The Philippine government’s health ministry revealed last week that at least 1,245 health workers across the country had tested positive for the coronavirus.
Department of Health Undersecretary Maria Rosario Vergeire said that among the infections were 471 nurses, 464 doctors, 69 nursing assistants, 41 medical technologists, 25 radiologic technologists, and 10 midwives. Already 21 doctors and six nurses have died from the virus.
Figures from the John Hopkins University and Medscape showed that Philippine healthcare professionals have the highest death rate from COVID-19 in the world.
According to a Reuters report last week, the World Health Organisation (WHO) had pointed to the country’s lack of adequate protective gear for medical personnel at an early stage of the crisis. Abdi Mahamud, the COVID-19 incident manager for the WHO Western Pacific Region, described the vulnerability of health workers to the virus as a “worrisome trend,” and an indicator of what lies ahead for the country’s healthcare system.
Mahamud concluded that the rate of infection among health workers, which is now 13 percent of all cases in the Philippines, is probably linked to the shortage of personal protective equipment (PPE) and high levels of exposure to the coronavirus among infected individuals.
Medical workers had sounded the alarm over an extreme shortage of equipment for several weeks before the government announced it would aim to produce 10,000 sets of PPE daily, news website Rappler reported. Government purchases of at least a million PPEs for health workers over the past month have proven inadequate to meet the demands of overwhelmed hospitals.
Frontline health workers have, in addition, been demanding regular staff testing and more trained employees in dealing with the outbreak for months. Protests have taken place at various locations across the archipelago nation, including the National Children’s Hospital in Manila in February.
More significant than the shortage of equipment, however, is the chronic lack of doctors and nurses. In a country renowned for medical professionals moving to advanced Western countries to escape low wages, there are six doctors and eight nurses for every 10,000 people, in a population of 109 million.
For decades, successive Philippine governments and private nursing schools have actively marketed the nursing profession as a stepping stone towards emigration. This has encouraged thousands of Filipino youth to invest in nursing degrees, only to find a shortage of permanent positions in hospitals after graduation.
Instead of bringing newly-qualified professionals into the depleted healthcare system, governments disbursed small funds to hire nursing graduates on three-month contracts with no promise of renewal, as Channel News Asia explained in a commentary last month. Labour officials waged a campaign in which unemployed medical graduates were urged to apply for other, more lucrative health-related industries in the private sector.
Consequently, hospitals and other health facilities are now being pushed to breaking point by the COVID-19 crisis. The Department of Health has called on workers to volunteer as hospital nurses, offering an allowance of $US10 per day, with no health insurance or benefits.
Quarantine capacity at airports is similarly unprepared for the scale of the pandemic. Overseas workers are currently unable to return home due to a temporary suspension of all commercial flights in and out of the country, which began yesterday. Over 24,000 Filipinos working abroad have so far placed immense pressure on quarantining, the Straits Times wrote, with an estimated 250,000 more expected to return in the coming weeks.
The decision has left hundreds of thousands of migrant workers, most of them jobless, marooned in other countries. Many are confused by the abrupt order, after ambiguous instructions were originally issued by government officials.
Roldan Abarentos, a seaman, expressed on a Facebook post the frustration of thousands of migrant workers: “As seafarers, we really want to go home. We’re stuck in the ship, and now again [the government] makes a decision without any further notice!”
As of yesterday, the Philippines had reached a total of 9,223 cases and 607 deaths. Due to the low rate of testing, and the speed of transmission from island to island, the real total is likely far higher.
Crematory workers have been inundated with dead bodies, most of which had never been tested and were, therefore, not counted in the official COVID-19 death toll. As they were suspected victims of the virus, the bodies are still wrapped in plastic and treated with caution.
Families of the victims are denied traditional death rites in favour of hurried, impersonal cremations. Virus restrictions often mean they are forbidden even a last look at their loved ones. People asking for the ashes of their relatives cannot be certain as to whose remains they are receiving, due to the hurried methods of cremation.
Romeo Uson, a 54-year-old worker at a Manila crematorium, told Agence France-Presse that his facility has been conducting six to seven cremations a day since March, double the usual number.
Viral hotspots tend to be underdeveloped and impoverished neighbourhoods in the major cities. Despite lockdown measures and a month-long quarantine of the island of Luzon through April, widespread community transmission continues throughout the poor districts of Metro Manila.
Prisons have been severely affected, with outbreaks of the virus infecting both inmates and staff. On Saturday the government ordered the release of nearly 10,000 inmates in a bid to ease congestion in the country’s most overcrowded jails in Metro Manila, as well as the Visayas and Mindanao regions.
Social distancing is all but impossible in the Philippine prison system, where cells are sometimes filled to five times their capacity due to totally inadequate infrastructure and a slow-moving and overburdened judicial system. Quezon City Jail is a facility so crowded that inmates take turns sleeping on staircases and open-air basketball courts.
Prison overcrowding is a direct result of President Rodrigo Duterte’s “war on drugs” launched in 2016, which has sent thousands to prison.
For the past four years, Duterte has repeatedly threatened to impose nationwide military rule over the Philippines, evoking the nation’s memory of the decade-long Marcos dictatorship. He is now seeking to utilise the social crisis caused by the pandemic to justify the further implementation of police state measures, as a means of suppressing any form of opposition to the government.
Police said they have arrested more than 100,000 people since the lockdown was first declared. Videos showing curfew violators being abused by police officers quickly went viral on social media.
Strict social distancing measures in Manila have meant that residents who are not essential workers are only permitted to leave home for food or healthcare. But large sections of the Philippine working class, with no current source of income, have no choice but to seek work.
In a televised address on April 16, Duterte addressed the public in the following manner: “I’m just asking for a little discipline. If not, if you do not believe me, then the military and police will take over. The military and police will enforce social distancing and curfew… It’s like martial law. You choose.”
Duterte went on: “My orders to the police and military… ‘If there is trouble and there’s an occasion that they fight back and your lives are in danger, shoot them dead…’ Is that understood? Dead. Instead of causing trouble, I will bury you.”
His comments came only hours after the arrests of around a dozen residents in a poor area of Manila for protesting about inadequate government food aid. The incident provoked mass outrage on social media, with the hashtag #OustDuterte trending on Twitter. On hearing about the popular anti-government sentiment, Duterte responded that only the military and the police could remove him from power.