS, WEAKNESSES,

OPPORTUNITIES and THREATS of your situation should be done at
least once a year…even better, twice a year. It’s a “big picture” exercise
that challenges you to compile, analyze and evaluate the significant
influences that work for or against your strategic objectives.

A SWOT analysis is useful for hospitals, medical groups, and individuals

in private practice—it helps focus your marketing in areas that harbor
the strongest benefits. Here are a few ideas to maximize the value and
generate effective strategies from this exercise.

Sketch the quadrants.

Create a four-part grid on a single piece of paper to provide an overview
that helps visualize the relationships.

8
Identify and list the key elements in each quadrant. Get these down on
paper as the first step.

Internal: Strengths & Weaknesses

The top two sections (STRENGTHS and WEAKNESSES) both originate
internally. These are things that you can control. Strengths are helpful;
Weaknesses are harmful.

STRENGTHS: List of your capabilities and resources that can be the

basis of a distinct competitive advantage. Ask: What are the most
important strengths? How can we best use them and capitalize on each
strength? Strengths could include:

 a new and/or innovative service

 capabilities or cost advantages
 cultural connections
 extraordinary reputation
 other aspects that add value
 special expertise and/or experience
 superior location or geographic advantage

WEAKNESSES: What areas need improvement (or should be

avoided)? Ask: What would remove or overcome this weakness?
Weaknesses can sometimes be the absence of certain strengths, and in
some cases, a weakness may be the reverse side of one of your
strengths. Weaknesses might include:

 absence of marketing plan

 damaged reputation
 gaps in capabilities or service areas
 lagging in technology
9
  management or staff problems
 own known vulnerability
 poor location or geographic barriers
 undifferentiated service lines

External: Opportunities & Threats

The lower two sections (OPPORTUNITIES and THREATS) both
originate externally. These are things that you cannot control.
Opportunities are helpful; Threats are harmful.

OPPORTUNITIES: In addition to new or significant trends, what other

external opportunities exist and how can we best exploit or benefit from
each? Examples might include:

 a market vacated by a competitor

 availability of new technology
 changes in population profile or need
 Competitor vulnerabilities
 lack of dominant competition
 new market segment that offer improve profit
 new vertical, horizontal, or niche markets

THREATS: Can include anything that stands in the way of your

success. No practice is immune to threats, but too many people miss,
ignore or minimize these threats, often at great cost. Ask: What can be
done to mitigate each threat? Can a threat become an opportunity?
Threats could include:

 a competitor has an innovative product or service

 a new competitor(s) in your home market
 adverse changes in reimbursement or regulations
 changing insurance plans and/or contracts for major area
employers
 competitors have superior access to channels of distribution
 economic shifts
 loss of key staff or associates
 new or increased competition
 seasonality
 shifts in market demand or referral sources

Seven simple rules for successful SWOT analysis

1. Be Specific: Avoid gray areas, vague descriptions or fuzzy
definitions.

2. Be Objective: Ask for input from a well-informed but objective third

party; compare it with your own notes.

10
3. Be Realistic: Use a down-to-earth perspective, especially as you
evaluate strengths and weaknesses. Be practical in judging both
sections.

4. Apply Context: Distinguish between where the organization actually

is today, and where it could be in the future.

5. Contrast and Compare: Analyze (realistically) in relation to your

competition i.e. better than or worse than your competition.

6. Short and Simple: Avoid needless complexity and over-analysis.

7. Update your marketing plan and goals: Once the key issues have
been identified, define the action steps to achieve change.
Send us your SWOT notes for a reality check.

If you’d like to know more about putting this high-value assessment tool
to work in your plan, we would be pleased to provide a well-informed
and objective sounding board for you. Call us today at 866-238-8976,
or connect with us here. Make every marketing dollar count with a
custom, strategic plan.

https://healthcaresuccess.com/blog/medical-advertising-agency/swot.html

==============================================================================

HEALTHCARE | CORONAVIRUS

How Covid-19 is Unveiling US Healthcare

Weaknesses
Three questions to Eric Schneider by Angèle Malatre-Lansac
INTERVIEW - 27 MARCH 2020

ANGÈLE MALÂTRE-LANSAC
ASSOCIATE DIRECTOR - HEALTHCARE POLICY

ERIC SCHNEIDER
SENIOR VICE PRESIDENT FOR POLICY AND RESEARCH AT THE
COMMONWEALTH FUND

11
With 81,000 people infected with the coronavirus on March 27 and more than
1,000 deaths, the United States are now the new epicenter of the disease.
According to Eric Schneider, senior vice president for policy and research at The
Commonwealth Fund, a national philanthropy engaged in independent research
on health and social policy issues, the very decentralized nature of the American
Healthcare system where states set their own policies, the weaknesses of care
delivery as well as a series of lost opportunities made the United States the
country hardest hit by the pandemic.

The first known case of COVID-19 in the U.S. was confirmed on January 20, 2020 and cases
have now been confirmed in all 50 US States. The coronavirus pandemic exposes any and all
health care systems’ weaknesses. What are the biggest challenges for the American healthcare
system?

The first challenge is the decentralization and weakness of our public health and
disease surveillance systems. When facing a pandemic, a nation as large as the
U.S. needs a central agency to collect and monitor data from abroad and from
within the country to detect emerging disease threats early and coordinate a
response. These functions are decentralized in the U.S. Each state funds and
operates its own public health and disease surveillance system. As this
pandemic started, the consequence of that decentralization was a failure to
understand the magnitude of the problem and to pursue the kind of testing
done that other countries did early to detect cases and start contact
tracing. Despite several experts’ warning of the threat in January, our nation’s
Center for Disease Control was very slow to ramp up testing and failed on some
crucial decisions about which test kits to permit and how to distribute them. We
lost many weeks in this process.

On the other hand, a strength of our decentralized system is that an independent

team of researchers in Washington State, frustrated by the slow federal response,
started testing on their own. At state level, public health agencies stepped in to fill
the vacuum in leadership.
On the healthcare delivery side, one big challenge is that our system depends
heavily on private companies, private practices and private hospitals. We
tend to rely on the market to deliver primary care services and hospital
services. Half of healthcare spending in the U.S. is private spending. Spending
from our government is channeled through private delivery systems. Some
weaknesses of that approach are that those private organizations operate with a
high degree of independence. It is rare for the government to order them to change
their procedures and coordinate except in a crisis.

A strength of our decentralized system is that an independent team of researchers

in Washington State, frustrated by the slow federal response, started testing on
their own.

They also rely on a fee-for-service revenue stream that depends on people coming
in for face-to-face visits. What we are seeing now because of stay-at-home
orders and the shut-down of much of our economy, is that those private
practices are experiencing serious challenges to their revenue. We are hearing
of a 30 to 50% decline in revenues because providers can’t bill for visits that don’t
happen and because there is no payment for telephone consultations. That creates a
weak spot in our primary care system.

A second major challenge in this pandemic is the capacity of hospitals: bed

capacities are lower in the United States than in most other high-income nations.
In part this is because we let market forces, who can pay the most, drive the
availability of services. There is a misallocation of resources: we have too few
intensive care units’ beds and too few ventilators for the crisis we are

12
facing. Many of the hospitals in New York already report that they have reached
their capacity and many are “safety-net” hospitals that serve poor patients.
Another issue is staffing, we don’t have enough people trained and respiratory
therapists to manage the ventilators. One of the reasons for this shortage is that
respiratory therapists are traditionally paid less than many other health
professionals.

Another third weakness is the lack of universal insurance coverage: we still have
around 10% of the population lacking any health insurance and half of
Americans reporting that they are underinsured. Those people face high
deductibles and copays when they seek healthcare and their out of pocket spending
can be very high. We have known for decades that people who lack financial
means end up going without care. They avoid going to a doctor and going to
hospitals until they are really sick. And in a pandemic like this one, we want
people to identify that they have a problem early so that they can be dealt with.
The spread of coronavirus may be accelerated by the lack of access to
healthcare. Initially, people did not want to face the cost of testing because it
wouldn’t be covered by insurance companies. Now insurance companies have
agreed that they will cover testing without copay, but even that doesn’t solve
the problem: once a person is sick and goes to the hospital, or if they need an
ambulance to go to the hospital, they can face significant financial costs.

Another weak point is that Americans may be in worse health than their

counterparts in other countries. On average Americans are a bit younger than
people in Japan or in Europe. But a higher proportion of the population suffers
from chronic diseases: high cholesterol, diabetes, heart problems, and respiratory
conditions. The excess burden of chronic diseases is partly a result of inadequate
insurance and access to care. We also have a large homeless population that
carries its own set of health challenges. All of those individuals are in the high
risk category if they get sick with Covid-19. We don’t have the hospital capacity,
the ICU and medical capacity and ventilators. In New York City, now the
epicenter of the US pandemic, tens of thousands of people are homeless, living in
the streets, subways, and in shelters. The virus can be transmitted easily through
those communities. Their risk of death is very high. We’ve seen in the last few
days a tremendous surge in people, arriving at New York hospitals seriously ill
with Covid-19.

We see that every country has a different response to the outbreak. What can be done in the U.S.
to contain and mitigate coronavirus?

I’m in New York city, and the State of New York has become the epicenter of the
epidemic in the United States within the last two weeks. It’s likely due to a
combination of New York being a place with a lot of travelers, and because of the
city’s high population density: New York City has two times the population
density of Los Angeles.

What we are seeing in the State of New York is a very dramatic response. The first
response was a physical distancing strategy (some people call it a social
distancing). The state moved quickly to close schools and non-essential
businesses, and issue stay-at-home orders: those changes can slow the progression
of the disease (as they did very successfully in China). New York started this
lockdown a week and a half ago. Hopefully that will reduce the number of people
demanding hospital care in the coming weeks.

The second response was to increase the hospital capacity to answer the needs of
the population. New York is beginning to mobilize the equipment that is needed:
ventilators, opening new hospital beds, building new facilities such as temporary
field hospitals. That’s all beginning to happen. Another response is testing. We’ve

13
been flying blind for the last several weeks in terms of knowing the
magnitude of the demand for care. Other countries such as South Korea have
tested hundreds of thousands of people and have set up drive-through testing
centers. Testing has now expanded dramatically in New York. We started late but
the production of tests finally ramped up to allow testing tens of thousands of
people. Other states like Texas and Florida have been much further behind in
terms of testing.

We are going to need a federal coordinated response. States right now are
actually competing against one another to acquire ventilators and protective
equipment for healthcare workers.

We also need a federal response. A lot of people fled New York for other states
and cities over the past several weeks going to other cities. Now the first cases are
surging in those other cities. We see New Orleans becoming another epicenter in
the U.S. It is speculated that the Mardi Gras festival in February may have drawn a
lot of people to New Orleans, some of whom were carrying the infection. In
March, Spring break brings lots of students to Florida. The number of infected
people is still low in Florida but they are not testing actively. The point is that the
pandemic is unfolding differently in different parts of the country. We are
going to need a federal coordinated response. States right now are actually
competing against one another to acquire ventilators and protective
equipment for healthcare workers. And companies that are selling that
equipment are raising prices. That’s not a great way to allocate resources in a
crisis. Our federal government really needs to step in to prevent misallocation and
price gouging and to allocate resources to where the needs are greatest. And the
needs are going to change and spread throughout the country at different times. A
federal coordinating response could really help. 

Last but not least, we also need a centralized monitoring system. One of the
strengths we see in the United States is the high level of telecommunication and
computerization of daily life that enables the sharing of data despite much of the
economy being locked down. Healthcare professionals are able to share ideas and
information on the nature of the disease and how to manage it. But we still don’t
have the monitoring and measurement system we want that would help us
understand where the disease outbreak is at its worst, and where supplies are
needed. We have a very weak federal central capacity that is hurting the states that
need the most help, such as New York City, Seattle, and California. These places
are experiencing major epidemic outbreaks and have to face them without
sufficient federal help right now.

With 33 remaining primaries and caucuses and the presidential elections in November, the
Coronavirus crisis has put politics in an entirely new light and the impact of the situation on
campaigns and elections is becoming increasingly evident. How is Covid-19 reshaping politics?
We are already beginning to see a small shift in the balance of political power
because of the absence of quarantined Senators.

This is unprecedented of course, and we are in an election year. One of the very
urgent worries is whether our government can maintain its functioning capacity.
Members of our Congress have to vote in-person at the Capitol in Washington
D.C. Several members of Congress have already tested positive for the disease.
We are already beginning to see a small shift in the balance of political power
because of the absence of quarantined Senators.

There is also a level of uncertainty about whether our elections can be

conducted. Several primary elections in states across the country have been
postponed. There are even concerns about whether the November presidential

14
election can be held. But there is still time to sort that out. Certainly, what we see
is that the ability of politicians to campaign to the public is threatened.

In a pandemic, the need for strong leadership is clear. We’ve seen very gratifying
leadership among our state governors: governor Cuomo in New York, governor
Newsom in California or governor Inslee in Washington State have really stepped
up by making hard decisions to shut down schools and business activity to control
the pandemic. Other state leaders have been less active: Florida is still not willing
to shut down businesses for example. We don’t see cooperation. On the contrary,
some states are starting to talk about restricting travelers from other states
and sealing their borders, something we have not seen since the US Civil War
in the 1860s.

Copyright: Johannes EISELE / AFP

https://www.institutmontaigne.org/en/blog/how-covid-19-unveiling-us-healthcare-weaknesses

==============================================================================

COVID-19: Its Impact on the Philippines

- Parts I, II, III and IV of V
Monday 4 May 2020, by DE SILVA Raymund

Introduction: The Global and Regional Contexts of COVID-19

1. Brief Chronology of Events in the Philippines
2. Steps taken by the Philippine Government in Fighting the Invisible
Enemy
3. Current Status of the COVID-19 Situation in the country
4. Impact of COVID-19 on Peoples’ Lives
4.1. Perfect Storm of Virus affecting the Country’s Poor and the Vulnerable
sectors. Livesavers thrown to the Elite
4.2. Poor Health System Aggravates the COVID-19 Triggered Crisis. Fighting fire
with one arm tied behind our backs.
4.3. Control in an Open Society. Forcing People to STAY HOME…where many of
THEM consider the STREETs as their homes
4.4. Prayers Need Actions. ORATIO IMPERATA
4.5. COVID-19 Crystallizes China’s Influence on the Country’s Affair
5 Some Analyses and Conclusions
5.1. China’s Grand Belt and Road Initiatives have greatly helped China weather
the Impact of COVID-19. Setting the stage for building the Health Silk Road.
5.2. Globalization and Protectionism: The “Beggar Thy Neighbor” Dynamics
5.3. Controlling Run Away Infectious and It’s Economic Cost in the Philippines
5.4. The Country’s Working Class and the Killing Effects of COVID-19. Overseas
Filipino Workers (OFWs) worst hit.
5.5. Bracing up for the Second Wave.
5.6. People Need People. Strengthening Genuine Peoples’ Solidarity and Building
the Eco-Socialist Society: A Curative and Preventive Approach to the Deadly
Virus of Capitalism.

Introduction: The Global and Regional Contexts of COVID-19

The world has experienced a prolonged period of uncertainty and unrest caused by the
SARS-COV2 responsible for the Corona-virus or COVID-19 pandemic. To date it has
already affected the lives of peoples in almost 200 countries (and still counting) globally.
The human cost is rapidly being matched by huge economic costs.

15
There is still considerable uncertainty around the fatality rates of COVID-19 and
definitely it varies depending on the quality of local health care and the availability of test
kits to determine the number of people positively suffering with the virus. In fact, when
one considers the rapidly changing numbers of the mortality and transmissibility, the
figures quickly get scary.

A bombshell study from a team of infectious disease experts at Imperial College of

London last week (March 19) predicted that without intervention, the disease could lead
to 510,000 deaths in Britain and 2.2millions in the U.S. Both countries according to the
study’s hypothesis will have 80% of their population that would be affected by the
disease.

Further, disease experts estimate that each COVID-19 sufferer infects between 2-3 others
(twice as high as the seasonal flu). Earlier, experts would also say that the number of
those affected doubled in every 6.4 days. But it is strongly believed that the number of
the sufferer increases exponentially as what has been manifested in different countries. In
fact, COVID-19 could have been circulating for many weeks before it was detected
because people simply thought they had a common cold and did not go to hospitals. But
in most countries the virus could have been infecting people but could not be confirmed
because of the absence or limited supply of the testing kits and machine which could
validate or confirm the cases of people suffering from the sympthoms of the COVID-19.
The number of silent COVID-19 carriers could not be estimated.

Currently, what is certain is that, COVID-19 – a respiratory disease caused by the novel
coronavirus or SARS-COV2 which outbreak started in China’s Wuhan City in Hubei
province in the last quarter of 2019 has profoundly shaken the basic fundamentals in our
society. What started as health crisis has morphed into a full-blown economic crisis
which has affected the world much more than the 2008 financial crisis. It has destroyed
consumption activities and paralyzes the economy. The economic experts have been one
in seeing and saying that a recession unfolds in their very eyes. The economy which is
mostly dominated by consumerism is grounding effectively to a halt causing grave
repercussions especially for retailers, services and financial institutions. Such
development has made the politicians and policymakers scrambling to offset and mitigate
the damages in their respective countries.

The grounding of the productive activities resulted to the contraction of the demand for
oil. It is expected to contract by 90,000 barrels per day and in return triggered the all out
price war between Saudi Arabia and Russia. This has led to the crushing of oil price in
the global market by about a third (24%-30%). This is believed to be the worst situation
for the Petroleum dependent economies since the Gulf War in 1991. Logically, this
condition would be considered a big boon to consumers but COVID-19 is increasingly
keeping them at home.

Currently, the COVID-19 has reached and affected the most and advanced as well as the
poorest countries but the most glaring difference is in the manner of their respective
governments to manage the containment and the isolation of the disease. The case of
massive unemployment does not discriminate the above countries. The obvious
difference again has been manifested in the way countries cushion and mitigate the
impact of the pandemic on the working and toiling masses. The governments of both the
strongest and the weakest nations have been facing the problem of how to reach a proper
balance of controlling the movements of the peoples and to continue with the functioning
of the economy or the balance between the virtual and actual economic activities.

The COVID-19 pandemic has exposed the best and the worst manners of how on one
hand autocratic and rightist governments have taken advantage of the situation to tighten
and suppress the democratic activities of their people, and, on the other hand, some
governments have seen the decisive role of their peoples in controlling the spread of the
COVID-19. This can only be done with ensuring the participation of the people and can
only be done by being open, transparent and always in consultation with them.

In the current phenomenon, there is a great difference of how social media play to
mitigate or to aggravate the development of COVID-19 vis-à-vis 2003-3 SARS and the

16
MERS 2012. It can be used by those autocratic and dictatorial states to control the
projection of its effects in the positive management of COVID-19 in their nations. But it
can also be used to expose and tell the truth of some countries mismanagement of the
pandemic in their respective countries.

Through social media, the world has come to know that most of the countries, including
the most advanced are not prepared to face a phenomenon like COVID-19. It has also
showed that the more the leaders of these countries are not convinced with the
seriousness of COVID-19, the most number of cases of their people are affected. The
earlier these leaders have taken actions, the most effective these nations and the people to
have contained the deadly virus.

US and China have just concluded their trade agreement and in the process to end the
conflict between them when the COVID-19 hit China in the last quarter of last year. The
first phase of this two-year agreement was for China, to buy $200 billions worth of goods
from the US. But as the catastrophic impact of COVID-19 has unfolded in both countries,
they will surely not able to implement the first phase of abovementioned trade agreement.

As early as the month of November 2019, the Novel Corona Virus-2 had already hit the
capital city Wuhan of the Hubei province in the central part of China with a population of
around 60million people. But, it took the Chinese leadership more than 7 weeks to act
and contain the spread of the virus. In fact, when several doctors including Dr. Li
Wenlaing tried to warn their close friends and relatives, about the deadly virus they were
reprimanded by their government and threaten to be imprisoned if they would not retract
their warning. Dr. Li Wenlaing and another director of the Wuhan Hospital died as a
result of the virus infection but they became the rallying point for people in the Wuhan,
Hubei area to criticize the handling of the epidemic of the Chinese government. Earlier
the Chinese government even tried to keep and hide the information about their deaths.

In a very unprecedented move, the seven members of the Standing Committee of the
Politburo of the Central Committee of the Communist Party of China had came out and
admitted their weakness in underestimating the impact of virus from Wuhan around the
second week of January 2020. With such admission, they quarantined and closed Wuhan
and the province of Hubei in January 20, 2020. Around this time, the number of cases of
COVID-19 in China had skyrocketed and deaths had reached several hundreds. During
this period, millions of Chinese workers (more than 5millions) were still travelling
around China to celebrate the Lunar New Year holidays. Hundreds of thousands were
still travelling around the world as tourists. The first cases in the US, South Korea, Italy
and the Philippines were brought in by Chinese tourists just before the locked down
(January 23, 2020).

At this period, huge waves of business closures have not only disrupted China’s
consumers’ spending and manufacturing but also the world’s supply chains.

It should be noted that in 2002, when SARS hit China, its shares of manufacturing output
was only 9%. At present, China’s share of global manufacturing output has ballooned to
28% or nearly 1/3 of global goods had originated from China.

China has become very important that when its manufacturing engines cease, the world
ceases along with it.

The drop in production last February this year is just a tip of the iceberg (according to
some experts) because most of the factories still maintained inventories of the China-
made parts. But by this month (March), these inventories are now depleted and cannot
immediately be replenished. Without alternatives, companies and factories will have to
shut down causing sales and profits to plummet and causing millions of workers to
unemployment.

In Asia, the export sector will be badly affected since its reliant on China-made
components.

17
Agricultural sector in the region will also be affected because they export their
agricultural products like tropical fruits and other products to China’s market.

Currently, everybody could see blood bath in tourism and the transportation industries
especially the airline sector. Global market is in meltdown and $14 trillion worth of
shareholders value and companies based in China are looking elsewhere for transfer.

Another very important reality is that COVID-19’s disruption has magnified the region’s
pitfall of growing dependence on China’s investment on major infra projects. These
major infrastructure projects are part of China’s Belt and Road Initiatives (BRI). But
everybody knows that BRI is not only for economic reasons but its initiatives are a
leverage to enhance Chinese political influence in the region and around the world.

Big infrastructure projects such as railways linking China to Laos across Mekong,
artificial island in Sri Lanka, bridge in Bangladesh, hydro-powers in Nepal and Indonesia
are currently under construction. There are also $5.5billion worth of high speed rail lines
in Indonesia and another $10.4billions worth of high speed rail in Malaysia. There are on-
going construction projects in Sri Lanka and corporate expansion plan in Pakistan. But
since December, all these infra projects have been affected and delayed by COVID-19.

In the case of the Philippines and Cambodia it’s a worst situation because both are
economically and politically very dependent on China. Eighty (80%) percent of
Cambodia’s economy is dependent on China. The “Build, Build, Build” mega flagship
projects of the Duterte’s government are mainly dependent on China’s funding support.

The heavy dependency of these countries in the region on China will be paid in a very
heavy price. The government of the abovementioned countries had been very hesitant to
close their borders with China during the pandemic period because of the repercussions
of such moves on China. Chinese planes and ships had continued to fly their Asian
routes. Myanmar, Bangladesh and Laos have continued to open their borders with China
even if other countries had already closed all routes from China. The Philippine
government had temporarily banned flights from China, Macau and Hongkong on
February 2, 2020 but within the same week it had suddenly included Taiwan in the ban
even if Taiwan had shown less COVID cases compared to Singapore. It was a clear
political consideration for the Philippines in the “one China” policy rather than
responding to health crisis.

Cambodia has shown moves that would surely not antagonize China. Prime Minister Hun
Sen had received the cruise ship (Westerndam) and personally welcomed all the
passengers in its capital (Phnom Penh) without wearing masks (he actually ordered all his
welcoming staff not to wear masks) because Hun Sen believed that it would be
disrespectful. They had a big party for the guests and allowed them to visit the tourist
areas in Cambodia. And to complete his political genuflection to China’s Xi Jinping, he
personally visited him in China’s capital at the time when COVID-19 was at its peak in
China (last week of February 2020). The people in Cambodia have been put in hazardous
situation because of these moves. The fear and anxiety that they are going to pay heavy
price because of their leaders’ political show off are real.

Currently in the abovementioned countries, less number of COVID-19-related cases or

deaths are being manifested as reported. Many have wondered if this is a case of hiding
the real condition or because of the absence of test kits and laboratories to confirm the
COVID-19 cases in these countries.

Last month, Chinese authorities were trying to quell outrage at home and condemnation
abroad. Now, it is trying to win points globally. In fact, China is trying to rewrite the
COVID-19 narrative deflecting criticism of its initial attempts to cover-up the outbreak
and posing as the savior of the other countries who either delayed their response or were
less prepared than China. It is trying to paint itself as a good Samaritan while deflecting
criticism over its initial missteps in handling the COVID-19 by giving out millions of
face masks, extending low interest loans and sending out teams of medical experts. It has
even showered struggling European nations with aid as part of a diplomatic charm

18
offensive. In fact, China is trying to integrate its Belt and Road Initiatives and its Health
Silk Road. But it has to start correcting the previous error.

The Communist Party of China has posthumously exonerated a doctor (Dr. Li Wenliang)
who was officially reprimanded for warning about the coronavirus outbreak and later
died of the disease. This is a very rare admission of error by the ruling Communist Party
that generally described a different situation from that usual “no challenge” to its
authorities. The Party had offered its solemn apology to the late Dr. Li Wenliang and
eight other doctors for its error. They also disciplined 2 police officers who implemented
the order of the local party branch. Earlier the Party bosses of the City of Wuhan and the
Province of Hubei were sacked from their political positions because of the widespread
outcry of the peoples.

Currently, as the US economy is shutting down, China has announced to the world that it
is reopening. Surely the wind has changed direction. The epicenter of COVID-19 has
changed its course from China to Italy and now to the US. And it seems that the famous
Italian saying “Andra Tutto Bene”(Everything will be alright) will still be a long way to
go.

 I. Brief Chronology of Events in the Philippines

The Philippines and China have gone a long way into developing closer relationship
since 2016. President Rodrigo Roa Duterte (PRRD) has openly declared the country’s
pivot to China (obviously away from the US) inspite of the fact that China has continued
to occupy and expand its occupation on islands historically claimed by the country in the
West Philippine Sea or the former South China Sea. In fact, PRRD has continued to
politically genuflect to China despite the Philippines victory in its territorial claim in the
International Court of Justice in 2016. In return China has promised to support major
infrastructure projects in the country under PRRD’s flagship’s program “Build, Build,
Build”. In fact, it is not only in these infrastructures that China is closely involved. It has
invested in almost all strategic industries like communication, power and energy.
Hundreds of thousands of Chinese workers have been flooding to work in these industries
and in the Philippine Overseas Gaming Operations (POGOs). In fact for the Chinese,
Philippine visas have been issued to them upon arrival. But still many of them have been
working in the country especially in the POGOs without visa or have expired visa.

The Philippine-China relations have been manifested on the local levels like forging city
to city pacts or sisterhood. A case in point here is the Davao City – Wuhan City trade and
cultural pacts. With this kind of relationship, direct daily flights had been going on
between the two cities just before the Philippines’ locked down but more than 10 days
after China’s locked down.

Since December 2019, news about the outbreak of Novel Coronavirus had been all over
the news. The Philippine media had been covering and broadcasting the seriousness of
the impact brought about by the new epidemic from China.

During the last weeks of December 2019 and practically the whole month of January
2020, there was no initiatives from the Philippine government aside from its reaction to
the first virus-infected cases which came out in the last part of January. In fact, there was
no immediate reaction by the Duterte government and its health agency when China had
locked down the areas where the Novel Coronavirus had originated like the City of
Wuhan and the province of Hubei in January 23, 2020. In the whole month of January
2020, the country did not do anything to brace itself for the possible impact of the Novel
Coronavirus in the country inspite of the fact that it does not have the capacity even to
identify and confirm if a person has been affected by the virus. During this period, only
the Research Institute for Tropical Medicine (RITM) could have preliminary testing
capacity but the confirmation would be from Victoria Infectious Disease Reference
Laboratory in Melbourne, Australia.

In addition, the health care system of the country is very weak. For a country of almost
109million, it has only 89,000 hospital beds and only 1,000 intensive care units (ICUs).
The Philippines has a total umber of 129,000 doctors, 80,000 are members of the

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Philippine Medical Association (PMA) of whom only 50% are active. In terms of 2020
budget allocation, the budget of the DOH is P166.5billion which includes PhilHealth
(Philippine Health Insurance) and P7 billion budget lodged under the miscellaneous and
Personnel Benefits Fund. It is number 6 in PRRD’s government priority and less
prioritized if one compares it to the Department of Defense and the Department of
Interior and Local Government with total combine amount of P427billion and the
Department of Public Works and Highways with the budget of P534.3 billion.

With such dire situation, we cannot survive a greater magnitude of infections. Experts
project that if the government does not do anything in the next five weeks, the infections
can affect 75,000 people.

1. First Case in the Philippines

This was the country’s situation when the first case had arrived in the country from
Wuhan on January 21, 2020. A Chinese couple came in the country from Wuhan to the
central City of Cebu and travelled to another island City of Dumaguete before they went
to Manila. By this time they were already sick and their travel had involved around 440
passengers. After they arrived in Manila on January 27, 2020, they went to the hospital
and tested positive after confirmatory test from Australia.

China has locked down Wuhan and Hubei on January 23, 2020. These people left the
City of Wuhan just before the locked down. Aside from the couple, another Chinese
woman tourist arrived in the central part of the country on the day of China’s locked
down. She also carried with her the virus from Wuhan. She became patient number 3 in
the country.

On February 1, 2020, the man who was confirmed with the virus later died in a Philippine
hospital while the woman, who was the first virus carrier in the country had been cured
and later went back to China. The death of the Chinese man in the Philippines was the
first death caused by the novel coronavirus outside of China.

On the same day (Februay 1) World Health Organization (WHO) declared a Global
Health Emergency.

2. Steps taken by the Philippine Government in Fighting the Invisible Enemy

The following day (February 2), PRRD declared temporary ban on all people coming
from China, Macau and Hongkong. This delayed in the declaration of the ban was very
decisive in terms of stopping the flow of Chinese tourists to the country. In the last part of
January for instance, Xiamen Airlines was able to land in Davao City from Wuhan with
79 Chinese tourists. And around this time, World Dream Cruise ship landed in Manila
Port bringing with it, 1,400 Chinese tourists. Where did these tourists go, nobody was
able to monitor.

On the first week of February, both Houses of Congress (Senate and House of
Representatives) were busy investigating and tracing the 440 Filipino passengers who
flew with the Chinese couple. And then nothing is heard on this investigation.

On February 4, 2020, The National Institute of Health at the University of the

Philippines, Manila, had announced that it was able to develop testing kits for COVID-19
(the name used to refer to the Novel Corona virus earlier). These kits if sold is 6 times
cheaper than the foreign testing kits – it costs P1,300 a piece while a foreign product
costs P8,000. This UP Institute has been aware of the urgency to produce our own and
much cheaper testing kits. The DOH and the Food and Drug Administration (FDA)
advised the UP Institute to delay the production until the process of validation is
completed. As of this writing, it has not gotten the go signal for mass production. It has
been almost two months this day and positive cases and deaths caused by COVID-19 are
rapidly increasing but the preparation to manage the epidemic by properly capacitating
and protecting the frontliners seem to be very slow.

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On February 9, 2020, the travel ban against China, Macau and Hongkong was extended
by PRRD to Taiwan. The latter had strongly protested because it was clear that it is more
political (one China policy) rather than health consideration. Taiwan retaliated by
cancelling the Visa on arrival privileged given to Filipino tourists. In fact, at this period,
Singapore had more COVID-19 cases than Taiwan. A week after the ban on Taiwan was
imposed, PRRD had to take back or reverse this clearly political move. There were
protests from Overseas Filipino Workers (OFWs) coming from those working in Taiwan.
There are around 400,000 OFWs working in Taiwan, Macau and Hongkong.

On February 26, 2020, and almost 3 weeks after the UP Institute’s announcement, the
RITM purchased 19,000 testing kits from a source abroad. But the testing was still very
slow and the results would take around a week before the result was known because it
was still process mainly in Australia. No go signal yet on the commercial production of
much cheaper testing kits from UP.

On March 7, 2020, there was the case of husband and wife who were positively
confirmed with the virus with no history of travel abroad and they were to be the first
local transmission. The Department of Health(DOH) declared Code Red Sub-Level 1 and
imposed a public health emergency. This imposition authorized DOH to mobilize
resources for the procurement of safety gear and the imposition of preventive quarantine
measures.

On March 9, 2020, PRRD had issued Proclamation No. 922 placing the country under a
State of Public Health Emergency obviously upon the recommendation of the DOH. The
government had considered COVID-19 constitute an emergency that threaten national
security which requires a whole-of-government-response.

Two days after the declaration of Code Red Sub-Level 1 and during a Senate hearing,
DOH admitted that the total number of testing kits in the country at this time was just
2,000. If PRRD’s government was really convinced that there was public health
emergency and that COVID-19 threatens national security the the concrete situation on
the ground does not reflect such appraisal.

On March 11, 2020, the World Health Organization had declared COVID-19 a pandemic
since it had inflicted more than 150,000 people including 6,000 deaths all over the world.
The Philippines during this period had so far confirmed cases of 140 people including 12
deaths.

The following day (March 12, 2020), PRRD declared Code Red Sub-Level 2. He had
imposed partial lock down in Metro Manila and suspended all classes in the metropolis
until April 12, 2020. PRRD did not directly call it lock down, he used the term
“Community Quarantine” from March 15-April 14.

PRRD’s government had closely timed its moves on the actions taken by WHO except
that he did not do much on WHO’s Chief Tedros Adhanom Ghebreyesus advice (during
conversation with journalists) that the best way to combat COVID-19 is by Test, test, test
every suspected case. The WHO Chief further said that “You cannot fight a fire while
blindfolded”.

Obviously, the Philippines approach in combating COVID-19 has been very reactive and
more in population control rather than giving stress to go testing in order to locate and
isolate the virus from spreading further. In fact, around this period, the seemingly small
number of COVID cases including the number of deaths was due to unavailability of
testing and validating the cases. Some would call this situation as underreporting of cases
because it did not really reflect the actual health condition of the people. DOH has to use
a decision tool to identify suspected cases like the following: Persons Under Monitoring
or PUM to refer to persons who showed some symptoms of COVID- 19 case. The PUM
is supposed to be monitored in their communities. Another term is Patient Under
Investigation or PUI where a person shows signs of having a flu-like virus like coughing,
cold and breathing problems. But as data show, there are persons suffering with the
COVID-19 but are asymptomatic. In fact, the reported positive cases and deaths due to
COVID epidemic during this period was more the picture in Metro Manila and not a

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national one. Furthermore, the data was just based on the people/patients who were
hospitalized and definitely did not include those with the symptoms but prefer to stay at
home.

On March 16, 2020, the entire island of Luzon (including Metro manila) was placed
under an “Enhanced Community Quarantine”. Social distancing was strictly imposed.
The COVID-19 cases in the Philippines during this time were 142 including 12 deaths.

Placing more than 60 million, including the more than 12 million in National Capital
Region or almost 60% of the 109million Philippine population under Enhanced
Community Quarantine for a month would be a nightmare. Restricting domestic travel in
and out of the areas and have government offices to function through a skeletal force to
contain the virus would come out at the cost to an economy that draws around ¾ of its
output from the island of Luzon and the Metro Manila areas. Millions of people who
belong to the informal sector or those who survive on the daily basis are residing in these
areas.

The following day (March 17, 2020), PRRD signed Proclamation No. 929, declaring the
Philippine under the State of Calamity for a tentative period of 6 months due to COVID-
19. This proclamation enjoins all government agencies and local government units
(LGUs) to render full assistance and cooperation and mobilize the necessary resources to
undertake critical, urgent and appropriate response and measures in a timely manner to
curtail and eliminate the threat of COVID-19.

The Proclamation was issued after the Code Alert System for COVID-19 was raised to
Code Red Sub-Level Two(2) in accordance with the recommendation of the DOH and
the Inter-Agency Task Force for Emerging Infectious Diseases (IATF).

The Proclamation was also acted upon based on the earlier law – R.A. No. 10121 or the
Philippine Disaster Rick Reduction and Management Act of 2010. The National Disaster
and Risk Reduction and Management Council has recommended the declaration of a
State of Calamity throughout the Philippines.

The declaration had afforded the National Government as well as the LGU’s, ample
latitude to utilize appropriate funds, including the Quick Response Fund, in their disaster
preparedness and response efforts to contain the spread of COVID-19 and to continue to
provide basic services to the affected population. The Presidential Proclamation
immediately makes available P16 billions of the Calamity Fund under the 2020 National
Budget.

The Enhanced Community Quarantine (ECQ) in the whole island of Luzon would
mobilize the big portion of the Armed Force of the Philippines and the Philippine
National Police (AFP/PNP) over and above the full mobilization of the LGUs with their
local peace and order units. In Metro Manila alone, there are a total of 56 border
checkpoints and almost every province and municipality down to the barangay (village)
levels have put up their own border control oftentimes without proper coordination to say
the least but without proper training and orientation to say the worst. Each of these units
and almost in all levels are making their own version and understanding of border control
but these local units seemed to be more powerful than what the National offices of the
IATF had ordered. A case in point here is that a standing order from PRRD & IATF to
allow traffic carrying strategic items like food and medical supplies to pass through the
various levels of border control, but it was not simply followed. A picture of a mob rule
is a best description of such situation. A population of almost 60 million cannot have
access to basic needs like food. People have been more afraid that they might die of
starvation and not because of the COVID-19.

The Economic team of PRRD based on Proclamation 929 rolls out P27.1 billion relief
package to counter the impact of COVID-19. This is supposed to support initiatives to
better equip health workers and provide relief and recovery measures to individuals and
sectors reeling from adverse impact of the pandemic.

The P27.1 billion will be allocated as follows:

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1. P14 billion to help the Tourism Infrastructure and Enterprise Zone Authority (TIEZA).
It will be intended to help the Department of Tourism to roll out various programs and
projects to support tourism sector.

2. P3.1 billion – help stop COVID-19 including the acquisition of test kits. This include
plan to borrow $1 billion from multilateral agency.

3. P1.2 billion – provide unemployment benefits for displaced workers.

4. P3 billion for Technical Educational Service for Development Administration

(TESDA) to provide technical training.

5. P2.8 billion – allocated for the Department of Agriculture and its Survival and
Recovery Program or SURE.

6. P1 billion for the Department of Trade and Industry for Pondo sa Pagbabago at Pag-
Asenso (P3) or Funds for Change and Development. This includes the micro-financing
special loan package for small businesses or corporations.

It is clear that only a fraction for the needs of the poor families and for health equipment
and protection of health frontliners are being appropriated. The big part is to save big
industries.

Meanwhile, people have been dying without even knowing the test results whether they
were positive or negative of the COVID-19.

On March 25, 2020, PRRD signed the Republic Act (R.A.) 11469 or The Bayanihan to
Heal as One Act which gave him additional powers to handle the outbreak of COVID-19
for 3 months (March 25-June24, 2020). This was after both Houses of Congress (no
session because they are on vacation) had an emergency sessions to act and give the
President additional powers.

This Republic Act gives PRRD the additional authority to re-allocate, realign and
reprogram a budget for almost P275 billion or $5.37 billion from the P438 billion or $
8.55 billion of the P4.1 trillion National Budget for 2020 in response to the pandemic.
PRRD has also been given powers to take over temporarily corporation and institutions
when the public interest so require.

There will be immediate relief package for the 18 million families who live below the
poverty line. An amount between P5,000 to P8,000 will be released to them every month
in 2 months. This amount of P275 billion is over and above from previous massive
amounts allocated and released in two proclamations (Proclamation 922 and 929), and
the billions donated by big corporations and individuals in both cash and in kind.

3. Current Status of the COVID-19 Situation in the country

As of this writing, the most affected sectors of the society, especially the toiling masses
have not yet received this promised aid package. The different agencies in the
government have not yet agreed on the manner and mechanism of the distribution of the
so-called emergency help. This is in spite of the creation of the Inter-Agency Task Force
for the Emerging Infectious Disease (IATF-EID) since it was activated after
Proclamation 922. The Task Force was created based on Resolution No. 10 series of 2014
based on Executive Order No. 168 series of 2014, precisely to manage any disaster and
emergency in the country and give appropriate and timely advice the President. It is
composed of Department of health (DOH), Department of Foreign Affairs (DFA),
Department of Interior and Local Government (DILG), Department of Justice (DOJ),
Department of Labor and Employment (DOLE), Department of Tourism (DOT),
Department of Transportation (DOTr), Department of Communication and Technology
(DICT). Eight government agencies and seem to speak in 8 different voices. As events
would show there is no national and coherent program to really confront and manage the
COVID-19 pandemic on the country. There are missing weeks un-acted after China
(PRRD’s best ally) declared the pandemic of the Novel Corona virus on January 7, 2020.

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No concrete action after January 30, 2020 when WHO had considered the COVID-19 as
Public Health Emergency of International concern without new vaccine to treat this new
COVID-19. Is social distancing or population control enough to face this pandemic?

Further, the frontliners have been asking for more protection like face masks, personal
protective equipment, testing kits and laboratories where the tests can be diagnosed like
what the Research Institute for Tropical Medicine (RITM) has been doing. To date,
almost 15 doctors had already died fighting on the frontlines despite of a very limited
protection. This number does not include other frontliners like nurses, midwives, etc.
These constitute more that 15% of the total deaths caused by COVID-19 in the country
during this period.

Donations from both domestic and abroad have started to arrive but where are those big
amounts from the government go? As of this writing, there are P16 billions made
available after the declaration of the National Calamity, P27.1 billions after the
Proclamation No. 929 and P275 billions after the signing of Republic Act 11469?

 II. STEPS TAKEN by the Philippine Government versus COVID-19

Since the official declaration of Chinese Health officials that there is the existence of a
deadly and very contagious novel corona virus in their country on the 1st week of January
this year, nobody from the Philippine Health officials had seriously given attention on
this development. Considering that Chinese tourists have come and go in the country by
the millions. As of December 2019, Chinese tourists comprised 22.1% or 1.74 million of
the total tourists arrival in the country (8.26 million in 2019), second only to the Korean
tourists which comprised 23.7% or 1.98 million. Chinese workers, in the Chinese funded
strategic industries and the Philippine Overseas Gaming Operation (POGOs) have also
resided in the country by hundreds of thousands. Not a few of them came home to China
during the Lunar New Year holidays. It is no brainer to think that they could constitute
potential virus carriers.

Not even the deadly impact of Serious Acute Respiratory Syndrome or SARS in 2002-3
which also originated from central part of China and caused the death of 774 people out
of 8,099 cases (9.6% mortality rate) and the Middle East Respiratory Syndrome or MERS
in 2012-13 with around 800 deaths out of more than 2,000 cases or 36% mortality rate,
did serve as a wake-up call to the responsible agencies in the Philippine government to
act and prepare the country for the impact of the novel corona virus.

The World Health Organization or WHO had taken almost three (3) weeks (January 30,
2020) to consider the novel corona virus or the COVID-19 as Public Health Emergency
of International Concern. Why did it take this long for an international body with the
United Nations network and whose primordial mandate is to have in depth study and
initiate an ALERT if it observes danger of a contagious virus/disease so that in a
globalized setting, countries can prepare and brace themselves in the earliest possible
period to save lives. Unless lessons were not learned from the 2002 SARS and 2012
MERS then nobody could understand the long delayed action of WHO. The declaration
of the latter of COVID-19 as pandemic on March 11, 2020 would be almost four(4)
months since the epidemic had started in China. Lives could have been save.

The period between the middle of January and the middle of February 2020 was the most
decisive period in the containment and management of the novel corona virus. This
period, as the peaking of the curve of the virus impact in China and it was during this
period that millions of Chinese tourists were travelling throughout the world because of
the Lunar New Year holidays. Not a few of them became anonymous carriers of the
virus. Countries like the US, Italy, Spain, Iran and the Philippines got their first
transmissions and cases around this period.

The failure of China to contain through early locked down of movements from Wuhan
and Hubei for instance, exported the virus unintentionally to other countries. Italy and
Iran for instance got their first cases on the third week of January when Chinese tourists
arrived in the abovementioned countries. US first COVID case came from Iran, from an
American citizen who visited Iran.

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In the case of the Philippines, the ban for travel (in and out) of China, Macau and
Hongkong came in on February 2, a day after WHO declared Global Health Emergency,
making it as an International Concern.

The steps taken by Congress were the investigation after the first cases on the first week
of February when Patient Number 2 died and the tracing of 440 passengers who travelled
with Patients number 1 & 2. Patient NO. 1 was able to recover and came home to China
without being subjected to thorough examination in the manner of transmission. The next
step from PRRD was this, travel ban imposed on travelers from China, Hongkong and
Macau on February 2.

The step was after almost one month and long before the local transmission as confirmed
on March 7, 2020. The DOH declared a Red Alert Sub-Level 1 and imposed a Public
Health Emergency. Included in this imposition is the authorization of DOH to mobilize
resources and procurement of needed Personal Protective Equipment (PPE) and the
needed medical materials to combat COVID-19. Measures to quarantine people was
included in this emergency measure.

These requirements needed for effective management of COVID-19 had not been
followed because on March 9, 2020, the country was shock to hear from DOH in a Senate
hearing that the total number of testing kits available at that time was just 2,000 amidst its
declaration of Public Emergency based on the development of COVID-19.

From that period, the steps taken by PRRD’s government was to control the peoples’
movements in Metro Manila through the imposition of Community Quarantine. Several
days later the quarantine was extended to the whole of Luzon island calling it Enhanced
Community Quarantine. This kind of moves was just consistent of the government which
had not done its works seriously for more than two months. It has not done its job to set
up more testing centers because setting these machineries is not just the buying of the
materials needed to set them up but to train and equip people to operate and manage them
which will take more time. At this period, it would take a week to get the confirmatory
results from Australia for the RITM which was the only center in the country to
preliminary took the tests.

Definitely these people’s control were not the result of concrete and scientific moves by
the government to know and determine the mechanism and machineries we would need
to face the enemy. Imposition of community quarantine should be a result of scientific
moves rather than the other way around. Nobody could understand the statement of
Cabinet Secretary and the Spokesperson of the Inter-Agency Task Force against COVID-
19 when he always mentions that Science is in-charge in the steps they are making
against COVID-19.

These reactive and defensive moves of PRRD’s government would impact very much as
the people would suffer from the quarantine restrictions and the food chain of the affected
areas. This is simply hitting anyone (shotgun method) in sight. While it is true that the
virus cannot be seen but it can definitely be controlled by identifying and isolating those
tested positive and those showing signs of the symptoms and denying the virus to inflict
others who will become their carriers. Fighting this unseen enemy is like waging a war
where the first thing that generals will do is to study and identify their enemies. These
moves can be done with excellent intelligence machinery. Locating where the enemies
are staying can be easy when the generals know the characteristics of their enemies. Fifty
percent of winning the war is already achieved when you know your enemy and where
they are staying. In this manner, you save a lot of your limited resources and you
minimize the collateral damage. Without this, one can still fight the enemy but blindly
and so, you use a shotgun or carpet bombing where with one bullet/bombs you might hit
your target but also those who are not supposed to be your enemy. The still effective
option is what is called the surgical bombing – or selected bombing on those areas
identified by the intelligence machinery. In this kind of war, time is of essence. It can
help you what appropriate action and machines you are supposed to mobilize. One cannot
surely win a war by always being defensive and reactive. And definitely this kind of war
is not only the war fought by the generals. It should mobilize the whole nation or whole

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of nation approach. This kind of war is so complicated and strategic to leave it to the
generals or even the retired ones.

a. Learning from others

In fighting a war against COVID-19, the experience of Vietnam in the early stage of their
war against COVID-19 is worth studying and learning. It used the symbols that
Vietnamese people can easily identified with and will surely support. Through the
leadership of Premier Nguyen Xuan Phuc, Vietnam has launched its peoples’ war against
COVID-19 in the Tet New Year (end of January) ala a Tet offensive model during their
war against the most powerful nation in the world – the US. At the time, this declaration
of war, the outbreak of the coronavirus was still confined to China. In the meeting of
Vietnam’s ruling Party, Premier Phuc insisted that it would not be long before the
coronavirus reached the country. The country’s leadership has agreed that fighting the
epidemic caused by coronavirus means fighting the enemy and they have to prepare for
the war now. The Vietnamese government is aware that in order to win the war, it needs a
lot of government funding and a stout Public health system. Both are lacking in the
government’s arsenal. So, they have to wage the war maximizing the minimum resources
in their arsenal. Based on their intelligence gathering, they select the area to start the war
– Ho Chi Minh City – 8 millions population with less than 900 intensive care beds. With
such massive limitation, it institutes rigorous quarantine policies, carried out tracing of all
people who came in contact with the virus.

The twin measures of limited quarantine and selective and rigorous contact tracing have
helped a lot in limiting the COVID-19 cases in the country. They strictly implement a
measure where anyone arriving in Vietnam from high risk areas would be quarantined for
14 days. All schools have been closed as early as the beginning of January 2020. That
government has also implemented widespread system of public surveillance which was
helped along by a well-supplied and generally respected Vietnamese military. This close
surveillance largely keeps anyone from slipping through the net or evading regulations. It
is nipping in the bud of the virus.

Premier Phuc has applied the kind of war against coronavirus in this message “Every
business, every citizen, every residential area must be a fortress to prevent the epidemic”.
This hits a nerve with many Vietnamese, who are proud of their ability to stand together
in a crisis and endure hardships. Vietnam has called upon its people and mobilize them
through focusing in preventing, isolating and defeating the COVID-19. As of this writing,
Vietnamese peoples’ struggle against COVID-19 is still unfolding but we can learn from
this early stage and the later stages especially that they are preparing for the second wave
of attack by the virus.

The Vietnamese experience tells us many things about fighting and winning battles to be
victorious in war. Right timing, stern discipline and focusing are points of essence here
because otherwise you might be fighting two or several fronts at the same time.

b. People suffer as government falters

The Philippine government has started its significant moves/steps after almost two
months when confirmed COVID-19 cases had been exposed. This delayed has impacted
very much in terms of preparation. It should be remembered that more than a month since
the first COVID-19 case, DOH had to shamelessly admit that it had only a total of 2,000
test kits and that the final confirmatory step would still be coming from Melbourne,
Australia.

In the first part of March 2020, the government had made moves that looked like
panicking after the so-called local transmission. It had immediately raised the Red Alert
Code-Level 1 and imposed a public health emergency. Several days after, the government
had imposed another Red Alert this time it was Code Level 2 and imposed a partial
locked down in Metro Manila – area with more than 12 million population. A week after,
the area of quarantine was expanded to the whole of Luzon – the biggest island of the
country and has more than 60 million of population. Both the Metro Manila and Luzon

26
have been contributing ¾ of the country’s economy. The implementation of the Enhanced
Community Quarantine would take effect immediately.

Understandably, the peoples in the abovementioned areas panicked. They rushed to the
market and bought anything they could lay their hands on and the limit was the
availability of money they had with them. Peoples who were staying outside the
quarantined area had rushed to the airports, ports and bus stations to catch the last trip
out.

There was immediate but massive deployment of military and police forces because they
eventually would play a leading role during the locked down period. It makes one to
think of its oddness that while the coronavirus epidemic is a public health emergency
more than a security threat PRRD would depend on his military to enforce the rules and
guidelines.

Again, it makes one to ponder that when a government intends to restrict (partially or
totally) the mobility and supply chains of millions of people, obviously it needs careful
and meticulous planning to ensure effective enforcement and appropriate implementation.
People need full preparation so that they can plan accordingly and equip themselves
especially since their daily subsistence could be imperiled for several weeks or for
months. They should not be made to suffer because of the government’s inefficiency
neglect and slow response.
When PRRD had announced the locked down and enforce it immediately without
bothering to inform and relatively prepare at least the local government units especially
in the affected areas, it manifested an obvious sign of something else. If it is not panic
then what is?

To fight the COVID-19, the government banned the main transportations so how could
people move to prepare themselves and brace for the impact of the pandemic. As of this
writing, workers have been walking back to their homes outside Metro Manila. They are
mostly the construction workers who were not able to catch up the last buses out because
the quarantine order was imposed immediately. For weeks now, they are still walking
back to the places of their origin – reminding one to recall of the historical Death March
of the guerilla together with captured American soldiers during the Second World War.

The quarantine includes the curbing of people’s freedom to earn a living. This step
severely affected the daily wage workers, the “No Work, No Pay” will mean no food for
their families. The aid package promise to them is still being finalized by different
government agencies and many of them have not received them yet.

Both situations portray a defeated people. Definitely, not a good start to vigorously
combat the unseen enemy for the construction workers and their kind.

Meanwhile, people would receive food rationing. But considering the inefficiency of
public services in this kind of crisis, how many days will the people have to wait for the
most needed food? Currently, the food aid distribution has been done by the local
government units (LGUs) from the municipal/city to barangay levels. The burden was
placed on the local government to feed the people while the national agencies of the
government are still trying to plan the manner and mechanism to distribute the aid
package. Considering that many of the leaders of these LGUs have been practicing
patronage politics, they only give the food package to their voters or their followers.

Furthermore, PRRD has been vocal that more than 50% of the village heads/chairperson
are involved in drugs of which he (PRRD) used this reason to postpone the barangay
elections several times.

If this is the situation with the LGUs, how can the people depend their next meals on this
kind of people?

And as if to put more salt to injury, food and basic items needed by the people in both
Metro Manila and Luzon were included in the ban as various local government agencies
would have different understanding about the quarantine imposition. Medical items

27
including personal protective equipment, ventilators and test kits are blocked and stocked
in the Manila port because the Custom officials have to process their documents yet.
Foods like rice and vegetables needed by people in Metro Manila (almost 100%
dependent on its food supplies from outside the National Capital Region) have been
blocked in different border controls. Trucks carrying them could successfully pass on
several border controls only to be stopped in another border control. This control
continues to happen even after several announcements and warnings from the
government through the IATF and the Armed Forces of the Philippines and the National
Police have been issued.

The mob rule types of control forced the farmers to giveaway or throw away their
agricultural products because they could not sell them in Metro Manila. Obviously, one
sees in this situation that PRRD’s government is writing the rules as it goes along. The
fact that the outbreak has started last December 2019 and it (PRRD) has more than
three(3) months more than enough time to prepare the protocols needed by LGUs and the
civil society to function and still effectively fight the COVID-19 even while on
quarantine, almost nothing happened. Anyway, competent government would have
planned forward or a little bit in advance.

c. A Glimmer of hope or a Fading light?

The signing of PRRD of R.A. 11469 has given hope to those who are expecting that the
earlier government action of PANIC can be corrected. In fact, the name of the law says a
lot. Bayanihan – To heal as ONE will immediately makes one to expect something
proactive and strategic. But initial implementation steps show that, people (as the word
bayanihan – bayan) are still left out in the fight against the virus. Largely, they (people)
are just recipients of the aid package. The mobilization aspect is for the people to stay at
home and their movements should be limited. Social distancing is more on the surface
and its coming from the outside command rather than peoples’ action because they are
convinced that these actions are their contribution to fight the unseen enemy. But then
again, the people are told again and again that moves like social distancing are to save
their lives because there is still no vaccine manufactured to eliminate the virus. But how
can they be strong and energize to fight the virus if they do not have something to eat.
How can they enthusiastically fight the unseen enemy with empty stomach?

Quarantine and social distancing can be the peoples’ part in the battle but the government
has their part too. It has to provide enough medical hardware and personal protective
equipment to equip and secure the part of the people who serve in the other front of
combating the virus. The works of medical frontliners are to ensure that the testing of the
virus affected people to isolate and treat them (common medicines) so as not to infect
others. The relationship between the people and the medical frontliners should be
nourished otherwise fake news can be more effective in contaminating this relationship
than the COVID-19. The worst situation is that people look at the medical frontliners as
part of the virus as carriers and should be turned away and should be eliminated
altogether. This kind of situation makes one think that since the people cannot see the
virus then it is easy to fight the visible objects like the medical frontliners. This is an
obvious result of the serious problem of understanding the virus, a gap that should not be
there if the government has fulfilled its very basic function of educating its taxpayers
about the virus that we all should fight.

Fighting the COVID-19 as ONE is indeed can only be done in a Bayanihan manner.
People should be actively participating in this fight even if they are in the state of
quarantine and practicing social distancing. They can be called upon to contribute their
human and financial resources to fill in the gaps of medical, technical, financial and
psychological needs. They can definitely do these things even if they are home-based.
But then the government can build and strengthen this Bayanihan spirit through education
and concrete actions. Basic needs of the people should be assured without sacrificing
their basic human rights. Coercion should never be part of an option. Unity is basic
requirement for Bayanihan to go one step higher. Bayanihan should never be used to
divide people based on their beliefs, political affiliations, race and gender. The
government should lead these efforts because during these decisive stages of fighting the
virus – peoples’ unity and participation is already part of healing to combat divisiveness

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and discrimination. Healing starts with being aware of our wounds or virus which at
present affects us all.

CURRENT STATUS of the COVID-19 Situation in the Country

Unlike the Housing, Real Estate, Financing and banking meltdown of 2008, COVID-19
is a contagion which has affected public health that has hit badly and swiftly the global
economy. To date, this twin global pandemonium has already caused a tsunami of
suffering for billions of peoples – but especially the poorest of the poor. It has halted the
agricultural production activities which have already caused a food crisis. This
development will be worst felt by countries especially those from emerging economies
with liberalized and privatized food industry. This neo-liberal arrangement has made
these countries dependent on importing agricultural products to survive. The pandemic
caused by COVID-19 has closed the door of the food exporting countries in order to
secure first the food needs of their own people.

The liberalization of Agricultural Industry has directly eliminated the capacity of the
peasants and agricultural workers to produce their own food. Rice Tariffication for
instance made the Philippines farmers unable to produce and compete with cheap
imported rice.

The farmers and the toiling masses have continued to be buttered and are merely
surviving from this neo-liberal offensive when they are hit by the COVID-19.

a. COVID-19 EFFICIENTLY Magnified Pre-Existing Conditions

The pandemic caused by this virus has closely magnified the pre-existing conditions
affecting the most pauperized and peripherized sections of peoples. And while it is true
that this kind of virus does not chose its victims, those who do not have regular food and
the malnourished and those who cannot afford to access health care services have greater
possibility to become COVID-19 victims. In many countries, the lifelines thrown to help
the most needy by governments have become out of reach due to the pre-existing
conditions.

But this time can be a rare opportunity for many ordinary poor people to make
extraordinary struggles to reclaim their dignity with compassion like in keeping each
others’ safe by practicing forced distancing whenever and whatever the situations they
find themselves in. These struggles include among others building and strengthening of
solidarity by contributing and promoting global conversation which promotes
understanding and sharing experiences in managing COVID-19 in order to help stop the
contagion from spreading further. Such collective action and collaboration can indeed
help contribute in changing peoples’ lives and values away from COVID-19.

Furthermore, COVID-19 can be an opportune moment for good and genuine

characteristics of leaders to shine through.

In the period of almost five months (including the unofficial period) since the official
announcement of the existence of the COVID-19, many of the world’s leaders were
caught with their “pants down” so to speak. Big factor of this kind of unpreparedness or
the not so serious attention by the leaders about the novel coronavirus was the clear
attempt of China (where the SARS-2002-3 and COVID-19 originated) to hide or
downgrade the basic facts about the virus. A case in point here is that China through the
China National Health Commission (CNHC) the official agency of China which releases
the situation and development of COVID-19 had claimed in January 15, 2020 that the
official number of cases caused by the virus as 15,205 while the University of Hongkong
had publicized that during the same period the total cases in China was 75,815. The data
of the latter was published in its LANCET Medical Journal.

Another reason for the reticent attitude of several leaders of countries has been the
geopolitical situation during the period. China has been investing serious efforts and
almost unlimited funds to put people in the leadership position in the different levels of
multilateral institutions to further their global interests both economically and politically.

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China has also painstakingly built its Belt and Road Initiatives (BRI) that it has gained
big and strong influence on politics and economies of various countries in the world
including Ethiopia – the country of the current World Health Organization (WHO)
Secretary General Tedros Adhanom Ghebreyesus. Lately, it has shown its (China) global
muscle by strongly lobbying and electing the new head of Food and Agricultural
Organization (FAO).

Not a few global leaders have shown characteristics of running and changing
characteristics from denial and being arrogant at the same time showing the “been there
attitude”. Such characteristics and attitude oftentimes underestimate the gravity of the
situation on their people and later becoming panicky and resort to strong arm tactics and
more repression. From these conditions, such leaders have become wishful thinkers and
becoming further away from what science is telling them about the condition of their
people and their countries. And the worst thing that these leaders would do when people
have different position with them, they began to blame everybody except themselves.

Good and genuine leaders work selfishly and extraordinarily under stress while facing the
developments unleashed by a disastrous condition. This is the positive attitude one needs
in facing the unknown virus and the uncertainty it has brought about. They may become
unrecognizable and even anonymous with their face masks and protective equipment in
fighting the unseen enemy but their commitment, compassion and humanity have
continued to shine through.

b. PRRD’s Governance and COVID-19

The abovementioned characteristics are very important to profoundly understand the

Philippine situation and how it has responded and managed the pandemic in the country.
Just like in any country, the country’s leadership has a pivotal role to play in the
mitigation and suppression of epidemic to reverse the growth and maintain such level
indefinitely. But the decisive role of the people to finally contain the contagion cannot be
relegated to the back seat. Peoples’ trust is crucial to any strategy adopted by the
government. The more transparency and quickly but accurate information is shared with
them the more the people will put their trust with their government. People will act
swiftly and rationally for the good of their community in particular and the country in
general.

In the 1st and 2nd series of this paper, it has been stated that President Rodrigo Roa
Duterte’s (PRRD) government has hesitated and faltered with their early moves. The very
weak health system and infrastructures and the massive lack of medical protective
equipment and capacity of human resources to face a disaster much more a pandemic
have not really made PRRD’s government, especially the Department of Health (DOH)
to seriously pay attention and make massive and timely preparation to correct all these
inadequacies.

The characteristics of PRRD and his manner of governance have a lot to do with such
passive attitude to say the least. In the early stage, the President had played down the
threat of the contagion saying that Filipinos have natural antibodies that would shield
them from infections. This statement had been parroted by his spokesperson. The other
branches of the government did not say a word. Then the President called the COVID-19
threat an idiot and ordered his doctors to work double time to find the cure.

In the second week of March before he ordered the lockdown of Metro Manila, the
President had mentioned that in the event of the pandemic he would not hesitate to use
the military and the police for order and obedience. Then, when signs of COVID-19 are
becoming unstoppable and deadly, he had declared series of proclamations namely:
Proclamation No. 922 placing the country under the State of Public Health Emergency,
Proclamation No.929 declaring the Philippines under the State of Calamity. Surely these
are signs of buckling down and panicking so that the President has asked the Congress
for emergency power thru the signing of Republic Act 11469 giving the President
additional powers to handle the outbreak of COVID-19 for 3 months (March 25-June 24,
2020). During these times, PRRD already lockdown the biggest island of the country
(Luzon), using the military and police to ensure obedience and order. And then, he made

30
an order for the military and the police to shoot anybody who would violate the rules and
policies of lockdown.

Placing more than 60 million in community quarantine has indeed limited the peoples’
movement and giving strict instructions for social and physical distancing can physically
stop the spread of the virus. The bigger problem, however, is how to feed and pacify the
“quarantined” millions who had lost not only their jobs and livelihood but also their basic
human rights. And the worst thing here is that you lockdown millions of people but the
government has not done much for ensuring that the virus and the carriers have indeed
been neutralized. The utter lack or absence of testing kits and machines and personal
protection equipment of the medical workers have caused the snail pace response to
identify, trace and isolate the COVID-19 patients or carriers. The much delayed actions
of the PRRD government can even be the case of locking down the barn door after the
horses are long gone.

c. MAXIMUM PROTECTION with MINIMUM DISRUPTION

With the absence of the vaccine at the moment, responsible steps of any government
should be to implement the mitigative actions with the maximum protection and
calibrated minimal disruption as a guiding principle in mind.

In the absence of such guiding principle not a few would think that PRRD’s moves are
just strengthening its authoritarian grip because of the serious implication of not doing
much to brace the country and the people for the impending disaster inflicted by the
COVID-19 pandemic.

The principle of maximum protection and minimum disruption should not be seen as
contradictory with each other. One had just to factor in the socio-economic political
underlying and pre-existing conditions because only from these perspectives realistic and
effective steps can be made to seriously combat the stinging effects of the COVID-19.

The locking down of the island of Luzon including Metro Manila is actually controlling
the movement of more than 60 million people. This kind of physical control coupled with
aggressive social distancing and hygiene instruction of properly washing one’s hands
should be taken as part of implementing the massive testing of people based on its
prioritized sections scheme. The result of the testing should be the basis for tracing and
isolating those proven positive with COVID-19.

The abovementioned points can have positive results if the social distancing will be done
together with a thorough social investigation and social preparation. Having several
millions of people staying in the urban poor areas when people are living very closely
with each other (3-4 households in a small space) because of the density of population in
a small area and surely with very poor sanitation as well. Many if not most of these
people do not have health insurance because the country has been practicing the
employee-based health system. If one does not have a regular work, they are not usually
covered by health insurance (Philippine Health Insurance – paid by peoples’ tax and
contribution). More than 20% of the country’s population is living under poverty’s line
(earning below 2/USD a day). This massive social inequality can be seen in these peoples
living in the slums areas. One can just imagine what will happen if COVID-19 visits
these areas.

In addition, basic social services in these areas are almost non-existence. The big
challenge therefore aside from social or physical distancing is how to properly wash their
hands when many of them do not have regular water servicing.

Another almost impossible mission is how to feed the millions of quarantined people. A
month after the implementation of Enhanced Community Quarantine for Metro Manila
and almost a month for the island of Luzon not a few people have not yet received the
promise food aid. PRRD’s government through the Department of Social Welfare and
Development (DSWD) through its Social Amelioration Program (SAP)with hundreds of
billions of pesos already released but have not reached yet many of its target
beneficiaries. There are several factors for this much delayed food aid. The DSWD, the

31
department tasked by PRRD to implement the most needed package has to first
coordinate with the Local Government Units (LGUs), which comprised almost 1,500
cities and municipalities with around 150,000 barangays or villages. These LGUs have
been considered as the part of government accordingly ‘knows best” in identifying the
poorest of the poor constituents. But this is after PRRD had stingingly told the LGUs that
he could not trust them with money. The more than P200 billion allotted for the Social
Amelioration Program is intended for 18 million families/households identified as the
poor – this is almost 90 million people (each family with five members). From this 18
million families, 3.7 million or 18.5 million individuals are considered the poorest of the
poor who are currently receiving monthly social subsidies from the government through
the Pantawid Pamilyang Pilipino Program or 4Ps Program. But there must be serious
review of these figures since DSWD has been using the 2015 census made by the
National Statistics Authority or NSA. The Department claimed that they have adjusted
the figure every year based on estimated projected growth rate of the country’s
population. But still the figures of the LGUs and the DSWD are not coinciding. A case in
point here is the City of Manila. The Manila LGU has identified 500,000 families as their
figure for the poor including the poorest of the poor while the DSWD has only identified
350,000 families and the same with Taguig, the city of the Speaker of the House (Allan
Peter Cayetano). The LGU in the City of Taguig has more 200,000 families while DSWD
has only more than 100,000 families. The massive difference in figures has resulted to
widespread confusion because the DSWD had distributed forms based on their figures.
The LGUs are helplessly facing their peoples and these discrepancies and confusions
delayed the distribution in many areas. In most cases, people blame their local
governments or favoring only their supporters because the available forms have only
reached this section of the population. Other LGUs would just stop the form distribution
because they could not afford the division among the peoples in facing the COVID-19
contagion. The Social Amelioration form would be filled-up so as they can claim
urgently the needed food aid. Almost a month of locking down millions of people and
without food would surely create an excellent breeding ground not only for COVID-19
but chaos and instability as well.

Another point is that with the figures for the 18 million households (poor and the poorest
of the poor) are national in scope, other areas in Mindanao and Visayas will surely have
huge figures of discrepancies.

The sections of the Philippines’ population, which are having regular employment and
regular income have also been hit very hard. Others are calling this middle class - the
“new poor” because they have all lost their jobs and small businesses. Their number is
estimated to be around 7-8 million households or around 40 million. They too have asked
the PRRD government for subsidies which will be around several billions pesos. In
principle, the government has considered the plight of the “new poor” and the exact
amount is being appropriated.

Another factor for the delayed aid in both Department of Labor and Employment
(DOLE) and the DSWD is that, responsible people in both agencies are hesitant to release
the needed monetary aid because they have to be careful of the guidelines set by the
Commission on Audit (COA). The guidelines and policies of COA were made in the
situation when there was no crisis. The PRRD government should have considered this
situation. The crisis should not only be the burden of the people but government agencies
as well. New guidelines should be crafted which could answer for the new normal and
not the old normal situation. The imposition of Emergency is not only to ensure the
control of the peoples’ movement but also the policies of government agencies should
adopt to an emergency situation.

Obviously, as the developments are unfolding the pre-existing conditions of different

government agencies are also magnified. For one, the utter lack of unified and updated
baseline data for implementing different programs, are alarming. This means that in the
pre-COVID-19 period, the data which the basic programs of the government (like 4Ps)
were unreliable and outdated. The country have faced various disasters in the past with
these outdated baseline data, how can one measure whether emergency aid packages have
indeed reached the targeted victims or constituents. For another, each government agency
wants to dip their hands on the billions budgeted and allocated for the intended victims.

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Again, the DSWD and the Department of Labor and Employment (DOLE) have their
own implementing scheme of the emergency package and both have shown a much
delayed action. One thing is common to these agencies that are to always want to fast
track for the approval of their proposed budget from peoples’ money but they are not as
in a hurry to implementing them. Another common among the agencies will their uniform
explanation of the delay. This is, they have to comply with the Commission on Audit
policies.

The continued delay of the releases of the emergency aid packages and the confusion it
has created, can obviously create chaos and direct peoples actions.

The abovementioned points should be addressed soonest otherwise the people will not
simply obey with the rules of the community quarantine. It will be a choice between
dying of hunger or by COVID-19.

There are other important considerations in order for the lockdown to relatively succeed.

d. BUILDING UP ISLANDS of Stability

The aim of the Enhanced Community Quarantine is to either mitigate or suppress the
spread of the pandemic. Staying at home for everyone is a must. For those living in
cramped and heavily populated homes, there must be actions taken so as to temporarily
house them during the quarantine period.

Aside from providing enough provisions for food, this staying at home steps should be an
opportunity for testing people for COVID-19, identifying the patients and carriers so that
those who will be isolated can be out into limited areas. It can be calibrated into setting
up the localized lockdown.

During the month of March (2020), the testing were done to people who went to the
hospitals because they felt that they have the symptoms of the virus. Not a few of them
were from the legislative and executive branches of government. That is why some of
them tested positive. With limited test kits at that time, they have prioritized and allocated
for themselves the testing because of the limited supplies of the kits. Meanwhile, those
who could not be tested (this figures can be in millions) have continued to be anonymous
carriers of the COVID-19.

As mentioned earlier, the total number of confirmed cases for COVID-19 patients are
mainly based on the record reported from those who were hospitalized and mostly
coming from Metro Manila. But as supplies of testing kits, personal protective
equipment(PPEs) and with additional testing centers, the number of confirmed cases
began to increase and the geographical coverage of testing began to expand outside
Metro Manila.

The sudden increase of number of reported cases and its mortality has drastically
increased as manifested during the 1st week of April. The number of test kits, PPEs, face
masks and testing centers have begun to arrive in the last week of March both from
donations and government purchases. These numbers do not manifest the real picture of
the COVID-19 infected people. Many have been infected but chose to remain at homes.

These development on reported cases has been shown in the following: The Enhanced
Community Quarantine (ECQ) was imposed in the middle of March and the number of
cases in March 15 up to March 19, the average number of the increased of daily cases
was around 38. The number of confirmed cases on March 30, 2020 has jumped to 2,278
from 142 cases on March 15, 2020. On April 2, 2020, the confirmed cases of 2,278 from
which 1,395 from Metro Manila and 1,238 outside of Metro Manila. On April 5, 2020,
with the total number tested of 22,958 around 15,000 came out negative and those tested
positive were 3,246 and almost 50% of these cases came from outside Metro Manila.
From April 6 to 10, the average daily increased of those confirmed positive were 134
compared to just 34 daily increased of positive cases when the ECQ was imposed. This is
an increase of more than 400 percent. In terms of the average number of death cases from
March 15 to 19 was 16 deaths and from April 6 to 10, the average number of daily death

33
cases was 15. This seemingly flattening of the curve in terms of the daily mortality rate
right after the ECQ was imposed vis-à-vis the first week of April’s mortality rate which
does not show the average increase was mainly due to the absence of the vaccine and
only due to the current status of the health care system of the country.

The abovementioned figures do not include the number of cases from outside the country
– or from overseas Filipino workers or OFWs.

Initial reports say that more than 500 OFWs have been infected and several dozen deaths
caused by the COVID-19.

It should also be mentioned that almost 10% of the total number of deaths in the country
is from the health care workers – a clear manifestation of how ill-equipped the frontliners
and first responders as they are directly confronting COVID-19 especially during the
early stage of the pandemic.

e. ECQ Extension without Unified and COHERENT ACTIONS SEEM to be Light

YEARS AWAY

On April 6, 2020, one week before the ECQ hade to end (April 14), the PRRD’s
government had announced the extension of the lockdown up to the end of April (April
30). The basis of the extension was not based on the assessment of the first cycle (period
of virus incubation-14 days). Some lessons could have been learned and could be
concrete basis for the upscaling of the next level. It was mentioned thru the spokesperson
of the Inter-Agency Task Force for the Emerging Infectious Disease or IATF that they
have consulted the people of the extension and 90% of them had agreed. It turned out that
90% referred to was the business sector belonging to the big enterprises. The small and
medium enterprises had reacted negatively to the extension. The government has
allocated big subsidies to the big enterprises – including wage allocation for their workers
while the medium and small enterprises with more than half a million workers do not
have clear subsidies. And worst, the people who comprised the vast majority of the
population has never been consulted, just like when it was first imposed on the middle of
March 2020.

With the extension of the ECQ, the PRRD’s government has instituted some changes.
One of the visible changes is the appointment of the Chief implementor of the Task Force
fight against COVID-19. This is in the person of Secretary Carlito Galvez of the Office of
the Presidential Adviser on the Peace Process (OPAPP). With the entry of Secretary
Galvez, PRRD has a complete set of his Marawi Generals to lead the fight against
COVID-19. Gen. Galvez was the Western Mindanao Commander when the Marawi siege
occurred. The Western Mindanao Command directly supervised the operation on the
ground which at that time was commanded by General Rolando Joselito Bautista, who is
the current Secretary of DSWD, one of the pillars in the IATF implementing department
together with the DILG and its Secretary Eduardo Año, the Chief of Staff of the Armed
Forces of the Philippines during the Marawi siege against the extremist Maute and Abu
Sayyaf groups.

Definitely the three generals were not able to kill the virus which started the Marawi
siege, more than 17,000 Maranao IDPs are still in their temporary shelters. They are now
suffering doubly because of the COVID-19. We just hope that serious lessons and
challenges can be learned from both wars, where peoples’ participation had been
relegated to the back seats. In both cases, peoples are seemingly referred to as mere
numbers and statistics. They are not counted to be important and decisive part of building
and protecting their own communities. We just pray that what we see in Marawi today
will not be the future picture of our fight against CONVID-19 on the whole country.

Further, all of us know that the ECQ and the massive use of Personal protective
Equipment, face masks, washing of hands and use of ventilators are just efforts to stop or
interrupt the chain of infections. Ventilators for instance are not the cure of the disease,
they are just instruments to provide oxygen to our lungs and prevent their collapse and
make the victims continue to fight the virus.

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They are not the cure. It has been said that it will be 18 months away before the scientists
can successfully have the vaccine against the virus.

Furthermore, it is a strong belief of many scientists that since the virus started as a
zoonosis (disease from animals) and spread to humans, there is therefore no natural
immunity for human beings. Immunity has first to be acquired so that it can be effective
in fighting a virus like the COVID-19 from inside.

According to the IATF, there will be calibrated mass testing for the potential and active
COVID-19 patients on 14 April 2020, a month after the ECQ was imposed. The IATF
mentioned that the aim is to have 2000 tests everyday until it can reach 2,000 per day.

The testing centers are more than a dozen now but still many are in Metro Manila with
one or two in both the Visayas and Mindanao.

The big increase of number COVID-19 cases in the 1st week of April was due to the
massive testing done during those periods. But it was geographically limited to Metro
Manila and Luzon areas. When regular and increase testing will be implemented in the
Visayas and Mindanao areas, it is expected that there will be massive increased in
positive as well as mortality rates. One can just hope that the ratio of recovery will also
increase.

Meanwhile with the 2nd extension of ECQ in Metro Manila and Luzon, different
provinces and cities in both Visayas and Mindanao have also declared their version of the
ECQ.

For almost a month of ECQ, one thing has become clear. The Armed Forces of the
Philippines (AFP) and the Philippine National Police(PNP) have been very passionate
and energetic in implementing the ECQ and act with dispatch for those who violated the
ECQ policies and rules. But one cannot see the same passion and enthusiasm for the
agencies of the government who are not delivering the basic needs like food of the
quarantined people. For several weeks with very limited or non-delivery of this basic
needs, the people are losing their patience and have become restless.

Islands of stability should be established now. This means to institute immediately the
calibrated mass testing target with calibrated lifting of the ECQ and build localized
quarantine.

In terms of pandemic caused by COVID-19 – when healthy people are put in quarantine,
the target day for lifting it up, seems a light years away. And as what PRRD had said
earlier, if the poor are hungry there will be surely chaos. It should never be a choice
between Health and Economy because its both. The country and the people need a
healthy economy nothing less.

It is reassuring to state what the United Nation (UN) General Assembly has approved on
April 3, 2020, a resolution calling for international cooperation and multilateralism in the
fight against COVID-19. This is its first statement since the outbreak and it stresses the
need for full respect for Human Rights and that there is no place for any form of
discrimination, racism and xenophobia in response to the pandemic.

II. Impact of COVID-19 on People’s Lives

As the Philippines enters its 6th week of a social lockdown and shuttered economy
manifestations of political fatigue and cultural toxicity have unfolded among PRRD’s
administration and the people. The idea that a second extension of a lockdown has
created different tendencies within the government officials. The Inter-Agency Task
Force for the Emerging Infectious Disease (IATFEID or IATF) has shown varied but
serious concerns on the economic implication with another extension. The agency is
composed of 8 departments which are principally tasked to confront and manage the
COVID-19 pandemic in the country. There is no corresponding mechanisms on the
Regional, Provincial and municipal levels. At the end of this month for instance, the
country will be losing an estimated amount of 1 trillion pesos (March 15-April 15= P630

35
billion and April 16-30 = P325 billion) and almost zero growth for the beginning of the
second quarter of this year. Such concerns have been coming from the economic team of
President Rodrigo Roa Duterte (PRRD).

Another group of PRRD’s men and women within the IATF has been showing their
support for another extension of the lockdown to tighten the authoritarian grip of PRRD
because of serious manifestations of social unrests.

The people have begun to doubt PRRD’s promise of financial aid and food packages
because as the second extension is about to begin, the financial help through social
amelioration program has not even reached 50% of the 1st tranche of the two tranches.
This is amidst the billions of pesos made available by Congress and several billions worth
of donations (both financial and materials). These poor people are convinced that while
they should close their ranks to fight against the destructive effects of COVID-19, they
should also watch and be vigilant of attempts to close the democratic space which should
be opened and respected at all times.

A third tendency within the PRRD’s administration is how to come out with proper
balance with the lockdown to physically contain the contagion without putting the
country’s economy on ice. On this basis the lockdown can be modified in some areas and
can be very hard in other communities.

The almost two months of enhanced social lockdown without corresponding

enhancement of the distribution of the Social Amelioration Program have resulted in
toxic cultural practices in the country like physically hurting the medical frontliners in so
many ways because they want to save their own skin. The worst (or one of the worst) is
treating the country’s new heroes (in pre-COVID-19 period) – The Overseas Filipino
Workers or OFWs – as villains and in many cases they become unwelcome in their own
communities because they might be COVID-19 carriers. In the old normal, everybody in
the country could simply refer to these attitudes as ingrate or unfilipino.

But the most revealing of the intensifying differences among the IATF and the PRRD’s
administration is what resigned National Economic Development Authority (NEDA)
Director General Ernesto Pernia – a senior member of the PRRD’s economic team had
said in an interview using the analogy of an orchestra, that if the IATF is an orchestra it
has not been well conducted – that is why he resigned. He was not clear though if he was
the one making the out of tune note.

● PERFECT STORM OF VIRUS AFFECTING THE COUNTRY’S POOR AND

THE VULNERABLE SECTOR: LIFESAVERS THROWN TO THE ELITE

Several days from now, the first extension for the lockdown in Metro Manila and the
whole island of Luzon ends and the second extension in whatever form or duration will
be declared by PRRD. The President has been consulting different experts and the Inter-
Agency Task Force regarding the substance and mechanisms of the extension. Basically
this is consulting or talking to itself because all the members of the Inter-Agency are
PRRD’s appointees. As in the past, the people whose lives they are going to decide are
not or never consulted.

And if one wants to read the mind of PRRD and his administration, the reason/s he gave
3 years ago for extending Martial Law in Mindanao for 3 times is worth reviewing. And
this was because the terrorists and fundamentalists were still present and therefore there
had been clear and present danger so he extended the Martial Law in the whole island of
Mindanao.

Since last week, PRRD has been mentioning that the lockdown will remain as long as
there is no available vaccine to cure COVID-19. And to date, it will be at least 18 months
before a safe and medically proven vaccine can be on the market. Then this statement
was followed during his weekly report (April 20) that he is offering P10 million for
anyone who could produce this vaccine. In fact, PRRD said that if he is happy he will
make it up to P50 million but the worst is that he was mentioning this seemingly
unlimited amount in his pocket while he was saying about the drying up of funds to fight

36
COVID-19. Nobody (to date) has produced the vaccine in the country but even in the
global level

Meanwhile, the people have been considered as mere statistics and numbers in terms of
COVID-19 cases and casualties. They have not been consulted and considered in terms of
their socio-economic and psychological status and well-beings.

In fact, the President’s announcement of the lockdown extension (calibrated or modified)

will not give serious consideration of what has happened in the 1st extension of the
lockdown (April 15-April 30). Different government agencies in charge of providing and
distributing aids and food packages like the Department of Social Welfare and
Development (DSWD), Department of Interior and Local Government(DILG) and
Department of Labor and Employment(DOLE) have been remiss in their implementation
of the amelioration and relief aid for the millions especially the workers, farmers and the
informal sectors. In the fourth weekly report (April 20) of the President to the Congress
and to the nation, only 8.8% of the 2 million farmers (households) received their financial
aid package.

With regards to the workers, the number directly affected by the pandemic (no work no
pay) are more than 8 million and this includes the 2 million workers from the 79,000
small and medium enterprises which have closed shop.

Forty two(42) days after the lockdown only 345,000 of them were able to receive the first
tranche of the cash aid or 17.25%. These packages were given through beautiful
acronyms like Cash Amelioration Program (CAMP) and Tulong Panghanapbuhay sa
ating Disadvantaged/Displaced Workers or TUPAD (Livelihood Aid for the
Disadvantaged/Displaced Workers). With the first tranche not completed yet, the
Department of Labor and Employment (DOLE), the PRRD’s department in charge of
implementing these programs just declared that there are no more funds available.

For the CAMP, PRRD’s administration was able to release P1.7 billion for 345,685 and
P1.4 billion for 250,440 TUPAD program. There is also an aid package for the Small
Business Wage Subsidy Program (SBWSP) which includes 79,000 small and medium
enterprises with around 1.6 to 2 million workers. As of this writing, they have not
received anything yet. And just like with the farmers, DOLE has passed the task to
continue the distribution to agencies like Social Security System (SSS) and the
Department of Finance (DOF). This will be another long bureaucratic process and
financial aid will be done through the Automatic Teller Machine (ATM) which the
majority of the workers do not have. According to the data of DOLE as of April 28, 2020,
there are 2.3 million workers who were displaced higher than their March 2020 estimate
of 116,000 to 1.8 million displaced workers. Geographically, 6 out of 10 workers are
from Metro Manila, Cebu and Davao. Further, 6 out of 10 displaced workers have come
from the small businesses. Only 3-4% of these workers have their aid package processed.
Another delay of the social amelioration program (SAP) for these workers might be a
question of life and death already.

With regards to the Emergency Social Amelioration Program (SAP) for the 18 million
poor households nationwide, this program is divided into two; 1) Ang Pantawid
Pampamilyang Pilipino Program (4Ps) and 2) Social Amelioration Program (SAP). The
target households for the 4Ps are 4.3 million households and the total number who were
able to receive the aid package is 3.7 million households or 85.7% households. But for
the second group (the non 4Ps), the total target households for this package is 13,491,535
households or 13.5 million households and only 3,933,621 households were able to
receive or just 29.2% families as of this writing.

In terms of the transportation industry like the drivers, out of millions of the drivers in the
country, only 40,480 drivers were given P323 millions worth of cash aid and only in the
National Capital Region. Leaders of the biggest Associations of Drivers in the
Philippines claimed that not a single member of their association were able to receive the
amelioration package.

37
The reason for this much delayed aid package is again, they have to compare their data
with other departments and the different departments will validate their notes with the
local government units. And this is for 42 days already. The head of the Department of
Social Welfare and Development (DSWD) for the delay is the difficulty of the social and
physical distance protocols set by IATF of the constituencies like far-flung areas or the
island municipalities and barangays. So, one can just imagine for the non-existing
delivery of the basic services even in the pre-COVID-19 period of the government if the
above mentioned reason is given for the current non delivery of aid package of the
1st tranche of the SAP. But even if this reason is given for the sake of argument, the case
in Metro Manila has proven it wrong. The City of Makati has just released1.3% of the
cash aid and the case in Manila is just 5.6%. And the worst is that, there is no central
database for the different government agencies, so that they can have the reference point.
But even this last reason, some sectors have tried to muddle the issue like, there is a need
to have the National Identification System first. They are suggesting that the government
should prioritize this first before the Social Amelioration Program. The Law on the
National ID System was passed last year but currently the Philippine Statistics Authority
(PSA) is still processing the implementation of its first phase.

As the COVID19 has continued to shackle and stifle all aspects of the people’s lives, the
fangs of hunger have been making its clear presence especially among the poor. But one
thing has been magnified that is- there can be serious and profound cover-up in the
highest echelon of PRRD’s government. For more than 3 years now, there is no clear
database for its social programs. The billions approved annually by Congress and
downloaded to the different departments have been thickly padded. The base year of
2015 _ and or the basis of the total number of the poorest of the poor is simply imagined
figures. Again, if we take the case of Iligan City from Mindanao. The city’s population in
2015 was 342,618 or 68,523.6 HHs, currently the Mayor of the city claimed that there are
more or less 128,000 HHs. The difference in four years is 59,476 HHs or an annual
increase of 11,895.2 HHs. An annual increase of 59,476 individuals in a city like Iligan is
simply statistically impossible. This means that there is a daily birth of 165. Mortality
cases have not been factored in here. So this might be the figure that DSWD has based its
annual budget. The COVID 19 has made people behind this gigantic paddling of “names”
of peoples and cannot simply hide them from the eyes of the hungry people. The billions
worth of social amelioration program is too big an amount to hide even if they include all
the dead people in a year. The Filipino term for this is”Talagang bubukol.”

What has been highlighted now for the 2nd extension of the lockdown is the reason that
many people have not been strictly following the protocols of the lockdown. People have
been going out of their houses not observing the stay-at-home policies and the social
distancing. The mainstream media has been projecting this line of thinking. Many could
not simply or refuse to link the non-delivery of financial and food packages of the
government for the poor and hungry people. They (the people) have to go out because
their families have suffered hunger for several weeks already. They considered death of
hunger as the more immediate and visible problem than the death brought about by the
unseen COVID-19. The drivers for instance in Metro Manila have to go out to beg for a
few amounts so as to bring some food for their families.

Not a few private individuals and institutions have tried to fill up gaps left open by the
government by giving dole outs and food packages. But they (individuals and
institutions) could not replace the role of the government backed by Congress approved
billions or even trillions of pesos from the taxpayers’ money.

It is a perfect storm for millions of the poor in the country. They have to face the health
and humanitarian catastrophes brought about by COVID-19 and the inefficiency of the
highest degree of the government services highlighted by the pandemic. The people have
been seriously affected by tsunami of sufferings and anxieties like in no other time. They
are the ones being suppressed by the civil and military apparatus of the Philippine
government. Too bad, the people could not hold these irresponsible people who have
failed to timely and regularly give them the aid package while they are forced to stay-at-
home. And worst, they are the ones used to justify the de facto military rule in the
country. It would be like the best defense of an Administration who has not prepared the
country and its peoples for the unstoppable arrival of a pandemic including the socio and

38
economic impacts. And yet they are also used as a convenient escape for not delivering
its basic constitutional duty to ensure the health and welfare of the people with full
respect of their human rights.

As the second extension of the enhanced community quarantine has been announced only
30% of the first tranche of the aid package (both of financial and food aid fund) has been
downloaded from the department level which claimed releasing around 97% of the
package to the LGUs since the first week of April. Anyone could not help but ask the
question like ,”Where is the money now?”

When one sees the current situation where millions of people are locked down for almost
two months with very strict policies and regulations (with overt instruction from the
President to shoot dead the violators) and considering that most of those locked down
were poor (with no-work-no-pay and no food daily existence), not complying with the
timely distribution of social amelioration program (SAP) and food packages basically due
to government’s neglect is a crystal clear picture of a perfect storm hitting the country
and the poorest of the poor.

But the picture can also portray that the COVID19 pandemic strongly impacting the
world in all its aspects has conveniently provided the authoritarian/rightist governments
in the world to govern their respective countries and control the social unrest triggered by
the health disaster which has morphed into economic catastrophe. Such governments
have crafted laws and rules using the pandemic COVID 19 but seem to create conditions
that the poor could really and hardly follow and therefore would prefer to violate the
rules on social distancing and stay at home policies to solve the hunger problem of their
families. In the name of their safety against the virus they are suppressed and controlled.
The people’s reaction to such suppression will be the basis for stronger authoritarian grip
and less democratic governance.

Reasons can be cited for this CRIMINAL NEGLECT from the side of the government
are the absence of basic and centralized data, blatant corruption and patronage politics.
And in the forty days since the lockdown, PRRD’s administration has arrested 130,000
for violation of COVID-19 protocols and measures linked to the pandemic.

Thousands more were apprehended for curfew violations. In fact, the country ranked
number 4 in the world after Nigeria, Kenya and South Africa for COVID19 related
human rights violations according to the United Nations Council for Human Rights. But
nobody was arrested or held accountable for the CRIMINAL NEGLECT for not releasing
or delaying social amelioration program (SAP). Again if PRRD wants to extend the
enhanced community quarantine (ECQ), they should first implement the first tranche of
SAP and enhance also its implementation and punish those SAP violators. If a
government like that of PRRD’s is curtailing basic rights and ruling by decree because of
its health concerns and people’s welfare brought about by COVID19 pandemic then why
no corresponding concern for peoples’ health and welfare because of lack of food and
hunger and basic rights to earn their living. The obvious contradictory concerns by the
government have led many to think that such moves are securing and perpetuating certain
interests but surely it is not the peoples’.

It can help one to profoundly understand the PRRD’s outlook in the context of the
Marawi Siege in 2017 because the key players in this kind of war are the same key
players in the war against COVID-19. After so much neglect on what the intelligence
data were saying (later on the AFP leadership-headed by now DILG Secretary Eduardo
Año would admit that they got the wrong interpretation of the data) and did not take
proactive actions. From January to April 2017, the terrorists led by Abusayyaf and Maute
groups had launched battles from the municipalities of Butig & Piagapo before May 22,
2017 Siege of Marawi but nothing had been done. PRRD had even mentioned based on
the intelligence data that the AFP knew about the stockpiling of arms in the city. But why
did he not order the AFP to get these firearms? Nobody knew. When the battle of Marawi
erupted, Martial Law was immediately declared in the whole island of Mindanao while
PRRD was in Moscow. The Martial Law would be extended 3 or more times by Congress
and agreed upon by the Supreme Court. More than 400,000 Meranaws were displaced
and until now many of them cannot still go back to their burned and devastated houses

39
and lives. There was a clear neglect of why the Marawi Siege did happen. The
fundamentalists and the terrorists made the attack but it could have been avoided or at
least minimized the destruction and loss of lives. Nobody is held accountable for this
criminal neglect.

As stated in the third series of this paper, the principal players of the battle of Marawi are
now the key players in fighting COVID19 pandemic. Billions of pesos have been pouring
in to rehabilitate the city and its people (the big part was released during the Martial Law
period) but up to now, no substantial change has been done and majority of the
population of Marawi have not yet returned to their city. Every time the Meranaws would
insist on rebuilding their shattered life and destroyed houses, they were told that there are
still unexploded bombs in the most affected area.

Again it is helpful to remind everybody that the reason given by PRRD to launch war in
Marawi is to save the people against the terrorists namely Abu Sayyaf and the Maute
Group at that time. Now people in Marawi are silently witnessing the revival of the new
and young leadership of the fundamentalist group/s in the city. What will happen in the
next few months in Marawi, nobody could tell. What is obvious though is that it’s the
population of the city who have been displaced and destroyed and not the terrorists (new
breed) and the fundamentalist ideas.

Currently, it has been the knowledge of everybody that the security sector of PRRD is
building a military camp in the center of the city based on the claim that this is a military
reservation. What has happened with all the billions of pesos both donated and allocated
nobody could tell except that before the end of 2019, almost half a billion had to be
returned to the Department of Budget and Management (DBM) because it could not be
absorbed by PRRD’s management team in the rehabilitation and rebuilding of Marawi. A
very bad picture that money intended to help rebuild Marawi and people’s lives was
returned while thousands of those displaced do not have permanent homes.

Now, the reason given by PRRD of imposing the Community Quarantine is the presence
of COVID 19. Everybody knows that the virus brought about by the Novel SARs2 will
be here to stay longer if no vaccine is discovered to destroy it. PRRD had mentioned last
week that he would just lift up the community quarantine (in whatever forms) if a vaccine
would be discovered. This will take the middle of next year. Meanwhile, the people of
Marawi have a triple burden on their shoulders.

The majority of the members of the Senate and led by the Senate President had asked the
current Secretary of Department of Health (DOH) to resign, an obvious step of
frustrations from the Senate for the snail-pace response by the DOH’s leadership. For
three months (since January 2020), the senators did not see any serious steps from the
leading PRRD’s department against COVID19 to prepare the country of the pandemic.
Aware that there is no vaccine at hand, the leadership of DOH Secretary Francisco Duque
III did not ensure the frontliners would be protected when confronting the contagious
virus. The senators could not understand why they were not in a hurry in setting up more
testing centers to identify the virus carriers and isolate them. In fact, locking down of
areas and communities should be based on the results of the massive and aggressive
testing. But what had surprised not only the senators but many people, was the sudden
change of DOH’s scientific reasons of the Department of the unreliability of the medical
equipment: personal protective equipment (PPE) and face masks coming from China. The
spokesperson of DOH cleared China the day after the announcement due to the Chinese
Embassy’s intervention and made shameless cover up that those medical paraphernalia
are from another source abroad. Further, several countries had complained about the
same thing on the same date the DOH raised the complaint. In fact, The Netherlands,
which ordered around 1.2 million PPEs, facemasks and others, had to return to China the
first 600,000 or 50% of which had already arrived in their country for being unreliable
and the Netherland government could not risk their frontliners using these defective
equipment in treating the COVID-19 patients.

After the clearing of China by the DOH, nothing has been heard on this issue. If there are
connections between this medical issue it is the extraordinary high number of cases in the
country’s frontliners affected by the virus but nobody could tell. The country in fact,

40
though the DOH has continued to receive the medical supplies from China- many have
been donated.

The move of the Senators to Secretary F. Duque’s resignation did not materialize because
PRRD simply said that he still trusts the DOH Secretary.

Meanwhile, on the eve of the second extension (last days of April), there was a silent but
conspicuous change in PRRD’s fight against COVID19. This is the re-appointment and
taking over of Harry Roque as the spokesperson of the IATF and in concurrent capacity
as PRRD’s spokesperson. In effect, Roque has replaced cabinet Secretary Carlo Alexie
Nograles as IATF spokesperson and Presidential Legal Counsel Salvador Panelo who
acted as PRRDS’s Spokesperson.

Currently Harry Roque is both the spokesperson of PRRD and the IATF. Actually in
substance, there is no difference between the two positions. IATF is composed of 8
departments where the heads are all PRRD’s appointees but with Roque’s return (he was
once PRRD’s spokesperson but resigned before election – when he had tried to run as a
senator against the advice of PRRD), is saying something. PRRD’s administration needs
somebody like Roque with his background as a Human Rights lawyer to speak on behalf
of the President in his fight against the illegal drugs and the COVID-19. Both campaigns
have defined PRRD’s administration with regards to issues affecting the people at the
expense of Human Rights and democracy. It has been known by many who know Harry
Roque that he would speak in behalf of his principal even if it contradicts his basic
principles especially on Human Rights and International Law.

Currently, the number of people arrested for violating the protocols set by PRRD in the
campaign against COVID 19 far exceeded the total number of people tested for the virus
in the country. But nobody has been arrested for the criminal neglect of withholding the
social amelioration program (SAP) and the food aid for the hungry people who suffered
the loss, not only their livelihood, but basic human rights as well.

Meanwhile, the IATF through their initiative of PRRD’s economic team has approved an
amount of P613 billion or more than $6billion as economic stimulus for the big business
sector. Another P35 billion for the small and medium business aid package has also been
approved.

Indeed, with COVID19 becoming a great equalizer where a playing field has been
leveled up, those who are now the new favored elite can have a bigger advantage at the
expense of not only the old oligarch but most especially the toiling masses in the country.
With another extension of the lockdown in the country and where it is still far from the
cusp of limiting much more defeating the COVID19, the current situation has intensified
the country’s crisis.

In addition, the RA 11464 or the law which says that Bayanihan is needed for the nation
to HEAL AS ONE is becoming unreachable unless the country and the people should
first ACT AS ONE. Having enhanced quarantine can only be bearable if the social
amelioration fund and aid package can be proportionately enhanced as well. The effort
should be done together with aggressive testing so as to locate and identify the COVID-
19 carriers so that they can be isolated and cured.

Success can never be a coincidence; its formula can be a combination of efforts by

medical professionals including all the frontliners, government, private sectors and the
society at large. This is a sure step of seriously strengthening the armor of our defenses
against the COVID-19. This is also putting flesh to the belief that human capacity to
overcome whatever challenges when working together is simply limitless.

While the 2nd extension is about to start, we should brace ourselves with the next
extension and the best way to prepare for such endeavors is to expose and prosecute those
who committed the criminal neglect of not implementing the COVID-19 Social
Amelioration Program.

Part 5 will be added here as soon as they become available

41
P.S.

• Raymund De Silva is a political activist based in Mindanao for more than three
decades.

http://www.europe-solidaire.org/spip.php?article52772

==============================================================================

COVID-19 strategy: Here's how

Philippines can combat the pandemic,
according to a data scientist
Patricia Lourdes Viray (Philstar.com) - April 3, 2020 - 11:23am

MANILA, Philippines — Aside from implementing an enhanced community

quarantine, the Philippines needs to include multiple strategies in its fight against
the novel coronavirus disease (COVID-19).

Three weeks into the implementation of the enhanced community quarantine

Luzon, the national government has yet to decide whether to lift or extend the
lockdown.

Inter-Agency Task Force on the Management of Emerging Infectious Diseases

(IATF-EID) spokesperson Cabinet Secretary Karlo Nograles earlier said science
would be "in charge" on this matter.

The IATF has a technical working group, headed by the Department of Health,
that will "finalize the parameters for deciding on the eventual total or partial lifting
of the ECQ in Luzon, the possible extension of its duration, or its expansion to
other areas outside the contained area, subject to the approval, amendment or
modification by the IATF."

Metro Manila epidemic peak projected between April to June

Data scientists from the University of the Philippines project the virus to infect
around 600,000 to 1.4 million individuals in the country, with 80% from Metro
Manila.

In its report, the UP COVID-19 Pandemic Response Team emphasized the need
for community collaboration to fight the deadly virus, which has infected nearly
one million people across the globe.

"This estimate includes possible asymptomatic individuals and unreported cases.

The high estimate for Metro Manila is mainly due to the high population size and
density of the region," the UP report read.

This projection is based on a reproduction rate between 1.5 to 4, which is the

average number of people that will be directly infected by a COVID-19 positive
person in a susceptible population.

Based on mathematical simulations, the UP COVID-19 Pandemic Response

Team predicted that the peak of the epidemic in Metro Manila will happen
between April and June 2020.

42
As of April 2, the Philippines has detected 2,633 COVID-19 cases, 1,395 of
which are in Metro Manila.

"As the government and the public implement interventions, the peak might shift
to a later date and may also be flattened," the report read.

Noting that peaks in the provinces might be asynchronous or would not happen
at the same time, the UP report pointed out that mobility in and out of provinces
should be monitored and regulated to prevent an outbreak.

University of the Philippines COVID-19 Pandemic Response Team

University of the Philippines COVID-19 Pandemic Response Team

43
 University of the Philippines COVID-19 Pandemic Response Team

Multiple strategies suggested in war vs COVID-19

Given these circumstances, the UP pandemic team suggested multiple
strategies, in addition to the ECQ, in response to the coronavirus outbreak.

These measures include maintaining social distancing and avoiding mass

gatherings; inreasing detection and isolation, including mild and asymptomatic
cases, to reduce infections; and increasing protection and good personal hygiene
to reduce transmission.

UP scientists also proposed to increase clean and safe space and to implement
physical distance between random people. 

In hospitals, the report suggested to decrease the rate of patient encounter per
health care worker, such as implementing a policy of maximum of three
encounters per hour in a 12-hour work shift. Another proposal was to decrease
the interaction time between the frontline health care worker and patients, with
less than 40 minutes for the whole day.

The report also noted that providing protective gears and facilities to frontline
health care workers during their shift is 95% effective.

Extending the community quarantine, in addition to multiple strategies mentioned

above, are seen to further "shift the peak" of the epidemic to buy more time to
prepare.

44
University of the Philippines COVID-19 Pandemic Response Team

University of the Philippines COVID-19 Pandemic Response Team

University of the Philippines COVID-19 Pandemic Response Team

45
Philippines needs to prepare for long-term
Data scientist Jomar Rabajante, professor at UP Los Baños Institute of
Mathematical Sciences and Physics, said the war against COVID-19 is not just in
a month but may extend until vaccine arrives, which is expected next year.

Thus, the country needs to be prepared not just during the lockdown period but
for the long-term.

"So we need more community collaboration to fight COVID. It is imperative to

include multiple strategies not just ECQ, as we need to consider other factors
such as socio-economic status of our country," Rabajante told Philstar.com in
an online exchange.

On the lifting of the ECQ, Rabajante said that if the government has solid
strategies to move forward, the Philippines can do a modified community
quarantine, which means that it would be local government unit-based and not
national or Luzon-wide.

The UPLB professor also noted that before considering the lifting of the ECQ,
LGUs must be equipped to implement protocols, such as regulated travel and
quarantine of persons under monitoring and persons under investigation, to
prevent initiation of outbreak.

The country should also have enough hospital beds, equipment, personnel and
other healthcare support in case of a surge in the number of cases, he said.

"If the public is already prepared to change their 'epidemic-friendly' practices.

That is, can we still maintain physical distancing in public (e.g. inside MRT)? Can
we maintain or improve our personal hygiene habits? If not, then it is dangerous,"
Rabajante told Philstar.com.

He also noted that the country's hospitals should also have enough detection
capability to identify those who are infected and isolate them immediately. 

While the Philippines has yet to acquire vaccine and COVID-19 drugs, the
country should at least have a strategy to control transmission to vulnerable
people, such as the elderly and those who have weak immune system.

"If the government can guarantee enough provision of economic resources for
vulnerable communities then ECQ can be extended, or else we need modified
[community quarantine] where socio-economic factors are considered,"
Rabajante said.

Mass testing to start April 14

On Thursday evening, Presidential Peace Adviser Carlito Galvez Jr., chief
implementer of the national policy against COVID-19, announced that the
government is planning to start mass testing of PUIs and PUMs starting April 14.

Earlier this week, the Food and Drug Administration (FDA) approved the use of
five rapid test kits for the new coronavirus.
The FDA is also expected to issue a certificate of product registration to locally-
made test kids on April 3. These test kits were developed by scientists from the
University of the Philippines National Institutes of Health and the Philippine
Genome Center, which will be manufactured by Manila HealthTek Inc. 

“The Manila HealthTek Inc. reported that the first batch of reagents has arrived
which will enable them to start the manufacturing process to create additional kits
that can accommodate 120,000 tests,” the DOST earlier said.

https://www.philstar.com/headlines/2020/04/03/2005234/covid-19-strategy-heres-how-
philippines-can-combat-pandemic-according-data-scientist

46
==========================================================================

By contrast, Vietnam has relied on mobilizing its society and on

massive social closures and extensive surveillance of citizens.
From the early onset of the pandemic, Vietnam shuttered non-
essential businesses and schools and enacted large-scale
quarantines—the entire province of Vinh Phuc, north of Hanoi,
was put under a 21-day quarantine starting February 13, and
tens of thousands of citizens have been placed in “quarantine
camps” run by the military. Vietnam’s aggressive monitoring and
surveillance of citizens has been supported by the government’s
large network of informants, which has helped to identify and
quarantine those suspected of infection and those who have
been in contact with them. The government also mobilized
retired doctors and nurses and medical students to join the fight
against the virus, while some entrepreneurs have set up “rice
ATMs” to help people out of work. Vietnam has weathered the
epidemic remarkably well, with only 268 cases out of a
population of 95.5 million people, and not a single reported
death.
Despite their markedly different approaches, Singapore and
Vietnam share some important characteristics that have shaped
their responses. Both countries were among the hardest hit by
the SARs outbreak in 2003 and were determined to better
prepare for the next pandemic. Both governments are highly
centralized, unified, and well organized. Vietnam’s “culture of
surveillance” and Singapore’s “nanny state” are both highly
effective in monitoring and communicating with their citizens, and
these systems have publics that are broadly accepting, or at
least accustomed to, this level of intrusiveness.
xxxx
As of this writing, the main concern for the health impact of the
crisis is that major outbreaks in the region’s megacities will
overwhelm hospitals, raising death tolls and leading to further
economic impacts. There is also concern that overly restrictive
lockdowns and market disruptions in the food supply chains
will lead to hunger and malnutrition among the urban poor, which
could, in turn, cause social unrest and political violence. For the
rural poor, the food situation may be more manageable, but the
lack of capacity in the local health care systems in rural regions
will be severely challenged. The final concern is focused on the
second wave of infections that we are seeing in Singapore and
other parts of Asia that were hit early with Covid-19 cases, like
Hong Kong and Taiwan. Singapore’s soaring infection rates after
the government’s misstep on foreign workers offer a cautionary
tale about the vulnerability of even the most capable
47
 bureaucratic systems. The region needs to prepare for second
and additional waves of infection, which will further complicate
government strategies and deepen economic impacts.
Ultimately, while other global hotspots, particularly the United
States and Europe, appear to be turning the corner, this story is
still only beginning to be written in Southeast Asia, with profound
public health, economic, and political impacts close on the
horizon.
https://www.csis.org/analysis/strengths-and-vulnerabilities-southeast-asias-response-covid-19-
pandemic

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100 days of COVID-19 in

the Philippines: How
WHO supported the
Philippine response
9 May 2020

Exactly 100 days have passed since the first confirmed COVID-19 case was
announced in the Philippines on 30 January 2020, with a 38-year old female from
Wuhan testing positive for the novel coronavirus. On the same day, on the other
side of the world at the WHO headquarters in Geneva, WHO activated the
highest level of alert by declaring COVID-19 as a public health emergency of
international concern.

The Philippine government mounted a multi-sectoral response to the COVID-19,

through the Interagency Task Force (IATF) on Emerging Infectious Diseases
chaired by the Department of Health (DOH). Through the National Action Plan
(NAP) on COVID-19, the government aims to contain the spread of COVID-19
and mitigate its socioeconomic impacts.

The Philippines implemented various actions including a community quarantine

in Metro Manila which expanded to Luzon as well as other parts of the country;
expanded its testing capacity from one national reference laboratory with the
Research Institute of Tropical Medicine (RITM) to 23 licensed testing labs across
the country; worked towards ensuring that its health care system can handle
surge capacity, including for financing of services and management of cases
needing isolation, quarantine and hospitalization; and addressed the social and
economic impact to the community including by providing social amelioration to
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low income families.

The World Health Organization (WHO) has been working with Ministries of
Health worldwide to prepare and respond to COVID-19. In the Philippines, WHO
country office in the Philippines and its partners have been working with the
Department of Health and subnational authorities to respond to the pandemic.
The country level response is done with support from the WHO regional office
and headquarters.

Surveillance
Surveillance is a critical component and is used to detect cases of COVID-19 as
well as to understand the disease dynamics and trends and identify hotspots of
disease transmission. The Department of Health included COVID-19 in the list of
nationally notifiable diseases early in the outbreak to ensure that information was
being collected to guide appropriate response actions. Existing surveillance
systems were capitalized upon to speed up identification of cases as well as
identify unusual clusters. Laboratory confirmation is a critical component of the
surveillance system but cannot be the only sources of information. The non-
specific symptoms and the novel nature of the disease means that the DOH, with
support from WHO, are looking at all available information sources to guide
response decision making. WHO also provided technical assistance to selected
local government units to strengthen field surveillance for timely data for action at
the local level.

Contact tracing
Contact tracing is crucial to the response. It is a system to detect and
isolate cases and identify close contacts who will be advised for
quarantine. It allows the investigation the system to tracjk the chain of
infections as well as the settings, places, events or other avenues that
where transmission have occurred or may have been amplified. A major
bottleneck to doing this is the availability of timely and complete
information from the hospitals for suspected, probable and confirmed
COVID-19 cases. WHO assisted the DOH Epidemiology Bureau in
developing COVID KAYA, a case and contact tracing reporting system for
epidemiology and surveillance officers, health care providers and
laboratory-based users, expanding the capacity of the previous COVID-19
information system. WHO also continued to support the government to
establish the system and improve capacity for contact tracing at the city
and municipal levels.

Infection prevention and control

Patients and health workers must be protected from the possible transmission of
COVID-19 inside health facilities. Infection prevention and control (IPC) is vital in

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minimizing the harm caused by the spread of infection in these facilities. In the
early part of the response, WHO supported the DOH with the provision of
personal protective equipment (PPE) for health workers. To strengthen IPC,
WHO and DOH developed modules and conducted online IPC training of trainers
for frontline health workers in health care and community settings. The training
has since been rolled out more widely by partners USAID-MTaPS and UNICEF
to cover over 5,500 health workers to date.

Laboratory and therapeutics access

Laboratory testing for COVID-19 is critical to be able to rapidly identify, treat and
isolate the positive patients, and be able to see the bigger picture of how many
people are infected and ultimately stop the transmission of the virus. Since the
beginning of the response, WHO provided support to the DOH’s Research
Institute for Tropical Medicine with laboratory supplies and extraction kits. WHO
also assisted the DOH in the accreditation of COVID-19 testing laboratories. To
date, 23 real-time reverse transcription polymerase chain reaction (rRT-PCR)
laboratories nationwide are now conducting COVID-19 diagnostic tests. The
Philippines has also recently joined the WHO Solidarity trial to find effective
COVID-19 treatment.

Clinical care
With a new disease, there are a lot of unknowns regarding the proper clinical
management of suspect and confirmed cases. But when clinicians are armed
with the necessary knowledge and skills to care for sick patients, the more the
patients are likely to recover. WHO supported the frontline health workers
through a webinar series on clinical management, providing up-to-date WHO
clinical perspectives. At the same time, WHO also supported the DOH and the
Department of Interior and Local Government in preparing policies to form health
care provider networks for COVID-19, from primary care that includes
telemedicine and community management, to tertiary care linking to referral
hospitals.

Non-pharmaceutical interventions and mental

health
Non-pharmaceutical interventions (NPIs) refer to public health measures, which
are not related to medicines or vaccines, that people and communities can do to
prevent the spread of infections like COVID-19. These interventions involve
personal protective measures, environmental measures, physical distancing
measures and travel-related measures. WHO supported the DOH in the
development of a policy on NPIs as well as assisted in rapid assessment on local
government capacity on NPIs and policy-gap analysis.

In times of extreme experiences brought by COVID-19, it is likely that people feel

fearful and anxious. Providing mental health and psychosocial support (MHPSS)
during the time of COVID-19 pandemic is important. WHO assisted the DOH in

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developing policy guidance and advice on integrating MHPSS within health and
social services and increasing access to care to these services.

Risk communication and community engagement

Effective communication and engagement with communities is essential for
people to understand the situation, know the situation and practice protective
measures to protect their health, their family and the larger community. WHO
supported and amplified DOH messaging by releasing various communication
materials on the risk of COVID-19 and how people can protect themselves
through social media and traditional media. WHO also worked with partners such
as UNICEF and OCHA in reaching vulnerable groups, getting their feedback and
understanding their information needs.

Logistics support
With lots of moving equipment and supplies required for COVID-19, logistics
support is an important part of the response. WHO provided technical support to
the DOH in the recalibration of PPE requirements by using WHO projection tools,
provided cost estimates, and advised on streamlining the distribution flow of
PPEs and other essential supplies. WHO also supported DOH in the
development of a commodities dashboard that provides real-time PPE stocks at
the facility level, as well as assisted in building an information system for tracking
essential COVID-19 commodities.

https://www.who.int/philippines/news/feature-stories/detail/100-days-of-covid-19-in-the-
philippines-how-who-supported-the-philippine-response

==============================================================================

How to Conduct a Situation Analysis

 or environmental analysis is the fundamental first step in the social and behavior change
communication change (SBCC) process. It involves a systematic collection and study of
health and demographic data, study findings and other contextual information in order to
identify and understand the specific health issue to be addressed. It examines the current
status of the health issue as well as the social, economic, political and health context in
which the health issue exists and establishes the vision for the SBCC program. A
complete situation analysis gathers information on four areas:

 The problem, its severity and its causes.

 The people affected by the problem (potential audiences).
 The broad context in which the problem exists.
 Factors inhibiting or facilitating behavior change.

Why Conduct a Situation Analysis?

situation analysis guides the identification of priorities for an SBCC intervention and
informs all the following steps in the SBCC process. It establishes a clear, detailed and
realistic picture of the opportunities, resources, challenges and barriers regarding a
particular health issue or behavior. The quality of the situation analysis will affect the
success of the entire SBCC effort.

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Who Should Conduct a Situation Analysis?
A small, focused team should conduct the situation analysis. Members should include
communication staff, health/social service staff and, if available, research staff.

Throughout the data collection process, team members should also consider how to
engage stakeholders including opinion leaders, service providers, policy makers, partners,
and potential beneficiaries. Ways to obtain stakeholder input include in-depth
interviewsfocus group discussions, community dialogue, small group meetings, taskforce
engagement or participatory stakeholder workshops

When Should a Situation Analysis Be Conducted?

situation analysis should be conducted at the beginning of a program or project, before
developing an SBCC strategy. It is part of the inquiry phase of the P-Process

Estimated Time Needed

Completing a situation analysis can take up to two weeks. Consider the size of the
project, scope of the literature review, how much data is available and easily accessible,
and whether additional stakeholder or audience input is needed. Allow for additional time
if formative research is needed to fill in any gaps that may exist in the literature.

After completing the activities in the situation analysis guide, the team will:

 Know the vision of the program. 

 Understand the current situation (extent and severity) of the health issue. 
 Understand the broad context in which the health issue exists.

The steps below will help to identify the problem and establish the vision for the SBCC
intervention. Please note this how-to guide should be followed along with an audience
analysis and a program analysis to obtain the full picture required for a successful SBCC
strategy.

Steps
Step 1: Identify the Health Issue
For many health programs or strategies, the health issue is identified at the outset, such as
when a funder releases a request for proposals for a child health project or when a
government ministry requests specific technical assistance for HIV prevention programs.

At other times, it may be necessary for an organization itself to identify the broad health
issue that needs to be addressed in a particular geographic area. To do so, review existing
health and demographic data, survey results, study findings and any other available data
to identify the priority health issue. Throughout the review, pay attention to the following
types of information:

 Population segments that are most heavily impacted by the health issue.
 The existing priorities of the government.
 The donor landscape.
 Health trends from one point in time to another.

Step 2: Develop a Problem Statement

Successful SBCC strategies focus on one specific issue at a time. Addressing too
many issues or too general an issue, such as overall reproductive health, can be
confusing. To help focus the situation analysis, develop a focused problem
statement, such as:

This problem statement names the health issue (family planning) and indicates
who is affected (newly married couples), where (Zed district) and, if known, the
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extent of the problem (a high amount). A well-written problem statement has the
added benefit of providing specific search terms to use in collecting documents
for the desk review (see Step 4).

To develop a problem statement, it may be helpful to first have all of the team members
state the problem in their own words. Then, as a group, write a clear one- to two-sentence
problem statement that reflects the team’s common understanding and that can guide the
data collection and analysis on that specific health issue.

Step 3: Draft a Shared Vision

A vision provides a picture of what the situation will look like when the SBCC
effort is completely successful and will anchor the SBCC intervention by stating
what the program hopes to influence. A good vision statement provides direction,
communicates enthusiasm and fosters commitment and dedication. A good
vision should:

 Be Ambitious - go beyond what is thought likely in the near term.

 Be Inspiring and Motivating - call to mind a powerful image that triggers
emotion and excitement, creates enthusiasm and poses a challenge.
 Look at the big picture - give everyone a larger sense of purpose.

To guide the team during the initial data collection and analysis, draft a
provisional vision statement, which will later be shared with stakeholders to
create a shared vision for the SBCC effort. One approach to developing the vision
follows: each team member individually imagines the future she wants to see and
draws that image on a paper. Team members share the pictures with each other
and discuss similarities and differences. The team agrees on the elements that
inspire them, adding new elements that arise from the discussion, and draws a
new picture that represents the vision of the entire team. The team then
translates the picture into words to create a vision statement.

The vision should be written in the present tense and then tested to make sure it
meets the criteria of a good vision listed above. 

The vision should be written in the present tense and then tested to make sure it
meets the criteria of a good vision listed above. 

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Once the team has conducted an initial situation analysis, the provisional vision
will be shared with stakeholders involved in the SBCC strategy design process
and agreed upon. This can be done through a stakeholder workshop or
informal meetings where stakeholders provide feedback and suggest changes to
the provisional vision statement. The resulting shared vision statement should
clarify what is important for all stakeholders and guide the strategy design and
development process.

Step 4: Conduct a Desk Review

To better understand the health issue and to address the problem, the team needs
to conduct a desk or literature review. To start this process, review the vision and
problem statements and divide them up into concepts. Develop a list of keywords
related to those concepts. Brainstorm additional synonyms and related keywords
for each concept. These keywords will be the search terms used to find relevant
literature.

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Step 5: Decide the Scope of the Review
Determine how many studies and how comprehensive the review should be.
Decide on the dates for the data, the studies to be collected and the best
databases (or other sources of information such as partners) to focus the search
(see commonly used databases for literature reviews under resources). Decide
whether the review will include only peer review literature or will expand
into grey literature

Step 6: Identify the Relevant Information

Use the keywords/search terms to look for literature that fits within the scope of
the review, including existing quantitative and qualitative data about the problem
and the people affected. Look for information on:

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Look for both national and local data using online searches, local library
resources, and partner resources. Good sources include:

 Large-scale, population-level studies such as the Demographic and Health

Survey (DHS)
 National policies and strategies to address the issue
 Reports on national, regional, district or health facility-level indicators
 Published research on the topic
 Bibliographies and references of relevant research studies
 Unpublished studies conducted by programs working in the area
 Stories and reports in the media
 Census research
 Media reports
 Anecdotes and narratives from communities

Step 7: Review and Organize the Data

Focus only on information that will help the project team address the problem
and avoid including information that is not as relevant for SBCC. Organize and
summarize the findings in a way that makes them easy to use (see Literature
Review Template under templates).

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While reviewing the data, organize the studies that contain information on
potential audiences for SBCC interventions. Some studies provide information on
what people think, feel and do about the health problem, what influences their
behavior and the communication channels they use. Capture this information for
use in the audience analysissee Audience Focused Literature Review
Template under templates).

A desk review is complete when no new information is discovered and the articles
introduce similar arguments, methodologies, findings, authors and studies. 

Write a list of questions that are not adequately answered in the available data
and questions that arise from the data. For example, the team may need
additional information on local practices or beliefs about the health issue. These
are gaps that stakeholders might be able to address during a stakeholder
workshop

Step 8: Analyze the Data and Summarize the Findings

Look closely at the information collected. Determine the commonalities and
conflicts among the studies. Decide if the information is valid and important in
addressing the health issue. A good way to summarize the findings is to write a
situation analysis report, which can be shared with the larger project team and
relevant stakeholders. 

Step 9: Fill the Existing Gaps

Focus group discussions and in-depth interviews with members of potential
audiences can help fill any information gaps that remain after the desk review.
One way to fill gaps is to hold a stakeholder workshop. Other ways to fill gaps
include holding in-depth interviews and focus groups with key informants or
potential audience members; and conducting facility surveys (health, social
service, religious or other facilities). 

 Let the numbers and facts you learn tell a story. The story can be powerful and give
clues to what needs to be done.
 Data does not only mean numbers. Personal accounts and reports can also be very
powerful. Ideally, the project team will look at both. Consider including brief, insightful
personal accounts (vignettes) in the situation analysis report to help bring the problem
to life.
 When reviewing the literature, start by reviewing the abstracts to save time. Read
article abstracts for the keywords and discipline-specific jargon that authors and scholars
are using in their publications.

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 Draw on the experience, expertise and insights of the stakeholders and those who
have worked on the topic before. Set aside your own beliefs and values and keep an open
mind to learning.
 When preparing for the stakeholder workshop, include only the information
needed to achieve the objectives. If there is uncertainty, have optional slides ready, and
create new ones as needed during the workshop.
 If the information does not exist, is outdated or does not provide enough insight into
priority audiences, conduct additional primary qualitative formative research in the form
of focus groups, interviews or informal visits to communities and homes.
 situation analysis might appear to be a lot of work. However, a good situation
analysis is well worth the effort. The benefits will become clear when you reach the
implementation stage. 
 Stakeholders are those who are affected by, have a direct interest in or are
somehow involved with the health issue.   
 Incidence measures the rate of new cases of a particular health issue per thousand
people in the population. For example, the number of cases of malnutrition in the
northern region is increasing by 5 percent per year. 
 Grey literature refers to academic literature that has not been published. 
 Prevalence measures the proportion – usually the percentage – of people in a
defined population who have the problem at a given time. For example, last year, 55
percent of all children in the northern region were malnourished. 
 Mortality is the number of deaths in a population. 
 Morbidity is the incidence of illness or disease in a population.
 Quantitative data tells how many, how often, what percentage. 
 Qualitative data is descriptive and often help explain quantitative findings.
Qualitative data tend to emphasize what, why and how. 

This website is made possible by the generous support of the American People
through the United States Agency for International Development (USAID) under
the Health Communication Capacity Collaborative (HC3) Cooperative Agreement
#AID-OAA-A-12-00058.  On-going support is provided by Breakthrough
ACTION with support from USAID's Bureau for Global Health, under
Cooperative Agreement #AID-OAA-A-17-00017. Breakthrough ACTION is based
at the Johns Hopkins Center for Communication Programs (CCP). The contents 
of this website are the sole responsibility of Breakthrough ACTION and do not
necessarily reflect the views of USAID, the United States Government, or Johns
Hopkins University. 

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