persuasive essay about covid 19 in the philippines

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Pandemic Pantries in the Streets? You Communist!

By Glenn Diaz

Mr. Diaz is a writer based in Manila. His second novel, “Yñiga,” about the spate of political killings in the Philippines in the 2000s, was shortlisted for the 2020 Novel Prize.

MANILA — The day the city went back into a hard lockdown in late March, I started a ritual: Trapped again, I took to counting the ambulance sirens I’d hear from my place in Quezon City, the most populous area of this sprawling capital. At one point, blare after dystopian blare came every 20 minutes or so.

The confirmed Covid-19 case total in the Philippines breached the one million mark in late April. New daily cases were averaging about 7,700 this week, down from a peak of about 10,800 in mid-April, but that’s still considerably more than the previous high of about 4,400 in late August. And the Department of Health warned recently that the situation could quickly worsen again and the Philippines could face the “big possibility” of an “India-like” catastrophe.

Dire superlatives limn the costs of the state’s neglect. Figures for infections and deaths per capita in the Philippines are now the worst in Southeast Asia. The economic downturn here has been the steepest in the region . The country faces the most sluggish economic recovery .

I started counting sirens out of helplessness and rage; it was a desperate attempt to get a handle on what is really happening on the ground, given competing accounts and confounding official policies.

At the height of the recent surge, the government claimed that around 14 percent of beds in intensive care units in Metro Manila were still available , even as social media feeds were flooded with calls for help and stories of patients being taken to facilities four or five hours away because of long waiting lists.

The health care system is buckling after decades of austerity and privatization . But more than anything, the culprit is the Duterte administration’s penchant for solutions anchored in brute force and draconian control rather than science and concern for the public’s welfare.

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Philippines

Filipinos and nationalism during the covid-19 pandemic, filipinos helping fellow filipinos.

As COVID-19 strikes the Philippine nation, people rise together to counter it. At the forefront of the fight against the virus are our healthcare workers and various frontliners. Daily, they face the hazard of infection with their mantra: “We go to work for you. Please stay at home for us.”

Healthcare workers who directly work with COVID-positive patients are outnumbered; and due to their first-hand exposure, some staff require quarantine themselves - reducing their numbers. Another big challenge for frontliners is the lack of medical supplies including Personal Protective Equipment (PPEs).

Community quarantine and social distancing has not hindered our kababayans in looking for ways to help with the battle. Different groups, individuals, classmates, colleagues - groups big and small - have come together, despite limited resources and movement. Showing everyone that we are all #InThisTogether.

Asia 21 Young Leaders , Darwin Mariano and Harvey Keh , used their platform, Ticket2Me – The Kaya Natin! Movement in coordination with the Office of the Vice President to help raise funds in order to purchase PPEs, other medical supplies, and care/food packs needed by our health workers and frontliners.

“Each PPE Daily Set Ticket consists of one N95 mask, one gown, two sets of gloves, two pieces of head covers, two sets of shoe covers and one pair of goggles. This is only good for one (1) health worker. Each Food and Care Pack Ticket will help one health worker/frontliner per day. All donors will receive an electronic ticket from our ticketing platform as proof of donation to the Kaya Natin! Movement. Ticket2Me has waived its service fees for this campaign but third-party payment gateway service fees will apply. These service fees are charged by the system's various payment partners including: the credit card processing bank, PayPal, GCash, 7-Eleven, MLhuillier, Cebuana Lhuillier or ECPay. To observe social distancing, online donations are coursed through our #AngatBuhay partner Kaya Natin!”

As of March 24, 2020, The Kaya Natin! Movement has reached PhP28,868,752.79 and have already distributed 23,475 daily sets of PPEs to 1,565 workers.

Ticket2Me is not the only platform and group reaching out to help our frontliners and our most at risk. Netizens have come together to compile organizations seeking donations and assistance through a collaborative spreadsheet HOW TO HELP OUT DURING COVID-19 CRISIS. The list includes drives for frontliners, our affected daily wage earners, homes for the elderly, and our most at risk.

Here are some of the organizations (catering to frontliners) you can donate to:

1. Tulong Kabataan – UP Manila

- What they need: Asking for masks and alcohol

- Who are they helping: patients, healthworkers, and interns of Philippine General Hospital

- Contact Details: +639082111437

2. Philippine General Hospital

- What they need: Personal Protective Equipment (n95 mask, surgical mask, face shield, surgical gowns) 70% Ethyl Alcohol

- Who are they helping: Frontliners (Healthcare Workers)

- Contact Details: Dr. Mia Tabuñar (Coordinator for Resource Generation) 09193506917

3. Ospital ng Muntinlupa

- What they need: Asking for N95 masks, face shields, 70% Ethyl Alcohol, surgical gown, clean/sterile gloves

- Contact Details: Dr. Edwin Dimatatac - 09176294301

4. Philippine Association of Medical Technologists, Inc. (PAMET)

- Contact Details: PAMET Secretariat -  (02) 8817-1487  / 09178901118

5. National Children’s Hospital (NCH)

- What they need: PPE, N95 masks, face shields, 70% Ethyl Alcohol, surgical gown, clean/sterile gloves

- Who are they helping: Frontline government workers and healthworkers

- Contact Details: Dr. Jennifer Gianan, Chief Resident - National Children's Hospital 09176392278 or at 264 E. Rodriguez Ave., New Manila, QC Swift Code - BOPIPHMM

6.  #ProtectTheFrontline

- What they need : Asking for Surgical masks, surgical gloves, surgical caps, PPE set, N95 masks, protective goggles, plastic boots, plastic aprons, disposable gowns, face shields, scrub suit, alcohol, soap, food, hazmat suits

- Who they are helping: Frontliners

We salute all the people who are trying their best to fight this crisis for fellow Filipinos. There are many ways to support our frontliners and each other during this time. However, one of the best ways to help them is by KEEPING HEALTHY and STAYING AT HOME . 

#ProtectTheFrontline

We are here and we are #InThisTogether.

The Kaya Natin! Movement

If interested in donating click here  for more details

You can also contact them at [email protected] or +639985968820

How to Help Out During Covid-19 Crisis

If interested in sharing information or donating to organizations – click here  for more details

To show your appreciation for our medical frontliners, click here  for more details

The Philippine economy under the pandemic: From Asian tiger to sick man again?

Subscribe to the center for asia policy studies bulletin, ronald u. mendoza ronald u. mendoza dean and professor, ateneo school of government - ateneo de manila university @profrum.

August 2, 2021

In 2019, the Philippines was one of the fastest growing economies in the world. It finally shed its “sick man of Asia” reputation obtained during the economic collapse towards the end of the Ferdinand Marcos regime in the mid-1980s. After decades of painstaking reform — not to mention paying back debts incurred under the dictatorship — the country’s economic renaissance took root in the decade prior to the pandemic. Posting over 6 percent average annual growth between 2010 and 2019 (computed from the Philippine Statistics Authority data on GDP growth rates at constant 2018 prices), the Philippines was touted as the next Asian tiger economy .

That was prior to COVID-19.

The rude awakening from the pandemic was that a services- and remittances-led growth model doesn’t do too well in a global disease outbreak. The Philippines’ economic growth faltered in 2020 — entering negative territory for the first time since 1999 — and the country experienced one of the deepest contractions in the Association of Southeast Asian Nations (ASEAN) that year (Figure 1).

Figure 1: GDP growth for selected ASEAN countries

And while the government forecasts a slight rebound in 2021, some analysts are concerned over an uncertain and weak recovery, due to the country’s protracted lockdown and inability to shift to a more efficient containment strategy. The Philippines has relied instead on draconian mobility restrictions across large sections of the country’s key cities and growth hubs every time a COVID-19 surge threatens to overwhelm the country’s health system.

What went wrong?

How does one of the fastest growing economies in Asia falter? It would be too simplistic to blame this all on the pandemic.

First, the Philippines’ economic model itself appears more vulnerable to disease outbreak. It is built around the mobility of people, yet tourism, services, and remittances-fed growth are all vulnerable to pandemic-induced lockdowns and consumer confidence decline. International travel plunged, tourism came to a grinding halt, and domestic lockdowns and mobility restrictions crippled the retail sector, restaurants, and hospitality industry. Fortunately, the country’s business process outsourcing (BPO) sector is demonstrating some resilience — yet its main markets have been hit heavily by the pandemic, forcing the sector to rapidly upskill and adjust to emerging opportunities under the new normal.

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Second, pandemic handling was also problematic. Lockdown is useful if it buys a country time to strengthen health systems and test-trace-treat systems. These are the building blocks of more efficient containment of the disease. However, if a country fails to strengthen these systems, then it squanders the time that lockdown affords it. This seems to be the case for the Philippines, which made global headlines for implementing one of the world’s longest lockdowns during the pandemic, yet failed to flatten its COVID-19 curve.

At the time of writing, the Philippines is again headed for another hard lockdown and it is still trying to graduate to a more efficient containment strategy amidst rising concerns over the delta variant which has spread across Southeast Asia . It seems stuck with on-again, off-again lockdowns, which are severely damaging to the economy, and will likely create negative expectations for future COVID-19 surges (Figure 2).

Figure 2 clarifies how the Philippine government resorted to stricter lockdowns to temper each surge in COVID-19 in the country so far.

Figure 2: Community quarantine regimes during the COVID-19 pandemic, Philippine National Capital Region (NCR ), March 2020 to June 2021

If the delta variant and other possible variants are near-term threats, then the lack of efficient containment can be expected to force the country back to draconian mobility restrictions as a last resort. Meanwhile, only two months of social transfers ( ayuda ) were provided by the central government during 16 months of lockdown by mid-2021. All this puts more pressure on an already weary population reeling from deep recession, job displacement, and long-term risks on human development . Low social transfers support in the midst of joblessness and rising hunger is also likely to weaken compliance with mobility restriction policies.

Third, the Philippines suffered from delays in its vaccination rollout which was initially hobbled by implementation and supply issues, and later affected by lingering vaccine hesitancy . These are all likely to delay recovery in the Philippines.

By now there are many clear lessons both from the Philippine experience and from emerging international best practices. In order to mount a more successful economic recovery, the Philippines must address the following key policy issues:

• Build a more efficient containment strategy particularly against the threat of possible new variants principally by strengthening the test-trace-treat system. Based on lessons from other countries, test-trace-treat systems usually also involve comprehensive mass-testing strategies to better inform both the public and private sectors on the true state of infections among the population. In addition, integrated mobility databases (not fragmented city-based ones) also capacitate more effective and timely tracing. This kind of detailed and timely data allows for government and the private sector to better coordinate on nuanced containment strategies that target areas and communities that need help due to outbreak risk. And unlike a generalized lockdown, this targeted and data-informed strategy could allow other parts of the economy to remain more open than otherwise.
• Strengthen the sufficiency and transparency of direct social protection in order to give immediate relief to poor and low-income households already severely impacted by the mishandling of the pandemic. This requires a rebalancing of the budget in favor of education, health, and social protection spending, in lieu of an over-emphasis on build-build-build infrastructure projects. This is also an opportunity to enhance the social protection system to create a safety net and concurrent database that covers not just the poor but also the vulnerable low- and lower-middle- income population. The chief concern here would be to introduce social protection innovations that prevent middle income Filipinos from sliding into poverty during a pandemic or other crisis.
• Ramp-up vaccination to cover at least 70 percent of the population as soon as possible, and enlist the further support of the private sector and civil society in order to keep improving vaccine rollout. An effective communications campaign needs to be launched to counteract vaccine hesitancy, building on trustworthy institutions (like academia, the Catholic Church, civil society and certain private sector partners) in order to better protect the population against the threat of delta or another variant affecting the Philippines. It will also help if parts of government could stop the politically-motivated fearmongering on vaccines, as had occurred with the dengue fever vaccine, Dengvaxia, which continues to sow doubts and fears among parts of the population .
• Create a build-back-better strategy anchored on universal and inclusive healthcare. Among other things, such a strategy should a) acknowledge the critically important role of the private sector and civil society in pandemic response and healthcare sector cooperation, and b) underpin pandemic response around lasting investments in institutions and technology that enhance contact tracing (e-platforms), testing (labs), and universal healthcare with lower out-of-pocket costs and higher inclusivity. The latter requires a more inclusive, well-funded, and better-governed health insurance system.

As much of ASEAN reels from the spread of the delta variant, it is critical that the Philippines takes these steps to help allay concerns over the country’s preparedness to handle new variants emerging, while also recalibrating expectations in favor of resuscitating its economy. Only then can the Philippines avoid becoming the sick man of Asia again, and return to the rapid and steady growth of the pre-pandemic decade.

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Adrien Chorn provided editing assistance on this piece. The author thanks Jurel Yap and Kier J. Ballar for their research assistance. All views expressed herein are the author’s and do not necessarily reflect the views and policies of his institution.

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COVID-19 vaccines in the Philippine context

Several months and over 400,000 COVID-19 cases later, the Philippines has begun its long-awaited and promised process of acquiring vaccines as a means to end the pandemic. As early as April, President Duterte spoke optimistically of the prospects of a vaccine. Realistically, however, we must be aware of the realities of vaccination in the recent past in order to truly ensure its success.

Before looking at the advances of COVID-19 vaccine technology, it is important to look at the role immunization has played in the Philippine health care system. Indeed, this has been one of the cornerstones of preventive care for disease not just of childhood (mumps, chickenpox) but eventual adult concerns (HPV, pneumonia) as well. Yet despite the government’s Expanded Program on Immunization (EPI) and the National Immunization Program (NIP), the country has seen a drop in population coverage, leading to the resurgence of vaccine-preventable illnesses such as measles, diphtheria, and even poliomyelitis in the past decade. The Philippines’ circulating vaccine-derived polio cases in 2019-2020 placed us on a list with African countries struggling to end the transmission of this disease.

Many attribute the dismal immunization coverage to the dengue vaccine scandal, but while it doubtless eroded vaccines confidence in the Philippines, our immunization programs have actually been problematic long before Dengvaxia, failing to reach the coverage goal of 95 percent for many years now. The scandal only represented the nadir of what’s already been an alarming trend.

In fact, when it comes to timeliness of vaccination, the 2017 National Demographic and Health Survey showed only a 10.6 percent rate for all vaccines (ranging from 38 to 67 percent per vaccine). The gaps in delivery boil down to the quality and accessibility of our public health system, which, during the recent polio vaccinations, for instance, relied heavily on private sector support. It also faces a lot of challenges when it comes to maintaining the cold chain.

Looking forward to the COVID-19 vaccines, there have been major breakthroughs, the speed and complexity of which have never been encountered before. Of those nearing approval, there are two mRNA vaccines from Moderna and Pfizer—both requiring negative temperatures in their delicate handling. There are also the vector-based vaccines from Astra-

Zeneca and Gamaleya’s Sputnik V, as well as China’s inactivated vaccines developed by Sinopharm and Sinovac, all of which will only need normal refrigerated temperature.

Beyond the vaccine type, its corresponding handling, and the limitations of our health infrastructure, a major concern is the potential politicization of the acquisition, prioritization, and distribution protocols that will be put in place. There have been conflicting reports on who will be vaccinated first—health workers, vulnerable individuals, the poor, and uniformed personnel—according to different government agencies. There is also a need to address people’s concerns about the vaccines, from fears of being made “guinea pigs” to misconceptions about side effects and efficacy.

Surprisingly, there are reports of politicians having already received the vaccine, even if no emergency use authorizations have been granted by the local FDA. The vaccine “czar,” Gen. Carlito Galvez Jr., also mentioned that equitable access to the vaccine will only be achieved by 2022—an election year, which may bring about a predicament not unlike that of Dengvaxia in 2016, which some quarters allege was funded and launched for political considerations. These issues once again raise the danger of politicizing vaccination, especially if the process for prioritization will have potential interference from vested interests. With the urgency called for by the still uncontrolled pandemic, the success of not just the COVID-19 vaccine, but also of the entire vaccination institution in our country, hangs in the balance.

In the end, however, the solution for COVID-19 goes beyond vaccination. The World Health Organization reminds governments of the continuous need to strengthen their countries’ health system to provide for adequate testing, tracing, quarantine, treatment, and monitoring, aside from the provision of essential services. States must invest in public health to strengthen the infrastructure for pandemic preparedness, and to ensure the well-being of all, now more than ever.

Joshua San Pedro, MD, and Gideon Lasco, MD, PhD, are both physicians and anthropologists.

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How COVID-19 impacted vulnerable communities in the Philippines

Ditte fallesen.

When people around the world started to bear the brunt of the COVID-19 pandemic in mid-2020, the World Bank launched COVID-19 surveys to monitor the social and economic impacts of the pandemic on communities.   In the Philippines, the community survey conducted in collaboration with the Department of Social Welfare and Development (DSWD), provided important insights on how best to deliver pandemic response and recovery programs aimed at supporting the poorest and most vulnerable rural communities. Respondents included community volunteers and barangay (village) officials from some of the poorest communities identified through the country’s existing national community-driven development project . 

In August 2020, the first round of the community survey had 180 respondents representing 101 barangays. The second round in April 2021 had 200 respondents from 135 barangays across the three main group of islands—Luzon, Visayas, and Mindanao.  

Using a standard questionnaire developed to capture the community’s socio-economic conditions, respondents were asked to share their views on the situation in their communities. These results reflect the general observations of community leaders based on their perception and knowledge of their respective communities.  

Economic impact on communities  

COVID-19 has taken a heavy toll on rural livelihoods. Loss of income and job opportunities were overarching challenges in poor communities in the Philippines.     Disaster-prone communities experienced more difficulties in coping with COVID-19 restrictions and its severe economic impact. Results show the most pressing problems before and during COVID-19 were: 

• Lack of income opportunities and reduction of pay were pre-existing challenges but had worsened significantly due to the pandemic.  
• During the pandemic, communities reported continued insufficient food supply and health, sanitation, and nutrition issues.  

The economic impact of COVID-19 is particularly worrisome as the surveyed communities are already a subset of the poorest and most vulnerable communities in the Philippines. Following significant job and income losses, communities are at risk of further increases in poverty. 

In August 2020 , job losses were particularly severe in the construction sector (56%) and public transportation (52%) while cumulative job losses were seen among informal workers such as laundry women, hairdressers, and workers in small canteens; and in informal retail like “ sari-sari ” stores , street vendors, and markets. The farming sector also saw significant job losses reportedly in 70% of communities in formal agriculture and 61% in small-scale farming.  

The situation had somewhat improved by the second round of the survey in April 2021. The sector that saw the biggest improvements was retail, where reported incidence of job losses decreased by 13%. However, construction workers and public transport drivers continued to be most affected by job cuts (56% and 52% respectively). 

Social cohesion 

Seventy-four percent (74%) of communities did not observe any peace and order problems such as theft, crime, arguments, and community-level conflict because of COVID-19.  However, there was an increase in peace and order problems when the second round of the survey was carried out. This seemed to be mainly caused by loss of employment. While cases of COVID-related discrimination similarly increased, there was no increase in sexual harassment, rape, and domestic violence according to respondents. However, findings from an independent conflict monitoring system ( Conflict Alert ) covering a smaller area of the Philippines, the Bangsamoro Autonomous Region in Muslim Mindanao suggests there may be more vulnerable communities . The Conflict Alert data , based on police and media reports, reveals a significant increase in gender-based violence during the periods of strict COVID lockdown. 

Gender and women’s roles 

Half of the respondents found that women and men were equally affected by job and income losses, while 29% found that women were more affected. Women were also identified as one of the groups most in need of assistance because of COVID-19.  

Health and vaccine concerns 

In the Philippines, access to health care during the pandemic remained consistent, though a main challenge was the lack of medical supplies and PPEs, especially in the early phase. 

The survey finds that there was significant concern about vaccine safety (86%) and effectiveness (60%). Vaccine hesitancy was hampering the rollout of the vaccines in the country. Communities mainly trust doctors and health practitioners for information on vaccines. Though the respondents knew vaccines could prevent COVID-19, they were aware that health and risk mitigation protocols were still needed. While respondents generally found the government-issued rules and restrictions appropriate, they suggested that local governments should be more stringent and consistent in the enforcement of these health-related protocols. Vaccine hesitancy continues to be a challenge in the Philippines, and further analysis is being initiated to identify key incentives and constructive messaging. 

The results of the community survey, along with the firm and household surveys, were shared with the Philippine government and other stakeholders. Future rounds will strengthen the validity of results and will provide an opportunity for focusing on additional sub-themes, including gender and coping strategies, or new themes that emerge as relevant.  

The survey clearly highlights how poor and vulnerable rural communities are affected by the economic impacts of COVID-19. Going forward, we hope that the valuable insights into the situation and perceptions of the communities can help inform target policies as well as response and recovery programs.    

Learn more about the surveys monitoring COVID-19 impacts on families and firms in the Philippines: http://www.worldbank.org/philippines/covidmonitor  

Through additional financing for the Kalahi-CIDSS National Community Driven Development Project , the World Bank is supporting early recovery of rural poor communities from the pandemic. The Philippine government will undertake community-driven development projects that promote inclusive service provision and support economic recovery, such as cash-for-work programs and local economic development activities using the project’s Disaster Risk Operations Modality.  

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COVID-19 in the Philippines – at a Glance

• Marjorie Pajaron

This is the third installment in our series, “Stories in a Time of Pandemic,” in which APARC alumni across Asia share their perspectives on the responses to and implications of COVID-19 in their communities. In part 1 and part 2 of the series, we feature observations from our alumni in China, Mongolia, Myanmar, and Singapore.

The first case of COVID-19 in the Philippines was reported on January 30, 2020, and local transmission was confirmed on March 7, 2020. As of May 21, the number of cases of COVID-19 has risen to 13,434 and the number of deaths attributed to the virus increased to 846, according to the Philippine Department of Health COVID-19 Case Tracker . It is quite alarming that among the ASEAN countries, the Philippines had the second-highest mortality due to COVID-19, next to Indonesia (as per May 5 date by the WHO COVID-19 Dashboard ). This could be attributed to several factors, including whether the country’s health system can handle the overwhelming demand for health care due to the COVID-19 crisis and how effective the government’s response is in stemming the spread of this new pathogen. Inherent in the death statistics is the capacity of a country to conduct COVID-19 tests, which means that there should be a sufficient number of test kits available and that the health workers are properly trained to conduct the tests, trace the contacts, and isolate identified individuals.

The President of the Philippines imposed a total lockdown called enhanced community quarantine (ECQ) for the entire island of Luzon, which encompasses eight administrative regions, including the national capital region, from March 15 to April 30. Other parts of the country have also been under some degree of quarantine at different periods since the appearance of local transmission. Executive Order 112 , signed on April 30, 2020, was issued to further extend the ECQ in identified high-risk areas and a general community quarantine (GCQ) in the rest of the country. The inter-agency task force for the management of emerging infectious diseases defines ECQ as the implementation of temporary restrictions on the mobility of people, strict regulations of industries, and a heightened presence of uniformed personnel. GCQ is, in a nutshell, a less strict version of ECQ.

The Philippines has faced a lot of challenges during this crisis. First, the health system lacks adequate surge capacity to safely handle a nationwide outbreak of COVID-19 due to shortages of personal protective equipment (PPE), mechanical ventilators, and hospitals with ICUs and isolation beds (see this World Bank report and this Rappler article ). More importantly, the insufficient number of health workers , especially in areas outside the metropolitan, is a major concern. Nonetheless, the Department of Health has worked hard to meet the surge in demand due to COVID-19, including partnering with the private sector to repurpose structures and providing data to the public to ensure transparency and accountability. As in other countries, the health workers and those with frontline responsibilities have truly been the new heroes or “bayani” with their tireless efforts and sacrifices. 

Another challenge pertains to the adverse economic impact of COVID-19. The Philippines has a relatively large informal sector and the income of many families depends on daily transactions with no formal job or social security. This has prompted the government to extend cash or in-kind support to vulnerable populations – a response that has posed several challenges, particularly related to the who/what/how framework. First, the Philippine government had to properly identify those in need (who). Second, it had to ensure that sufficient resources can be allocated to the identified groups (what). And third, it had to distribute aid in an efficient, timely, and equitable way (how). The government's social welfare efforts to provide for the vulnerable groups have mixed results: at times, the distribution of aid is organized and efficient, at other times insufficient and disorderly (see these CNN Philippines reports of April 7 and April 30 ).

COVID-19 in the Philippines – How Filipinos Have Coped

There has been a strong spirit of “bayanihan” or collectivism in the country amidst the COVID-19 crisis. People are volunteering, distributing goods to vulnerable groups, or donating PPE to those with frontline duties. Some enterprises also rose to the occasion by repurposing their businesses to meet the local demand for medical products and PPE.

Different individuals have coped differently: some have welcomed the work hiatus that the quarantine has afforded them, some connected more with friends and family, others become more productive working from home. Staying healthy and being mindful are also factors that contribute to remaining calm and rational in this time of national distress.

Despite the challenges, we will continue to face, especially once the quarantine has eased and the new normal is in effect, we can say that Filipinos have also learned some valuable lessons amid this crisis. For one, Filipinos have become more mindful of the importance of good sanitation and non-pharmaceutical public health measures in mitigating the transmission of the virus. Most Filipinos have also become more proactive in their approach, keeping social distance, wearing masks, and practicing proper handwashing, among others. Furthermore, this crisis has redefined and created new heroes who rose to the challenge – from those staying at home to avoid the further spread of the virus to those on the frontline who have dedicated their time and effort to combat the pandemic, to government and business leaders who have served the country sincerely during this crisis.

Perhaps there really is a silver lining in every cloud.

Lessons from Mongolia’s COVID-19 Containment Strategy

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In these recent years, covid-19 has emerged as a major global challenge. It has caused immense global economic, social, and health problems. 

Writing a persuasive essay on COVID-19 can be tricky with all the information and misinformation. 

But don't worry! We have compiled a list of persuasive essay examples during this pandemic to help you get started.

Here are some examples and tips to help you create an effective persuasive essay about this pandemic.

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Examples of Persuasive Essay About Covid-19

The coronavirus pandemic has everyone on edge. You can expect your teachers to give you an essay about covid-19. You might be overwhelmed about what to write in an essay. 

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Here are a few examples to help get you started.

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

Check out some more  persuasive essay examples  to get more inspiration and guidance.

Examples of Persuasive Essay About the Covid-19 Vaccine

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• Case Report
• Open access
• Published: 14 April 2020

First COVID-19 infections in the Philippines: a case report

• Edna M. Edrada 1 ,
• Edmundo B. Lopez 1 ,
• Jose Benito Villarama 1 ,
• Eumelia P. Salva Villarama 1 ,
• Bren F. Dagoc 1 ,
• Chris Smith 2 , 3 ,
• Ana Ria Sayo 1 ,
• Jeffrey A. Verona 1 ,
• Jamie Trifalgar-Arches 1 ,
• Jezreel Lazaro 1 ,
• Ellen Grace M. Balinas 1 ,
• Elizabeth Freda O. Telan 1 ,
• Lynsil Roy 1 ,
• Myvie Galon 1 ,
• Carl Hill N. Florida 1 ,
• Tatsuya Ukawa 2 ,
• Annavi Marie G. Villanueva 2 ,
• Nobuo Saito 4 ,
• Jean Raphael Nepomuceno 2 ,
• Koya Ariyoshi 5 ,
• Celia Carlos 6 ,
• Amalea Dulcene Nicolasora 6 &
• Rontgene M. Solante 1  

Tropical Medicine and Health volume  48 , Article number:  21 ( 2020 ) Cite this article

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A Correction to this article was published on 07 May 2020

This article has been updated

The novel coronavirus (COVID-19) is responsible for more fatalities than the SARS coronavirus, despite being in the initial stage of a global pandemic. The first suspected case in the Philippines was investigated on January 22, 2020, and 633 suspected cases were reported as of March 1. We describe the clinical and epidemiological aspects of the first two confirmed COVID-19 cases in the Philippines, both admitted to the national infectious disease referral hospital in Manila.

Case presentation

Both patients were previously healthy Chinese nationals on vacation in the Philippines travelling as a couple during January 2020. Patient 1, a 39-year-old female, had symptoms of cough and sore throat and was admitted to San Lazaro Hospital in Manila on January 25. Physical examination was unremarkable. Influenza B , human coronavirus 229E, Staphylococcus aureus and Klebsiella pneumoniae were detected by PCR on initial nasopharyngeal/oropharyngeal (NPS/OPS) swabs. On January 30, SARS-CoV-2 viral RNA was reported to be detected by PCR on the initial swabs and she was identified as the first confirmed COVID-19 case in the Philippines. Her symptoms resolved, and she was discharged. Patient 2, a 44-year-old male, had symptoms of fever, cough, and chills. Influenza B and Streptococcus pneumoniae were detected by PCR on initial NPS/OPS swabs. He was treated for community-acquired pneumonia with intravenous antibiotics, but his condition deteriorated and he required intubation. On January 31, SARS-CoV-2 viral RNA was reported to be detected by PCR on the initial swabs, and he was identified as the 2nd confirmed COVID-19 infection in the Philippines. On February 1, the patient’s condition deteriorated, and following a cardiac arrest, it was not possible to revive him. He was thus confirmed as the first COVID-19 death outside of China.

Conclusions

This case report highlights several important clinical and public health issues. Despite both patients being young adults with no significant past medical history, they had very different clinical courses, illustrating how COVID-19 can present with a wide spectrum of disease. As of March 1, there have been three confirmed COVID-19 cases in the Philippines. Continued vigilance is required to identify new cases.

The novel coronavirus 2019 (COVID-19) is responsible for more fatalities than the severe acute respiratory syndrome (SARS) coronavirus, despite being in the initial stage of a global pandemic. It is thought that the index case occurred on December 8, 2019, in Wuhan, China [ 1 ]. Since then, cases have been exported to other Chinese cities, as well as internationally, highlighting concern of a global outbreak [ 2 ]. The first suspected case in the Philippines was investigated on January 22, 2020, and 633 suspected cases have been reported as of March 1. Of them, 183 were in the National Capital Region of Manila, of whom many were admitted to San Lazaro Hospital (SLH) in Manila, the national infectious disease referral hospital [ 3 , 4 ]. We describe the epidemiologic and clinical characteristics of the first two confirmed COVID-19 cases in the Philippines, including the first death outside China.

In this case report, we describe two cases: patient 1, the first confirmed COVID-19 case, and patient 2, the second confirmed case, even though the symptoms of patient 2 started first. The cases are presented based on reports from the clinicians involved in patient care and results of investigations available to them at the time. Figure 1 shows a timeline of symptoms for both patients according to the day of illness and day of hospitalisation.

Timeline of symptoms according to day of illness and day of hospitalisation

History prior to hospitalisation

Both patients were Chinese nationals on vacation in the Philippines travelling as a couple. They had no known comorbidities and reported no history of smoking. Patient 2, a 44-year-old male, reported fever on January 18, 2020, whilst the couple were residing in Wuhan, China. It was reported that he was in contact with someone that was unwell in Wuhan, but not that he had visited the seafood market. During January 20 to 25, they travelled from Wuhan via Hong Kong to several locations in the Philippines (Fig. 2 ). Patient 1, a 39-year-old female, developed cough and sore throat on January 21. Due to persistence of symptoms of patient 2, they travelled to Manila on January 25. In Manila, patient 2 was denied entry to a hotel because he was febrile and both patients were transferred to San Lazaro Hospital (SLH), the national referral hospital for infectious diseases [ 4 ]. On admission, patient 2 was classified as a COVID-19 person under investigation (PUI) based on his travel history and fever [ 2 ] and was transferred to a designated isolation area with negative pressure rooms. Patient 1 did not fit the PUI criteria due to absence of fever, but was also isolated because of possible exposure.

Travels of patient 1 and 2

Clinical course of patient 1

On admission to the ward on January 25 (illness day 5), patient 1 complained of a dry cough, but the sore throat had improved. She was awake and conversant with a blood pressure of 110/80, HR 84, RR 18 and temperature 36.8 °C. Her chest was clear. The remainder of the physical examination was unremarkable. Nasopharyngeal and oropharyngeal swab (NPS/ORS) specimens were collected and sent to the Research Institute for Tropical Medicine (RITM) in Muntinlupa City [ 5 ]. A chest radiograph was reported as unremarkable (Fig. 3 ).

Posteroanterior chest radiograph of patient 1, 27 January 2020 (illness day 7). Unremarkable

On January 27, the results were released of a commercially available respiratory pathogen multiplex real-time PCR for detection of pathogen genes on the NPS/OPS samples (FTD Respiratory pathogens 33, Fast Track Diagnostics) at the RITM Molecular Biology Laboratory. These assays reported detection of Influenza B viral RNA, human coronavirus 229E viral RNA, Staphylococcus aureus DNA and Klebsiella pneumoniae DNA. A 10-day course of oseltamivir 75 mg BID was given on the basis of the influenza result. The NPS/OPS specimen was then sent by RITM to the Victorian Infectious Disease Reference Laboratory (VIDRL) in Melbourne, Australia, for COVID-19 testing [ 6 ].

On January 29, further NPS/ORS specimens were collected and sent to the RITM. On January 30, the result of the initial NPS/OPS sent to VIDRL reported detection of 2019-nCoV (subsequently termed SARS-CoV-2) viral RNA by real-time PCR. The patient was thus identified by the Department of Health as the first confirmed COVID-19 case in the Philippines [ 6 ].

On illness days 6 to 10, she remained afebrile with minimal cough and clear breath sounds. During this time, real-time PCR for detecting SARS-CoV-2 was established at the RITM using the Corman et al. protocol [ 7 ]. Further NPS/OPS specimens collected on January 29 (reported on January 31) and January 31 (reported on February 2) also reported detection of SARS-CoV-2 viral RNA. On illness day 11, the patient reported resolution of symptoms. She remained afebrile and clinically stable apart from two episodes of loose watery stool on illness day 12. Further samples were collected on February 2 and 4. On February 8 (illness day 19), she was discharged when SARS-CoV-2 was no longer detected on an NPS/OPS sample.

Clinical course of patient 2

In contrast, patient 2 experienced a more severe clinical course. On admission (illness day 8), he reported fever, cough and chills. On examination, he was awake and conversant with a temperature of 38.3 °C, blood pressure of 110/80, HR 84, RR 18, and SpO 2 of 96% on room air. His chest was clear. The remainder of the physical examination was unremarkable.

A working diagnosis of community-acquired pneumonia and COVID-19 suspect was made. He was started on ceftriaxone 2 g intravenously (IV) once daily (OD) and azithromycin 500 mg OD. NPS/ORS specimens were collected and sent to the RITM. On January 27, the results of a respiratory pathogen real-time PCR detection panel performed at RITM on the NPS/OPS samples were released, reporting detection of Influenza B viral RNA and Streptococcus pneumoniae DNA. The NPS/OPS samples were sent to the VIDRL for additional testing. Oseltamivir 75 mg BID was commenced on the basis of the influenza result.

During illness days 9 and 10, his fever continued with occasional non-productive cough. He remained clinically stable apart from intermittent SpO 2 desaturations of 93–97% on 2–3 L/min of oxygen. On illness day 11, he developed increasing dyspnoea with reduced SpO 2 at 88% despite 8 L/min of oxygen via a face mask and haemoptysis and was noted to have bilateral chest crepitations. A chest radiograph was reported as showing hazy infiltrates in both lung fields consistent with pneumonia (Fig. 4 ). Meropenem 2 g IV three times a day (TDS) was commenced.

Posteroanterior chest radiograph of patient 2, 27 January 2020 (illness day 10). Hazy infiltrates in both lung fields consistent with pneumonia

On illness day 12, he became increasingly dyspnoeic, hypoxic and agitated and was intubated and sedated with a midazolam drip. An endotracheal aspirate (ETA) and a further NPS/OPS were collected and sent to the RITM. Vancomycin, 30 mg/kg loading dose followed by 25 mg/kg BD, was commenced with a working diagnosis of severe community-acquired pneumonia due to Streptococcus pneumoniae secondary to Influenza B infection, plus consideration of COVID-19 pending the ETA result. A complete blood count showed values within the normal range (Table 1 ). On illness day 13, he continued to be febrile (38.5–40.0 °C) with bibasal crackles. Vital signs were stable with adequate urine output. A chest radiograph was reported as showing worsening of pneumonia (Fig. 5 ).

Posteroanterior chest radiograph of patient 2, 30 January 2020 (illness day 13). Endotracheal tube in situ approximately 2 cm above the carina. There is worsening of the previously noted pneumonia

On illness day 14, increased crepitations in both lung fields were noted. Blood cultures showed no growth after 24 h of incubation. An HIV test was non-reactive. On this day, the RITM reported detection of SARS-CoV-2 viral RNA by real-time PCR from the NPS/OPS taken on illness day 12 and hence the 2nd confirmed COVID-19 infection in the Philippines. This result was later confirmed on February 4 on the initial admission sample sent to VIDRL.

On the morning of illness day 15, the patient remained febrile at 40 °C, with BP 110/70, HR 95, RR 30, SpO 2 99% with 80% FiO2, and adequate urine output. However, the patient’s condition deteriorated with the formation of thick sputum and blood clots in the ET tube. Despite frequent suctioning, the patient’s condition deteriorated. He was noted to have laboured breathing followed by a cardiac arrest. Despite several rounds of cardiopulmonary resuscitation, it was not possible to revive the patient. He was thus confirmed as the first COVID-19 death outside of China.

Discussion and conclusion

This case report describes the first two confirmed cases of COVID-10 in the Philippines and highlights several important clinical and public health issues. Despite both patients being young adults with no significant past medical history, they had very different clinical courses, illustrating how COVID-19 can present with a wide spectrum of disease [ 8 ]. Whilst patient 1 had a mild uncomplicated illness consistent with an upper respiratory tract infection and recovery, patient 2 developed a severe pneumonia and died.

One possible explanation for the differing clinical courses is the presence of co-infection. In both patients, the real-time PCR detection panel was reported to be positive for multiple pathogens. The Staphylococcus aureus and Klebsiella pneumoniae detected in patient 1 most likely represent bacterial colonisation, and it is unclear to what extent her presentation was due to influenza or COVID-19 or both. Patient 2 tested positive for COVID-19, Influenza B , and Streptococcus pneumoniae , all of which can cause respiratory infection and severe pneumonia. Unfortunately, sputum culture was not possible due to biosafety concerns. It is unclear which pathogen was the leading cause of death, but previous research has shown that outcomes of acute viral respiratory infection are worse if multiple pathogens are present [ 9 ]. This highlights the importance of testing for other respiratory pathogens in addition to COVID-19 in order to optimise antimicrobial therapy.

Patient 2 developed increasing dyspnoea on day 11 of illness, similar to the first COVID-19 case in the USA, where mild symptoms were initially reported with progression to pneumonia on day 9 of illness [ 10 ]. The median time from illness onset to dyspnoea in a case series in Wuhan was 8 days (range 5–13) [ 11 ]. The explanation for patient 2’s worsening condition and development of haemoptysis was progression of pneumonia rather than acute respiratory distress syndrome or pulmonary embolism, but it was not possible to perform a CT scan, additional laboratory tests or an autopsy to further assess this. Although he was treated with broad-spectrum antimicrobials, it is not clear if the outcome would have been better in a high-resource setting. Both patients were treated with oseltamivir in view of positive results for Influenza B . Further studies are required to establish the optimal treatment and role of antiviral medication for patients with suspected or confirmed COVID-19 infection.

Our cases contrast with the US case in terms of the relative paucity of lab data and time to receive results. Limited in-house testing was undertaken due to biosafety concerns. In the case of patient 2, the diagnosis of COVID-19 was not made until a day before the patient died. This was because SARS-2-CoV testing was being established in the Philippines at the time that the patients were admitted, and initial samples had to be sent to Australia. Although the delay of diagnosis is unlikely to have altered management, expansion of COVID-19 diagnostics including multiplex panels for other respiratory pathogens is urgently needed for prompt diagnosis of patients for screening of hospital personnel or other contacts.

Three SLH hospital staff who were caring for the patients developed symptoms and themselves became PUIs, but were later discharged following negative SARS-CoV-2 testing and symptom resolution. This highlights the risk of an outbreak in the hospital, or a ‘super-spreader’ scenario, as was observed in other settings during the early stages of the SARS coronavirus infections in 2003 [ 12 ]. In the case of SARS, as with COVID-19, SLH managed two cases and was able to contain the infection without further spread [ 13 ].

The third confirmed COVID-19 case was announced on February 3 from a sample taken on January 23, also a Chinese national who had travelled from Wuhan. She recovered and returned to China on January 31. Contact tracing has been undertaken of all three patients [ 14 ]. Despite travel to several locations in the Philippines whilst experiencing symptoms, as of March 1, there has not been any confirmed local transmission arising from these cases and the number of PUIs has decreased [ 3 ]. However, as infection can be mild or subclinical, local transmission cannot be excluded. Increasing the number of laboratories able to perform SARS-CoV-2 testing would allow better surveillance and improve detection of COVID-19 cases.

In conclusion, as of March 1, there have been three confirmed COVID-19 cases in the Philippines including the first death outside of China. No local transmission has been confirmed. Continued vigilance is required to identify new cases.

Availability of data and materials

Change history, 07 may 2020.

An amendment to this paper has been published and can be accessed via the original article.

Abbreviations

Coronavirus disease 2019

Novel coronavirus

Nasopharyngeal swab/oropharyngeal swab

Polymerase chain reaction

Person under observation

Research Institute for Tropical Medicine

Severe acute respiratory syndrome

San Lazaro Hospital

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Edna M. Edrada, Edmundo B. Lopez, Jose Benito Villarama, Eumelia P. Salva Villarama, Bren F. Dagoc, Ana Ria Sayo, Jeffrey A. Verona, Jamie Trifalgar-Arches, Jezreel Lazaro, Ellen Grace M. Balinas, Elizabeth Freda O. Telan, Lynsil Roy, Myvie Galon, Carl Hill N. Florida & Rontgene M. Solante

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Chris Smith, Tatsuya Ukawa, Annavi Marie G. Villanueva & Jean Raphael Nepomuceno

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Department of Microbiology, Faculty of Medicine, Oita University, Oita, Japan

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Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan

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Edrada, E.M., Lopez, E.B., Villarama, J.B. et al. First COVID-19 infections in the Philippines: a case report. Trop Med Health 48 , 21 (2020). https://doi.org/10.1186/s41182-020-00203-0

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100 days of COVID-19 in the Philippines: How WHO supported the Philippine response

Exactly 100 days have passed since the first confirmed COVID-19 case was announced in the Philippines on 30 January 2020, with a 38-year old female from Wuhan testing positive for the novel coronavirus. On the same day, on the other side of the world at the WHO headquarters in Geneva, WHO activated the highest level of alert by declaring COVID-19 as a public health emergency of international concern. The Philippine government mounted a multi-sectoral response to the COVID-19, through the Interagency Task Force (IATF) on Emerging Infectious Diseases chaired by the Department of Health (DOH). Through the National Action Plan (NAP) on COVID-19, the government aims to contain the spread of COVID-19 and mitigate its socioeconomic impacts. The Philippines implemented various actions including a community quarantine in Metro Manila which expanded to Luzon as well as other parts of the country; expanded its testing capacity from one national reference laboratory with the Research Institute of Tropical Medicine (RITM) to 23 licensed testing labs across the country; worked towards ensuring that its health care system can handle surge capacity, including for financing of services and management of cases needing isolation, quarantine and hospitalization; and addressed the social and economic impact to the community including by providing social amelioration to low income families. The World Health Organization (WHO) has been working with Ministries of Health worldwide to prepare and respond to COVID-19. In the Philippines, WHO country office in the Philippines and its partners have been working with the Department of Health and subnational authorities to respond to the pandemic. The country level response is done with support from the WHO regional office and headquarters.

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Surveillance is a critical component and is used to detect cases of COVID-19 as well as to understand the disease dynamics and trends and identify hotspots of disease transmission. The Department of Health included COVID-19 in the list of nationally notifiable diseases early in the outbreak to ensure that information was being collected to guide appropriate response actions. Existing surveillance systems were capitalized upon to speed up identification of cases as well as identify unusual clusters. Laboratory confirmation is a critical component of the surveillance system but cannot be the only sources of information. The non-specific symptoms and the novel nature of the disease means that the DOH, with support from WHO, are looking at all available information sources to guide response decision making. WHO also provided technical assistance to selected local government units to strengthen field surveillance for timely data for action at the local level.

Contact tracing

Infection prevention and control

Laboratory and therapeutics access

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Effective communication and engagement with communities is essential for people to understand the situation, know the situation and practice protective measures to protect their health, their family and the larger community. WHO supported and amplified DOH messaging by releasing various communication materials on the risk of COVID-19 and how people can protect themselves through social media and traditional media. WHO also worked with partners such as UNICEF and OCHA in reaching vulnerable groups, getting their feedback and understanding their information needs.

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With lots of moving equipment and supplies required for COVID-19, logistics support is an important part of the response. WHO provided technical support to the DOH in the recalibration of PPE requirements by using WHO projection tools, provided cost estimates, and advised on streamlining the distribution flow of PPEs and other essential supplies. WHO also supported DOH in the development of a commodities dashboard that provides real-time PPE stocks at the facility level, as well as assisted in building an information system for tracking essential COVID-19 commodities.

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Much more needs to be done to break the chain of COVID-19 transmission. Some of the challenges that the Philippines continues to face are containing transmission of infection, mitigating the impact in high risks communities and confined settings, as well as ensuring the uniform enforcement of non-pharmaceutical interventions that are already in place. The continuation of the community quarantine will have substantial social and economic impact and thus a heightened effort to control  transmission of infections through rigorous contact tracing, isolation of cases, quarantine of contacts while ensuring timely and adequate treatment to save lives will continue to be the primary public health measure. In addition, while the government is exerting all its efforts in this current situation, it also needs to prepare its health systems for surge capacity in the event that a wide-scale community transmission occurs.

In the next few days, the government will carefully consider the next steps, especially on deciding whether or not the communty quarantine will be lifted or levels of quarantine will be differentiated based on the situation of provinces. WHO strongly recommends that when the government considers adjusting public health and social measures in the context of COVID-19 the following requirements must be in place:

• COVID-19 transmission is controlled through two complementary approaches – breaking chains of transmission by detecting, isolating, testing and treating cases and quarantining contacts and monitoring hot spots of disease circulation
• Sufficient public health workforce and health system capacities are in place
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Viral video of a confused altercation on lockdown rules exposes fundamental errors in the Duterte administration’s pandemic response.

Manila, Philippines – Is lugaw – a savoury Filipino rice porridge – essential?

Filipinos have both laughed and fumed at the question for over a week now after a village official outside of Metro Manila apprehended motorcycle riders for waiting outside a restaurant past curfew during the current lockdown.

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Since March 29, the Philippine capital and its neighbouring provinces have returned to stricter lockdown to curb an alarming new wave of COVID-19 infections that has hit new records.

One of the riders, Marvin Ignacio, was about to deliver porridge to customers, who booked his services through a mobile app, when he was stopped. He reasoned that the food item belonged to the “essential goods” allowed by the government for delivery beyond curfew hours.

The village official, however, proceeded to lecture Ignacio on what qualified as essential. Unlike water, milk, and grocery items, the porridge was not essential because a person could last a day without it, the official insisted.

The official then ordered the restaurant to close down immediately, and the food delivery service riders waiting outside to go home.

Luckily for Ignacio, he had the whole incident on Facebook live video, and it went viral in a matter of hours, igniting an outcry and setting off several memes on social media.

“Anyone will tell you, it’s food. Food is essential. Lugaw is food. Therefore, lugaw is essential, right? It’s common sense,” Ignacio told Al Jazeera later on.

The office of President Rodrigo Duterte was forced to issue a statement on the incident, with his spokesman Harry Roque saying that the delivery of food items must remain unhampered, and should not be held up at checkpoints.

“The local regulation must be consistent” with national lockdown regulations, interior department spokesman Jonathan Malaya told Al Jazeera.

Heavy policing during a pandemic

The incident punctuated an anxiety-inducing week of record COVID-19 tallies, the highest of which was on April 2 with 15,298 new infections.

As of Tuesday, the government reported 152,562 active cases in the country, pushing the total over 800,000. The number of deaths also hit a record daily high of 382, bringing the total to more than 13,800 fatalities.

This randomized dot map shows the comparison in the number of active COVID-19 cases in the National Capital Region between March 8, 2021 and March 29, 2021. See original post here: https://t.co/K8U64V9YVF pic.twitter.com/68MMZYA6ph — University of the Philippines (@upsystem) April 5, 2021

With the country already facing the sharpest economic decline since World War II and worsening unemployment, analysts say many Filipinos are growing more frustrated with the government’s failure to contain the virus after more than a year of repeated lockdowns.

“It really underscores the absurdity of the government’ lockdown policies. It pits the law enforcement perspective of the government against the basic necessities of people,” JC Punongbayan, an analyst from the University of the Philippines School of Economics, told Al Jazeera.

The government under Duterte has responded to the pandemic in much the same way as it did to other national problems: a law-and-order crackdown with heavy policing.

Duterte put former military and police generals in charge of key areas of his pandemic response, including contact tracing, vaccinations and social welfare, defying calls for him to enlist public health experts.

When the pandemic reached the Philippines in March 2020, Duterte enforced a lockdown on Manila and the surrounding provinces for nearly 5 months, one of the longest in the world.

BREAKING: DOH reports 15,310 new cases today, a new record-high ‼️ Active cases (now more than 150,000) have reached a new record-high for the 4th straight day ⚠️ 3,709 case backlogs from COVIDKaya were included today. Seven labs were not able to submit data. pic.twitter.com/EKwTUFHRVi — Edson (@EdsonCGuido) April 2, 2021

Evolving tiers of lockdowns

Much of the policymaking revolved around which types of businesses were allowed to operate under different tiers of lockdowns, where people may or may not travel, what modes of public transport should be allowed in the streets and how many people should board them.

Filipinos, concerned more about daily survival than watching the news, could barely keep track of the evolving lockdown tiers and rules. Stretched thin, the police and military were hardly consistent with implementation.

Because of the confusion, many people ended up inadvertently breaking lockdown rules, with police or village officials rounding them up and gathering them in halls where social distancing could scarcely be practised.

False dilemma

A year since the first lockdown began, the Philippines still finds itself unprepared for a sudden, dramatic increase in COVID-19 infections.

Hospitals in the capital region and nearby provinces have become so overcrowded they have had to turn away patients needing intensive care.

Critics blame the surge in cases on the government having relaxed mobility restrictions after the first lockdown without building up its public health capabilities.

Officials in charge of the pandemic response recently admitted that widespread testing for the coronavirus remains unfeasible, and contact tracing is “deteriorating” in many parts of the country.

The country’s COVID-19 vaccination drive is moving slowly, with only 0.8 percent of its 110 million people inoculated with at least one dose of the vaccine. Only some 28,000 Filipinos have been fully vaccinated as of the last count.

“The main problem, really, is that the government is primarily looking at this as a law enforcement issue, and you can tell that by the way they have beefed up checkpoints and curfews, but not the requisite testing, contact tracing and hospital capacity improvements,” Punongbayan said.

Earlier this year, the government planned to further loosen restrictions by allowing leisure establishments such as cinemas to reopen, despite warnings of new, more contagious COVID-19 variants. Economic managers said the country could no longer afford to keep businesses shuttered.

Now faced with a spike in infections likely driven by the new COVID-19 variants, the government has little else to fall back on but another lockdown.

By seeing the problem as a dilemma between protecting public health and salvaging the economy, the Philippines drove itself into a dead-end, says Punongbayan.

“That’s the wrong way to frame it. There’s really no trade-off between public health and the economy because the pandemic recession really stems from the health crisis first and foremost. Unless you solve the public health crisis first, you cannot expect the economy to recover anytime soon,” the economist said.

Scramble for jobs

The pandemic hit the then-burgeoning economy hard. The Philippines’ gross domestic product (GDP) contracted by 9.5 percent in 2020, and government data in February showed that 4.2 million Filipinos were unemployed.

Under lockdown yet again, even more Filipinos are expected to lose their income. With social welfare funds all but depleted, the government could only promise one thousand pesos ($20) worth of aid to poor individuals, and its rollout has just begun, more than a week after stay-at-home orders took effect.

The crunch has forced thousands of Filipinos to find work in the “essential” industries such as food and healthcare, even if they are overqualified for the job.

Ignacio, the food delivery worker at the centre of the controversy, has been working in the industry since 2018. He was in his third year studying to become a teacher in 2015 when financial burdens forced him to drop out.

Since the pandemic took hold, Ignacio noticed it has become much harder to book customers on the mobile app, even if a lot more people are staying home and having their meals delivered.

“So many people lost their jobs and businesses closed, it’s like they all joined the delivery service, so now there’s too many of us,” Ignacio said.

In a report published on its website, Singapore-based ride-hailing company Grab said some 115,000 people across Southeast Asia have signed up as a driver or delivery rider during the pandemic. Grab declined Al Jazeera’s request for figures specific to the Philippines.

A delivery guy’s troubles

With Filipino riders competing for every single booking on the app, they have little choice but to wait in front of restaurants – until dawn if necessary – for night owls to order lugaw.

It is not as if he enjoys being out and about in the middle of a pandemic, Ignacio said. He worries he might catch the virus and end up transmitting it to his wife, his three-year-old son, and his elderly father who lives with them.

“We’re part of what they call ‘front-liners’. But even if I’m nervous every time I ride out, I just tell myself that if I don’t go out and work, my family will have nothing to eat,” Ignacio said.

The run-in with the village official complicated things for Ignacio. The night following the incident, two large men from the village authority came to the restaurant and taunted and threatened Ignacio, blaming him for the distress his viral video caused their colleague.

He caught this on video, too.

“I didn’t mean to make them famous. It was all their fault, wasn’t it? I was just documenting what happened,” Ignacio said.

The village chief and the officials Ignacio encountered have since issued public apologies. The officials who accosted him have been suspended, the village chief said in a radio interview on Tuesday.

Still, Ignacio fears for his safety. Bulacan has gained notoriety for vigilante-style killings. In July 2019, Amnesty International reported that the province had become “the bloodiest killing field” in Duterte’s so-called “war on drugs”, with 827 people killed between July 2016 and February 2019.

“That’s really what comes to my mind. It’s not far-fetched, because I’ve offended some people in high places. They’re powerful,” Ignacio said.

The 23-year-old plans to stay home and not work for some time, at least until he feels people have moved on from the incident.

In any case, he will not be waiting for porridge orders at that restaurant near his house any more. The owner, Mary Jane Resurreccion, has closed the business for good.

In another time

Despite the public and the palace taking her and Ignacio’s side of the argument, Resurreccion thinks she has not heard the end of it.

Two consecutive nights of village authorities barking orders to shut down has traumatised the restaurant staff, she told Al Jazeera.

“I haven’t been able to sleep since it happened. That first night, I knew [the village officials] would come back. So now I’ve decided to just close shop. It’s not safe any more and you never know what might happen,” she said.

Resurreccion had already shut down some of her other restaurants that failed to do well during the pandemic. The branch in Muzon village had good business thanks to the delivery service riders. Although it saddens Resurreccion to close it down too, she thinks keeping it would be too risky.

“That’s just money. What if a life ends up lost? That would be something else. So I’ll just make the sacrifice. At least we’ve made our point,” she said.

Ignacio and Resurreccion say they are speaking up on behalf of countless other “little people” like themselves who get pushed around by people in power.

“They’re like flies hitching a ride on a buffalo. It’s too much. They ought to stop being abusive because they cause so many people to suffer, and it all goes unnoticed,” said Resurreccion.

Ignacio, who has resumed his studies through online classes, dreams of telling his story to his students someday, when he becomes a teacher.

“I hope my experience will motivate them to persevere no matter what,” he said.

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Examining persuasive message type to encourage staying at home during the COVID-19 pandemic and social lockdown: A randomized controlled study in Japan

• • We examined persuasive message types in terms of a narrator encouraging self-restraint.
• • Messages from a governor, an expert, a physician, a patient, and a resident were compared.
• • The message from a physician increased intention to stay at home the most.
• • The physician’s message conveyed the crisis of collapse of the medical system.

Behavioral change is the only prevention against the COVID-19 pandemic until vaccines become available. This is the first study to examine the most persuasive message type in terms of narrator difference in encouraging people to stay at home during the COVID-19 pandemic and social lockdown.

Participants (n = 1,980) were randomly assigned to five intervention messages (from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area) and a control message. Intention to stay at home before and after reading messages was assessed. A one-way ANOVA with Tukey’s or Games–Howell test was conducted.

Compared with other messages, the message from a physician significantly increased participants’ intention to stay at home in areas with high numbers of people infected (versus a governor, p  = .002; an expert, p  = .023; a resident, p  = .004).

The message from a physician―which conveyed the crisis of overwhelmed hospitals and consequent risk of people being unable to receive treatment―increased the intent to stay at home the most.

Practice implications

Health professionals and media operatives may be able to encourage people to stay at home by disseminating the physicians’ messages through media and the internet.

1. Introduction

The outbreak of the coronavirus disease 2019 (COVID-19) has emerged as the largest global pandemic ever experienced [ 1 ]. Experts have proposed that social lockdown will lead to improvements such as controlling the increase in the number of infected individuals and preventing a huge burden on the healthcare system [ [2] , [3] , [4] ]. Governments of many countries across the world have declared local and national social lockdown [ 4 , 5 ]. In April 2020, the Japanese government declared a state of emergency, which allows prefectural governors to request residents to refrain from unnecessary and nonurgent outings from home [ 6 ]. However, despite such governor declarations, people in various countries have resisted and disregarded calls to stay at home [ [7] , [8] , [9] ]. Because social lockdown is the only existing weapon for prevention of the pandemic until vaccines becomes available to treat COVID-19, behavioral change in individuals regarding staying at home is crucial [ 3 , 4 ]. Many news articles about COVID-19 are published daily by the mass media and over the internet. Such articles convey messages from governors, public health experts, physicians, COVID-19 patients, and residents of outbreak areas, encouraging people to stay at home. This is the first study to examine which narrator’s message is most persuasive in encouraging people to do so during the COVID-19 pandemic and social lockdown.

2.1. Participants and design

Participants were recruited from people registered in a survey company database in Japan. The eligibility criterion was men and women aged 18–69 years. Exclusion criteria were individuals who answered screening questions by stating: that they cannot go out because of illness or disability; that they have been diagnosed with a mental illness; or/and that they or their family members have been infected with COVID-19. A total of 1,980 participants completed the survey from May 9–11, 2020, when the state of emergency covered all prefectures in Japan. Participants were included according to the population composition ratio in Japan nationwide by gender, age, and residential area. Participants were randomly assigned either to a group that received an intervention message (i.e., from a governor, a public health expert, a physician, a patient, and a resident of the outbreak area) or to one that received a control message. The study was registered as a University Hospital Medical Information Network Clinical Trials Registry (number: UMIN000040286) on May 1, 2020. The methods of the present study adhered to CONSORT guidelines. The protocol was approved by the ethical review committee at the Graduate School of Medicine, University of Tokyo (number: 2020032NI). All participants gave written informed consent in accordance with the Declaration of Helsinki.

2.2. Intervention and control messages

We searched news articles about COVID-19 using Yahoo! JAPAN News ( https://news.yahoo.co.jp ), the largest Japanese news portal site. We also searched videos posted by residents of outbreak areas such as New York using YouTube ( https://www.youtube.com/user/YouTubeJapan ). By referring to these articles and videos, we created five intervention messages from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area. The content of each message encouraged readers to stay at home. We included threat and coping messages in each intervention message based on protection motivation theory (PMT) [ 10 , 11 ]. Appendix A shows the five intervention messages used in this study, translated into English for this report. For a control message we obtained textual information about bruxism from the website of the Ministry of Health, Labour and Welfare ( https://www.e-healthnet.mhlw.go.jp/ ).

2.3. Measures

The primary outcome was intention to stay at home. The secondary outcomes were PMT constructs (i.e., perceived severity, vulnerability, response efficacy, and self-efficacy). Participants responded to two or three questions for each measure (see Appendix B ). These measures were adapted and modified from previous studies [ [12] , [13] , [14] , [15] ]. All primary and secondary outcomes were measured before and after the participants read intervention or control messages, and mean scores were calculated. Higher scores indicated greater intention and perception. All participants were asked for their sociodemographic information before they read intervention or control messages.

2.4. Sample size

Based on the effect size in a previous randomized controlled study [ 16 ], we estimated a small effect size (Cohen’s d  = .20) in the current study. We conducted a power analysis at an alpha error rate of .05 (two-tailed) and a beta error rate of .20. The power analysis indicated that 330 participants were required in each of the intervention and control groups.

2.5. Statistical analysis

A one-way analysis of variance (ANOVA) was conducted with the absolute change in mean values for each measure before and after intervention as the dependent variable and the group assignment as the independent variable. For multiple comparisons, Tukey’s test was conducted on significant main effects where appropriate. The Games–Howell test was performed when the assumption of homogeneity of variances was not satisfied. Additionally, we conducted subgroup analyses including only participants who lived in 13 “specified warning prefectures,” where the number of infected individuals showed a marked increase [ 17 ]. A p value of <.05 was considered significant in all statistical tests. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 21.0 (IBM, Armonk, NY, USA).

Table 1 shows the participants’ characteristics. Table 2 , Table 3 present a comparison among the five intervention groups using one-way ANOVA and multiple comparisons when including all prefectures and only participants who lived in the specified warning prefectures, respectively. More significant differences between intervention messages were found in the specified warning prefectures compared with all prefectures. In Table 3 , the Games–Howell test indicates that the message from a physician increased participants’ intention to stay at home significantly more than other narrators’ messages (versus a governor, p  = .002; an expert, p  = .023; a resident, p  = .004). Multiple comparisons demonstrated that the message from a physician increased participants’ perceived severity (versus a governor, p  = .015), response efficacy (versus a resident, p  = .014), and self-efficacy (versus a governor, p  = .022; a patient, p  = .009) significantly more than other narrators’ messages.

Participants’ sociodemographic information.

Comparison of amount of change before and after intervention among groups when including all prefectures (N = 1,980).

Comparison of amount of change before and after intervention among groups when including only the “specified warning prefectures” (N = 1,274).

4. Discussion and conclusion

4.1. discussion.

As Appendix A shows, the message from a physician specifically communicated the critical situation of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment. Depiction of the crisis of overwhelmed hospitals may have evoked heightened sensation that elicited sensory, affective, and arousal responses in recipients. Social lockdown presumably evoked psychological reactance in many individuals [ 18 ]. Psychological reactance is considered one of the factors that impedes individuals’ staying at home during a pandemic [ 18 ]. Studies of psychological reactance have indicated that heightened sensation is the feature of a message that reduces psychological reactance [ 19 , 20 ]. Additionally, in Japan recommendations by physicians have a strong influence on individuals’ decision making owing to the remnants of paternalism in the patient–physician relationship [ 21 ]. These may constitute the reasons for the message from a physician generating the greatest impact on recipients’ protection motivation.

Public health professionals, governors, media professionals, and other influencers should use messages from physicians and disseminate relevant articles through the media and social networking services to encourage people to stay at home. It is important that health professionals and media have a network and collaborate with one another [ 22 ]. To build relationships and provide reliable resources, health professionals are expected to hold press conferences and study meetings with journalists. Through such networking, journalists can acquire accurate information in dealing with the pandemic, such as using messages from physicians to encourage people to stay at home. Consequently, journalists should disseminate such messages. It is also important that governments, municipalities, medical associations, and other public institutions convey messages from physicians and that the media effectively spread those messages. Owing to the advances of Web 2.0 [ 23 ], health professionals’ grassroots communication with journalists and citizens via social media may provide opportunities for many people to access persuasive messages from physicians.

4.1.1. Limitations

First, the content of the intervention messages in this study may not represent voices of all governors, public health experts, physicians, patients, and residents of outbreak areas. Second, it is not clear from this study which sentences in the intervention message made the most impact on recipients and why. Third, this study assessed intention rather than actual behavior. Finally, it is unclear as to what extent the present findings are generalizable to populations other than the Japanese participants in this study.

4.2. Conclusion

In areas with high numbers of infected people, the message from a physician, which conveyed the crisis of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment, increased the intention to stay at home to a greater extent than other messages from a governor, a public health expert, a patient with COVID-19, and a resident of an outbreak area.

4.3. Practice implications

Governors, health professionals, and media professionals may be able to encourage people to stay at home by disseminating the physicians’ messages through media such as television and newspapers as well as social networking services on the internet.

This work was supported by the Japan Society for the Promotion of Science KAKENHI (grant number 19K10615).

CRediT authorship contribution statement

Tsuyoshi Okuhara: Conceptualization, Methodology, Formal analysis, Investigation, Writing - original draft, Funding acquisition. Hiroko Okada: Methodology, Investigation, Writing - review & editing. Takahiro Kiuchi: Supervision, Writing - review & editing.

Declaration of Competing Interest

The authors declare that there is no conflict of interest.

Acknowledgement

We thank Hugh McGonigle, from Edanz Group ( https://en-author-services.edanzgroup.com/ac ), for editing a draft of the manuscript.

Appendix A. 

Intervention: the message from a governor.

The following is a message from the governor of your local area.

Please avoid leaving your house as much as possible.

Staying at home can save lives and prevent the spread of infection.

Intervention: The message from an expert

The following is a message from an infectious disease control expert.

Intervention: The message from a physician

The following is a message from an emergency medical care doctor.

Intervention: The message from a patient

The following is a message from a patient who is infected with the novel coronavirus.

Intervention: The message from a resident

The following is a message from an individual who lives in an area where an outbreak of novel coronavirus has occurred.

A control message

According to the traditional definition, grinding one’s teeth is when somebody makes a sound by strongly grinding the teeth together, usually unconsciously or while asleep. Nowadays, it is often referred to as ‘teeth grinding,’ a term which also covers various actions that we do while awake.

Whether you are sleeping or awake, the non-functional biting habit of grinding one’s teeth dynamically or statically, or clenching one’s teeth, can also be referred to as bruxism (sleep bruxism if it occurs at night). Bruxism can be categorized into the movements of: sliding the upper and lower teeth together like mortar and pestle (grinding); firmly and statically engaging the upper and lower teeth (clenching); and dynamically bringing the upper and lower teeth together with a tap (tapping).

Bruxism is difficult to diagnose, as it often has no noticeable symptoms. Stress and dentition are thought to be causes of bruxism, but it is currently unclear and future research is anticipated.

Splint therapy, which involves the use of a mouthpiece as an artificial plastic covering on one’s teeth, and cognitive behavioral therapy are being researched as treatments for bruxism.

Appendix B. 

All questions above were on a scale of 1–6, ranging from “extremely unlikely” to “unlikely,” “a little unlikely,” “a little likely,” “likely,” and “extremely likely.”