On a knife’s edge of a COVID-19 pandemic: is containment still possible?

The Coronavirus Disease 2019 (COVID-19) outbreak is an unprecedented global public health
challenge which different regions around the world is trying to address. The first cases of
COVID-19 were seen in Wuhan, China in December 2019 which was said to be acquired from
the exposure at the Huanan Seafood Wholesale Market before spreading globally. It is evident
that there was a substantial person-to-person transmission in COVID-19 that is likely to be
similar with SARS-COV and MERS-COV. Moreover, it commonly hits the older adults and
those with chronic underlying conditions. The outbreaks have also occurred in confined settings
such as cruise ships, prisons, hospitals and aged care facilities, with growing epidemics in other
countries. By late February, laboratory-confirmed cases had surged to more than 80 000 globally,
with 96% of cases confined to China, and 80% of those in Hubei province.

Moreover, in the case of COVID-19, it appears that virus spreads through symptomatic and
asymptomatic carriers. Symptomatic carriers are easily detected because they show signs of
pneumonia-like illness; however, the extent of asymptomatic transmission cannot be fully
distinguished; hence, to prevent community transmission, quarantine is necessary. Further, as
control measure to reduce the transmission, travel restrictions, quarantine of well people who
have been in contact with a case or are otherwise high risk for becoming ill, and isolation of
people with infection (whether symptomatic or not) are key interventions for disease control. In
addition, travel is the major vector of infections globally, so border control measures including
restriction of travel (lockdown) will likely regulate its spread. Just like in Wuhan and other parts
of China which imposed lockdown in their infected areas showed significant decline of COVID-
19 cases in the country. However, by late February, cases began to heave outside of China,
reflecting missed cases, poor testing capacity and delayed control measures in many countries.

With regard to Australia as setting of the study, it was stated that if nothing has done, they may
see greater morbidity and mortality impact than of China considering its capacity for ICU and
isolation beds may be easily exhausted as well as the stockpiles of personal protective equipment
(PPE) and other supplies. Although travel bans and quarantine are proven effective interventions
for the delay may give them time to prepare, expand the quarantine and isolation capacity and
shorten the time to the availability of the vaccine; but, it may not be sustainable because they
cannot close the economic ties with China and other countries. The government of different
countries need to make choices between the economic and public health consequences brought
by COVID-19. When travel bans are lifted and activities are set to its normal pace, everyone
should be prepared for the impact surge of the virus, especially in those sites where people gather
such as schools, universities, sports and entertainment venues and the like.

The article provides comprehensive and holistic approach of what COVID-19 is as well as its
mitigation measures on how to combat or else lessen the case of COVID-19 in the community. It
also presents the challenges and risks posed by the virus should it rapidly spread in Australia.

In the same manner, in the local settings, the virus has reached the Philippines as it listed a total
number of 2,084 confirmed cases as of March 31, 2020 (www.doh.gov.ph).

The Philippines should have been warned regarding the risks and threats brought by the COVID-
19 as it recklessly lax policy on allowing people from the heart of the emerging pandemic to
enter the country at the beginning of the COVID-19 outbreak.

but prior to its outbreak in the country, the government disregarded some security measures as
influx of Chinese nationals still entering the country amidst its outbreak in China in late
December up to late February of this year. In fact, prior to the confirmation of the first COVID-
19 case last January 30, 2020, various sectors have already called on the government to impose
safety measures or travel restrictions from countries and foreign cities that are severely affected
with the virus. However, the government dismissed the call in order not to hurt the diplomatic
relations with China. The President then assured the people that “everything is well in the
country” and “we have enough funds”. It was also recalled that in a non-serious manner, he
threatened to “slap the virus” and that it will just die in its natural death. The Secretary of Health
even went bragging in late February that the Philippines is a model country in containing the
epidemic (abs-cbnnews). More so, the Presidential Spokesperson Salvador Panelo even said that
there is no need to ban the Chinese friends, instead, everyone is encouraged to boost their
immune system to beat the COVID-19.

However, things began to crumble, and cards have been tossed when the first local transmission
of the virus was confirmed in the first week of March. It is after the fifth case of COVID-19
logged by DOH (www.doh.gov.ph). In the article, it was highlighted that local transmission
added with undiagnosed cases leads the high ratio of deaths in Iran and Italy which later
considered the COVID-19 pandemic as declared by World Health Organization (WHO) since it
already affected more than a hundred countries at various scale (www.who.int).

The article also discusses the possible interventions for disease control such as travel restrictions,
isolation, quarantine of people who are in contact with a case or high risk of becoming ill and
even community lockdown. The writer agrees with these counter measures while there is no
vaccine yet for the said disease, it may slow down the number of cases and assure that the
contamination won’t go any farther. These measures also employed in Wuhan, China as the
epicenter of the disease which seemed to be effective as it declined the COVID-19 case in just a
month. The same counter measure was also adopted in the Philippines as President Duterte
announced the Community Quarantine particularly in Metro Manila to contain the spread of
COVID-19. He even leveled up the policy into enhanced community quarantine in Luzon
mainland in response to the growing spread of COVID-19 outbreak.

Although there were some people who were against with this measure, but an online survey
conducted by Martha Jean Sanchez on March 27, 2020 with regards to Filipino’s perception of
the government’s response to the COVID-19 outbreak in 2020, showed that almost 99% of the
respondents said that the government acted appropriately on coronavirus (www.statista.com).
Moreover, according to former DOH Secretary Manuel Dayrit in his interview said that “not
imposing community quarantine will risk a Wuhan-like situation in the early days of the
epidemic when thousands became infected and died” (Ravelo, 2020).

The writer also agrees that it was a good move by the government because the Philippines cannot
afford to sustain the needs should it spread rapidly like in other countries. In an opinion article
written by Janisse Ellao, she said that our country is ill-prepared and ill-equipped in combating
COVID-19 considering the number of hospitals, medical practitioners, personal protective
equipment, laboratories and testing kits which the writer also accedes. The government cannot
commit the same mistake just like of Italy which is one of the richest regions in Europe as well
as United States of America with equipped hospitals and better health care system but is now
vastly overwhelmed by the infection.
The writer thinks that a drastic circumstance calls for drastic measure, while there is no sign yet
that the virus is slowing down and no vaccine yet available.

And yes, while travel bans and quarantine are proven effective but as what the article is saying,
Australia and even other countries including Philippines cannot close its economic ties with
other countries because of innumerable supplies and products that the China and other countries
provide. Countries everywhere will need to make choices between the economic and public
health consequences of COVID-19. As what Dayrit metaphorically said “in the end the choice
lies between the devil and the deep blue sea”. Prolonged community quarantine, assuming it is
implemented well, will have severe economic effects which in and of themselves, will impact the
lives of people so negatively. However, the country cannot also sacrifice the citizen’s health
should it continue the occurrence of the disease. It will pose greater health risks which also
affects economic activities.

With regards to the title of the article “is containment still possible?”. Well,

One thing is for sure, after this chaos, there are underlying lessons which the government should
take into consideration: (1) knowing the importance of having strong national public health
systems which provides all citizens with access to health care; (2) stressing the need for
preparation for such health disaster. In 2013, former Senator Miriam Santiago filed “Pandemic
and All-Hazards Preparedness Act” aiming to help the country prepare and combat “public
health emergencies” such as result from natural disasters and severe weather, outbreaks and
pandemics, bioterrorism, mass casualties and chemical emergencies, among others;
unfortunately, according to Senate’s official website, the bill’s legislative status remains
“pending” in the committee (Monde, 2020). Moreover, just like the introduction of the article,
our experts or administrators should have a training simulation to address such kind of pandemic,
so when time comes that it happens again, we are prepared and can handle it better; (3)
improving the government health facilities and strengthening medical practitioners and front
liners; and lastly (4) massive campaign to public and create awareness dealing with such health
crisis.
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Ellao, J.A. (2020, March 9). Under a Fragmented Health Care, Philippines is ill-equipped in
combating COVID-19. Retrieved from the _________: www.bulatlat .com/2020/03/13/under-a-
fragmented-healthcare

World Health Organization. Coronavirus disease (COVID-19) in the Philippines. Retrieved from
official website of World Health Organization:
https://www.who.int/philippines/emergencies/covid-19-in-the-philippines

Santos, Rudy (2020, January 29). No order to ban Chinese in the Philippines. Retrieved from
The Philippine Star.

Department of Health. Updates on Novel Coronavirus Diseases 2019 (COVID-19).

Department of Health (2020, March 7). Press Release. DOH confirms local transmission of
COVID-19 in PH; reports 6th case. https://www.doh.gov.ph/doh-press-release/doh-confirms-
local-transmission-of-covid-19-in-ph

Dayrit, M. & Mendoza, R. (2020, March 18). Social Cohesion vs COVID-19. Ateneo de Manila.
Ateneo School of Government.
https://ssrn.com/abstract=3555152 or http://dx.doi.org/10.2139/ssrn.3555152

World Health Organization. (2020, March 11). WHO Director-General's opening remarks at
the media briefing on COVID-19. https://www.who.int/dg/speeches/detail/who-director-general-
s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

Sanchez, M.J (2020, March 27). Filipinos perception of the government's response to the
coronavirus COVID-19 outbreak in 2020. Retrieved from the published study in The Statista:
https://www.statista.com/statistics/1103474/philippines-population-perception-of-government-
response-coronavirus-covid-19/
Ravelo, J.L. (2020, March 24). To contain the spread of coronavirus, Manila grapples with
lockdown. Retrieved from DevEx News: https://www.devex.com/news/to-contain-the-spread-of-
coronavirus-manila-grapples-with-lockdown-96823

Monde, J. (2020, March 28). Miriam Santiago “Pandemic Preparedness Act” in 2013 Still
Pending. Retrieved from Philippine News: https://www.philnews.ph