“WE are blessed that our experts and lawmakers are here. Nagtutulungan tayo rito. Kasi itong battle, this battle against COVID can be won. But let us do it in a quicker, more efficient fashion by working together and working hand in hand. Huwag lang batikos.”
Thus said House Majority Leader and Leyte Rep. Martin Romualdez as the House leadership under Speaker Alan Peter Cayetano on Thursday called for unity and cooperation in the campaign against coronavirus disease-19 (COVID-19) during the Defeat COVID-19 Committee (DCC) Technical Working Group (TWG) on health cluster meeting.
The virtual meeting via Zoom presided by Romualdez, DCC co-chairman like Cayetano, gathered significant insight and enriching discussion as it brought together the country’s leaders in public health, namely Health Secretary Francisco Duque III, former Health Secretaries Dr. Manuel Dayrit and Dr. Esperanza Cabral, PhilHealth President and CEO BGen Ricardo Morales, Health Undersecretary Lilybeth David, Dr. Susan Mercado, and Dr. Willie Ong.
“We are blessed that our experts and lawmakers are here. Nagtutulungan tayo rito. Kasi itong battle, this battle against COVID can be won. But let us do it in a quicker, more efficient fashion by working together and working hand in hand. Huwag lang batikos,” stressed Romualdez, chairman of the powerful House committee on rules, stressed.
While presiding over the TWG meeting, Romualdez noted that the rising number of confirmed COVID-19 patients is a sad reality and that it must further strengthen the resolve of the House to contain the pandemic.
“In the face of adversity, we have no choice but to remain steadfast, resolute, and optimistic as we work tirelessly in the service of the Filipino people. We Representatives, are your eyes and ears on the ground and your voice on the national stage,” Romualdez explained.
Romualdez admitted that the pandemic is “the greatest battle” that the country must fight but affirmed that House efforts to curb the outbreak will continue.
“Rest assured that the House of Representatives is working towards crafting resolutions to help ensure the promotion public health safety, help ensure the delivery of basic goods and services, the upliftment of the economy, and the restoration of livelihood to many of our countrymen,” said Romualdez.
Cayetano said that no earlier time in history has the concept of ‘one-ness’ been so important.
"Hindi po sapat ngayon ang whole-of-government approach. It’s really whole-of-society or community approach. Despite social distancing, we should have social cohesion,” Cayetano added.
Cayetano decried finger-pointing and assigning blame to different agencies of government.
“There’s a lot of temptation to say na ‘This department is the weakest link, That department is the weakest link, The finances is the weakest link.’ But actually, we’re all only as good as the weakest link… As I said, one body. Yung sakit ng kalingkingan ay sakit ng buong katawan,” the Speaker said.
The Speaker said he is not joining the call of senators for the resignation of Health Secretary Francisco Duque.
“My personal opinion is I’m not joining the call of Senators for the Secretary’s resignation. I have not consulted or there’s been no consensus with Members of House because this has been a recent development,” the Speaker said.
At this time, he stressed the DCC meetings will focus on gathering information and looking for solutions to the pandemic.
“But I’d like to say precisely, we need a new mindset during these times. If this was a normal hearing there would be a lot of interventions and a lot more confrontation and it would be a little bit more toxic, which is okay because the nature of our democracy is that the Executive and the Legislative, while depending on each other, is also a check and balance… Allow me to avoid right now going to the headlines and really more looking for solutions. So that’s precisely why we’re having these hearings, so we can get direct information,” Cayetano stressed.
Quezon Rep. Angelina Tan M.D. and Iloilo Rep. Janette Garin, co-chairpersons of the DCC Sub-Committee on Health, presented updates on measures being undertaken by the government to combat the pandemic.
Tan, chairperson of the House committee on health, underscored the importance of bridging the gaps in the current information dissemination system. She urged the Department of Interior and Local Government (DILG) to aid the Department of Health (DOH) in cascading accurate and latest updates for FIlipino families to understand that the fight against COVID-19 begins at home.
To prevent further spread of the virus, Tan proposed to intensify contact tracing efforts and be aggressive in addressing the stigma that has caused front-liners, patients, and their families to be discriminated.
“Dito nakita natin kung anong klaseng healthcare system ang mayroon tayo. We could have responded better, but we still have time. Naniniwala tayong may panahon pang ayusin ang sistema ng pangkalusugan. We really need to invest on health. Together, let us fight COVID-19 and heal as one,” said Tan.
Tan also proposed the creation of a “War Council” to provide further assistance to the DOH as it addresses the crisis.
The council shall consist of representatives from the government, the private sector, and the academe.
Duque welcomed the proposal and requested for a concept paper from the DCC so that the DoH can provide inputs.
Minority Leader Bienvenido Abante Jr. welcomed the “War Council” concept and proposed it to have 11 members.
Garin, a House senior Deputy Minority Leader, discussed how the country could move forward in the midst of the pandemic.
She stressed the need for timely test results and simplified laboratory operations. To guarantee efficiency, she proposed to install a “Laboratory Czar” so that all COVID-19 laboratories are aligned and are maximized to their full capacity.
She also pushed for the continuity of other public health programs apart from efforts against the virus, noting that there has been an increasing mortality among non-COVID patients.
“In a pandemic, we target reduced morbidity and mortality. We look for the virus, isolate, and make it extinct. But we continuously take care of our people, remembering that other illnesses kill. Public health is complicated, but if united, we are more capacitated,” said Garin.
Deputy Majority Leader Wilter Wee Palma II inquired on the new PhilHealth case rates, to which Morales assured that indigent patients shall be fully covered and shall not be required to adhere to the new case rates.
With this, indigents shall no longer be required to apply for additional coverage after April 15.
Senator Pia Cayetano, who joined the meeting as a resource person to discuss possible joint efforts between the House and Senate, said that it is not advisable to benchmark the Philippines with the best practices of other countries due to the uniqueness of each country.
She emphasized the need for both Houses to “start thinking of the next steps" and suggested an efficient communication strategy by involving athletes who can connect with the youth.
"We need to calibrate our approach to the realities we have," she said.
Duque said the call for his resignation is the Senate’s opinion.
He stressed he would still serve as DoH Secretary at the pleasure of the President as his appointment to the position is based on the President's trust and confidence.
“We need to unite in battling the COVID-19. This is a war. This is a third World War and we cannot see the enemy. How I wish that the Senate should have been magnanimous, more appreciative of the efforts that we have tried to put in place. Actually, the country was the first to impose a ban on travel from China which has actually caused the delay of the virus to spread,” said Duque.
Asked how the government would address the increasing number of deaths of healthcare frontliners, Duque said that there are COVID patients who have deteriorated and did not disclose their history of exposure which put healthcare workers, particularly doctors, at risk.
“It hurts each and everyone, and me in particular, because of the danger put on our doctors, and the lack of PPEs will have to be prioritized, we have to import. I am glad the Speaker has discussed with me the department’s projection of a medium- and long-term response for ample safety of health workers through the PPE. Sana ay magawan pa rin ng paraan ang proper disclosure ng mga pasyente para po hindi malagay sa alanganin ang ating mga healthcare workers lalong lalo na ang ating mga doktor,” said Duque.
David said the enhanced community quarantine (ECQ) implementation has been very successful in lowering the curve on COVID infection cases. She said that computing with the ECQ implemented, the number of COVID cases that would have happened had the ECQ not been implemented has drastically gone down.
As of April 15, David said the World Health Organization (WHO) global data showed that there are more than 1.9 million confirmed cases.
The country with the top highest cases are the United States of America with more than 578, 000 cases followed by Spain, Italy and China.
In the Southeast Asian countries, the Philippines registered the highest number of cases at 5,233. But the Philippines standing globally on confirmed cases is 0.28 percent and 0.28 percent on confirmed deaths.
David said the global fatality rate is 6.4 percent superseded by Italy with 12.9 percent case fatality rate and Spain with 10.5 percent case fatality rate and Indonesia with 9.4 percent case fatality rate.
In comparison, the Philippines has case fatality rate of 6.6 percent, said David.
For the strategy of detecting, the DoH has been increasing the testing capacity in the health sector.
From January 1 where it started with one functional testing laboratory, it now has 16 certified laboratories and another 37 applications in the process.
“Based on the ECQ that we are now performing, the target sample that we have to target to be able to do in the health sector is 8,000 tests per day,” said David.
She said that as of now, they have samples tested of more than 48,000 and out of this has been a lot of repeat tests. “But if we have to count the number of persons tested, it is more than 42,000.”
Morales said that as of April 15, 2020, PhilHealth has already released P8.3 billion from prepositioned funds of the agency to support health care facilities and enable some 5,095 PhilHealth-accredited Health Care Institutions (HCIs) to quickly respond to the COVID-19 pandemic.
“We have also extended the submission for COVID-19 claims from 60 to 120 calendar days from the date of discharge. And we have provided a special tagging for COVID-19 cases reimbursements, for those who already paid for their bills before we made the announcement,” Morales added.
According to PhilHealth Circular No. 2020-0010, the benefit packages for affected Filipinos for inpatient care of probable confirmed COVID-19 were divided into four levels according to severity. The package rates are as follows: for mild pneumonia, P43,997; moderate pneumonia, P143,267; severe pneumonia, P333,519; and critical pneumonia, P786,384.
Morales clarified that if the hospital bill exceeded the package rate, PhilHealth would still cover the remaining bill as required by law. PhilHealth also came up with benefit packages for testing laboratories of COVID-19. PhilHealth also reported a full financial risk protection for Filipino health workers and patients against COVID-19. The agency also provides a COVID-19 Community Isolation Benefit Package (CCIBP) applicable to all Filipinos who are suspect, probable and confirmed COVID-19 positive patients.
“For the community isolation units, we have a case rate of P22,449 per patient for the 14-day quarantine period. We are going to course this through the supervising facility which will be taking care of the isolation unit,” said Morales.
Dayrit said the government should focus on how to prevent, detect, isolate, and treat COVID-19. "Speed, speed, speed" is urgently needed to prevent, detect, isolate, and treat."
If millions are infected and only a small proportion become seriously ill, those critically ill will still number up to hundreds of thousands, according to him.
He also said the nature of COVID-19 overwhelms health systems and shuts down economies.
Dayrit also pointed out that the country’s current healthcare system is not equal to the crisis it is facing. He urged the government to work on improving the healthcare system.
“Because no matter how many accomplishments we have made if the country’s health system is not equal to the threat, then we are still playing catch up,” he said.
Among Dayrit’s proposals were: 1) over the long-term. medium-term, and long-term, the need to modernize disease surveillance capacity nationwide; 2) modernize laboratory capacity aside from disease surveillance capacity; and 3) strengthen primary healthcare facilities.
According to Cabral, government management is important in all of these things. She cited the need for coordination and alignment of activities between private and public healthcare facilities.