Medical workers call for better primary care, community response as 'time-out' ends
Health workers tend to patients inside the COVID-19 emergency response medical tents outside the Gat Andres Bonifacio Memorial Medical Center in Tondo, Manila on August 4, 2020.
The STAR/Miguel de Guzman
Medical workers call for better primary care, community response as 'time-out' ends
Gaea Katreena Cabico (Philstar.com) - August 18, 2020 - 1:38pm

MANILA, Philippines — A coalition of healthcare professionals has proposed a unified plan, which included a community-based pandemic response, as the supposed two-week 'time-out' comes to an end Tuesday.

The Healthcare Professionals Alliance against COVID-19, made up of 160 medical societies forwarded the plan that it hopes will address problems such as workforce overload, inefficient contact tracing and quarantine, workplace outbreaks, inadequate transport options, poor compliance to protocols and worsening inequalities.

On top of their proposal is scaling up community response by expanding the One Hospital Command to One COVID Referral Center to cover clinics, laboratories and local government units. The One Hospital Command aims to monitor hospital occupancy and smoothen the referral of COVID-19 patients.

"For those who don't need to go the hospital but need consultation or testing, the problem even before, is weak primary care—the healthcare workers who patients go to first," Dr. Antonio Dans of the Philippine Society of General Internal Medicine said in Filipino in a briefing Tuesday.

He said that patients will not have to go to specialists or the hospital if primary care is improved by including it in the 'One Hospital Command' system.

Other proposals include the following:

  • Enforce policies on workplace safety
  • Strengthen the role of science in the decision-making process of government entities through the Health Technology Assessment Council
  • Develop and disseminate unified guidelines on COVID-19 response that can be implemented at the local level
  • Provide safe, sufficient and sustainable transport options especially for the poor
  • Facilitate access to internet connection especially for those living in disadvantaged areas
  • Ensure equity in access to social amelioration programs
  • Develop key messages to inspire behavior change

The suggestions include concerns already raised before the shift to a modified enhanced community quarantine was announced as a "time-out" for medical workers. The MECQ period was also meant to give the government a chance to 'recalibrate' its pandemic response.

READ: Has pandemic response been recalibrated or is MECQ a repeat of the same policies? | Galvez says task force 'recalibrating' COVID-19 response, highlights tighter quarantine enforcement

Communities as frontliners

Also among the recommendations of the HPAAC is the change in the narrative that communities, not hospitals, are on the frontlines.

“We are also calling to shift the narrative of the hospital being the frontline to the community as the real frontline,” Dr. Aileen Espina of the Philippine Society of Public Health Physicians said.

Dr. Pauline Convocar from the Philippine College of Emergency Medicine also said there is a need to protect the last line of defense—hospitals—and strengthen communities.

“We always emphasize that the first line of defense is actually not the hospitals, not even the frontliners. The first line of defense is in the community and that is within the hands of the patient and the community,” Convocar said.

Time-out

Two weeks ago, dozens of doctors’ groups warned the country was losing the coronavirus fight and called for a two-week lockdown in Mega Manila so the government can improve its pandemic response.

President Rodrigo Duterte heeded their call and placed Metro Manila, Bulacan, Rizal, Cavite and Laguna under modified enhanced community quarantine until August 18.

READ: Duterte tells frontliners: No need to raise hands as if calling for revolution

“This two weeks won’t give us the immediate effect we really wanted na mawawala na,” Convocar said, noting there are still emergency departments reporting they have reached full capacity.

Dans said a lot of things happened in the two-week time-out. "A lot of things have been done, a lot of things have been discussed, many plans have been changed. We need to implement these properly and we will help."

Metro Manila and its neighboring provinces will return to looser general enhanced community quarantine starting Wednesday.

The number of confirmed COVID-19 cases in the country reached 164,474—the highest in Southeast Asia. The country also reported 112,759 recoveries and 2,681 deaths.

GENERAL COMMUNITY QUARANTINE MEDICAL FRONTLINERS NOVEL CORONAVIRUS
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