Flatening the Curve
THE INITIAL spike of COVID-19 cases in March 2020 triggered nationwide calls for mass testing — a measure that the WHO had prescribed as necessary for halting the spread of the deadly virus. Mass testing was also something that had been done with great success in South Korea which had experienced the pandemic earlier than the Philippines. Enough literature was available and various expert groups could have been consulted on the different tests that could be used to control the contagion.
But government efforts seemed dependent on a coercive and punitive lockdown that relied on the police and military to enforce it. There was little evidence that the government was prepared to consider any other measures during that critical juncture, hence the surge in the number of cases despite the lockdown.
The country’s mass testing efforts were severely behind those of other countries. At the time, no government official seemed to know that this negate the gains of the lockdown that it could not sustain indefinitely without severely damaging the economy. Tracking the steady rise of cases showed that all other actions would only be catch-up measures, which thus doomed the country to suffer the worst from the pandemic.
Unfortunately, media’s reporting on this issue was fixed on what government sources were saying. Recording contradictory statements, journalists were not ready to point to the main problem. The president and those he depended on did not seem to understand the enormity and complexity of what they had to do in order to confront the challenge. Worse, it was also clear that the government agencies were not involved in internal policy discussions and did not coordinate with one another to sort out how they could best curb the pandemic onslaught.
Gold standard vs. rapid testing
Sadly, reporters themselves were not informed or knowledgeable enough about the science of testing to provide independent analyses of the weakness of government’s response.
Even as the number of cases continued to rise, DOH still rejected calls for mass testing, citing a lack of resources to acquire the “gold standard” of tests (RT-PCR). Apart from being more expensive than “rapid testing,” the “gold standard” test also took longer to confirm findings and required more infrastructure to ensure the safety of healthcare workers in the laboratories.
With the lack of the RT-PCR tests at the time, government seemed without any solution, or any alternative plan to map the disease transmission.
The conduct of tests was limited to diagnosis of sick patients. In mid-April, the number of cases recorded by government had breached the 5,000 mark.
At this stage, tests were done by the Research Institute for Tropical Medicine (RITM) or were sent abroad, delaying results. The backlog in case findings required the DOH to analyze how to deal with the delayed test results and keep their case count accurate. But DOH and the media continued to report the numbers without explanation.
There was also no discussion of what government had to do to expand laboratory capacity. The delay in the DOH approval of the laboratory built by the Marikina City government was widely reported but without reference to the larger issue of mass testing, the use of other tests, the need to sort out the case counts coming out of the RITM labs.
CMFR cheered Boo Chanco’s column “Demand and Supply” published in The Philippine Star on April 13 that pointed out the need for rapid testing to see “how widespread the virus is in the community and where the infection hot spots are.” “It is not one test or the other. We need these two tests for different purposes,” said Chanco.
Delayed testing: a key to the failed response
DOH finally declared that it was ready to do “expanded testing” on April 14. By then, media had caught on to the reality of government’s poor capacity to administer tests and began to pick up the slips in coordination and implementation of what the administration was touting as a huge gain in its strategy against COVID-19.
Analyzing the country’s capacity to address the health crisis, Rappler revealed on April 21 that the problems besetting the implementation of mass testing could be traced to the government’s tardy response to the issue. This delay was at the core of all kinds of problems, even as the pressure to re-open the economy caused government to ease the three-month lockdown in May.
When government announced on May 14 that it was lifting the strict lockdown and adopting modified quarantine conditions, it allowed some 14 million people across the country to return to their jobs. Media reported the lifting or modification of quarantine measures, but the disjointed coverage did not mention the risks posed by the lack of mass testing. Reports also failed to note the connection between testing and the protection of those who were returning to work.
With the decision to open up critical sectors of the economy, both the health and labor departments dismissed the need for tests. Pressed for comment on the issue during a press briefing, Presidential spokesperson Harry Roque said that the government could not conduct “mass testing” and would delegate the responsibility to the private sector.
In the same briefing, Roque argued that the term “mass testing” was misleading because no country can conduct coronavirus tests on all their citizens. He further explained that the government is carrying out “expanded targeted testing,” not “mass testing.” Reports explained the nuances of the terms “expanded targeted” and “mass” testing. Media pointed out Roque’s incorrect assumption that mass testing meant mandatory testing for the entire population of the country.
Nobody really knew if mass testing was being done
Still in May, Roque in a televised briefing claimed that the country had already achieved its target in testing. “Nakaabot na po tayo sa 32,100 tests per day. Nalampasan po natin ang ating target,” he said, a statement designed to project the president in a positive light. He seemed to be referring to actual tests done, when in fact he was merely referring to the country’s testing capacity.
Some news accounts did the right thing. They clarified the difference between testing capacity and actual tests, presented actual test figures, and cited DOH on the factors that caused the low turn-out. On social media, netizens promptly called attention to DOH figures showing that actual daily tests remained below 10,000.
Failure to understand
It was only toward the end of the year in December, deep into the pandemic, when Duterte revealed that he only then saw the importance of accessible and affordable testing: “…What’s really important, and I realize (it) now, it’s the testing.”
Despite evidence to the contrary, the Palace maintained on the following day that testing had always been a regime priority. Roque even touted the country’s testing capacity, claiming it was the best in Asia. Unfortunately, most of the media still publicized Roque’s boast, which was an attempt to shield government from blame.
The Duterte administration’s poor grasp of the significance of testing from the beginning foreshadowed its failure to address the pandemic in a timely and strategic manner. Disinformation and misinformation flowed from the highest levels of government, including the leading health agency and the Palace itself, revealing serious lapses of judgment and the grave consequences of official incompetence.
For the media, only a few exceptions fulfilled the watchdog role by correcting the falsehoods, calling out officials for their failings, and serving as frontliners in the Filipinos’ battle for truth.
READ CMFR CHEERS ON THE ISSUE:
- “Testing beyond close contacts of confirmed cases is still not recommended by the DOH. Are the people’s fears and anxieties unfounded? CMFR cheers Rappler for looking into the capacity of the country in addressing this public health issue.” | Still on COVID-19: A closer look at DOH mass testing
- “News organizations recalled statements from different officials which revealed the glaring disconnect among agencies involved in the pandemic response.” | Media catching on: Government still confused about “mass” testing