Just days into the new year and the country is facing yet another surge in COVID-19 cases. With the pandemic entering its third year in the Philippines and across the world, those handling the response should have learned from the evidence in mitigating the spread of the virus. Instead, however, local authorities have put so much premium on vaccination over other interventions to the point that it has now resorted to locking down the unvaccinated and allowing essential services like testing to be paid out-of-pocket.
The more infectious Omicron variant has assumed to be driving the rapid increase of cases locally, especially with the four known local cases detected in NCR and the Bicol region. However, it must be noted that there have been significantly fewer samples available for genomic sequencing given low testing. From the IATF and DOH’s promise of 90,000-100,000 tests per day, December saw a mere 20,000-30,000 tests daily.
This only shows a testing system based on demand and symptoms instead of active surveillance. However, price continues to be an issue for many who have become apprehensive toward the idea of testing, which has still not been addressed. Despite lowering the price ceiling for COVID-19 tests by the DOH, the upper limit remains expensive, at P2,800 for public and P3,360 for private.
Given that majority of testing laboratories are private, this further drives up the cost. To make matters worse, in December 2021, PhilHealth reduced its coverage or subsidy for testing, with the benefit package for PCR testing reduced to P800-P2,800 from P901-P3,409. With 28 provinces still without a testing lab and an additional three without a public facility, the integral aspect of testing is still neither free nor accessible to all Filipinos.
With a variant that can infect as high as 12-16 other individuals, regardless of vaccination status, mass testing is as important as ever. This is the cornerstone of any COVID-19 response, and is the starting point of other, yet equally as important, interventions—contact tracing, quarantine and isolation, and treatment. While vaccination is also key to ending the pandemic phase, testing remains essential to detecting breakthrough infections, something increasingly seen with Delta, Omicron, and potential future variants. Communities must have these services available and accessible to truly address the infectious disease and its social determinants.
The Coalition for People’s Right to Health (CPRH) renews and reiterates its call for #FreeMassTesting now more than ever. The IATF, NTF, and health leadership must cease resting on its imagined laurels from a vaccination campaign that has not even met its 2021 targets. As government investigates the obvious failures in weak quarantine protocols at entry points while dealing with vaccine inequity and hesitancy, we must not neglect testing the way it has been in the past two years. Access to testing must be ensured, especially for symptomatic individuals and those who cannot afford to work from home, regardless of vaccination status.
This can be done through maintaining a pricing methodology that acknowledges the effect of the economic crisis on patients, rather than enabling laboratories to charge an “allowable markup” which is already exorbitant at 20 percent. In a genuinely free and comprehensive health system, the state must address out-of-pocket spending instead of worsening it. Through greater health benefits, national or local subsidies, incentivization and direct investment in provincial laboratories, access to testing can be vastly improved if such an integral health service is seen as the people’s right amid an ongoing and worsening health crisis.
The evolution of variants necessitates a health response that can equally adapt to concrete conditions. This entails that testing be made as accessible as possible, from proximity to cost. Omicron and future variants will continue to infect people, both vaccinated and unvaccinated; we must be one step ahead in detecting and preventing its spread in communities. In fulfillment of the right to health, and as a New Year’s resolution, CPRH demands that testing be finally made free and accessible for the people.
JOSHUA L. SAN PEDRO, MD
Co-convenor
Coalition for People’s Right to Health
cprh.ph@gmail.com