GOVERNANCE MATTERS
Former Vice President Jejomar Binay
We seem to be hearing more bad news than good news these days, and these do not bode well for government’s optimistic scenario of a jumpstarted economy by the second quarter of the year.
The scenario is dependent on two factors. One is the timely arrival of vaccines purchased by government and the private sector. With sufficient vaccines, government is confident it would then be able to meet its target of vaccinating 58 million Filipinos, scaled down from 70 million, by the end of the year. But this is conditional on vaccine manufacturers meeting their commitments. The latest announcement both from senior government officials and business leaders is that the deliveries have been pushed back to July and August. No reasons were given for the delay, although by most accounts, the COVID situation in India, where several manufacturing plants are located, is affecting vaccine production.
The second condition, however, is beyond government’s control. It relies on a scenario where infections are brought down to a manageable level. It assumes that the concerned government agencies have already learned from the past year and is in a better position to prevent a repeat of the surge that prompted government to impose a hard lockdown in Metro Manila and the rest of Luzon, effectively shutting down the country’s economic centers.
By now, government should realize that waging war against an unseen enemy that has managed to replicate and form new mutations is akin to a war of attrition, a prolonged conflict where the terms of engagement is dictated by the virus. Government can control it through a limited arsenal that includes enforcing compliance with health standards, testing, contact tracing, and vaccination. But a decisive victory is far from attainable in the coming months or even years.
The presence of new and more contagious variants poses new challenges and difficulties. Indeed, while the Department of Health (DOH) has recorded a decline in the number of infections in Metro Manila, but not enough to confidently warrant a downgrade in quarantine restrictions, cases are rising at alarming rates elsewhere, notably in some parts of Luzon and key cities in Visayas and Mindanao. In Iloilo City, for example, all hospitals are said to be at full capacity. The same situation prevails in other localities, and their officials are imploring the national government to give them more vaccines so they can inoculate more residents.
But the current vaccine supply, all of them donations from rich countries, are insufficient to meet the demands of local officials in these critical areas. It is not even sufficient to vaccinate essential workers, whose protection from infections will help boost economic recovery.
Why has it reached this point? A health experts observed that while government placed all its efforts in containing the surge in NCR Plus, it failed to act on danger signs in other parts of the country already noted in mid-May.
What should concern our government is the capacity of hospitals and health facilities in the provinces to handle a surge of the same magnitude as the one that recently brought Metro Manila and the other provinces comprising NCR Plus to a standstill.
There are not enough hospitals and health workers outside Metro Manila. That is a fact. According to a 2018 health assessment report released by the World Health Organization (WHO), hospitals and other health facilities, and health workers are largely concentrated in Metro Manila and major cities. Said the report, “Almost two thirds of hospital beds are in the island of Luzon, which includes the National Capital Region (NCR). There are 23 hospital beds for 10,000 people in the NCR while the rest of Luzon, Visayas and Mindanao have only 8.2, 7.8 and 8.3 beds, respectively.”
At the peak of the surge last year and in March this year, Metro Manila hospitals were treating infected patients in hallways, driveways, and open parking lots. Those who were turned away, including non-COVID cases, were forced to seek medical treatment in nearby provinces which were also near to full capacity.
Imagine if such a surge would occur in areas where hospitals have limited facilities, bed capacity, and manpower. Imagine that these underfunded hospitals are forced to deal with a rush of infected cases from adjacent provinces where there are no health facilities to speak of. The toll would be devastating.
These and other concerns critical to economic recovery are matters of health management, which fall within the jurisdiction of the DOH. Unfortunately, the department’s leadership has exhibited since last year a management acumen thus far untarnished by competence, urgency, and foresight. Unless drastic steps are taken to steer the compelling aspect of health management in a manner that is proactive, focused, and competent, I am afraid we will be in for more bad news.