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The Department of Health (DOH) raised a Code Red alert on COVID-19 in the country this weekend following the confirmation of more cases of the novel coronavirus. As of March 10, there were at least 33 confirmed COVID-19 cases in the country, as the DOH and hospitals implemented tighter monitoring measures.
The rapid increase in the number of confirmed cases prompted the Office of the President, through Proclamation No. 922 signed by Executive Secretary Salvador Medialdea, to declare a state of public health emergency throughout the country starting March 8, a measure the DOH recommended as early as Feb. 21.
As the number of confirmed COVID-19 cases in the Philippines continues to rise, here are three things you need to know about the different stages of alert on the disease:
1. What is a Code Red alert and how does it differ from a state of public health emergency?
The DOH raised Code Red sub-level 1 on March 7 after the first case of local transmission of COVID-19 was confirmed, when a patient -- a 62-year-old man -- with no recent travel history contracted the disease. The patient’s wife, who is 59 years old, also tested positive for the disease.
The department said this was a “preemptive call to ensure that the national and local governments and public and private health care providers can prepare for a possible increase in suspected and confirmed cases.”
The Philippines is currently on Alert Level 4 Code Red sub-level 1 for the confirmed local transmission, which may be raised to sub-level 2 when the number of confirmed cases continues to rise and spreads to communities that reach past the level that the government is prepared to handle.
The first case of local transmission was also the government's basis for the declaration of a state of public health emergency. The proclamation was meant to facilitate the implementation of the Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act, otherwise known as Republic Act No. 11332.
The declaration of a state of public health emergency would “capacitate government agencies and [local government units] to immediately act to prevent loss of life, utilize appropriate resources to implement urgent and critical measures to contain or prevent the spread of COVID-19, mitigate its effects and impact to the community, and prevent serious disruption of the functioning of the government and the community.”
2. What are the effects of the Code Red alert and the state of public health emergency?
Health Secretary Francisco Duque, in a media briefing in Malacanang on Monday, said Code Red alert sub-level 1 means the DOH will intensify efforts in contact tracing, surveillance, and testing. Government and health workers will also strictly implement home quarantine measures.
“It is our surveillance team who will reach out to close contacts,” Duque said when asked about contact tracing. He defined close contacts as those who directly care for COVID-19 patients without proper protective equipment, those who stay in the same closed environment with a patient, and those who have travelled in close contact with a patient within the last 14 days since the onset of the patient's symptoms.
On hospital care, the DOH said only severe and critical cases of COVID-19 should be referred to the Research Institute for Tropical Medicine (RITM), San Lazaro Hospital, and Lung Center of the Philippines. All hospitals caring for COVID-19 cases should be disclosed.
Proclamation No. 922 also expands the response to COVID-19 to all government sectors, not just the DOH. It gave the DOH, through the Health Secretary, the power to call on the police and other law enforcement agencies to address the “COVID-19 threat.” It is meant to implement RA 11332, which mandates disclosure of all COVID-19 cases.
In the same press briefing, the Department of Foreign Affairs laid down its plans in monitoring countries that have a travel ban due to COVID-19, and in assisting Filipinos who want to be repatriated.
The Department of Tourism reported that it has been working with the tourism stakeholders to come up with a response to suspected COVID-19 cases. The DOH said a price freeze must be implemented on crucial materials and medicines.
3. What happens when the DOH declares Code Red Alert sub-level 2?
Code Red alert sub-level 2 would be raised if there is evidence of community transmission, or when the cases reach a high level to the point that “surpasses the government’s ability to respond.”
The World Health Organization defines community transmission of COVID-19 as “the inability to relate confirmed cases through chains of transmission for a large number of cases, or by increasing positive tests through sentinel samples.”
Possible responses cited by the DOH include community quarantines, suspension of classes and office work, and augmentation of medical staff and uniformed personnel from unaffected communities to areas where they are needed.
However, Duque said it was premature to place Manila -- where most of the confirmed COVID-19 cases are located -- on lockdown. He added that there is an existing protocol for the declaration of a community quarantine. On Monday night, President Rodrigo Duterte rejected a suggestion to put Metro Manila under lockdown. Although the national capital region is still under Code Red sublevel 1, Duterte already suspended classes in all levels from March 10 to 14 to allow schools to fumigate and minimize transmissions of the highly-contagious disease.
Department of Health, DOH confirms local transmission of COVID-19 in the PH; reports 6th case, March 7, 2020
Department of Health, Press Conference, March 10, 2020
Department of Health, DOH reports 4 new COVID-19 patients; cases up to 10, March 8, 2020
Office of the President, Proclamation No. 922, March 8, 2020
World Health Organization, Coronavirus disease 2019 (COVID-19) Situation Report - 49, March 9, 2020
Department of Health letter to Executive Secretary Salvador Medialdea, Declaration of State of Public Health Emergency due to the COVID-19, Feb. 27, 2020
Department of Health, Ano ang iba't-ibang alert levels, March 7, 2020
Official Gazette, Republic Act No. 11332
Department of Health, Laging Handa Press Briefing, March 9, 2020
Department of Health, What does Code Red (Alert Level 4) Sublevel 1 Mean?, March 10, 2020
CNN Philippines, President Rodrigo Duterte speaks to the media after meeting on coronavirus, March 9, 2020
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