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Pandemic response under Duterte: Wasted opportunities, squandered gains

By DR. SATURNINO P. JAVIER Published Jul 21, 2021 12:42 pm

Almost a year and a half into the COVID-19 pandemic, we still grapple with uncertainties and anxieties. While there is some sense of cautious optimism in the air as we roll out the vaccines, there is simply no way we can put our guard down. 

In Makati Medical Center [MMC], there were three distinct COVID-19 surges. The first was in March-April  2020, then in July-August 2020 and finally in March-April this year. Each peak was higher than the previous one – leaving behind on its trails 99,600 suspected COVID-19 cases seen in the Emergency Department so far, nearly 15,000 confirmed positives and  nearly 300 deaths.

Even with the learnings of the last 17 months, we remain on edge whether or not we can stave off the onslaught of this unseen ferocious virus.

There were unseen yet  impactful effects on hospital leaders and healthcare workers — tired souls, drained faculties, frayed nerves and waning stamina. Without a doubt, each peak wasted and exhausted everyone, as everyone witnessed how this viral menace could cause desolation and sorrow as it wreaked physical, mental, financial and emotional havoc on the lives of our patients, families and friends. The pandemic surely changed our lives, interfered with our careers and redefined our priorities and orientation. Yet, each episode certainly forced on everyone a number of diverse lessons  and enhanced our capabilities and strategies to mitigate the impact of this vicious virus.

Tricycle drivers and public utility riders receive their 2nd dose of Sinovac vaccine at a drive-through vaccination site at the CCP Complex in Pasay City on July 20, 2021. (The Philippine STAR/KJ ROSALES)

But even with the learnings of the last 17 months, some of which addressed our initial uncertainties and unanswered questions, we remain on edge whether or not we can stave off the onslaught of this unseen ferocious virus – as we shudder at the  images of India and Indonesia and their healthcare systems being overwhelmed and crippled by the highly transmissible variant of COVID-19.

While vaccination clearly remains a free and individual choice by each one of us, we can only heed the judgment and recommendation of most local and international experts – 'the best vaccine is what is available.'

We confronted the pandemic in the first quarter of 2021 with two course-altering and game-changing scenarios: the variants  [mutated COVID-19 viruses] and the vaccines. With several COVID-19 variants already in our shores – Alpha [UK], Beta [South Africa] and the dreaded Delta [India] among others, the specter of more [and deadlier] COVID-19 infections seemed imminent, if not yet prevalent. As the variants lurked, the initial roll-out of the Covid-19 vaccine took place. 

Variant or Vaccine? Which shall emerge triumphant? In this arena, everyone in the community is a participant. Inevitably, our individual decisions and collective disposition toward the vaccines and the variants will be aided in no small way by science and technology, political will, and governance. All these will help determine which of the two major pandemic elements will emerge as victorious or vanquished. While vaccination clearly remains a free and individual choice by each one of us, we can only heed the judgment and  recommendation of most local and international experts –  “the best vaccine is what is available.” 

Does it even matter what pandemic wave we are in – when some things never change?

When we experienced the massive surge this year, I mused, through official posts issued to the MMC medical community Viber group which had also served  as a cathartic avenue for musings and insights, frustrations and outbursts: “Does it even matter what pandemic wave we are in – when some things never change?  We just keep confronting this menacing virus whose exponential upward trajectory makes the country one of the worst hit in the region?” 

For many months, we remained vulnerable – and scared sometimes. We were caught in the throes of helplessness and misery as more patients came in droves in our emergency room, as more souls begged to be admitted when our bed capacity would not allow it, as more weary families waited in horror and agony as their loved ones got worse – or died. Our healthcare workers continued to be infected – though in much less numbers compared to last year [if that was any consolation]. 

As MMC medical director, I occasionally get jolted by the ringtones or successive messages of my phone at the height of the surge. Whenever the cellphone sounded off in the middle of the night, or a series of SMS came in, I ventured somehow – “will this be another urgent pleading  for admission, or for acceptance of transfer from another hospital?” 

Individuals hoping to be inoculated with their 1st dose of the COVID-19 vaccine endure long lines and bad weather as the queue from the San Andres Sports Complex vaccination site reaches Quirino Avenue in Manila on Tuesday morning. (The Philippine Star/Miguel de Guzman)

To be able to do nothing when one is in power and position can be the most disconcerting and frustrating component of an already exhausting situation.

It was a period of unexpected calls and unwarranted pleas  from high school classmates I last saw or heard from more than three or four decades ago, or from professors or colleagues I have never seen in ages. You knew things were bad when the earnest request had now been channeled through  your children who had been cajoled and urged to ask their father if a room or bed could be provided for their classmates’ father or relative who badly needed to be admitted. 

To be able to do nothing when one is in power and position can be the most disconcerting and frustrating component of an already exhausting situation. My  heart breaks, but my willingness and resolve find no meaning – when the MMC Emergency Room teems with some 30 patients all waiting to be admitted, many of them on ventilators and requiring ICU confinement. 

Through a system of community quarantine that is touted one of the longest, we should have made some headway with what we had achieved in the latter part of 2020 and early part of 2021.

Undoubtedly, all of these reasons could have contributed to the chaotic situation. Add one more – which is the need for good governance and political resolve.

Many were quick to blame the people for their failure to comply with public health measures. Many  justified the surge due to quarantine fatigue and compliance exhaustion. Authorities pointed to returning workers and  residents – even foreigners. And certainly the mutations - and the ensuing virulence of the COVID-19 variants - undoubtedly added to the vicissitudes of our existence. 

Undoubtedly, all of these reasons could have contributed to the chaotic situation. Add one more – which is the need for good governance and political resolve to uplift all of us from the quagmire of frustration and desperation. One thus wonders if we seem to waste valuable opportunities and squander precious gains.

Questions arise – “Did we miss the opportunity to procure those vaccines ahead of time – to give our communities at  least the much needed protection? Did we entrench ourselves in too much bureaucracy which prevented well-intentioned sectors from immediately procuring the much needed vaccines for their constituents? Did we put more premium on personal favors and gains rather than the welfare of the people? Did we not decide well enough and early enough to gain advantage over the unseen enemy?”

One eternally wonders if these questions will ever find the right answers. Meanwhile, we brace ourselves for what may yet to come. Thus, we continue to maintain a state of  heightened preparedness and sustained readiness in our daily grind in the hospital – as the threat of our worst [delta] nightmare remains.