Twin threats to health sector

If there’s anything the pandemic should have taught us, it’s that we must always be prepared for a crisis. Or more precisely, we must never be caught off guard by it, having anticipated it well in advance, such that any emergency is averted, managed or mitigated long before taking root.

Whether the government, particularly the Department of Health (DOH), has learned this lesson well, or at all, appears to be in serious doubt, considering the outbreaks of two erstwhile-eradicated diseases that threaten to cripple our health sector yet again, not even a year since the lifting of the global and national emergency due to COVID-19.

That pertussis, or whooping cough, and measles have reemerged as life-threatening infections in our country, especially among children, exposes once more the same vulnerabilities that paralyzed our health-care systems at the peak of the pandemic.

Low vaccination coverage

Ironically, it was the COVID-19 crisis itself that essentially birthed the conditions which resulted in the twin threats posed by pertussis and measles to young Filipinos today.

Last week, Health Undersecretary Eric Tayag blamed the rise of the two diseases to low vaccination coverage of Filipino children since the onset of the pandemic in 2020. “During the height of the COVID-19 pandemic, lockdowns were implemented and children were not brought to their health centers for their routine immunization. When restrictions were lifted, some parents were still afraid to bring their children outside in fear of contracting COVID-19,” he said.

At present, only 72 percent of over two million children aged one year and younger are fully immunized under the DOH National Immunization Program—far below the 90-percent target to protect the population from vaccine-preventable diseases.

568 reported cases

The consequence of such low vaccination rates has been nothing short of disastrous.

To date, four local government units (LGUs) have declared a pertussis outbreak: Quezon City and Pasig City in Metro Manila; Cavite province; and Iloilo City in the Visayas, while a measles outbreak has been declared in the entire Bangsamoro Autonomous Region in Muslim Mindanao (BARMM). More cities and towns are expected to declare outbreaks once updated data are sent to the DOH Central Office in Manila, the DOH said.

As of March 16, the DOH said there were already 568 reported cases of pertussis, several times higher than the 23 pertussis cases in the same period last year. Of these, 40 have died, mostly infants.

On the other hand, from September 2023 to March this year, over 2,600 measles cases have been recorded, of which 1,400 were from BARMM alone. The self-governing region’s health ministry said three children—two in Lanao del Sur and one in Sulu—had died of measles since the start of the year.

Upcoming vaccine delivery

The light at the end of this dark tunnel is that the DOH is expecting the delivery of at least eight million vaccine doses “at the soonest possible time.” The agency’s Disease Prevention and Control Bureau, in coordination with its Procurement Service, will receive some three million pentavalent (5-in-1) vaccine doses, which protect not only against pertussis but diphtheria, tetanus, hepatitis B, and Haemophilus influenzae type B, and some five million measles-rubella vaccine doses.

These batches will augment more than 64,400 and 2.6 million doses of pentavalent and measles-rubella vaccines, respectively, that are already being distributed by the DOH. The pledge came after some local governments had complained of a shortage of pentavalent and MMR (measles-mumps-rubella) vaccines.

Since late March, hospitals have been on “Code Blue,” or medical emergency, for the implementation of “intensified activities to mitigate the spread of the virus through vaccination, micronutrient supplementation, community engagement, and risk communication” across the country, the DOH said.

Catchup vaccinations

In the meantime, LGUs and private medical facilities are being urged to help in “catchup vaccinations,” especially during the just-concluded Holy Week break, for children who missed their immunization shots.

“We are racing against time,” Tayag said.

With due respect to our health officials, this looming crisis could have been prevented, were it not for the DOH’s own shortage of foresight. The data on low vaccination rates were already at hand, but it’s clear that the agency didn’t sound the alarm bells early enough to swiftly contain the emerging threat.

Of course, another unspoken variable is the persistent harm of disinformation being waged by so-called anti-vaxxers on social media—fueled by the Dengvaxia fiasco of a few years ago—that may be stopping many parents from having their children jabbed.

The government’s task ahead is to reintroduce the concept of herd immunity to convince the public that vaccinations are safe and will protect not only their families but the whole population from an early and preventable death.