In the second installment of “Sustaining the Conversation on COVID-19: How Do We Cope? The eTURO Webinar Series on Engaging Communities and Networks (WE CaN!!)” webinar last 03 April organized by the Ateneo de Manila University - Institute of Philippine Culture (ADMU - IPC) in collaboration with the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD), former Department of Health (DOH) Secretary Dr. Jaime Galvez Tan explained how the COVID-19 pandemic demands a whole-of-government and whole-of-society approach.
He discussed how the involvement of every sector and individual is vital in defeating the pandemic through the implementation of cross-cutting strategies such as:
Implementing a national unified communication plan by targeting a change in behavior
Putting in place a nationwide monitoring and evaluation system for evidence-based policy making
Protecting health workers from being COVID-19 patients by providing enough supply of personal protective equipment (PPEs)
Increasing COVID-19 testing centers giving priority to epicenters of COVID-19
Increasing number of dedicated COVID-19 Hospitals - with designated ICU beds for COVID-19 patients who are senior citizens, those with comorbidities, severely ill and pregnant women
Shifting from a hospital centric response to an LGU-led or business sector-assisted community based systems:
Classification of each home according to capacity for quarantine (i.e. number of rooms). Every barangay should have a COVID-19 map located in the barangay hall.
Classification of provinces, cities or municipalities into those: at the epicenters, with less than 50 confirmed cases of COVID-19 or those with no confirmed cases at all at present
Classification of citizens according to risks: comorbidities, age-bracket, socio-economic class
Covering communication strategies, local government initiatives, monitoring and evaluation systems, Dr. Galvez Tan reiterates that the current situation demands proactive and creative initiatives. “We are in extraordinary times demanding extraordinary thinking and extraordinary action,” he says.
To download Dr. Galvez Tan’s full presentation, go to this link: bit.ly/COVID19andme.
The webinar series is hosted by the IPC as part of the eTuro project which aims to create an online catalog of eHealth and other health-related short courses, training opportunities, and graduate programs for healthcare professionals and health workers in the Philippines.
Replays and subsequent webinars are scheduled as follows:
Evidence-based forecasts of possible cases and scenarios on the spread of COVID-19 in the country can now be accessed thanks to the Feasibility Analysis of Syndromic Surveillance using Spatio-Temporal Epidemiological Modeler or FASSSTER.
Developed by Ateneo Center for Computing Competency and Research (ACCCRe) of Ateneo de Manila University in collaboration with the University of the Philippines Manila - National Telehealth Center (UP-NTHC) and the Department of Health-Epidemiology Bureau and funded by the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD), FASSSTER is a web-based disease surveillance platform that uses deterministic compartmental modeling.
Data generated from this technology allows policymakers to understand the pandemic at the national, regional, and local levels; assess the effects of the preventive measures in place; and use best practices in specific communities.
When the novel coronavirus or COVID-19 ravaged the country, FASSSTER determined appropriate model parameters that can be used to forecast future numbers of infections, confirmed positive cases, deaths, and recoveries.
FASSSTER dashboard generates disease models that enable users to project the effect of interventions such as community quarantine, social distancing, and optimal testing on the total number of confirmed cases, deaths, and recoveries over time. Data generated from FASSSTER, alongside health capacity and economic models developed by volunteers from Asian Institute of Management (AIM) and the Philippine Institute of Development Studies (PIDS), was used by the Inter-agency Task Force (IATF) in their recommendations and the government’s decision to extend the enhanced community quarantine (ECQ) until April 30.
Another feature of FASSSTER to address COVID-19 is the TanodCOVID, a self-reporting application which enables constituents to report COVID-19 related symptoms to their local health authorities. The data will then feed into the FASSSTER LGU dashboard which serves as a tracker for confirmed cases upon validation of Provincial/City/Municipality Epidemiology Surveillance Units. This will be useful in contact tracing and monitoring identified contacts to ensure that they are appropriately quarantined and managed.
Considering the initial interventions and precautionary measures implemented against COVID-19, FASSSTER estimates the number of confirmed positive cases in the National Capital Region (NCR).
Data gathered enabled the FASSSTER team to generate models to predict the peak number of cases and peak dates in four scenarios. The tool showed that the peak will reach around 2 million confirmed cases on May 30 if no ECQ was implemented. If, however, ECQ is lifted on April 14, with health capacity at 25%, cases will be slightly reduced to 1.5 million on July 31. If the health capacity is increased to 50%, at the same lift date, a huge decline in confirmed cases is predicted, which is now projected to reach 15,000 on May 4. The last scenario showed that cases will drop to 6,800 on May 21 if the ECQ is lifted on April 30, provided that the health system capacity reaches 75%.
The graph shows another scenario which reveals the condition of NCR. If ECQ is lifted on April 30 and health capacity is increased to 50% starting April 30, we expect a peak of confirmed positive cases of 20.9K on May 20. This information can be used by NCR to ensure that our health capacity can accommodate the management of 20.9k confirmed positive cases. Note that confirmed positive cases can further be distributed to critical, severe, and moderate/mild.
Health system capacity can be further explained by two factors: a) testing capacity, or the availability of test kits, testing centers with quantitative polymerase chain reaction (QPCR) machines, trained health workers to perform testing, and turnaround time of test results; and b) health management capacity, or the availability of health facilities, medical devices and health workers to manage the confirmed positive cases so that they are isolated and given proper medical care.
Peak date is the day with the highest number of cases. The projected maximum number of active confirmed positive cases for the duration of the outbreak is referred to as the “Peak of active confirmed cases”.
Peak date is an important factor for epidemiologists in assessing the spread of the virus, an epidemic starts to decline after the peak date. The goal of the government is to “flatten the curve” or to take the necessary preventive measures before hospitals and other healthcare facilities are overburdened with positive cases.
Aside from these data, FASSSTER is also able to project the number of people who will be: exposed, symptomatic and asymptomatic infectious, confirmed positive cases, recovered, deaths, and projected mild, severe and critical cases.
With these projections, the extension of the enhanced community quarantine was approved by the President to provide ample time for the different agencies to strengthen the capacity of the health system against the pandemic.
The initial forecast shows the level of the country's health systems capacity in containing and managing the infection. It also highlighted the need to increase the number of quarantine facilities, implement stronger healthcare programs and regular assessment of health capacities.
Disease modeling is an iterative process. As data comes in, the model will be updated to reflect the latest projections, where performance can be measured and decisions on planned interventions is driven by science.
Ano ang ginagawa ng FASSSTER at anong mga datos ang pwedeng makuha rito?
Ang FASSSTER ay isang instrumentong maaaring gamitin sa pagtataya, pagbabantay, at pagtatala ng paglaganap ng COVID-19 sa Pilipinas. Gamit ang FASSSTER maaaring malaman kung gaano karami ang maaaring magkaroon ng COVID-19 sa isang lugar at ano ang epekto at bisa ng mga isinasagawang preventive measures (hal. ECQ, social distancing, testing) sa pagkalat ng sakit.
Sa pamamagitan ng FASSSTER, maaari nating mahulaan at masabi kung gaanong karaming kaso ng COVID19 ang makikita natin sa pilipinas at sa ano mang lugar sa Pilipinas sa ano mang takdang panahon. Maari rin nating Makita ang epekto ng ibat ibang solusyon at intervention sa dami ng kaso ng covid19 sa ating bansa.
Ang FASSSTER ay maaaring gamitin ng ating mga health planners at officials at mga LGUs at ng mga tagapamuno nito upang malaman ang kalagayan ng COVID-19 sa kani-kanilang nasasakupan. Maaari itong makatulong sa “contact tracing” ng mga posibleng apektado ng COVID-19.
Paano makakatulong ang FASSSTER laban sa COVID-19?
Gamit ang FASSSTER, makikita ng ating mga health planners and officials at mga tagapamuno ng mga LGU ang mga projections ng COVID-19 na ipinapakita sa website. Ang impormasyong ito ay maaaring gamitin upang mas maging handa ang mga pasilidad at kagamitan kung sakaling makita ang pagtaas ng mga kaso sa nasasakupang munisipalidad o siyudad.
Saan kinuha ang mga datos na ginagamit ng FASSSTER?
Ginagamit ng FASSSTER ang mga datos na ibinibigay ng Department of Health - Epidemiology Bureau upang makuha ang mga model parameters na kailangan at upang maberipika ang mga projections nito. Araw-araw ay ipinapasok at ginagamit ng FASSSTER ang mga bagong datos tungkol sa mga bagong kaso, mga namatay at mga gumaling galling sa DOH.
Ano ang TanodCOVID application na kasama sa FASSSTER?
Ang TanodCOVID ay isang SMS-based symptom reporting service. Sa pamamagitan ng TanodCOVID, maaari ng i-report ng isang indibidwal ang mga sintomas na kanyang nararamdaman sa kanyang LGU pamamagitan ng isang text lamang.
Rm 313, PLDT Convergent Technologies Center
Ateneo Center for Computing Competency and Research
Department of Information Systems and Computer Science, School of Science and Engineering
The Food and Drug Administration (FDA) finally issued an approval for the commercial use of the GenAmplify™ Corona Virus 2019 (COVID-19) rRT PCR Detection Kit developed by Dr. Raul Destura of the Manila HealthTek, Inc. The FDA Advisory No. 2020-513 was released today, three days after the completion of its field validation study last April 1, 2020.
The test kit is the first locally manufactured test kit for COVID-19 and was developed in collaboration with the Philippine Genome Center (PGC) and the University of the Philippines - National Institutes of Health (UP-NIH) with support from the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD).
The approval issued by the FDA signals the start of its roll-out to several hospitals in and out of Metro Manila starting on April 4.
Dr. Destura and his team are currently working on the production of 120,000 tests - 26,000 of which will be distributed by the DOST to the Philippine General Hospital, Makati Medical Center, The Medical City in Pasig City, Vicente Sotto Memorial Medical Center in Cebu City, Southern Philippines Medical Center in Davao City, and Baguio General Hospital Medical Center in Baguio City for field implementation from April 4 to April 25. The remaining 94,000 tests will be sold commercially by the Manila HealthTek Inc.
The COVID-19 detection kit was developed to provide accessible and affordable testing for the Filipino as a response to the growing worry on the risks posed by the infection towards public health. By utilizing a one-step multiplex real-time polymerase chain reaction (PCR) platform, each test is projected to cost P1320 which is significantly cheaper than its foreign counterparts.
In the press briefing held for the test kit last March 12, DOST Secretary Fortunato T. de la Peña cited the project as an example of solutions brought by R&D that help the country achieve its national goals and address emergencies or crises.
Written by: Jwynne Gwyneth Macan Contributor: Catherine Joy Dimailig
4. Aside from a research proposal, what are other documents required when applying for a research grant to PCHRD?
Workplan Schedule (Gantt chart of activities)
Appropriate clearance needed (Ethics clearance; Biosafety clearance; Animal care and use clearance)
Informed consent form (for research involving human participants)
Case report form, if applicable
Endorsement of agency head
Duties and responsibilities of each project personnel
Letter of request addressed to PCHRD Executive Director
5. What is the evaluation process for research proposals?
In-house screening in terms of alignment to the research priorities, duplication, and completeness of requirements
Technical review by external consultants
Approval by the PCHRD Governing Council or the PCHRD Executive Director depending on the recommended total budgetary requirement of the proposal. If funding will be sourced from the DOST-Grants in Aid, the DOST Executive Committee will be the final approving body.
6. What are the PCHRD research priority areas?
For this year’s call for proposals, the DOST-PCHRD accepts proposals on the following program areas:
Functional foods, Nutrition, Food Safety
Biomedical Engineering & Health Technologies
Information and Communication Technology for health
Dengue and Other Arboviruses
Disaster Risk Reduction and Climate Change Adaptation
OMIC technologies for health (Platform technology across research priorities)
It must be in the correct order, yet it’s difficult to do. They must grasp the gown and pull it away so ties break. Then gloves must be peeled at the same time too. They’ll lift the headband, grasp the ties of their masks, and remove it without touching the front. They must remove everything without touching the contaminated parts.
“And if you do the wrong sequence, you can get infected.”
This is how Dr. Edsel Salvaña describes the donning and doffing of PPE, his unusual routine for the past weeks. As an infectious disease specialist, he is seeing suspected COVID-19 patients at the Philippine General Hospital (PGH). He is also a member of the Technical Advisory Group (TAG) that advises the Department of Health and the Inter-Agency Task Force (IATF).
Until March 14, two days after one of his patients died from pneumonia, he became a Person Under Investigation (PUI).
“It took six days for the results to return and I was still coughing,” narrated Dr. Salvaña while completing his 14-day quarantine during our online interview. His typical day though would still be pretty busy, with multiple patient care, teaching, administrative work and research work.
“It's challenging to multitask but we need to fulfill these roles since there aren't enough people with the right skills to go around,” he added. Currently, Dr. Salvaña is the Director of the Institute of Molecular Biology and Biotechnology at UP-National Institutes of Health (NIH). He also serves as a professor and research coordinator at the PGH.
On normal days, rarely do we see health workers express their emotions in caring for their patients. During these times, however, a lot of frontline health workers use different platforms to tell us how they feel being in the frontline in the fight against the COVID-19 pandemic.
As a doctor who has recently been a PUI, Dr. Salvaña has this to say: “It was really scary. Two of my patients died and they both tested positive. When I developed a sore throat, I dropped everything and had myself admitted because I did not want to expose my family.”
Things were a lot different for him though back in 2008, for after serving as Chief Fellow at the Division of Infectious Diseases in University Hospitals of Cleveland, he returned to the Philippines as a Balik Scientist of the Department of Science and Technology through the Philippine Council for Health Research and Development (DOST-PCHRD).
The health community would say that Dr. Salvaña is a very important person in the field of HIV research and medicine. Upon his return as a Balik Scientist, he recognized the HIV epidemic in the country, and was heavily involved in training doctors to treat HIV, raising awareness, and successfully lobbying the policymakers to declare an AIDS pandemic. TED talk even wrote that he has been a “national force in the formulation of HIV treatment guidelines, campaigning against stigma, and raising awareness.”
Despite his numerous experiences in facing HIV patients, and while he knows pandemics in theory, he stressed that there is nothing like a real on to make you appreciate how devastating they can be. He noted “I don't think anything has prepared us for this. My knowledge of infectious diseases enabled me to project very clearly in my head what would happen if we did not act early. If our health system is overwhelmed, thousands could die.” He added that this has helped him advise the IATF, and said he is glad they listened.
This is not his first time working with policymakers. Currently, he is also the head of the subcommittee for HIV of the Philippine Society for Microbiology and Infectious Diseases, and was an institutional representative at the Global Fund Country Coordinating Mechanism. He has led the formulation of local clinical practice guidelines for the treatment of opportunistic infections in HIV, and has established the first HIV fellowship in the country.
“It also helped that I told them [IATF] that every disaster movie begins with everyone ignoring a scientist. They didn't ignore me and they listened. Hopefully we have changed the ending,” Dr. Salvaña, on being a member of the TAG said. He has done research on a pandemic before. He studied the molecular epidemiology of the A(H1N1) influenza, analyzing hundreds of virus samples from the 2009 to 2010 epidemic.
During our interview, Dr. Salvaña mentioned that it’s “super scary” to be a front line health worker during this pandemic. When asked about how he feels during this crisis, he has this to say: “Well, this is what I trained for. It's always scary, but it's also exciting because you know the skills you acquired during training are being put to good use and can potentially save a lot of lives.”
While most must know by now that doctors face a multitude of risks by serving in the front lines, we’re still curious as to why they risk their lives to serve the people. And Dr. Salvana told me, “I've been a government scholar since high school. I am Philippine Science High School Batch 1992, an Oblation Scholar at UP Diliman, and I did my medical training at the UP College of Medicine. After training further in the United States, I came home as a long-term Balik Scientist. So I've always felt the need to give back. I'm just really lucky that what I do is useful and beneficial to the country.”
What should be the right word though, to describe how it must be a happy and sad feeling, for someone to offer his life to his country. He is just one of the thousands of our frontline health workers who repetitively do the donning and doffing of PPEs in the correct sequence to avoid getting infected.
Thankfully, Dr. Salvaña’s test turned out negative for COVID-19 infection. After his quarantine, he will still continue to care for patients, coordinate donations, and do research work just like his routine weeks before.
As of March 31, the Philippines lost twelve of its brave doctors to COVID-19. Despite this, Dr. Salvaña has this to say to his fellow frontline workers: “I know you are scared, just like me. But we are the only thing standing between this monster and our families and friends. This is what we are trained for. Some of us may die. But we die doing our duty and on our terms. Whatever happens, we will make a difference.”