Managing the threat

How prepared is the Philippines to cope with the Middle East respiratory syndrome coronavirus (MERS-CoV)?

The World Health Organization says 243 confirmed cases of MERS-CoV have been reported worldwide, including 93 deaths, since March 2012. The virus has crossed the Middle East and traveled the globe; in South Korea, hundreds, many of them health workers, have been infected, and at least 19 have died.

Fears about MERS-CoV have been exacerbated by its uncertain cause: It is said to have mutated and jumped to humans from camels or bats, its original hosts. Though not airborne, it infects those in close contact with the afflicted.

No vaccine has yet been developed to counter it, and treatment has been limited to relieving its symptoms which, unfortunately, are too similar to that of the ordinary flu: cold, cough, fever, shortness of breath, chills, diarrhea—symptoms common enough for people to shrug off as self-limiting, until they deteriorate into pneumonia or kidney failure.

Even more worrying is the Philippines’ labor export policy under which at least two million Filipinos are working overseas, such as in the Middle East, and possibly coming in contact with carriers of the virus. Which begs the question: Has the Department of Health, which insists that the Philippines is well-prepared for MERS-CoV, considered this unique factor in addressing what could become an outbreak?

“The Philippines is fully prepared to thwart and contain MERS-CoV, and government has put in place all the necessary preventive measures, including contact-tracing and other infection control protocols to isolate those exhibiting symptoms of the virus,” Communications Secretary Herminio Coloma has announced.

But the Private Hospital Association of the Philippines through its president Rustico Jimenez is saying that not all private hospitals in the country are physically capable of handling MERS-CoV. “Only a few hospitals have isolation rooms or negative pressure rooms for patients with infectious diseases, and they can only accommodate a few patients,” Jimenez said. Even the San Lazaro Hospital and the Research Institute for Tropical Medicine (RITM) will be overwhelmed in case of an outbreak, he said, adding that even healthcare workers in private hospitals are not adequately trained to manage MERS-CoV patients.

Short of seeking a travel ban to and from South Korea, Jimenez also said, the government must review screening procedures not only at the airports but in seaports as well in order to track possible cases.

Health Secretary Janette Garin has since rejected such a travel ban, saying it would only make contact-tracing doubly difficult. She assured the public of more airport scanners coming in, and government hospitals assisting smaller private hospitals unprepared to handle MERS-CoV. “In the past, private hospitals would call us so we pick up the patients and transfer them to government hospitals,” she said.

But that scenario provides scant comfort, and prevention seems the most viable option given the Philippine healthcare system’s severe limitations. A concerted prevention effort can start now, with a vigorous information and education campaign that the government, the private sector and the media can hopefully manage together.

Despite the seriousness of the threat, there are not enough reminders and health notices in public spaces with precise and accurate information on the virus and how to prevent its transmission: Avoid crowded places, wash hands thoroughly and frequently, cover the mouth when sneezing or coughing, dispose of used tissue properly, consult a doctor should any of the symptoms be experienced, and so on.

Rather than stoking panic and “sowing intrigue,” as the health secretary has warned, timely, relevant and accurate information as well as guidelines will serve to counter speculation on and sheer ignorance of the possible danger.

The government can also walk its talk by assigning medical attaches to attend to our new heroes in the Middle East and help direct them to health-seeking behavior, including the need to take extra precautions in the face of this current threat.

Since 2013, a total of 10 Filipinos—eight from Saudi Arabia and two from the United Arab Emirates—have died after contracting the virus. Another, from Saudi Arabia, has tested positive and is now in isolation at the RITM together with her husband.