Sigue: A brave new world

Disruptive Mode

MINDSET, as defined by Cambridge English Dictionary, is a set of assumptions, methods, or notations held by one or more people or groups of people. The novel coronavirus or Covid-19 is constantly challenging the mindset of Filipinos nowadays. I believe it is our only way to survive this pandemic -- by understanding our strengths and limitations as a country and identifying where we can have more headways rather than just watching events as they unfold.

It is a challenge to be writing this column amidst the disruption the Covid-19 caused the community. Indeed, we are at the portal of hopefully "a brave new world." It was just more than a week since the Department of Health has announced raising the alert level to Red Sublevel 1 which defines that a Sublevel 2 entails a "lockdown" as read from the DOH website. A few days later, the President raised the whole country to Sublevel 2 but used the term quarantine for the whole of Metro Manila.

The entire Luzon has been placed by the President under enhanced community quarantine this week. Now the number of positive cases has reached 187 and the deaths due to the virus have reached 14. In the DOH COVID Tracker, there are 251 Persons Under Investigation (PUIs) and 2,443 Persons Under Monitoring (PUMs) and only 4 recovered. Already 1,030 patients have been tested. The numbers show a slow system that is attributable to many factors. This isn't an article blaming anyone, but a piece to let us all realize we need to be smarter than ever before.

My perception is we lack the proper systems to face the situation. True, we are not prepared for this now is any country in reality but I still think we should scramble to adopt the "improve as we go" mindset and fix or put as many systems as we can to contain the spread of the virus.

At the moment, our biggest challenge is the number of test kits that we need to identify the virus and the turnaround time (TAT) or the time a specimen is received until the result is released. I had a very enlightening chat with a Negrense laboratory scientist who is currently in Taiwan as a virologist and is familiar with tests since his lab is making diagnostic test for viral infections. He shared with me his assessment about how Korea and Taiwan were able to contain the virus and that is because these countries were able to efficiently test sample with shorter turnaround time. Exactly, the same point that has been bothering me these past days. Sadly, the Philippines is not as equipped with the same capability as the two countries.

So far, the only process is Polymerase Chain Reaction (PCR). The laboratories make copies of the genome of the virus, then they sequence it. But PCR is very expensive, and not all medical personnel in hospital laboratories are trained to do the process since it is not part of the minimum skill requirement. The Research Institute of Tropical Medicine (RITM) could be the only laboratory capable of PCR at present. Just this week, the DOH announced four more institutions to conduct Covid-19 testing, namely, Southern Philippines Medical Testing in Davao, Vicente Sotto Memorial Medical Center in Cebu City. Baguio General Hospital and Medical Center in Benguet and San Lazaro Hospital in Manila.

The University of the Philippines (UP) has invented a test with a shorter TAT, but with the number of samples, it might take days for results to come out and although the UP kits have higher throughputs (more tests) and shorter TAT, the kits are still undergoing validation testing. A chat ended with his note about "if we survive this" which I would like to change to "when we survive this" -- "I think our government should invest more in research and development. Give incentives to scientists. It saddens me because I am using my skill to help Taiwan and not my country. Given my training, honestly, there is no place for me to work there. Even if I go back now, we are not equipped."

The protracted time in obtaining the results and even in transmitting the results now that the so-called "lockdown" of local government borders is in place -- adversely affect the containment strategies. There should also be a standard scenario coding which would ideally set turnaround time for procedures, in order to earn public confidence in reporting as soon as possible since they know how they will be handled. The DOH or any spokesperson may just use scenario code to report status of each patient without any excess statements and consolidation of big data may be used to study behavior of Covid-19 and understand cultural patterns through aggregated data in the different regions.

Our city and province today face a crisis like no other. Covid-19 has affected almost every country today. Facing this problem is not just anyone's responsibility but everyone's. Let us all join hands to fight the virus from spreading.


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