COVID-19 and greater disaster resilience

The jolt of a new coronavirus outbreak should motivate governments to strengthen resilience to disasters, especially frequent in the Philippines. COVID-19 continues to unfold dangerously as seen in Italy, Iran, and Spain. In the Philippines, that the new coronavirus broke out as communities were struggling to recover from the Taal Volcano eruption highlights the urgency for preparedness. And the rainy season will soon be upon us, with the attendant fears of fiercer typhoons and floods.

That the Philippines scores above the global average on the World Health Organization’s Global Health Security Index is of no comfort. This is because the global average of the measures of prevention, early detection, rapid response, health system quality, standards, and risk environment is a low 40.2 out of 100. The Philippines’ score is 47.6 (53/195 countries), showing that preparedness for COVID-19 needs to be fortified. The shortage of test kits is alarming.

COVID-19 is still not well enough known for us to be able to anticipate its behavior. But we do know from past emergencies the priorities for action. The following six priorities are particularly relevant to the Philippines.

The first urgency is to protect high-risk groups—the elderly, the sick, and frontline health care workers—by taking measures to reduce their exposure to the virus and to prioritize them for medical support.

Second, clear surveillance protocols are needed. Close attention must be paid to high-risk groups in each province and to monitor community transmission. There is a need for decentralized testing centers, including drive-by testing and quarantine facilities. Each province should do a “stress test” to reveal crucial gaps, such as in diagnostic equipment and prevention protocols.

Third, as in most Asian countries, the government needs to increase spending to strengthen the capability of health services to deal with public health emergencies, particularly surges in case numbers. Government health expenditure as a share of GDP in the Philippines needs to be higher for a middle-income country. Another concern is that Filipinos make sizable out-of-pocket expenses for health. By one estimate, there is one doctor for 33,000 patients and one hospital bed for 1,121 patients.

Fourth, Asian countries should strengthen partnerships between the public and private sectors, for example between government agencies and the pharmaceutical industry, to help maintain supply chains. Collaborative approaches exist for tuberculosis, AIDS, and malaria, but more is needed for disasters on the scale of COVID-19 and SARS. A flexible loan facility, as the World Bank and the Asian Development Bank have for natural disasters, can boost the country’s resources. Networks for health professionals are vital to address clusters of infections.

The fifth priority is to tackle the growing link between environmental changes and new viruses, and the dangerous interaction between particulate matter and viral respiratory tract infections that are being noted in epidemiological studies. Two-thirds of known pathogens and three-quarters of newly emerging pathogens are spread from animals to humans, triggered by increased human encroachment on wildlife territory. So, protecting biodiversity should be a priority for national health, too.

The sixth is clear communication of risk levels and steps to help health professionals and the public to prepare as calmly as possible for emergencies. This would help reduce panic-buying, for example, as in the COVID-19 outbreak. It is crucial to understand diagnostic tools and surveillance systems linking laboratory information with electronic health records. China’s handling of COVID-19 showed the cost of delaying the announcement of the outbreak. Global lessons speak to the need to build public trust. In the Philippines, overseas workers need to get accurate and timely information for wise travel decisions over Easter, for example.

The Philippines is increasingly at the sharp end of disaster risks. COVID-19 might just provide the needed push to invest more and better in disaster resilience.

Vinod Thomas (vthomas@aim.org) is a visiting professor at the Asian Institute of Management.