2020: COVID-19 pandemic brings world to its knees

MANILA, Philippines — A year like no other.

This was how Health Secretary Francisco Duque III described 2020, saying it is the “most difficult year in the history of the Department of Health (DOH)” due to the COVID-19 pandemic, which still rages across the globe.

“It brought the whole world to its knees. COVID-19 brought tears to even the most powerful countries,” Duque said during a recent Kapihan sa Manila Bay forum.

The Philippines documented its first infections of SARS-CoV-2, the virus that causes COVID-19, in January. A Chinese couple from Wuhan City, Hubei province in China, where the virus was first detected, arrived as tourists in Dumaguete on Jan. 21 and then traveled to Manila.

The man, aged 44, died on Feb. 1 of severe pneumonia and became the first death from COVID-19 outside China. The woman survived.

The third case is a 60-year-old Chinese woman, also from Wuhan, who went to Cebu and Bohol in January. She survived the virus.

In March, the country confirmed its fourth case with a 48-year-old Filipino lawyer from Taguig City who traveled to Japan in February. He recovered from the illness.

The fifth case was a 62-year-old Filipino man from Cainta, Rizal who became the first case of local transmission in the country. He had no travel history abroad but regularly frequented a prayer hall in San Juan.

As of Dec. 25, the DOH has documented 467,601 COVID-19 cases, with 9,062 deaths and 430,791 recoveries.

Just like the rest of the world, the Philippines has met various challenges as COVID-19 is a novel virus and no one was prepared for it.

At first, there was a global shortage of personal protective equipment (PPE) that put health care workers at high risk of being infected with the virus. There was also shortage of testing kits and other laboratory supplies.

Initially, the Philippines sent specimens to a laboratory in Melbourne, Australia until the Research Institute for Tropical Medicine was capacitated to do the tests itself.

There are now 153 licensed laboratories doing real-time polymerase chain reaction tests while there are 45 licensed GenExpert laboratories. A total of 84 laboratories have pending application to do COVID-19 testing.

To contain the virus, President Duterte placed the entire Luzon under enhanced community quarantine (ECQ) in the middle of March.

Since then, various levels of community restrictions have been implemented, depending on the number of cases and status of health system in an area.

The DOH has also implemented a COVID-19 response anchored on the “five pillars,” summed up as “BIDA Solusyon Laban sa COVID-19.”

The campaign promotes the active role of individuals in the fight against COVID-19 by practicing four behaviors simplified as B-I-D-A.

These are Bawal walang mask, I-sanitize ang mga kamay, Dumitansya ng isang metro and Alamin ang totoong impormasyon.

These minimum health standards, particularly on physical distancing, are not easy to implement because they require behavioral change.

According to the DOH, the country was already seeing a decline in the number of cases a few months before the Christmas holiday.

During a peak in August, the health system was almost overwhelmed, using up almost 80 percent of critical care capacity.

“We have managed to reduce the reproduction number to around 1.0 from a starting reproduction number of 3.27 and have maintained a lower critical care utilization rate even in highly urbanized cities,” the department said.

However, the DOH is seeing an increase in cases due to the “increased mobility” of people during the holiday season.

The agency had warned people against unnecessary travel and crossing households on Christmas as this could become a “super spreader event” for COVID-19.

Based on trends in the recent weeks, the DOH has seen a slowing down of the previous improvement in the epidemic curve.

There has been a continuous spike of cases in Metro Manila. Nine cities in the region are now at moderate risk compared to last month when all cities were at low risk.

An increase in the number of cases was also observed in Ilocos region, Cagayan Valley and Cordillera Administrative Region.

“If this trend continues and is not mitigated, it will lead to a sharp spike of cases that might overwhelm our health system capacity, similar to the peak we experienced last August in Metro Manila,” Duque said.

The Philippines is participating in various clinical trials for natural remedies such as virgin coconut oil, tawa-tawa and lagundi and for “re-purposed” medicines such as Avigan, registered in Japan as a treatment for flu but seen as a potential cure to COVID-19.

The country is also participating in the World Health Organization’s Solidarity Trial for Medicines and in GAVI COVID-19 Vaccine Global Access or COVAX Facility, a mechanism which will guarantee “rapid, fair and equitable access to COVID-19 vaccines worldwide.”

Vaccines

The country is looking forward to the rollout of a vaccine against COVID-19.

There are several candidate vaccines from countries like China, United States, United Kingdom and Russia, but none has been approved so far in the country.

The government is expecting a vaccine to come by the second quarter as it has been in talks with various manufacturers such as Pfizer and Moderna, both from the US.

Some companies have filed their applications with the Food and Drug Administration to do clinical trials here. These are Gamaleya of Russia, Janssen of US firm Johnson & Johnson, and China’s Clovers Biopharmaceuticals and Sinovac.

UK’s AstraZeneca also applied but eventually withdrew, saying the trials were no longer needed.

The goal is to vaccinate 60 to 70 percent of the population to achieve herd immunity.

Mutated strain

But near the end of 2020, the pandemic took a new turn when a variant of the coronavirus was detected in the UK, triggering fresh global panic.

The new strain, called SARS-CoV-2 VUI-202012/01 (Variant under Investigation, year 2020, month 12, varian 01), has spread to 13 countries, including Japan and Singapore.

It was also detected in Sabah, causing concern in Sulu, the nearest province to the island, which is a subject of dispute between the Philippines and Malaysia.

The new virus was said to be less virulent but could be up to 70 percent more transmissible. It is feared to compromise the efficacy of COVID-19 vaccines around the world.

According to Duque, the country needs to brace for the possible entry of the new strain.

“The question now is not if but when. We must all remain vigilant. There is no place for complacency now,” Duque said.

He underscored that more than ever, the public should strictly adhere to the health protocols against COVID-19.