Covid-19 and Global Socioeconomic and Health Issues

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While the worldwide cases of COVID-19 infections have generally appeared to be subsiding after several stringent measures were imposed by many countries to stem its spread, many areas in the world—Philippines included—are still seeing steady infection rate. The curve may have flattened, but the very tenacity of the disease is just beginning to show its effects on the country’s economic capability and health condition. Like a typhoon that has ravaged towns and cities, the disease has left a trail of despair and distress. Aside from the dramatic loss of lives, millions of people have been falling into extreme poverty; in areas where food are scarce, the disease has further made the hungry hungrier. Covid-19 has sweeping and devastating effects to the socioeconomic lives of people around the world, causing the largest recession in history.

Effects of the pandemic: an economic overview

An article published by Forbes enumerates the four basic ways the pandemic can affect the global economy. First, it will cause continuous disruptions in the supply chains,[1] a formidable problem but not the worst.[2] The second harm results in lost work by those who are sick or taking care of the sick as a direct effect of the epidemic. In its early stages, this health problem may be perceived as having a lesser impact.[3] Third is the indirect effect of quarantines, travel bans, and business closures, which to date has made the most immediate impact. Once a significant number of people lose their job and businesses get scarred by losses, the economy will experience demand shocks. Since several governments are now strictly limiting close human interaction, the global demand for products and services, especially air transportation, food service, and other service-oriented industries has precipitously declined.[4]

Figure 1. A graph that reflects the impact of the COVID-19 pandemic on global stock markets. Graph modeled after the graphics of BBC News, “Coronavirus: A visual guide to the economic impact,” https://www.bbc.com/news/ business-51706225.

Equity markets take a nosedive amid COVID-19 fears

Figure 2. A graph indicating the impact of the COVID-19 pandemic on airline companies. Graph modeled after the graphics of BBC News, “Coronavirus: A visual guide to the economic impact,” https:// www.bbc.com/news/ business-51706225.
Figure 3. A graph that presents the huge decline in Chinese industrial production because of the COVID-19 pandemic. Graph modeled after the graphics of BBC News, “Coronavirus: A visual guide to the economic impact,” https://www.bbc.com/news/ business-51706225.

Barometers of business expectations, global stock markets around the world have slid downward and experienced extreme volatility as business and industry have halted their operations to heed government restrictions. The biggest equity markets such as the Financial Times Stock Exchange (FTSE),[5] Dow Jones,[6] and Nikkei[7] have experienced steep declines since the start of the outbreak, with the FTSE and Dow Jones experiencing the lowest slump since 1987.[8] Asian equity markets also experienced a steep fall as well as in Australia.[9] This global freefall of stock prices signaled the impending prospects of a worldwide recession.

To counter this, many central banks in the world have resorted to monetary stimulus programs, slashing their interest rates to spur cheaper borrowing and infuse liquidity into their national economies.

On 23 March, the US Federal Reserve launched an aggressive plan to protect the American economy. It bought as many government-backed debts as it sought to keep US financial markets afloat. This was followed by a program that would give companies adequate sources of funds. Meanwhile, the US Senate approved the biggest-ever stabilization package worth more than two trillion US dollars that will aid healthcare, businesses, and families.[10] In the UK, the Bank of England has slashed its interest rate to 0.25 percent, the lowest level in its history as a response to the effect of the pandemic.[11] Notwithstanding these drastic measures, many economists still warn of an impending global recession or economic downturn.[12]

The national responses reflected the growing disparity between richer and developing nations, with wealthy ones such as Denmark, Germany and the United Kingdom, discarding their austerity programs in favor of generous infusions of their stimulus programs that are directed at big and small industries as well as individuals.[13]

Economists predicted that many nations, particularly the world’s richest, may not fully recover economically until 2022, or at least not until vaccines have immunized the general population. China’s economy is growing strongly again, but many of the world’s richest nations may not fully rebound until 2022 at the earliest. The gap between the poor and the rich has widened; inequality has become unbridled. While America’s 651 billionaires have increased their net worth by 30% to US$4 trillion, a quarter of a billion people in developing countries could face absolute poverty, and up to half the global workforce may have lost their livelihoods. [14]


Travel and tourism are the most affected

Tourism is an essential driver for socio-‎economic progress. National governments are aware of its power to stimulate growth, as evidenced by Arab countries that are banking on tourism sector to propel their barren land to growth. Prior to the pandemic, tourism had been one of the fastest growing economic sectors globally. The sector witnessed an almost 60% growth over the decade in international tourists’ arrivals from 1.5 billion 2019 compared to 880 million in 2009. One of ten jobs in the world is about tourism, which translates to over 300 million jobs. However, all changed when COVID-19 hit the world. The pandemic has cut international tourist arrivals in the first quarter of 2020 to a fraction of what they were a year ago, devastating what had been yet another glorious decade for the sector. [15]

Many countries implemented travel bans, particularly in the worst-hit pandemic zones. More airlines cancelled flights and reduced their workforce to keep afloat. In half of the year of the pandemic in 2020, over 90 percent of the global population were stuck in many lockdowns and quarantines, unable to travel from one place to another, even domestically. In UAE, Emirates ceased to fly for the short term and will cut their workers’ salaries in half. Meanwhile, in Hong Kong, Cathay Pacific slashed its passenger capacity by ninety-six percent. China, one of the countries with thriving tourism sector, slashed almost all inbound and outbound air travel. Air Canada, on the other hand, was forced to lay-off over 5,000 employees temporarily. In Europe, the biggest airline Deutsche Lufthansa AG decreased its passenger capacity by ninety-five percent and halted the operations of its 700 aircraft.[16] The European Union, meanwhile, banned travelers from non-member states for many weeks, affecting thousands of flights and millions of seats.[17] Replicated in every continent, such temporary scenarios could persist for an extended period, leading many airlines and its related industries to bankruptcy.

Production in China decreased

China, where COVID-19 was first reported, became one of the worst-affected country in the world after the United States, Spain, Italy, Germany, and France. When the disease became an outbreak, it ordered the strictest lockdown of many cities, confining people to their homes and only allowing them to buy food or medicine. It also utilized the army and the police, as well as other draconian measures to monitor its citizens, thus shutting down businesses and services in the process.

Figure 4. A graph shows how the price of oil has plummeted to its lowest level since 2001, brought about by the COVID-19 pandemic. Graph modeled after the graphics of BBC News, “Coronavirus: A visual guide to the economic impact,” https://www.bbc.com/news/ business-51706225.

Unfortunately, China is also the second largest economy as well as the world’s biggest manufacturer of many vital products. Many multinational companies rely on China when it comes to raw materials or parts.[18] Therefore, when Chinese factories were ordered to shut down, the global supply chains have been disrupted. This situation has eased in the early part of March, when China loosened its policies and allowed workers to return to work after eight weeks of a virtual shutdown. However, the country might find it difficult to restart as global demand plunges as other countries still reel from their own ordeal with COVID-19.[19]

Prices of oil and gold plummeted

Due to restrictions on movement and travel, the demand for oil hit its lowest price since 2001. The price of petroleum has been reduced this year due to the conflict between Russia and OPEC, an oligopolistic group of oil producers. Falling demand caused by the pandemic contributed further to the drop in price of crude oil. And as COVID-19 continues to spread to other countries, the price of oil is forecast to decrease even further.[20]

Even the price of gold, which is a barometer as a “less risky” investment and regarded as a “safe haven” in times of economic crisis, has also been affected. As the threat of a global recession looms, even the price of gold has slid.[21]

The global economy will take years to recover

The Organization for Economic and Cooperation and Development (OECD) offered a grim assessment that many advanced countries may take years to recover from the health and economic crisis, with no certainty on when businesses can undertake normal operations. According to Angel Gurría, the director-general of OECD, a serious pandemic could halve the global growth rate[22] to 1.5 percent, which is the lowest since the 9/11 terror attack or the 2008 recession.[23]

The Philippine scenario

Figure 5. A graph illustrates how the value of gold has declined this year amidst the COVID-19 pandemic. Graph modeled after the graphics of BBC News, “Coronavirus: A visual guide to the economic impact,” https://www.bbc.com/news/ business-51706225.

In the Philippines, Pres. Rodrigo Duterte placed the entire country under a state of calamity as the nation combated the contagion. Government declared an enhanced community quarantine setup in many areas of the country, including lockdowns that were some of the world’s longest. The quarantine mostly affected major cities like Metro Manila, Cebu, Davao, crippling its economy and ultimately changed the population’s way of life. While the stringent measures were followed by many, there were a greater number of Filipinos who were not able to abide the quarantine due to their needs. Furthermore, many businesses, particularly the small-scale ones, were seriously affected barely a week after the declaration of a quarantine.

As a response, the Bangko Sentral ng Pilipinas (BSP) cut interest rates, suspended bank penalties, and allowed increased lending. BSP Governor Benjamin Diokno added that there was no need for “unconventional tools to address the COVID-19 pandemic,” and the programs it implemented would suffice.[24]

This was in response to the position paper titled “A Philippine Social Protection and Economic Recovery Plan,” which called for a “liquidity bazooka.” It was authored by UP economists led by Professor Emeritus Emmanuel de Dios. According to this study, the measures undertaken by the central bank are not enough due to the sudden demand suppression, which knocked down the vulnerable sector, especially those who belong to the informal economy.[25] Furthermore, the paper also proposed that the government should offer a social insurance package that would minimize the economic impact brought by the outbreak on people, especially on the poorest of the poor, who do not have safety nets they can tap in times of financial crisis.

Figure 6. A graph presents the grim forecast for the economic growth in countries in 2020, expected to be slowed down by the COVID-19 pandemic. Graph modeled after the graphics of BBC News, “Coronavirus: A visual guide to the economic impact,” https://www.bbc.com/news/ business-51706225.

By allocating at least 100 to 300 billion pesos for social protection and economic recovery programs, the government would be able to protect its most vulnerable citizens, avert an economic recession, and cushion the effects of COVID-19.[26] Among the social protection measures it suggested was securing supply chains for food and non-food items, such as medicine and personal hygiene products, and ensuring unhampered operations of essential services, such as groceries, supermarkets, pharmacies, hospitals, and clinics. Another was the immediate distribution of cash and non-cash support to poor households. For the economic recovery program, the paper recommended that small and medium-scale enterprises should be given tax relief and workers should continue to receive salaries even if they have temporarily ceased to work.[27]

Government response to COVID-19 in the Philippines

The Philippines set up checkpoints around Luzon as part of the enhanced community quarantine. People coming in and going out from each area are required to present quarantine passes and IDs to verify if they can be allowed entry. Frontliners also check their temperature to ensure that they do not present COVID-19 symptoms. Source: Shutterstock.

The Department of Health in the Philippines confirmed local transmission of the COVID-19 disease on 7 March 2020. Only a week later, they issued a warning on sustained community transmission[28] with contact tracing for new cases becoming more impossible to detect. Pres. Duterte announced a partial lockdown of Metro Manila on 15 March 2020 which escalated to the National Capital Region (NCR) and the municipality of Cainta in Rizal being placed under “community quarantine” until 14 April. With the growing number of COVID-19 cases in Luzon, Pres. Duterte then announced on 16 March that the entire Luzon island was to be placed under a partial lockdown, which was euphemistically called an “enhanced community quarantine.” However, some Philippine scientists, however, predicted the outbreak could last until June this year.[29]

The local government of Antipolo uses a high-powered mechanical spray to disinfect public spaces and residential areas to reduce transmission of COVID-19. Source: Shutterstock.

Suppression of the viral disease has proven to be more difficult for the country due to a shortage of personal protective equipment (PPEs) and, respirators, poorly executed social distancing guidelines in various communities, as well as the slow testing process. On 21 March 2020, the Department of Health announced the news of 120,500 COVID-19 test kits donated by different countries in order to boost the country’s testing capacity.[30] On April 4, the FDA announced the approval of the homegrown PCR-based test kit of UP for public distribution, which only costs ₱1,300 each, as well as the approval of 30 rapid test kits, which are blood-based strips that detect antibodies in the blood of a person who has been previously exposed to the COVID-19 virus.[31] As of 3 April, the country has tested 16,368 people only, with certified laboratories processing 900 to 1,200 tests in a day. The DOH signaled that it will increase the labs’ testing capacity to more than 3,000 a day by April 14 and 10,000 a day by month end.

COVID-19 and its impact on society

Worldwide media broadcast scenes around the world that seem straight out of an apocalyptic movie: deserted highways, barricaded roads, uniformed personnel in hazmat suits milling around a makeshift tent housing the sick, and military staff singling out people and vehicles at checkpoints. Words like work-from-home, quarantine, code red, lockdown, N95 mask, social distancing, and coronavirus became bywords of a population forced to endure traumatic developments in their country and across the entire world. The “new normal” and alternate reality is demonstrated by people being compelled to maintain a safe distance of a meter or more while interacting with others. The afflicted claimed by the disease are given unceremonious send-offs to the afterlife with funerals banned and families barred from visiting their loved ones. Healthcare workers begin to crumble both physically and emotionally under the strain of having to cope with the deluge of the sick and the fear of contracting the viral disease themselves.

Social events and gatherings were postponed along with travel plans, business conferences, community events, and entrepreneurial activities. Close physical interaction with families and friends has been put on hold. Schools, offices, and establishments were ordered to close temporarily. Entire streets, neighborhoods, villages, cities, ports, and islands were cordoned off. All these countermeasures in the guise of fighting an unseen enemy made a gargantuan impact.

Risks to mental health

The alarming number of COVID-19 cases around the world can stress people and communities. Experts around the world have noticed that the coronavirus disease has produced strong emotions and stress in both adults and children. Source: Shutterstock.

Apart from dealing with the ever looming COVID-19 contagion, individuals and communities have been cut off from the other and may also become more susceptible to loneliness and alienation. The fear and anxiety caused by the coronavirus disease can incite strong emotions and stress in adults and children. Each individual has different reactions to stressful situations and ways of coping with it.[32]

On the other hand, the community quarantine can also give people an opportunity to be closer to their families and their community. Helping ourselves and others cope with anxiety and stress is a vital factor in making a community stronger. According to the Centers for Disease Control and Prevention (CDC), people can make the outbreak less stressful by: (1) taking breaks from watching, reading, or listening to news stories because constantly being bombarded by the pandemic could be upsetting; (2) taking care of the body by exercising, eating healthy food, getting enough sleep, and avoiding alcohol and drugs; (3) doing activities that you enjoy; and (4) connecting virtually with people you trust and care for.[33]

Social distancing and proper hygiene are best practices to prevent the disease from entering our body. However, we should make extra efforts to maintain our mental well-being in order to continue to cope with unbearable hardship and sacrifices.

Long-standing societal problems

Social distancing is now being implemented in supermarkets, drugstores, and other public spaces. Source: Shutterstock.

The COVID-19 pandemic has also unearthed prevailing societal problems, especially the issues related to poverty and inequity. In the Philippines, the community quarantine has amplified the clamor to help daily-wage earners, blue-collar workers and laborers, the homeless, and poverty-stricken neighborhoods. For disadvantaged ones, the outbreak is not just a battle against the disease. It is about their survival from day to day in the absence of any means for them to continue making a living.

While most are stuck at their homes, some have chosen to make use of the situation to give back and help. Many Filipinos are used to lending a hand to the needy. Some have raised funds to help the impoverished and the frontliners. Some also volunteered their skills to contribute to information campaigns on COVID-19.[34] Retired medical practitioners also returned to hospitals, stepping up to fight COVID-19 and supplement hospital manpower.[35]

One of the major global problems is the ongoing armed conflicts around the world. As more nations followed lockdown and community quarantine, the government deployed the military to monitor access points of city and provincial boundaries. To focus on the COVID-19 outbreak, Pres. Duterte also declared a ceasefire, ordering government forces to stop operations against armed communist rebels, effective from 19 March to 15 April 2020.[36] Worldwide, the United Nations also urged an immediate ceasefire in conflicts around the world to tackle the new coronavirus pandemic. In a statement, UN Secretary-General Antonio Guterres said that the world faces “a common enemy—COVID-19” which doesn’t care “about nationality or ethnicity, faction or faith.”[37]

In the Philippines, at least two recent shipments have been made, including 100,000 testing kits which the county is in dire need of.

Canada for its part vowed to spend millions to help the world’s poor amidst the pandemic[38], while the United Nations has been working non-stop to ensure humanitarian aid for poor countries.[39] Donation drives continue to come in left and right, with different organizations seeking ways to send help to the hard-hit areas of the pandemic.

In the Philippines, while local government units come up with their own “creative” ways to roll out relief operations for locked down cities, the nation’s largest corporations have also funded relief initatives. “Project Ugnayan” is a joint venture of the country’s biggestt conglomerates, among them the Aboitiz Group, ABS-CBN/Lopez Group, Alliance Global/Megaworld, AY Foundation and RCBC, Ayala Corporation, Caritas Manila, Century Pacific, Concepcion Industrial Corp, DMCI, ICTSI, Jollibee, Leonio Group, Metrobank/GT Capital, Nutri-Asia, Oishi/Liwayway Marketing Group PDRF, PLDT/Metro Pacific Investments Corporation, Robinsons/Gokongwei Group, Puregold, San Miguel Corporation, SM/BDO, and Suyen Corp.[40]

Over 51.5 billion in funds will be used to distribute grocery vouchers worth 51,000 to urban poor residents in Mega Manila. The noble venture is in partnership with the Philippine Disaster Resilience Foundation (PDRF), and will aim to benefit over a million households in the metro. The vouchers can be used to purchase food items from groceries and supermarkets. The project has been initiated in four pilot areas, in collaboration with Caritas Manila’s Project Damayan and ABS-CBN’s Pantawid ng Pag-ibig program.

Aside from relief distribution, the big businesses are also showing their humanitarian side by extending pay for employees who are presently on forced leave due to the enhanced community quarantine. SM Supermalls has assured their employees of regular compensation despite going on vacation or sick leave, while their frontliners get premium pay for serving customers during the lockdown. The mall chain also volunteered to waive rental fees for tenants who have been affected by the closure order during the Luzon-wide quarantine.[41]

Other notable efforts from the private sector:[42]

  • The Jollibee Group under billionaire Tony Tan Caktiong donated food products worth ₱100 million for health workers and other frontliners.
  • Udenna Group under presidential ally Dennis Uy turned over 1,000 COVID-19 test kits to the Department of Health (DOH).
  • Vista Land under Manny Villar donated 200,000 face masks and a daily supply of bottled water to nine public hospitals in NCR.
  • Alibaba founder and Chinese billionaire Jack Ma pledged a donation of 500,000 face masks and 100,000 test kits to the Philippines.
  • Aboitiz Group turned over 5,700 N-95 masks to DOH for health and security workers, apart from medical supplies such as surgical gloves, thermometers, folding beds, laboratory goggles, and tents.
  • Metrobank and GT Capital Holdings Group of the Ty family pledged ₱200 million to respond to the health crisis, mainly for the production of more coronavirus test kits by the University of the Philippines - National Institutes of Health.
  • The Gokongwei Brothers Foundation led by the heirs of the late taipan John Gokongwei, Jr. pledged a ₱100-million fund to mitigate the impact of COVID-19, which will be spent on additional protective gear of health workers and rapid test kits produced by scientists from UP.
  • Businessman Manny Pangilinan through Metro Pacific Hospitals deployed frontline workers to needed areas and have been importing additional protective gear for their use. Some 4,000 liters of alcohol have also been donated for government hospitals.
  • The Araneta Group donated UP-made COVID-19 test kits to the Quezon City Government through the J. Amado Araneta Foundation.
  • San Miguel Corporation produced ethyl alcohol in its liquor plant, which is under regulatory approval for public use. The diversified conglomerate said it has started to distribute rubbing alcohol for free to hospitals and local government units. SMC has also revived the production of the Nutribun, or vitamin-packed bread popular originally distributed for feeding programs in the 1970s, to donate to Caritas Manila for distribution to communities.
  • Tycoon Andrew Tan and the Alliance Global Group also pledged 1 million liters of 70 percent ethyl alcohol to the Department of Health, the police, military, and local government units.
  • Ayala-owned GCash launched an online donation drive for hospitals and frontline health workers. Using the e-wallet app, users can choose to donate money which will be evenly divided to its partners: the Philippine Disaster Resilience Foundation, the Philippine Red Cross, World Vision, UP Medical Foundation, PGH Foundation, Inc., ABS-CBN Lingkod Kapamilya Foundation, and Ayala Foundation.
  • Cosmetic surgery firm Belo Medical Group led by its CEO Vicki Belo donated its remaining stocks of PPE in its clinics for the use of hospitals and health centers in need and will continue to donate once additional supplies arrive.

Government responses in different parts of the world

Frontliners, such as these Iranian ambulance staff, have been hailed all over the world for their courage and heroism in treating patients with COVID-19. Source: Shutterstock.

At a media briefing held on 11 March 2020, the WHO Director-General proclaimed the COVID-19 outbreak as a global “pandemic”— the first caused by a coronavirus[43]. A call for collective action was deemed necessary by the organization, prompting governments and international agencies around the world to do their part in implementing emergency response mechanisms. With the alarming rise of case numbers around the world, social distancing is being strictly implemented, mass testing is encouraged; schools, offices, and establishments are being closed down—every country is forced to choose their particular set of strategies to address the global health crisis.

A month before the proclamation of a global pandemic, the United States discovered its first ever case in Chicago. Currently, the US has the most number of confirmed cases. Tragically, a study of the Trump administration’s Department of Health and Human Services in 2019, however, had previously warned of the incapability of the US to fully protect itself from a large-scale epidemic much like that started by the novel coronavirus.[44]

A faulty test kit distributed by the U.S. Centers for Disease Control and Prevention also slowed down efforts to control the outbreak in the American continent.[45] Following former President Donald Trump’s acknowledgement of the spread of the COVID-19 disease as a matter of national concern and the US government’s declaration of a public health emergency, orders for stay-at-home lockdowns, travel restrictions, school closures, cancellation of events and large gatherings were executed throughout different states. Several of the hardest hit states are New York, Michigan, Washington, New Jersey, and Louisiana.[46]

On 13 March 2020, the WHO proclaimed Europe as the epicenter of the pandemic with the most reported cases and deaths outside China (this has been surpassed by the US – ed). The European Union then announced “a 30-day restriction on non-essential travel” in 26 of its nations.[47] With Europe closing off its borders, other member countries followed with nationwide lockdowns including Italy, Spain, Germany, France, Belgium, and more. Much like other nations, European nations have shut down schools, prohibited gatherings involving more than 100 people, and advised self-isolation at home. On the other hand, the British government ordered 1.4 million of its people who have serious health problems to self-quarantine for 12 weeks.

On 17 March 2020, Dr. Poonam Khetrapal Singh, the Regional Director of WHO Southeast Asia region, urged more aggressive action in preventing further spread of the deadly disease across the region[48]—with the individual case numbers of several Southeast Asian nations surpassing the 3,000-mark during that time. As a response, most SEA countries have imposed travel bans and restricted foreign or local travel including Vietnam, Thailand, Singapore, Malaysia, and the Philippines. In the South Asian region, India ordered a three-week sudden lockdown on 24 March 2020, even though it had recorded only 469 active cases of COVID-19 out of a population of over 1.3 billion, a huge sacrifice for a nation representing a fifth of humanity.[49]

From horizontal to vertical interdiction—a probable solution

Nations across the globe closed their borders. Southeast Asia’s confirmed COVID-19 case numbers is still alarming. Europe has been declared devastated by the pandemic and the United States is now the epicenter of the disease. Yet, some countries have achieved some success in flattening the curve of new infections. From the unprecedented Wuhan outbreak that grew to thousands of active cases and deaths in the last two months, mainland China reported no new locally transmitted infections after implementing strict social distancing measures. New Zealand also successfully flattened the curve in a little time.

Empty shelves and sections in a supermarket (such as this one in Madrid, Spain) has become a common occurrence around the world, brought about by the panic and fear of lockdowns caused by the COVID-19 pandemic. Source: Shutterstock.

On the other hand, the Republic of South Korea also saw a significant drop in their case numbers even without China’s “draconian” measures such as large-scale lockdowns, which have also been implemented in Europe and the US.[50] Instead of impeding everyday economic activities, South Korea has instead put up massive mass-testing programs, completing by 16 March 2020 more than 270,000 tests.[51] Isolating and contact tracing of all known and previously undocumented cases were strictly followed. Although mass testing, self-isolation, and extensive lockdowns have been proven effective, how can viral transmission be halted without causing an economic collapse, especially for nations who are underfunded and unprepared for a disaster such as this?

Dr. David L. Katz of Yale University suggests a “vertical interdiction strategy” as opposed to a horizontal approach to the problem by implementing quick isolation for two weeks in communities experiencing an outbreak while letting other unaffected communities’ function.

The lockdown in the Philippines is also vertical in that only Luzon were closed down, with other local government units in Visayas and Mindanao presented with an option to follow suit if they saw it fit. The concept of a 14-day total shutdown instead of gradually restricted actions also seem to be a sensible approach to this epidemic. But in doing so, Dr. Katz reminds us of three important goals—saving lives, maintaining a functionable health care system, and “making sure that in the process of achieving the first two goals we don’t destroy our economy, and as a result of that, even more lives.”[52]

It has been months since countries all over the world have initiated lockdowns and shut down “non-essential” businesses. However, depending on where one resides, this may either be a temporary inconvenience or a major life-changing event. In some countries like Belgium, Denmark, and the Netherlands, workers will have 90 percent of lost wages covered.[53] In most developing countries, locals are not provided the same safety nets. The Philippine government is heavily criticized for this reason. The 14-day lockdown of Luzon were labeled “anti-poor,” with daily wage workers out of work and unable to rely on the national government for support. Although everyone is faced with the same dilemma, it is a sad reality that not everyone is equipped to survive the crisis without suffering tremendous losses.

Lessons from Wuhan

After two months of battling the coronavirus, the people of the city of Wuhan in China finally took off their face masks and appreciated their newly recovered freedom. The ground zero of the coronavirus outbreak first declared zero new cases on 19 March 2020.[54] Wuhan, though, remains on lockdown to keep the virus from returning to the healing city. Now that the rest of the world is currently the new battlefield of the contagion, it is vital to look back and understand how Wuhan dealt with the viral foe.

Harsh but effective approach

The Chinese government promptly instituted quarantine of patients with COVID-19 symptoms in Wuhan, as a part of its lockdown measures. Source: Shutterstock.

Many have criticized the way the Chinese government contained the disease in Wuhan. To halt further transmission outside of Wuhan, the Chinese government mandated its lockdown on 23 January 2020 together with other major cities.[55]

Initially, the residents were still allowed to go out of their houses; but as days went by, the lockdown tightened. In some areas, going out to buy necessities was limited to one family member every two days. The residents were also restricted from leaving the city. Public transportation was put to a halt, giving no exception even for personal and medical emergencies. Private vehicles without special permission were also barred from the roads. For the entire duration of the lockdown, travel was banned. Establishments were also shut except for those selling food and medicines. Drugstores were strictly monitored by authorities. Later on, the lockdown became more aggressive. Health officials even went door-to-door to monitor and force anyone ill into isolation.[56]

It was the first time that a quarantine of this scale had been implemented in the modern world. Some had taken the policy with a grain of salt. Skeptics expressed that such measures were unnecessary, and that the government should have focused on mass testing, strict implementation of social distancing, and identifying those who needed to be isolated. However, it is also noteworthy that during the early onset of the outbreak, there were no reliable and rapid testing kits to screen the masses. They only depended on laboratory genetic sequencing analysis, which was a tedious and costly process. The only way to manage the spread of the disease and save more lives was to limit the movement of its carriers. The National Medical Products Administration of China took immediate action to hasten the production of detection kits. The first test kit in China was introduced on 23 January, the same day that Hubei was put under lockdown. Two weeks later, biotech companies in China manufactured a sufficient supply to accommodate the testing needs of the hardest-hit areas, especially Wuhan.[57]

Modern problem, modern solutions

As the number of COVID-19 cases ballooned in Wuhan, the demand for hospital beds to isolate thousands of patients also posed a major problem in the outbreak epicenter. This pushed officials to put up a makeshift hospital to house infected individuals. Thousands worked day and night to complete the coronavirus hospital in ten days. The Chinese state media reported that the design features of makeshift hospitals built during the SARS outbreak in 2003 were used. The new hospital was designed in such a way that patients were categorized based on the severity of the infection and the risk they posed.[58]

Technology also played an important role in combating the virus. The outbreak has tested China’s technology industry and how well people can utilize these advancements during catastrophic events such as public health crises. In hospitals, nurses roamed to check on patients and to deliver medicines. To reduce the risk among medical staff, hospitals replaced nurses with robots to deliver medicines to patients.[59]

Another hardware that provided multiple applications were drones. Heavy-duty drones were deployed in the cities to disinfect public spaces. There were also drones mounted with thermal cameras to detect suspected COVID-19 patients. Some drones equipped with facial recognition were also flown to fight crime and to monitor movement of the citizens. These efforts also tested the ethical boundaries of using such aerial surveillance technologies. Such collective initiatives seem to have paid off for Wuhan and were even being held as models to be replicated by other nations.

Lessons from Italy

Map of Italy highlighting the "red zones," or the worst affected regions of the country. Graphic modeled after the graphics of Daily Mail, “Australian au pair who was caught in Italy’s coronavirus ‘red zone’ reveals how her trip of a lifetime turned into a nightmare - before she fled over the border to Switzerland,” https://www.dailymail.co.uk/ news/article-8094627/amp/ Australian-woman-caughtItalys-coronavirus-red-zonereveals-escaped.html.

The Italian healthcare system has been regarded as one of the best among developed countries in the Western world. Its efficient structure largely depends on the shared authority between the central government and the 20 Italian regional governments, which oversee health services, provisions, and source appropriation.[60] In previous years, academic journals have commended this constitutionally tacit relationship for ostensibly improving and maintaining the health status of Italians. However, everything changed in the span of three weeks from late February to early March 2020. Italy’s healthcare system was suddenly crippled by an unseen enemy: COVID-19.[61]

Why did a country like Italy with a fully prepared and world-class healthcare system end up as such? What early measures did the Italian government take to fight the contagion many countries had already warned about? What mistakes did its officials commit for this health crisis to turn for the worse?

Italy: COVID-19 epicenter

The symptoms of COVID-19 can be easily attributed to ordinary severe flu. On 18 February 2020, a 38-year-old unsuspecting man went to a local hospital in Codogno in the northern Lombardy region of Italy. As he was only manifesting flu symptoms, the hospital released him hours later. But when the same man was rushed back into the intensive care unit and tested positive for the virus on the same day, people started to ask questions: How did the patient contract the virus without a travel history to China?[62]

That same week, two more Italians who recently traveled to China were also diagnosed with the virus.[63] In the succeeding weeks, the number of cases in Italy multiplied a thousand-fold. A month later, the country had already surpassed China’s total death toll by more than half, becoming the new epicenter of the COVID-19 pandemic. As of 5 April 2020, Italy reported 124,632 confirmed cases, with the death toll reaching 15,362, surpassing that of China.[64]

Italy’s draconian strategies and pitfalls

According to media and health experts, partly to blame for Italy’s woeful handling of the outbreak was the horizontal interdiction belatedly implemented by the central government in the affected regions. This strategy relied on draconian policies blindly imposed on an entire population, with complete disregard for other factors such as the population segments that are most vulnerable to illnesses. Rather than swiftly executing this to abate the rapid spread of COVID-19 across the country, the Italian central government chose to feed the people a false sense of normalcy and urged them to carry on with their daily lives. But when the cases surged into the local hospitals in northern Italy, the draconian measures already came too late. “Infodemic” or mixed messages from central government officials also had flummoxed the Italians on what was really happening in the country. This then forced local officials like the regional president of Lombardy, Attilio Fontana, to make tough decisions on his own.

The northern area of the Lombardy region was the first to be forced into lockdown. Along with the confirmed community transmission, this area also recorded almost half of the nationwide count of positive cases and two-thirds of the official death count.[65] Later on, the remaining towns in southern Lombardy, including its main city Milan, were placed under lockdown. On 10 March 2020, Italian Prime Minister Giuseppe Conte addressed the public and expanded the regional quarantine into a nationwide lockdown. He pledged that aside from the $28 billion allotted for relief package, the government would also provide economic assistance amounting $8.5 billion to prevent the country from sliding into recession.[66]

The overlooked factors

Italy’s healthcare facilities have been overwhelmed with the deluge of COVID-19 patients seeking treatment, forcing authorities to put up makeshift field hospitals just as this one in Florence. Source: Shutterstock.

Although Italy was indeed the first Western country to enforce such extreme measures in handling the domestic outbreak, initially there was little positive evidence that they could prove effective.[67] At the outset, the country was hobbled by its inability to conduct viral testing for its huge population. As of 23 March 2020, it had only conducted around 230,000 tests. This is way behind in comparison with the estimated 340,000 tests conducted by the South Korean government in mass-testing centers and drive thru clinics.[68] Also, the transmission trend revealed that COVID-19 tended to target immunocompromised and elderly people. Based on statistics, the relative risk of virus contractions among older age groups is critically high. Italy has an aging population, and the mean of its demographic age is around 45 years old. Like other family cultures, Italians of many generations tend to live under one roof, making the possibility of viral transmission within households even higher even with the implementation of the public containment policies. This then implied that the elderly may not be even safe in their own homes. As of 23 March 2020, the median age of COVID-19 deaths in Italy has been set around 80 years old, and patients over 90 years old have a very high fatality rate of 22.7%.

However, it may be said that Italy, as of writing, is not anymore at the peak of the outbreak. But even though local hospitals are still struggling to house patients with critical symptoms and seventy-four healthcare professionals have fallen victim to COVID-19 as of 3 April, they are all holding up and getting by. Italian hospitals and regional presidents have now already created improvised ICUs and distributed medical supplies and staff they have to more vulnerable areas.[69]

And even though the death count in the country continues to climb, the number of new infections has recently dropped to only 4,053 last 1 April 2020, compared to the recorded 6,557 cases in 22 March 2020.[70] If these rates of infections continue to drop, there is indeed hope for Italy, and the rest of the world can expect an alleviation in the battle against this global scourge if it manages the challenges right.

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