A crisis for all

With the COVID-19 wave about to engulf us, our response needs to be nuanced to the huge disparities in this country. The enhanced community quarantine, while certainly warranted, has markedly different impacts depending on where we sit on the income ladder. There is no doubt we all suffer from these measures, but we suffer to a greatly different extent.

For the 2.5 million people in Metro Manila who reside in crowded slums, or the 15.1 million poor households nationwide, community quarantining and social distancing have entirely different implications. Lost income from restricted movement matters greatly, not just to the income earner but also to the whole family dependent on those earnings. There are no savings to draw upon. Because they’re crowded in one room that may be 3 square meters, it is unrealistic to think that social distancing is possible. Collecting water or washing at communal points, walking through narrow alleyways, just stepping out to get some sunlight and less fetid air, or walking three hours to and from work because of the absence of public transport—all these present a whole set of risks.

Certainly, efforts to suppress transmission with strict community quarantine measures need to be in place. But what are the complementary policies and programs for the poor? Can the administration increase the amount and frequency of social safety net payments? Can we, as we would in the aftermath of a destructive typhoon, provide emergency water, sanitation, and food aid? These are preventative and alleviation measures. But there is also a looming crisis that requires a viable contingency plan. National epidemiologists are estimating that the number of people infected could rise to 75,000 within a few months (what about the projected fatality rate?), and that is likely a conservative figure. A significant proportion could be the poor living in crowded slums.

Local governments will need to run the numbers and develop the worst-case scenarios for planning. Personal protective equipment for frontline workers, testing kits (the World Health Organization tells us we must “test, test, test”), ventilators, sanitizers, ICU beds, and alternative bed space (for hospitals that may quickly reach their limits to house the sick), etc., need to be provided quickly. Much of this will be challenging given the huge demand on global supply. Health facilities have to be accessible, and ideally, testing and health services should be taken directly to poor communities. Innovative approaches to tracing and isolation in crowded slums areas will have to be implemented. The assignment of health workers needs to be calibrated to where the greatest numbers are likely to be.

The Senate and the House of Representatives approved early Tuesday morning the “Bayanihan To Heal As One Act,” which grants President Duterte expanded powers to address the COVID-19 health crisis, including reprogramming and reallocating savings from appropriations under the Executive branch in the 2020 General Appropriations Act, providing for a 30-day grace period for payment of loans and residential rents, moving the deadline for payment of taxes, expanding the Pantawid Pamilya program, and exempting from import taxes the importation of equipment and supplies needed for the fight against COVID-19.

This is now a matter of both the quantum and quality of expenditure. At all costs, we need to avoid the ethical dilemma of choosing whose life to save or care for. Income should certainly not be the defining factor. We are about to head into not only a health crisis, but also a humanitarian crisis. We need to act accordingly and leave no one behind.

Titon Mitra is the resident representative of the United Nations Development Program-Philippines.