Usec Juan Antonio Perez III, Executive Director

Who is hurting the most in this pandemic?

AS we are well into the second year of the pandemic, it is time to take stock. And in a long list of priorities, we all need to know who is hurting the most – a year and two months after the government declared a public-health emergency when it detected a few cases of local transmission of the coronavirus disease 2019 (Covid-19).

At the onset of Year 1, it was clear that the threat of Covid-19 was entirely external, initially brought by nationals of neighboring China. Cases were next seen in other nationals from Asean countries. Eventually, overseas Filipino workers and seafarers started coming home, initially as stranded individuals in quarantine hotels before being sent all over the country as locally stranded individuals (LSIs).

At that stage, early in the pandemic, the Department of Health, as the national health agency, was literally doing contact tracing through about a dozen or less contact tracing teams run from the central office—although the government had declared a national public-health emergency.

A second wave of cases in August 2020 showed that Covid-19 had reached all regions of the country. The “Balik Probinsiya” program was nipped in the bud, as local chief executives grew suspicious of LSIs from Metro Manila coming home by busloads or shiploads.

These days, well within our “third wave” (which has far exceeded last August’s surge), national agencies fret about the need for more intensive-care units (ICU) beds and more isolation wards (which also begs the questions: how many restaurant tables can be filled, and whether taipans can buy vaccines for their employees (and of course, donate some for the poor…)). Yet, the poorest Filipinos are continuing to bear the burden of the pandemic.

While people write about the difficulty of getting an ICU bed, or even to gain admission to emergency rooms, the poorest among us are dying in even greater numbers in densely populated communities; more so, in the far-flung barangays where death is almost as common as in city barangays, because they have no means to bring their patients to the cities.

Narrative of the spread

FOR the poor in Barangays Addition Hills in Mandaluyong City, Pinagbuhatan in Pasig City, and Commonwealth in Quezon City, nearby medical centers could just as well be “on the moon;” they would not even dare approach these hospitals without seeking first the sponsorship of a politician.

The result is that in the Philippine Statistics Authority’s 2020 reports, two out of every three deaths from the pandemic were not even tested to confirm a “Covid” diagnosis. Doctors had to use their clinical acumen to confirm what the families knew: the virus had descended their homes.

The story of Covid-19 in Mandaluyong City is a microcosm of the way the contagion invaded our communities, and eventually dug deep roots in our poor urban barangays. The first case came from a foreign national (Singaporean, I believe) who played in the Wack-Wack Golf Course on March 21. Other cases also were reported within days in Highway Hills, which has a large number of high-rise condominiums.

Since the Singaporean had apparently gone home, Mandaluyong City was now reporting infections among local residents from Wack-Wack and Highway Hills. Within a month, Covid-19 had jumped from gated subdivisions and condos to urban poor communities, which were seeing more cases of infections.

By the time the first enhanced community quarantine in May 2020 was lifted mid-month, Barangays Mauway and Addition Hills were competing for the top spot for the most number of Covid-19 cases in Mandaluyong City, while cases in Wack-Wack and Highway Hills had flatlined. By the end of May—when the general community quarantine was imposed—Addition Hills had taken the top spot for the most number of cases and deaths.

What happened in Mandaluyong?

WITHIN a week of the first local transmission, the virus in Wack-Wack—a barangay which occupies one-fourth of the land area of the Mandaluyong City with a population of over 3,000, had jumped the fence literally and crossed Shaw Boulevard to find more hosts. By August Covid-19 infections were highest in Addition Hills, which has a land area half that of Wack-Wack, but with a population of almost 70,000.

Today all barangays in Mandaluyong City continue to grapple with Covid-19. By the second year of the pandemic, Addition Hills had seen 52 deaths from the contagion and Wack-Wack, four casualties.

Covid-19 has come to roost in the teeming, makeshift houses in Addition Hills, where only the small streets full of vendors break the monotony of tin roofs competing for a small share of the visible sky.

It is in communities like Addition Hills where Covid-19 has, regrettably, found a home—and continues to hurt the most vulnerable Filipinos. The lines of defense need to be drawn in our communities to win this battle.

-Usec. Juan Antonio A. Perez III, MD, MPH