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Address uneven distribution of health workers in PH—PIDS study

March 28, 2020

A STUDY of state think tank Philippine Institute for Development Studies (PIDS) found that Filipino healthcare professionals are more likely to work in areas where earnings are potentially high and near communities where they were trained. According to PIDS Senior Research Fellow Michael Abrigo and former PIDS Research Associate Danica Ortiz, authors of the study “Who Are the Health Workers and Where Are They? Revealed Preferences in Location Decision among Health Care Professionals in the Philippines”, the supply of healthcare workers such as nurses, physicians, and midwives are highly uneven in terms of their geographic distribution in the country.   The authors noted that the composite density of physicians, professional nurses, and professional midwives in the Philippines reached 40.8 per 10,000 population in 2015.   This was above the thresholds recommended by the World Health Organization (WHO) in 2006 and the International Labour Organization (ILO) in 2011. The WHO proposed “a density of 23 skilled health care workers, comprising of physicians, nurses and midwives, per 10,000 population”, while the ILO suggested “a density of 34 physicians, nurses and midwives per 10,000 population”.   Subsequently, WHO updated its threshold to 45 skilled healthcare workers per 10,000 population in 2016 while ILO updated it to 41 per 10,000 population in 2014.   While these international metrics suggest that there is a sufficient supply of healthcare workers in the Philippines, Abrigo and Ortiz argued that this is not the case based on the country’s disaggregated data on health human resource (HHR) density.   “Less than 25 percent of cities and municipalities have HHR density above the 41 physicians, nurses and midwives per 10,000 population recommended by the WHO [in 2016]. This leaves as much as three-quarters of cities and municipalities in the country with potentially insufficient number of HHRs to provide healthcare services,” they explained.   The authors also found that these cadres of healthcare professionals are more likely to work in cities and municipalities that have greater access to amenities like hospitals and clinics. However, they are less likely to work in areas with high levels of ethnic concentration.    The continuing maldistribution of healthcare workers can aggravate the country’s problem on limited access to healthcare services.   To address this issue, the authors highlighted some policy considerations in designing programs that will attract and retain healthcare workers especially in underserved areas.   One is to boost household incomes through local economic development, which is “essential in ensuring the economic viability of any professional practice, particularly in health care”. The role of the private sector should also be strengthened in providing healthcare services to the people. “Supporting private healthcare practices through the country’s social health insurance system or a similar voucher scheme may provide greater incentives for healthcare workers to practice in underserved areas,” the authors said. They also proposed for the reassessment of common- and deep-rooted beliefs on healthcare professional practice. However, they pointed out that “although altruistic motives among healthcare practitioners to serve in rural areas may be important in recruiting HHR for rural practice, it may not necessarily be the most sustainable.”     The authors also suggested using technology as an alternative mode of service delivery, particularly in conducting remote medical consultations and diagnosis, and in record management.   Lastly, they recommended the “certification of some primary healthcare skills that may be done by other cadres of healthcare professionals, instead of relying on the limited supply of physicians.” They cited as an example nurses in the United States, Canada, and the United Kingdom who are certified to assess patients’ needs, interpret diagnostic and laboratory tests, prescribe medication, and formulate treatment plans. This strategy may also be explored in the Philippines, the authors said.

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Health exec: No Covid-19 positive patients in barangays Nazareth, Patag

March 28, 2020

CAGAYAN de Oro City--A health official has belied reports that there are Covid-19 positive patients from barangays Nazareth and Patag. "Walay taga-Nazareth ug Patag nga nagpositibo sa coronavirus disease 2019 (Covid-19)," said Dr. Rachel Dilla, assistant city health officer, during the special session of the City Council held last Wednesday. Dilla clarified that there is only one Covid-19 positive patient in Cagayan de Oro City. "Kini mao kadtong nabalita nga 71 anyos nga lalaki nga naggikan sa numbered barangays sa syudad ug adunay travel history gikan sa San Juan City, Metro Manila." The health official said the city government of Cagayan de Oro was even grateful to the Covid-19 positive patient for the cooperation and for following the needed protocol to prevent the spread of the dreaded disease. According to the Power, a daily newsletter of the City Council, the Covid-19 positive patient opted to return to the Northern Mindanao Medical Center (NMMC). The patient is now undergoing quarantine, the report said. It said the Covid-19 Response Team has already conducted disinfection at the patient's residence. On one hand, Dilla said that the City Health Office (CHO) and the  Department of Health (DOH) have already conducted the contact tracing. For his part, Councilor Ian Mark Nacaya urged residents not to immediately believe in what they read in the social media, especially if the information did not come from reliable sources. Health exec: No Covid-19 positive patients in barangays Nazareth, Patag CAGAYAN de Oro City--A health official has belied reports that there are Covid-19 positive patients from barangays Nazareth and Patag. "Walay taga-Nazareth ug Patag nga nagpositibo sa coronavirus disease 2019 (Covid-19)," said Dr. Rachel Dilla, assistant city health officer, during the special session of the City Council held last Wednesday. Dilla clarified that there is only one Covid-19 positive patient in Cagayan de Oro City. "Kini mao kadtong nabalita nga 71 anyos nga lalaki nga naggikan sa numbered barangays sa syudad ug adunay travel history gikan sa San Juan City, Metro Manila." The health official said the city government of Cagayan de Oro was even grateful to the Covid-19 positive patient for the cooperation and for following the needed protocol to prevent the spread of the dreaded disease. According to the Power, a daily newsletter of the City Council, the Covid-19 positive patient opted to return to the Northern Mindanao Medical Center (NMMC). The patient is now undergoing quarantine, the report said. It said the Covid-19 Response Team has already conducted disinfection at the patient's residence. On one hand, Dilla said that the City Health Office (CHO) and the  Department of Health (DOH) have already conducted the contact tracing. For his part, Councilor Ian Mark Nacaya urged residents not to immediately believe in what they read in the social media, especially if the information did not come from reliable sources.

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World leaders hold emergency virtual summit thru video call to address covid-19 crisis 

March 27, 2020

VIRTUAL MEETING OF WORLD LEADERS VS CORONAVIRUS DISEASE DUBAI (MDN International News)  — A top-ranking official of the United Nations has challenged leaders of the 20 major industrialized countries of the world Thursday (March 28) that "the world is at war with a virus - and not winning it," even as countries implemented stringent measures to contain the deadly coronavirus disease. (covid-19)    The G20-member nations are made up of 19 countries and the European Union. The 19 countries are Argentina, Australia, Brazil, Canada, China, Germany, France, India, Indonesia, Italy, Japan, Mexico, the Russian Federation, Saudi Arabia, South Africa, South Korea, Turkey, the UK and the US. Government leaders around the world issued quarantine and lockdown measures to seal their borders and prevent the entry of the dreaded virus, but still the efforts proved futile as covid-19 continued to sneaked in unnoticed and only caught leaders by surprise when persons under investigations began to rise in numbers in their respective countries. The unusual video meeting of the members of G20 need to produce positive outputs purposely to flatten the curb of corona's onslaught as the world's economy really dwindled and shutter businesses in the process. US AND CHINA VIDEO CALL. US President Donald Trump is set to do a video call with China's Prime Minister Xi Jen Ping to discuss matters about coronavirus disease. During the online video conference, the world leaders have identified that the deadly coronavirus has successfully disturbed the world's business and economy which now starting to create massive poverty among nations, closed government and private buildings, crippled government and private operations and shockingly resulted to the deaths of over 20,000 patients from around the world. Now the G20 has vowed to help one another in response to criticism they were failures in containing the deadly spread of the virus, jointly injecting over $4.8 trillion into the global economy, as a way to counteract the financial and social impacts of the pandemic. As G20's final virtual summit's statement, G20 has committed to make the World Health Organization's (WHOs) mandate even more stronger and strengthened.  U.N. Secretary-General Antonio Guterres urged G20 leaders to adopt a war-time plan to tackle the pandemic.  “The unprecedented COVID-19 pandemic is a powerful reminder of our interconnectedness and vulnerabilities,” the group said. “The virus respects no borders.” “It took the world three months to reach 100,000 confirmed cases of infection,” he said. “The next 100,000 happened in just 12 days. The third took four days. The fourth, just one and a half.” Guterres said: “This is exponential growth and only the tip of the iceberg,” adding that countries must be able to combine systematic testing, tracing, quarantining and treatment, as well as coordinate an exit strategy to keep it suppressed until a vaccine becomes available. Meanwhile, a total of 250 million pounds ($302 million) will be provided by the United Kingdom (UK) as additional funding to the group developing vaccines to effectively contain the onslaught of coronavirus disease.  

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Nast Health Sciences Division Statement: Scientific Research and Development as drivers to win the race against COVID19

March 27, 2020

The current CoViD19 problem caused by the SARS CoV2 virus has raised and continue to raise issues on how programs and strategies can better control and prevent the escalation of the problem. With the recent declarations of the World Health Organization that COVID 19 is already a global pandemic and the implementation of community quarantine and subsequently extended community quarantine initially involving the National Capital Region and eventually the whole of Luzon, we expect greater urgency for countries to implement programs and strategies to stem and arrest this epidemic.      Almost all of these countries, and the Philippines is no exception, have proposed novel and sometimes radical measures as possible solutions. Almost all of them, however, are not based on scientific studies but largely on expert opinion and what we think worked and did not work during the SARS problem in 2003 and the pandemic influenza global pandemic in 2009.     Being caught in the midst of this ongoing epidemic and the consequent rapid rush of research institutions, both in the private and the public sector to find the magic cure for this disease, whether it be a drug or a vaccine to prevent transmission and infection of the virus, the research community should galvanize and unify efforts to spearhead researches that will address current health issues brought about by the CoViD 19 problem.     Dealing with and confronting this problem will require a whole of government-led approach with involvement and engagement of the private sector and the general public. Networking and collaboration among and within these different groups will be the key.      Researches, in particular, will be critical in the fight against the CoViD 19 recognizing that this is a new disease with a potentially different behavior, progression and effect on the health of individuals, the community and the nation as compared to the other emerging pathogens     We, at the National Academy of Science and Technology, fully support the current research initiatives of the government and the Department of Science and Technology.      In the face of limited resources and paucity of knowledge concerning the virus and the disease it causes, researches are being developed and implemented in collaboration with various research groups both here and abroad to address various aspects of the CoViD19 problem. In the light of all these, we propose that the following researches be done or enhanced to identify and implement the most effective measures to address problem of CoViD 19 in the following areas:     1) In the area of epidemiology, modelling studies , which are mostly mathematical, may help us better understand how the epidemic will evolve.      Input of health data into these disease models, as the epidemic progresses, will be very important to provide government planners scientific projections on how this epidemic will progress. The data generated will be very helpful in forward planning by concerned government agencies to anticipate, prepare and dampen the effects of this epidemic on different aspects of national life, including the economy.     2) In the area of diagnostics, whereas current tests are focused on the detection of the virus in affected patients, tests determining the presence of antibodies mounted by the human hosts should also be developed.      These antibody-based assays will help determine the patients who were truly infected, whether symptomatic or asymptomatic. It may catch the cases missed by the tests for detecting infection as these tests may have been done too early or too late in the disease.      The tests to detect antibodies will determine the true burden of disease and as well as provide added information on the infectiousness, transmission dynamics and progression of the disease. These tests may also be used for predicting chances for development of complications as well as mortality, especially if the antibodies are proven to be neutralizing antibodies.     3) In the area of therapy, the country should participate in clinical trials that would have already been initiated by other countries to help us better understand patient responses to this therapy and determine whether different genetic backgrounds, cultures and environment may affect patient response.      Moreover, participation in these multi-country studies can facilitate its availability in our country when the results become significant.     4) In the area of prevention and the development of vaccines, knowing more about the virus, its genetic makeup and how fast it mutates or changes will accelerate its development.      Characterizing the molecular and genetic structure as isolated from patients in the Philippines can be contributed to the international database that will serve as references for vaccine development. This will ensure that the vaccines developed can induce protection against all of the circulating SarsCoV2 viruses isolated from patients anywhere else in the world. 5) In the area of host factors, genetic biomarkers may be identified that may either predispose or make people less susceptible to the infection. They may also be used to determine risk for severity of disease and complications.     In all of these initiatives, sharing of information within and among scientists, researchers and institutions both here and abroad will help us build on each others’ strengths and accelerate the race for finding the solutions and the answers to many of our questions.     Ultimately, winning the battle would depend on how much and how good we understand our adversary- the Covid19 and the virus that causes it.      To many, the virus is like an unknown enemy that works silently easing its way among and through susceptible populations, evading detection and prevention. The experiences of many countries, whether good or bad, will serve as valuable learnings for all of us.      For one thing is certain, this epidemic will not be the only ones we will be confronting in the years to come. It has been established by scientists that in the area of zoonotic diseases that start from animal hosts before reaching humans, only half of viruses have been identified. Scientific research and development remain our most effective weapon to confront them and the SARS CoV2.

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Hungry and irate Oro residents mob the net to beg Mayor Moreno for the release food packs

March 27, 2020

* Irate residents say "Dili kita mamatay ani sa Covid kundi sa kagutom. Duha ka semana na gud walay kita akong bana."   CAGAYAN DE ORO CITY - Hungry and irate residents of this city mobbed the internet and beg for Mayor Oscar Moreno to start releasing food packs and other food supplies, as they are feeling the ill effects of a "community quarantine." Enday Lantuyan, children of 5 and wife of tricycle driver said since the quarantine implementation last week her husband cannot support the family anymore. "Unsaon paman niya pagsuporta kanamo nga nagpagawas naman ug order si Mayor nga magpuyo nalang sa balay. Ang kita ra sa iyang pagdrive among gisaligan sa matag adlaw." (How could he support us when the mayor ordered everyone to stay at home. His daily income is what we are dependent upon for our daily subsistence," Lantuyan told MDN in an interview. "Dili kita mamatay ani sa Covid kundi sa kagutom. Duha ka semana na gud walay kita akong bana. Sige lang presscon unya mga tawo gipanggutom na kay walay income. Bisag pan wala diha," she lamented. She said almost all the drivers of 'habalhabal' (single motorcycle), 'baobao' (tricab) and motorized tricycles (pedicabs) that were only dependent on their daily income are now sacrificing their families since the quarantine implementation of the mayor. "Ila untang nakita sa wala pay community quarantine kung pila ka libo ka mga draybers and magutman kay gasalig lang sa kita sa matag adlaw aron makapalit ug bugas," she claimed. (They should have seen this problem before the implementation of a "community quarantine." How many thousands of drivers are dependent on their daily income to survive everyday's food consumption)       Menwhile, many also of the city's working population who were forced to stay at home mobbed the internet and echoed their disgust of the mayor's executive order for a community quarantine. These were the sectors which comprised of sales clerks in malls, sales ladies in private businesses, ambulant vendors, beggars in the streets, workers, waiters and waitresses, and all other jobs which supposedly gave them daily income. Over a comment section of the City Mayor's daily press briefing, irate residents took turns on lambasting Mayor Mareno's alleged very slow responses on the need for food of those affected by the coronavirus crisis which also triggered the community quarantine order of the local chief executive. Other residents have also aired their grievances on the comments section of Magnum and Bombo Radyo, saying they needed help and intervention from City and barangay officials. Magnum Radio Station Manager Jun Albino in his morning news program said a crying caller has asked help from their station as the family have no more food supplies. "Naluoy gyud ko sa maong caller ug giadtuan gyod nako sa ilang lugar nga may pagkalayo raba," the radio manager said.  In today's press briefing at the City Hall, Michael Christopher Fabello, local DSWDs incharge of the food repacking and chief of the CDO Covid Preparedness and Response Food cluster, said that repacking are now ongoing at Xavier University Campus by qualified City Hall employees, and thousands of food packs are now ready for distribution. Fabello thanked XU President Yap for his offer to use one area inside the campus to be used in the repacking of food packs.   Fourth Infantry Division chief BGen Franco Nemesio Gacal also added they are now helping and coordinating with the barangays for the listing of those poor barangay residents badly affected by the coronavirus crisis, and whose parents who were forced to stay home to follow orders from the Local Chief Executive. "We are now closely coordinating with the barangays in regards to the preparation of the masterlist," the Fourth Infantry Divsion official said. Gacal feared the hungry feeling and lack of food of these people in the lower and vulnerable sector in society might result to chaos and disorder, if the food distribution will be delayed for more weeks. 

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7 stranded Russians catch flight to Clark

March 27, 2020

CAGAYAN de Oro city--Local police escorted seven stranded Russians to the Laguindingan Airport in Misamis Oriental Thursday to catch a special flight, the police said here. Lt. Col. Henry Dampal, chief of police of the Cagayan De Oro City Police Office (COCPO), said that the stranded Russians arrived here Wednesday night from Davao City. An initial investigation disclosed that the Russian nationals were reportedly stranded in Davao due to travel restrictions following implementation of the enhance community quarantine to counter the spread of the COVID-19 virus. The COCPO police escorted the Russian nationals to the Laguindingan Airport in Misamis Oriental to allow them to catch the “special flight” for tourists who were stranded due to travel restrictions. Lt. Col. Mardi Hortilloza, spokesperson of the regional police command in Northern Mindanao, said that the local police received a memorandum to escort the Russian tourists so that they would be able to catch the flight to the Clark International Airport in Subic. The Civil Aviation Authority of the Philippines (CAAP) has allowed “sweeper flights” from Misamis Oriental to the Clark International Airport and vice versa. The stranded Russian tourists arrived in Cagayan De Oro City Wednesday night after travelling by land from Davao to Cagayan De Oro City.

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