LIKE A cry in the wilderness, it was not heard. At the time, it was a probably more a prayer said in desperate silence.
Two weeks into the lockdown, journalists were still in a fog of quarantine and the strangeness of physical isolation. Working with limited reach to sources, journalists fixed on the trail of words of a president who had yet to wrap his head around the form or shape of the disaster that had struck the nation. His declaration oversimplified, without knowing how little he knew, he said, a virus goes away by itself.
Those who patiently listened to Rodrigo Duterte’s four briefings in the first two weeks of quarantine could not have missed the haphazard approach of the man at the helm. In the implementation of the lockdown of Metro Manila and surrounding areas in the NCR, he instructed the mayors to work out their own initiatives; but later, changing his mind without explanation, he questioned some of the measures undertaken in a particular district.
In tracking the administration’s moves, journalists assigned to their “beats” produced stories about efforts of national agencies and local government units. Coverage did not provide an overview of all the separate actions being announced by different officials. Neither did reporters note the problem at the core: that there was no central plan to guide everyone as they addressed the rising cases and no coordination of the different actions on the ground.
The cities of the Metro Manila have contiguous borders. People work in different jurisdictions from where they reside. Crossing borders, a person could be caught unaware of different rules and regulations in other areas. This level of confusion did not help the already fraught situation in the streets, with police and security officers interpreting rules on their own, questioning the travel of citizens including doctors who were responding to hospital calls.
These inconveniences or delays were examples of poor implementation, as it sometimes happens, the directions may be misunderstood or misleading. It was a government acting without checking how the instructions were working on the ground.
At this stage, media reports picked up the quick and clear decisions made by the private sector, assessing the needs of their clients and constituencies: issuing waivers of bank fees and other transactions, postponing due dates for payments, noting the lack of critical supplies such as masks and PPEs, with some manufacturers switching to production of supplies which were in short supply, such as alcohol for disinfection, masks and plastic shields.
In April, the government still had not communicated a central plan or comprehensive strategy to address the spread of disease, even as Duterte asked Congress for special powers that he said he needed to be able to deal with the crisis more effectively.
The lockdown and home quarantine imposed brutal restrictions which were most profoundly felt by the very poor. The orientation made the ordinary people vulnerable to all kinds of checks and barriers, resulting in inconvenience and hardship that should have been avoided, because the threat of disease was already a crisis in itself.
But even those who had more in life were not exempt from disruption of livelihood as in just a few weeks, the threat of insolvency hovered over small to medium enterprises and even larger companies in food, travel, recreation, entertainment and showbusiness were affected.
President Duterte with the members of the Inter-Agency Task Force on the Emerging Infectious Diseases (IATF-EID). Photo from PCOO.
Too big for a mayor
Sadly, Rodrigo Duterte sought the presidency thinking that he had succeeded to turn Davao City into some kind of model for development. As president, he still presumed that what worked in Davao City would work in the national arena. He acted with the instincts of a strongman who had been accustomed to wielding basic instruments of police force to get things done. He marshalled the same array of tactics and measures that he used with effect as city mayor. His was a small circle of trust, mainly family connections and friends from school. His Cabinet appointments drew from these and those recommended by political allies and patrons.
Even as the president moved to establish a task force to work out a centralized approach of an inter-agency authority, the poor implementation exposed the inadequacy of leadership and the stunning lack of competence.
The success of other governments to check the pandemic onslaught had little to do with their tendencies toward authoritarianism or democracy; but reflected a higher level of competencies and qualities of leadership.
Key to the success was to attend to both health and the economy and to be able to calibrate the responses to address both. Failure to address health would affect the other. The resort to a lockdown would slow down the spread; but these would have to be undertaken with other actions, such as testing and contact tracing. Without these, the impact of the quarantine was also limited. Unfortunately, DOH, the lead agency at the time, seemed at a loss about what to do. It did not call for an early ban on arrivals from China. Even after the ban was official, there were accounts of Chinese tourists arriving in Boracay Island.
Duterte decided on the strict lockdown of Metro Manila and the national capital areas and then extended this to cover the entire island of Luzon on March 16. But once cases increased, government response should have included other measures to check the spread of the disease. It also needed to spend on a widespread information campaign to explain the need for frequent disinfection, the basic use of masks, of plastic shields and social distancing.
The crisis quickly highlighted the weakness of the national health system in the country, a medical system which had lagged behind the growth of the population in its capacity to provide for normal medical needs. In 2019, the government asked for a dramatically lower DOH budget than what it requested in the previous year. It took bicameral meetings in Congress to reconsider the wisdom of the low budget because DOH would have to implement the Universal Health Care Law which had just been passed. Sadly, this background went missing in most reports, which should have suggested strongly that the weak link in the fight against the virus would be the DOH itself.
As the lead agency of the Inter-Agency Task Force on Emerging Infectious Diseases (IATF-EID), the DOH was late in assessing the status of critically needed supplies: life-saving drugs, ventilators and respirators, personal protective equipment (PPE), masks and disinfectants, isolation gowns, and test kits. It said little about the availability of such items and media did not ask. Private sector and volunteer work led by different NGOs supplied for the lack until government could secure its supplies.
Neither did media ask about a plan to designate hospitals for COVID-19 patients which private hospital officials had broached in a published statement. It was the Philippine Medical Association (PMA) which issued the alarm and called attention to the manpower shortage which would further cripple the health system.
A 24 Oras segment on March 17 presented the national predicament in numbers, citing data from the Asia Pacific Observatory on Health Systems and Policies (APO) which showed the Philippine ratio of doctor and nurse at a staggering four to eight per 10,000. It does not take an expert to see this as a major lapse even in normal times.
When reporters did ask about specific points, the answer from health officials was always: Plans are still underway.
How to supplant the gaping lapses of the DOH? The president’s remedy was to place primary responsibilities on his security and law enforcement officers. He also appointed as the chief implementer of the National Action Plan against COVID-19 the recently retired AFP chief of staff Ret. Gen. Carlito Galvez.
On March 24, the NEDA proposed a three-phased program that could cover public health, rebuilding public confidence and resumption of “new normal” economic activity. NEDA Secretary General Ernesto Pernia announced his resignation on April 17when his proposals were ignored by the other departments.
On March 26, the Philippine Daily Inquirer issued an editorial which raised the following point: “expanded powers would be another monumentally wasted opportunity—worse, a cover for abuse—without a clear, coherent, far-reaching game plan from hereon.”
In the year of the plague, the presidency seemed oblivious to the obvious need. On February 3, he dismissed the SARS-COV-2 virus: “Kagaya ng SARS, I assure you even without the vaccines it will just die a natural death. Apparently, itong mga ganito, mga virus, ano ‘to HIV, wala — nawala na. Meron, kokonti na lang.” (Like the SARS virus, I assure you that even without the vaccines it will just die a natural death. Apparently, viruses like this, like the HIV, are gone. There might still be a few cases.)
Playing Catch Up | Inquirer editorial, 26 March 2020
That “war” stance may prove useful—if Mr. Duterte has learned lessons by now from the inaction and complacency of his administration in the early days of the crisis, when precious weeks were wasted without an urgent and coherent policy on closing the national borders, procuring the required medical essentials, and shoring up the country’s rickety healthcare system for the daunting battle ahead.
Would the government move more quickly and strategically now, having been equipped with the huge war chest it demanded? The war footing, if that is how Mr. Duterte wants it, should immediately translate to government working double-time on the health threat. Already, it is playing desperate catch-up and falling short on many fronts. The country’s medical community, for one, is crying out for immediate relief, not only in terms of badly needed personal protective equipment and testing kits but also in the form of a clear strategy to lessen the pressure on the hospital system that is threatening to come apart at the seams. Many frontliners have been relying mostly on donated food and equipment from private individuals and organizations; more ominously, a number of the country’s largest private hospitals have said they have reached their maximum capacity and are no longer able to accept COVID-19 patients, opening another crisis situation as more patients are expected to enter the system with the ramped-up testing that would come with the arrival of more test kits.
That’s only on the medical front; the poorest sectors also need to be fed and protected during the entirety of the quarantine, and trade and business somehow kept afloat even as the economy is at a standstill. The administration has serious overtime to put in to inspire public confidence in the fight against COVID-19; those expanded powers would be another monumentally wasted opportunity—worse, a cover for abuse—without a clear, coherent, far-reaching game plan from hereon. [READ EDITORIAL]