Red Cross critical to COVID-19 testing

Testing for the presence of the COVID-19 virus, followed by tracking and tracing of those who might have been exposed to infected individuals is one of the key weapons in the arsenal against the spread of the virus. This in addition to wearing masks, social distancing, and practical hygiene. Public health officials rely on the results of COVID testing to track the state of the pandemic, and policymakers use the information to guide decisions on how to respond to the pandemic, including preventive and mitigation measures such as when to impose quarantine measures or lift them.

The Philippines was late in the game in testing. When the pandemic hit, we had just one laboratory. By April the country had five, but by then infections had began to accelerate. The World Health Organization (WHO) advised that at least 13 percent of the population should be tested in order to get a reasonably accurate picture of the rate of infection. In the Philippines that means 14 million persons nationwide or 1.6 million in Metro Manila alone. Today we have 158 accredited testing laboratories that can conduct 30,000 tests daily.

The critical role of the Philippine Red Cross (PRC) in testing has mostly gone under the radar until it caught the attention of the media when it cut down its testing services after PhilHealth racked up over P1 billion in payables to PRC. That was for the 303,332 tests it had conducted. Because of the delay in payment, PRC was unable to order test kits, reagents, and consumables from China. An order of 430,000 test kits was delayed, so PRC had to put on hold any further testing. It also stopped planned expansion of its testing facilities in underserved areas.

According to PRC chairman Sen. Dick Gordon, the government approached PRC in April in its desperate effort to scale up testing as the pandemic took hold. “PhilHealth asked us to put up laboratories in missionary areas like Zamboanga, CDO, Bacolod, Central Luzon and hotspots like Cebu and Batangas. We agreed despite the absence of a viable business plan for these areas. Our humanitarian nature prevailed, and so we are eating the cost out of those labs.”

PRC began acquiring molecular testing equipment in April and was able to set up several laboratories in a short period of time. It now operates 21 of the 158 accredited laboratories and has conducted over one million swab tests. Working 24/7, PRC served the OFWs when there was a surge and most of the OFWs have been under quarantine in Manila for a long time (total of 265,076 as of Oct. 20). It had also tested 34,093 healthcare workers (as of Oct. 17). In addition, it acquired six negative pressure ambulances; gave cash assistance and supported government efforts; provided emergency field hospital tents; and established the Convalescent Plasma Center.

PhilHealth guidelines allowed charging of P8,150, but PRC only charged P3,500 – which is the cheapest compared to other laboratories. It has since asked PRC to reduce the test fee to P3,409, to which PRC agreed to effective Oct. 1. This is the maximum that PhilHealth will shoulder currently, so it is essentially free for those availing of PRC testing.

In response to the clamor from government officials, legislators, and the media, PhilHealth made a partial payment of P500 million on Oct. 27 and subsequently another P100 million – bringing the remaining payable to P477 million. Despite the huge outstanding balance, PRC has since resumed testing full blast. Chairman Gordon says that everyday PRC laboratories conducts testing, this balance will grow by P20 million to P35 million daily. He hopes that PhilHealth does not allow its payables to balloon further so as not to disrupt PRC’s testing services.

The experience of PRC underscores how PhilHealth has failed to fulfill its critical role in fighting the pandemic. Delays in payment are also being experienced by other testing facilities, although not at the scale as PRC’s. We are still a long way from reaching the optimum testing level that will enable government to have a better handle of the situation. That target may prove to be elusive if testing laboratories – particularly PRC – are hampered by a liquidity crunch due to PhilHealth’s inability to reimburse them promptly. Down the road, I worry that unless PhilHealth ups its game, it may end up being the bottleneck in the deployment chain when the COVID-19 vaccine is finally rolled out nationally. On the other hand, PRC’s performance in testing merits their consideration as part of the vaccine deployment process.

Kasambahay rights

In the Philippines, if the relationship between an employer and their kasambahay does not work out, either party will just terminate the relationship. If there are issues, both sides have recourse to a third party, particularly in case of maltreatment. In an overseas setting, however, there is a potential for it blowing up into a major issue: there are domestic regulations that are in place and there is the presence of support groups that are either Filipinos or host country civil society organizations. In both instances, there is little sympathy for the employer should issues arise – be it alleged grossly unfair employment terms or mistreatment. It is the sort of narrative that the media will pounce on.

What can be done to avoid such situation? I believe that the DFA should have a say in the hiring of such workers. The US State Department has a policy that requires its personnel to treat their domestic workers fairly and provide employment conditions that follow host country labor laws and are consistent with department standards. The guidelines also instruct employers to observe high standards of conduct related to domestic employees. Pursuant to these requirements, the use of physical force, threats of force, coercion (including threatened withdrawal of immigration benefits), or fraud to compel labor or sexual services from a personal domestic worker could result in criminal prosecution under US law. The implementation of that policy – which imposes penalties for any violation – is administered by the Department’s Bureau of Human Resources.

In the Philippine situation, this may require another agency’s participation to ensure impartiality. Employment contracts should be required and vetted by the POEA before the process for issuing passports and applying visas are undertaken. Kasambahays should also be provided a recourse for filing grievances with DOLE either through the labor offices in the embassy or directly to POEA.