Despite instituting one of the most stringent responses to Covid-19, the Philippines still failed to turn the tide in its struggle against the pandemic. Last week, it emerged as Southeast Asia’s new coronavirus hotspot, dislodging Indonesia in the number of recorded cases.
With health-care capacity on the edge, state resources dwindling, and the onset of an economic recession, balancing the twin demands of health and economy will make for tough choices.
The Philippines imposed one of the most extensive lockdowns in Asia outside China, placing its largest and most populous island, Luzon, under quarantine in mid-March.
The island, where the capital city Manila is situated, covers a third of the country’s land area, accounts for 60% of its population and produces more than 70% of the national GDP. It was one of the world’s toughest and longest lockdowns. Manila’s lockdown is longer than the 76-day quarantine of Wuhan, the first epicenter of the coronavirus outbreak.
Based on Oxford University’s Government Response Stringency Index, the Philippines consistently maintained the highest score of 100 for 23 straight days between March 22 and April 30. The score was calculated from a basket of nine metrics. These are school and workplace closures, cancellation of public events, restrictions on public gatherings, closures of public transport, stay-at-home orders, public information campaigns, restrictions on internal movements, and international travel controls.
As of early August, the country continued to top the region in terms of enforcing restrictions on people’s movements.
The unprecedented scale of the pandemic and institutional gaps in its public health system stacked the odds against Manila. It exposed the low state of readiness despite past pandemics like SARS (severe acute respiratory syndrome) and H1N1 that also hit the region and the lack of an emergency medical supply reserve.
The government began the campaign anchored on strong political will and a clear resolve not to sacrifice lives over economic growth. In his fifth State of the Nation Address in late July, President Rodrigo Duterte reiterated this emphasis: “Buhay muna, bago lahat” (Life first, before everything else).
But while the virus was quick to spread, the national game plan was slow to react. While the country acted fast in building quarantine facilities, it took time to enhance its testing capacity. Locally developed test kits would not be available until April and mass production continue to be hounded by charges of prioritizing imports.
While the speed of the health crisis made urgent the procurement of masks, medical supplies and personal protective equipment from China, India and other vendor and donor countries, less effort was spared mobilizing local industry to meet pressing demands. Building local capacity should have been accorded high importance early on in anticipation of a demand surge that may not dissipate until a vaccine is rolled out.
Moreover, despite the risks posed by returning overseas Filipinos and urban residents returning to the provinces, contact tracing remains a weak spot in the overall national response. Only in mid-July did the government revamp its contact-tracing approach by appointing a new czar to head it – a former police official turned mayor who excelled in conducting contact tracing in his city.
In contrast, other countries swiftly leveraged technology such mobile apps and national databases, or, in the case of Vietnam, a ready network of neighborhood informants, to address this critical vulnerability.
The Philippines recently reported the highest increase in Covid-19 cases to take the place of Indonesia as the region’s new coronavirus center of gravity. The uptick propelled the country to 22nd place globally in terms of caseload as of August 11.
Although it still has fewer deaths compared with its bigger southern neighbor, it posted the highest number of serious or critical cases in the region. Globally, it was ranked 32nd in casualties. On the upside, the country registered the region’s second-largest statistic in terms of recoveries and was ranked 27th worldwide.
The country is also catching up in testing. It now tops the region in the number of tests conducted and was ranked 26th globally in this department as of August 11. In fact, it already outstripped South Korea, Japan or Denmark in terms of tests performed.
However, the number of those tested still represent a small fraction of its 109 million people. It is ranked in the low-rung 127th in total tests done per million people. Hence much is expected from the country’s expanded targeted testing, especially of high-risk populations in dense areas.
Taken together, enhanced testing, contact tracing and isolation could check the spread of the disease and prevent over-stretching its hospitals.
In spite of growing lockdown fatigue and economic pressures, Duterte is keen against resuming traditional classroom instruction and reopening the economy. In his address in July, he said: “To open up the economy to pre-Covid-19 levels at this time is not an option because whatever good it can produce will only be gobbled up, or be outweighed, by the bad it will generate.… The recent upsurge of infections when we opened little windows to the resumption of business is proof of that.”
But while laudable, a prolonged lockdown is untenable. The country has already suffered its worst economic contraction in decades. Although its macroeconomic fundamentals may still be sound, the ebb in remittances and the heavy toll on consumption and small businesses may cast a long shadow over its recovery.
While new outbreaks may force a return to some form of quarantine as other countries such as Australia, China, Japan, Spain and Germany did, the geographic scope and duration should be well targeted to soften the blow on an already battered economy.
Public safety, public health and the economy are equally important. Thus striking the proper balance is imperative. This would require a strategy that can adjust to fast-changing situations and a capacity to anticipate the possible trajectory of the pandemic given trends and the experiences of other countries. Now in its eight month, much accumulated data and lessons available should offer Manila a better picture of how to calibrate its approach.
Furthermore, although President Duterte has a penchant for relying on the military and the police as organized forces that can easily execute orders, pandemic response cannot be overly securitized. Health experts and economic managers should play important roles in crafting and adjusting the overall plan.
In sum, the Philippine experience has thus far shown that lockdowns form only one part of the equation. If not complemented by early and vigorous testing, contact tracing, isolation and treatment, even the most draconian quarantine could only go so far.
Building local capacity and getting the public to remain vigilant and not let their guard down is crucial. Against the grave challenge posed by this contagious disease, all other policy distractions should become secondary.