impact of covid 19 in the philippines essay brainly

Stanford University

COVID-19 in the Philippines – at a Glance

• Marjorie Pajaron

This is the third installment in our series, “Stories in a Time of Pandemic,” in which APARC alumni across Asia share their perspectives on the responses to and implications of COVID-19 in their communities. In part 1 and part 2 of the series, we feature observations from our alumni in China, Mongolia, Myanmar, and Singapore.

The first case of COVID-19 in the Philippines was reported on January 30, 2020, and local transmission was confirmed on March 7, 2020. As of May 21, the number of cases of COVID-19 has risen to 13,434 and the number of deaths attributed to the virus increased to 846, according to the Philippine Department of Health COVID-19 Case Tracker . It is quite alarming that among the ASEAN countries, the Philippines had the second-highest mortality due to COVID-19, next to Indonesia (as per May 5 date by the WHO COVID-19 Dashboard ). This could be attributed to several factors, including whether the country’s health system can handle the overwhelming demand for health care due to the COVID-19 crisis and how effective the government’s response is in stemming the spread of this new pathogen. Inherent in the death statistics is the capacity of a country to conduct COVID-19 tests, which means that there should be a sufficient number of test kits available and that the health workers are properly trained to conduct the tests, trace the contacts, and isolate identified individuals.

The President of the Philippines imposed a total lockdown called enhanced community quarantine (ECQ) for the entire island of Luzon, which encompasses eight administrative regions, including the national capital region, from March 15 to April 30. Other parts of the country have also been under some degree of quarantine at different periods since the appearance of local transmission. Executive Order 112 , signed on April 30, 2020, was issued to further extend the ECQ in identified high-risk areas and a general community quarantine (GCQ) in the rest of the country. The inter-agency task force for the management of emerging infectious diseases defines ECQ as the implementation of temporary restrictions on the mobility of people, strict regulations of industries, and a heightened presence of uniformed personnel. GCQ is, in a nutshell, a less strict version of ECQ.

The Philippines has faced a lot of challenges during this crisis. First, the health system lacks adequate surge capacity to safely handle a nationwide outbreak of COVID-19 due to shortages of personal protective equipment (PPE), mechanical ventilators, and hospitals with ICUs and isolation beds (see this World Bank report and this Rappler article ). More importantly, the insufficient number of health workers , especially in areas outside the metropolitan, is a major concern. Nonetheless, the Department of Health has worked hard to meet the surge in demand due to COVID-19, including partnering with the private sector to repurpose structures and providing data to the public to ensure transparency and accountability. As in other countries, the health workers and those with frontline responsibilities have truly been the new heroes or “bayani” with their tireless efforts and sacrifices. 

Another challenge pertains to the adverse economic impact of COVID-19. The Philippines has a relatively large informal sector and the income of many families depends on daily transactions with no formal job or social security. This has prompted the government to extend cash or in-kind support to vulnerable populations – a response that has posed several challenges, particularly related to the who/what/how framework. First, the Philippine government had to properly identify those in need (who). Second, it had to ensure that sufficient resources can be allocated to the identified groups (what). And third, it had to distribute aid in an efficient, timely, and equitable way (how). The government's social welfare efforts to provide for the vulnerable groups have mixed results: at times, the distribution of aid is organized and efficient, at other times insufficient and disorderly (see these CNN Philippines reports of April 7 and April 30 ).

COVID-19 in the Philippines – How Filipinos Have Coped

There has been a strong spirit of “bayanihan” or collectivism in the country amidst the COVID-19 crisis. People are volunteering, distributing goods to vulnerable groups, or donating PPE to those with frontline duties. Some enterprises also rose to the occasion by repurposing their businesses to meet the local demand for medical products and PPE.

Different individuals have coped differently: some have welcomed the work hiatus that the quarantine has afforded them, some connected more with friends and family, others become more productive working from home. Staying healthy and being mindful are also factors that contribute to remaining calm and rational in this time of national distress.

Despite the challenges, we will continue to face, especially once the quarantine has eased and the new normal is in effect, we can say that Filipinos have also learned some valuable lessons amid this crisis. For one, Filipinos have become more mindful of the importance of good sanitation and non-pharmaceutical public health measures in mitigating the transmission of the virus. Most Filipinos have also become more proactive in their approach, keeping social distance, wearing masks, and practicing proper handwashing, among others. Furthermore, this crisis has redefined and created new heroes who rose to the challenge – from those staying at home to avoid the further spread of the virus to those on the frontline who have dedicated their time and effort to combat the pandemic, to government and business leaders who have served the country sincerely during this crisis.

Perhaps there really is a silver lining in every cloud.

Lessons from Mongolia’s COVID-19 Containment Strategy

Stories in a time of pandemic: aparc alumni share their experiences.

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Pandemic in 2021: How the Philippines responded to COVID-19

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This is AI generated summarization, which may have errors. For context, always refer to the full article.

The second year of the coronavirus pandemic in the Philippines was, in a number of ways, similar to the first. 

Lockdowns remained for the most part of the year as two waves of COVID-19 ravaged the country. While several millions of Filipinos were able to get vaccinated throughout the year, experts flagged the vaccination campaign’s sluggish pace. 

In the middle of it all, lawmakers investigated alleged anomalies involving billions of pesos in the Duterte administration’s pandemic contracts. These were probed in marathon Senate hearings that went on for months on end.

It was not until the latter part of the year until new daily coronavirus cases were reported only in the hundreds, restrictions were eased, and mandatory face shield policies were dropped – finally giving some kind of sense that, perhaps, the Philippines was getting out of the woods. (READ: Does wearing a face shield protect against COVID-19? )

While the holidays may be looking up for many Filipinos, the threat of a new variant of concern looms, and experts say that there is still a need to practice “risk-based” decisions when choosing activities and engagements despite the relatively low cases.

Here’s a list of stories reviewing what happened during the COVID-19 pandemic in 2021.

As the Philippines’ vaccination campaign began in March, one of the government’s main goals was to get as many Filipinos vaccinated. We monitored the arrival and rollout of the vaccines in these trackers, as well as where COVID-19 cases were most prevalent. We also chronicle the significant events in the pandemic in a running timeline.

• TRACKER: The Philippines’ COVID-19 vaccine distribution
• TRACKER: Status of vaccination in Metro Manila
• TRACKER: The Philippines’ plans for COVID-19 boosters, third doses
• MAPS: COVID-19 in the Philippines
• TIMELINE: The novel coronavirus pandemic

Things we learned about COVID-19

These stories and explainers explore new information about the virus as they came.

Why did we need to pay attention to the virus when it mutated?

• EXPLAINER: Ano ang pagkakaiba ng mutation, variant, at strain?
• What we know so far about new COVID-19 variant found in PH
• FAST FACTS: The coronavirus Lambda variant
• What the surge fueled by the Delta variant taught us
• Beyond the Stories: Ano’ng dapat malaman tungkol sa Omicron variant?

How did the public and health experts tackle the ivermectin debate, when it was floated as a possible alternative treatment to COVID-19?

• COVID-19: The Philippines’ race for a cure
• Are we missing out on alternative treatments for COVID-19?
• EXPLAINER: Myths and facts about ivermectin
• In fierce Ivermectin debate, doctors remind: ‘Do no harm’

How did we learn to understand the dynamics of new variants and vaccines, and was herd immunity the only goal? 

• Can COVID-19 vaccines in the Philippines beat Delta?
• 5 myths about COVID-19 vaccines debunked
• EXPLAINER: COVID-19 patients at PGH mostly unvaccinated
• In COVID-19 battle, herd immunity isn’t the only goal the PH needs to reach
• COVID-19 holiday plans: What would experts do?

Plight of health workers

Two deadly surges took an unprecedented toll on health workers employed in a healthcare system which had problems spilling over from before the pandemic began. 

The release to workers of their benefits mandated by law was also a rocky discussion as the Department of Health’s spending was put under scrutiny.

• Overworked, underpaid health workers are walking away as Delta ravages PH
• Are the doctors alright? Frontliners in remote areas feel Manila’s neglect
• Doctors plead with gov’t: ‘We can’t fight this virus with antiquated methods’
• How Philippine contact tracers lost track of the virus
• Philippine contact tracers: The forgotten frontliners
• Underpaid health workers walk out, call for Duque resignation at mass protests
• What you should know about COVID-19 hazard pay, special risk allowance

The Duterte COVID-19 response

The pandemic response of President Rodrigo Duterte was not without criticism on matters of public health policy, public funds management, and governance.

• PH scores lowest among ASEAN countries in gov’t pandemic response – survey
• ‘NCR Plus’ bubble vs COVID-19 pointless with lax LGU borders
• PH may be among last in Southeast Asia to reach herd immunity
• What you need to know about Duterte’s COVID-19 loans
• Many unknowns in Duterte’s COVID-19 jab as PH fights vaccine hesitancy
• EXPLAINER: What went wrong with Duterte’s pandemic response?
• EXPLAINER: The Philippines’ fight vs vaccine hesitancy
• Hesitancy not a major driver for PH’s low vaccination rates
• President Duterte, you can still get COVID-19 under control
• Duterte’s longest SONA leaves Filipinos hanging on pandemic recovery
• Often-ignored COA fuels pandemic outrage vs Duterte gov’t
• DOH’s poor use of P67 billion COVID-19 funds led to ‘missed opportunities’ – auditors
• DOH failed to spend P2.07 billion after parking it in PS-DBM in 2020
• How the Duterte gov’t shut out local PPE producers during a pandemic
• PH’s last-minute quarantine changes force travelers to spend thousands

Jobs and economy

The health crisis coincided with an economic crisis that was experienced locally and globally. Here’s what it was like for Filipinos in 2021.

• Philippines offers nurses in exchange for vaccines from Britain, Germany
• Labor secretary Bello aims to deploy more nurses, healthcare staff overseas
• With fresh lockdowns, 3.88 million Filipinos jobless in August 2021
• Philippines lowers 2021 economic growth target over fresh lockdowns, Delta
• Delta variant puts Philippine economy among most vulnerable in Asia
• COVID-19 pandemic to cost PH P41.4 trillion over next 4 decades – NEDA
• Philippine GDP growth slows but beats forecasts at 7.1% in Q3 2021
• Philippines raises deployment cap of healthcare workers to 7,000

Despair, ‘bayanihan’ amid crisis

The Philippines recorded millions of positive cases and tens of thousands dead – with more added to the health department’s daily tally. These are stories of people behind the numbers, as well as how Filipinos in the country and abroad banded together in times of crisis. 

• Philippines’ COVID-19 surge tears through families
• Facebook as lifeline: Desperate Filipinos turn to strangers for help
• Community pantries: Is it a ‘revolution’ when Filipinos just want to give?
• ‘Take care of your neighbor’: Communities battle doubts about COVID-19 vaccines
• Healthcare professionals turn to TikTok to fact-check, debunk health myths
• Through virus surge and separation, Filipinos in Indonesia closer than ever
• ‘Last year was nothing compared to now’: Learning from India’s second wave

The Pharmally controversy

As Filipinos struggled to survive, lawmakers investigated allegations of misspending in the government’s pandemic funds. These anomalies, which sprung from irregularities found by the Commission on Audit, had ties to the President himself.

• Biggest pandemic supplier has links to ex-Duterte adviser Michael Yang
• Pharmally had P625,000 capital before bagging P8 billion in COVID-19 contracts
• Pharmally bags P2 billion more deals in 2021
• PANOORIN: Bakit kahina-hinala ang pagkakuha ng Pharmally ng mga kontrata sa pandemya?
• ‘We swindled gov’t’: Pharmally changed expiry date of medical-grade face shields
• 2 days after bombshell testimony, Pharmally exec can’t be contacted by Senate panel
• Furious Duterte seeks to block Cabinet, witnesses from appearing in Senate probe
• Rigged favors for Pharmally, substandard supplies are graft – senators
• Pharmally’s Krizle Mago recants Senate testimony: ‘It was a pressured response’
• ‘Sue us instead’: Jailed Pharmally execs still won’t budge over missing documents

– Rappler.com

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Philippines

Health Systems Impact of COVID-19 in the Philippines

Attachments.

Diana Beatriz S. Bayani and Soon Guan Tan

Lockdowns and policy actions to curtail the transmission of COVID-19 have widespread health system, economic, and societal impacts. Health systems of low-to-middle-income countries may have fewer buffering resources and capacity against shocks from a pandemic. This paper presents a preliminary review on the collateral health systems impact of COVID-19 in the Philippines through review of academic and grey literature, supplemented by a qualitative survey. Community quarantines alongside transport and boarder restrictions have universally impacted health service access and delivery, affecting patients requiring specialist care the most. Existing record-keeping and surveillance measures were hampered as existing resources were tapped to perform COVID19-related tasks. Local health systems reinforced gatekeeping mechanisms for secondary and tertiary care through referral systems and implemented telemedicine services to reduce face-to-face consultation. The health system impacts in the Philippines have been variegated across municipal income class and topography, contributed by long-standing symptoms of inequitable resource allocation.

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The Philippine economy under the pandemic: From Asian tiger to sick man again?

Subscribe to the center for asia policy studies bulletin, ronald u. mendoza ronald u. mendoza dean and professor, ateneo school of government - ateneo de manila university @profrum.

August 2, 2021

In 2019, the Philippines was one of the fastest growing economies in the world. It finally shed its “sick man of Asia” reputation obtained during the economic collapse towards the end of the Ferdinand Marcos regime in the mid-1980s. After decades of painstaking reform — not to mention paying back debts incurred under the dictatorship — the country’s economic renaissance took root in the decade prior to the pandemic. Posting over 6 percent average annual growth between 2010 and 2019 (computed from the Philippine Statistics Authority data on GDP growth rates at constant 2018 prices), the Philippines was touted as the next Asian tiger economy .

That was prior to COVID-19.

The rude awakening from the pandemic was that a services- and remittances-led growth model doesn’t do too well in a global disease outbreak. The Philippines’ economic growth faltered in 2020 — entering negative territory for the first time since 1999 — and the country experienced one of the deepest contractions in the Association of Southeast Asian Nations (ASEAN) that year (Figure 1).

Figure 1: GDP growth for selected ASEAN countries

And while the government forecasts a slight rebound in 2021, some analysts are concerned over an uncertain and weak recovery, due to the country’s protracted lockdown and inability to shift to a more efficient containment strategy. The Philippines has relied instead on draconian mobility restrictions across large sections of the country’s key cities and growth hubs every time a COVID-19 surge threatens to overwhelm the country’s health system.

What went wrong?

How does one of the fastest growing economies in Asia falter? It would be too simplistic to blame this all on the pandemic.

First, the Philippines’ economic model itself appears more vulnerable to disease outbreak. It is built around the mobility of people, yet tourism, services, and remittances-fed growth are all vulnerable to pandemic-induced lockdowns and consumer confidence decline. International travel plunged, tourism came to a grinding halt, and domestic lockdowns and mobility restrictions crippled the retail sector, restaurants, and hospitality industry. Fortunately, the country’s business process outsourcing (BPO) sector is demonstrating some resilience — yet its main markets have been hit heavily by the pandemic, forcing the sector to rapidly upskill and adjust to emerging opportunities under the new normal.

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Second, pandemic handling was also problematic. Lockdown is useful if it buys a country time to strengthen health systems and test-trace-treat systems. These are the building blocks of more efficient containment of the disease. However, if a country fails to strengthen these systems, then it squanders the time that lockdown affords it. This seems to be the case for the Philippines, which made global headlines for implementing one of the world’s longest lockdowns during the pandemic, yet failed to flatten its COVID-19 curve.

At the time of writing, the Philippines is again headed for another hard lockdown and it is still trying to graduate to a more efficient containment strategy amidst rising concerns over the delta variant which has spread across Southeast Asia . It seems stuck with on-again, off-again lockdowns, which are severely damaging to the economy, and will likely create negative expectations for future COVID-19 surges (Figure 2).

Figure 2 clarifies how the Philippine government resorted to stricter lockdowns to temper each surge in COVID-19 in the country so far.

Figure 2: Community quarantine regimes during the COVID-19 pandemic, Philippine National Capital Region (NCR ), March 2020 to June 2021

If the delta variant and other possible variants are near-term threats, then the lack of efficient containment can be expected to force the country back to draconian mobility restrictions as a last resort. Meanwhile, only two months of social transfers ( ayuda ) were provided by the central government during 16 months of lockdown by mid-2021. All this puts more pressure on an already weary population reeling from deep recession, job displacement, and long-term risks on human development . Low social transfers support in the midst of joblessness and rising hunger is also likely to weaken compliance with mobility restriction policies.

Third, the Philippines suffered from delays in its vaccination rollout which was initially hobbled by implementation and supply issues, and later affected by lingering vaccine hesitancy . These are all likely to delay recovery in the Philippines.

By now there are many clear lessons both from the Philippine experience and from emerging international best practices. In order to mount a more successful economic recovery, the Philippines must address the following key policy issues:

• Build a more efficient containment strategy particularly against the threat of possible new variants principally by strengthening the test-trace-treat system. Based on lessons from other countries, test-trace-treat systems usually also involve comprehensive mass-testing strategies to better inform both the public and private sectors on the true state of infections among the population. In addition, integrated mobility databases (not fragmented city-based ones) also capacitate more effective and timely tracing. This kind of detailed and timely data allows for government and the private sector to better coordinate on nuanced containment strategies that target areas and communities that need help due to outbreak risk. And unlike a generalized lockdown, this targeted and data-informed strategy could allow other parts of the economy to remain more open than otherwise.
• Strengthen the sufficiency and transparency of direct social protection in order to give immediate relief to poor and low-income households already severely impacted by the mishandling of the pandemic. This requires a rebalancing of the budget in favor of education, health, and social protection spending, in lieu of an over-emphasis on build-build-build infrastructure projects. This is also an opportunity to enhance the social protection system to create a safety net and concurrent database that covers not just the poor but also the vulnerable low- and lower-middle- income population. The chief concern here would be to introduce social protection innovations that prevent middle income Filipinos from sliding into poverty during a pandemic or other crisis.
• Ramp-up vaccination to cover at least 70 percent of the population as soon as possible, and enlist the further support of the private sector and civil society in order to keep improving vaccine rollout. An effective communications campaign needs to be launched to counteract vaccine hesitancy, building on trustworthy institutions (like academia, the Catholic Church, civil society and certain private sector partners) in order to better protect the population against the threat of delta or another variant affecting the Philippines. It will also help if parts of government could stop the politically-motivated fearmongering on vaccines, as had occurred with the dengue fever vaccine, Dengvaxia, which continues to sow doubts and fears among parts of the population .
• Create a build-back-better strategy anchored on universal and inclusive healthcare. Among other things, such a strategy should a) acknowledge the critically important role of the private sector and civil society in pandemic response and healthcare sector cooperation, and b) underpin pandemic response around lasting investments in institutions and technology that enhance contact tracing (e-platforms), testing (labs), and universal healthcare with lower out-of-pocket costs and higher inclusivity. The latter requires a more inclusive, well-funded, and better-governed health insurance system.

As much of ASEAN reels from the spread of the delta variant, it is critical that the Philippines takes these steps to help allay concerns over the country’s preparedness to handle new variants emerging, while also recalibrating expectations in favor of resuscitating its economy. Only then can the Philippines avoid becoming the sick man of Asia again, and return to the rapid and steady growth of the pre-pandemic decade.

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Unicef philippines statement on covid-19.

MANILA, 13 March 2020 – Following President Rodrigo Duterte’s declaration placing Metro Manila under lockdown from 15 March 2020 to 14 April 2020, UNICEF Philippines remains steadfast in working with the Philippine Government and partners to stop the transmission of the virus and to keep children and their families safe.

UNICEF Philippines has been fully supporting the Government’s emergency response as early as the first few cases of COVID-19 were identified in the country. Just recently, we provided tents to the Department of Health (DOH) to support the management of COVID-19 cases requiring hospital care. 

DOH is further strengthening its capacity in hospital preparedness, rapid response, risk communication, and information dissemination with full support from UNICEF Philippines. 

UNICEF is working with DOH to take appropriate measures for the continuous delivery of other essential public health services including access to water, sanitation and hygiene, mental health and psychosocial support, and nutrition. 

“We are intent on staying on the ground working to mitigate impact on children and their families including pushing back against stigma associated with vulnerable groups,” said Wigdan Madani, UNICEF’s Chief of Health & Nutrition, “and we remain concerned by related control measures including school closures, the burden on local health systems for the delivery of primary care, protection risks, and economic pressures felt by families.”

With the suspension of classes in all levels within Metro Manila and in selected LGUs until 12 April 2020, UNICEF Philippines encourages schools to plan continuity for learning. We urge communities, caregivers, and parents to stay informed about COVID-19 through trusted sources like the DOH, local government units, WHO, and UNICEF to recognize symptoms, coordinate with schools to support safety efforts, and help children cope with the stress caused by the current situation. 

Characterizing COVID-19 as a pandemic is not an indication that the virus has become deadlier. Rather, it is an acknowledgement of the disease’s geographical spread. Let’s continue to prepare and respond to the epidemic to protect children and families in the Philippines.

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About unicef.

UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.

For more information about UNICEF and its work for children in the Philippines, visit www.unicef.ph .

Follow UNICEF Philippines on Facebook ,  Twitter and Instagram .

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Psychological impact of COVID-19 pandemic in the Philippines

Affiliations.

• 1 Department of Physiology, College of Medicine, University of the Philippines Manila, Taft Avenue, Manila 1000, Philippines; Philippine One Health University Network. Electronic address: [email protected].
• 2 Department of Pediatrics, College of Medicine, University of the Philippines Manila, Taft Avenue, Manila 1000, Philippines. Electronic address: [email protected].
• 3 Department of Psychiatry and Behavioral Medicine, College of Medicine, University of the Philippines Manila, Taft Avenue, Manila 1000, Philippines.
• 4 School of Statistics, University of the Philippines Diliman, Philippines.
• 5 South East Asia One Health University Network. Electronic address: [email protected].
• 6 Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge 119228, Singapore. Electronic address: [email protected].
• PMID: 32861839
• PMCID: PMC7444468
• DOI: 10.1016/j.jad.2020.08.043

Background: The 2019 coronavirus disease (COVID-19) pandemic poses a threat to societies' mental health. This study examined the prevalence of psychiatric symptoms and identified the factors contributing to psychological impact in the Philippines.

Methods: A total of 1879 completed online surveys were gathered from March 28-April 12, 2020. Collected data included socio-demographics, health status, contact history, COVID-19 knowledge and concerns, precautionary measures, information needs, the Depression, Anxiety and Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) ratings.

Results: The IES-R mean score was 19.57 (SD=13.12) while the DASS-21 mean score was 25.94 (SD=20.59). In total, 16.3% of respondents rated the psychological impact of the outbreak as moderate-to-severe; 16.9% reported moderate-to-severe depressive symptoms; 28.8% had moderate-to-severe anxiety levels; and 13.4% had moderate-to-severe stress levels. Female gender; youth age; single status; students; specific symptoms; recent imposed quarantine; prolonged home-stay; and reports of poor health status, unnecessary worry, concerns for family members, and discrimination were significantly associated with greater psychological impact of the pandemic and higher levels of stress, anxiety and depression (p<0.05). Adequate health information, having grown-up children, perception of good health status and confidence in doctors' abilities were significantly associated with lesser psychological impact of the pandemic and lower levels of stress, anxiety and depression (p<0.05).

Limitations: An English online survey was used.

Conclusion: During the early phase of the pandemic in the Philippines, one-fourth of respondents reported moderate-to-severe anxiety and one-sixth reported moderate-to-severe depression and psychological impact. The factors identified can be used to devise effective psychological support strategies.

Keywords: Anxiety; COVID-19; Depression; Philippines; Psychological impact; Stress.

Copyright © 2020 Elsevier Ltd. All rights reserved.

• Age Factors
• Anxiety / epidemiology*
• Anxiety / psychology
• Betacoronavirus
• Coronavirus Infections*
• Depression / epidemiology*
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• Stress, Psychological / epidemiology*
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Fighting COVID-19 in the Philippines

8 ways usaid reachhealth supports pandemic response.

As COVID-19 swept the world in 2020, the Philippines became Southeast Asia’s most affected country.

RTI International has been supporting the COVID-19 response in the Philippines through ReachHealth , a five-year United States Agency for International Development (USAID) project that strengthens and improves access to family planning and maternal and child health services.

Building on 14 years of RTI experience working with local governments in the Philippines to improve health outcomes, the USAID ReachHealth Project supports the COVID-19 response in 15 priority local government units across the country. Working closely with the Department of Health (DOH), the Department of Interior and Local Governance, UN agencies, the private sector, and civil society organizations, we strengthen the government’s emergency and ongoing response at all levels.

Our support has included operationalizing nationwide COVID-19 policies, rolling out vaccines, helping facilities access national COVID-19 financing and testing kits, strengthening the capacities of health workers on infection prevention and control and case management, improving contact tracing, and supporting risk communication and community engagement efforts. Most recently, ReachHealth has helped the country prepare for the roll out of child vaccines and the safe reopening of in-person schools.

Since ReachHealth began supporting the Philippines' pandemic response, we have trained over 20,000 people and reached nearly 37 million people with messages on preventing gender-based violence and COVID-19’s spread.

Here are eight of the important ways we have and continue to respond to COVID-19 in the Philippines:

1. Strengthening community health and support systems

Barangay Health Emergency Response Teams, or BHERTs, usually connect community members to health facilities — but during times of emergency their work becomes more important than ever. These neighborhood-based teams formed the frontline of efforts to delay COVID-19’s spread and locally contain the pandemic by communicating risk, facilitating contact tracing and vaccination, and connecting communities with broader local health systems. ReachHealth works to ensure BHERTs in hotspot communities are active, effective, and trained on critical elements of the COVID-19 community response, including essential behaviors to prevent the virus’ spread, infection prevention and control, vaccination and testing protocols, contact tracing, and quarantine and isolation. ReachHealth has helped train over 7,800 people on contact tracing and rapid response so far.

2. Increasing vaccine coverage

In 2021, ReachHealth collaborated with the DOH and local actors to plan for vaccine rollouts. We developed public messaging for local governments to spread the word, updated FAQs for community health responders like BHERTs, and supported health facility planning and preparation. Once vaccines were available, ReachHealth also helped speed up the roll out by deploying 28 mobile vaccine teams across the country to ensure even the most remote communities got access. ReachHealth has established or supported over 200 vaccination sites in the Philippines. More than 2.8 million Filipinos have been fully vaccinated with ReachHealth’s support.

Grace Jose receives a COVID vaccine at a vaccination site in Caloocan City. Photo by Christian Rieza/USAID ReachHealth

3. Strengthening health and testing facilities

Throughout the pandemic, the science on COVID-19 and how to address it has evolved. To help health facilities keep up, ReachHealth provided training to over 5,000 people on case management and over 3,000 people on infection prevention and control. We also partnered with local governments to establish 10 additional mobile testing units and four community testing centers in vulnerable areas. As COVID-19 testing increased, so did the demand for accredited labs that could process tests quickly. By providing support , ReachHealth helped increase the number of accredited labs across the country and reduced testing times to just a few hours in eight labs in Mindanao and Luzon. 

Vilma Cabral gets tested for COVID-19 at a USAID-supported community-based testing center in the Philippines. Photo by Rosana Ombao for USAID

4. Supporting a data-driven response

The DOH collaborated with the World Health Organization to launch a mobile application, COVID KAYA , that supports frontline responders with contact tracing and case monitoring. The introduction of any new, centralized data system across regions with varying needs and infrastructure can be challenging and uneven. Our team provided technical assistance to help local governments roll out the application, and directly trained officials, health workers, and personnel from health epidemiology units on its use.

5. Addressing gender-based violence

In the Philippines, 1 in 20 women and girls aged 15-49 have experienced sexual violence. COVID-19 lockdowns and quarantines brought extended periods of restricted movement and home confinement for millions of people — an unprecedented situation that worsened violence against women and children at home. ReachHealth supported the continued functioning of gender-based violence (GBV) services, such as a 24-hour helpline, while a messaging campaign, Hindi kailangang magtiis! (You don’t need to suffer in silence!), sought to prevent GBV and to let people know about available services. Since October 2020, this campaign has reached over 9 million Filipinos on Facebook alone.

6. Distributing essential equipment and supplies

Frontline health workers needed personal protective equipment (PPE) to care for their patients safely. In partnership with the Armed Forces of the Philippines, ReachHealth supported the distribution of PPE donated by the US Defense Threat Reduction Agency to 109 hospitals, rural health units, and quarantine facilities in vulnerable areas across the country. We also partnered with Proctor & Gamble to distribute more than 700,000 face masks. ReachHealth is now providing PPE and communication materials to local schools to aid in the safe reopening of in-person classes.

Boxes of personal protective equipment destined for health facilities during the COVID-19 pandemic in Cebu City, Philippines. Photo by Robyn Lacson/USAID ReachHealth

7. Prioritizing water, sanitation, and hygiene

Although water, sanitation, and hygiene (WASH) was not a focus area for ReachHealth, our team recognized that good sanitation and hygiene are critical to slowing the spread of COVID-19. We developed a tool to assess and prioritize sites for handwashing stations and installed these facilities in more than 200 quarantine centers, shelters, and public spaces. We also incorporated WASH messaging into our trainings and messaging campaigns and partnered with the DOH and Procter & Gamble to procure and distribute 70,000 hygiene kits to adults and young people. We have reached over 2.5 million Filipinos with WASH support so far, and our team continues to collaborate with local WASH organizations to bolster their ongoing work.

U.S. Ambassador Sung Kim uses one of the 16 handwashing stations installed in facilities and communities around the city. Photo by Rosana Ombao/USAID ReachHealth

8. Keeping our focus on family planning

Family planning (FP) continues to be an essential health service, especially in times of social and economic uncertainty. While our team stepped up to contribute their expertise to the COVID-19 response, they remain committed to expanding access to quality FP services across the Philippines. In March 2020, 25% of surveyed health centers reported a disruption in FP services and 81% saw a decline in people seeking FP care. From creating online resources to helping service providers improve their teleconsultation abilities, our team rapidly adapted approaches to accommodate the new normal and ensure all Filipinos could continue to access FP care. More than 2,000 teleconsultations on family planning have occurred since.

A team of "Nurses on Wheels" delivers family planning supplies to neighborhood health stations in Cainta. Photo by Mon Joshua Vergara/Cainta Municipal Health Office

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Health systems impact of covid-19 in the philippines, recommended.

Lockdowns and policy actions to curtail the transmission of COVID-19 have widespread health system, economic, and societal impacts. Health systems of low-to-middle-income countries may have fewer buffering resources and capacity against shocks from a pandemic. This paper presents a preliminary review on the collateral health systems impact of COVID-19 in the Philippines through review of academic and grey literature, supplemented by a qualitative survey. Community quarantines alongside transport and boarder restrictions have universally impacted health service access and delivery, affecting patients requiring specialist care the most. Existing record-keeping and surveillance measures were hampered as existing resources were tapped to perform COVID19-related tasks. Local health systems reinforced gatekeeping mechanisms for secondary and tertiary care through referral systems and implemented telemedicine services to reduce face-to-face consultation. The health system impacts in the Philippines have been variegated across municipal income class and topography, contributed by long-standing symptoms of inequitable resource allocation.

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Journalism, public health, and COVID-19: some preliminary insights from the Philippines

In this essay, we engage with the call for Extraordinary Issue: Coronavirus, Crisis and Communication. Situated in the Philippines, we reflect on how COVID-19 has made visible the often-overlooked relationship between journalism and public health. In covering the pandemic, journalists struggle with the shrinking space for press freedom and limited access to information as they also grapple with threats to their physical and mental well-being. Digital media enable journalists to report even in quarantine, but new challenges such as the wide circulation of health mis-/disinformation and private information emerge. Moreover, journalists have to contend with broader structural contexts of shutdown not just of a mainstream broadcast but also of community newspapers serving as critical sources of pandemic-related information. Overall, we hope this essay broadens the dialogue among journalists, policymakers, and healthcare professionals to improve the delivery of public health services and advance health reporting.

Introduction

In this essay, we reflect on how COVID-19 has brought to our attention the often-overlooked relationship between journalism and public health. We draw initial insights from critical analysis of media and public health ( Henderson and Hilton, 2018 ) to suggest that health reporting in the country during the pandemic can be connected to journalistic practices, technological changes, and structural constraints. For journalism to advance public health, it needs to contend with the pandemic and the context into which it is uniquely situated – both of which are moving targets and difficult to predict. In this essay, we pay attention to the Philippines not just because it has one of the highest COVID 19-related cases and deaths in the world but also because the country is at the crossroads of changes in digital media and shrinking space for media freedom, as evidenced by the shutdown of the country’s biggest media network, closing or suspension of community newspapers, and passage of laws that may restrict free speech. In doing so, we hope to broaden dialogue among journalists, policymakers, and healthcare professionals to improve the delivery of public health services as well as advance health reporting.

Similar to other countries, the public health system in the Philippines was unprepared for and overburdened by COVID-19. The first case was reported on January 30 when a Chinese woman reached the country from Wuhan, China, and then a few days later her male companion died of the virus – making it the first recorded death outside of China ( Department of Health (DOH), 2020b ; Ramzy and May, 2020 ; World Health Organization (WHO), 2020a ). By March 7, the first case of local transmission was confirmed ( DOH, 2020a ; WHO, 2020a ). To date, there are 112,593 confirmed cases, 6,263 new cases, and 2,115 deaths in the country ( WHO, 2020b ) – making the Philippines as one of the most highly impacted in Southeast Asia and the Western Pacific Region. Equally alarming is the number of doctors, nurses, and other hospital staff who get infected and die of COVID-19 ( CNN Philippines, 2020a ; McCarthy, 2020 ). Recently, professional medical and allied medical associations have called for a unified and calibrated response and temporary quarantine of the country’s capital to avoid a total collapse of the healthcare system ( Batnag, 2020 ). Critical but seldom discussed are the challenges of journalism in making sense of the rapid spread and devastating impact of COVID-19 in the Philippines and how the pandemic is also gradually transforming journalism in the country.

Journalism and public health work together to broaden health information sources, facilitate public understanding of health, and mobilize support for or against public health policy ( Henderson and Hilton, 2018 ; Larsson et al., 2003 ; Vercellesi et al., 2010 ) and this relationship is magnified during pandemics. The relationship between journalism and public health has mostly been explained based on journalistic roles and news framing. During the 2009 H1N1, for instance, Klemm et al. (2017) found that journalists shifted from ‘watchdogs’ to ‘cooperative’ roles. Holland et al. (2014) further argued that the 2009 H1N1 enabled journalists to be reflexive of their roles especially with conflicts of interest among experts and decision makers. News framing has likewise informed the conversations between journalism and public health. For example, Krishnatray and Gadekar (2014) found that fear and panic dominated the frames used by journalists in their news stories about the 2009 H1N1. In this essay, we hope to engage with ongoing discussion about journalism and public health by reflecting on how health reporting during COVID-19 in the Philippines relates to broader, emergent, and interconnected issues of journalistic practices, technological changes, and structural constraints in the country.

Reporting from home

COVID-19, along with the ensuing quarantines, poses challenges to existing journalistic practices that typically require fieldwork, but it also encourages journalists in the Philippines to reimagine news production. We observe that access to information has generally been limited because government offices have not been in full operation while virtual press briefings do not allow for a more open discussion between journalists and officials. To illustrate, Ilagan (2020) reported that most routine requests for information have not been processed since March 2020 when government offices were wholly or partly closed due to the ongoing quarantine. The Philippines is among many governments in the world that had to suspend the processing of freedom-of-information (FOI) requests because of the pandemic ( McIntosh, 2020 ). FOI officers working from home could not address requests because they lacked Internet connection, laptop computers, and scanners, including digital copies of files. They also found it difficult to coordinate remotely with record custodians. While some national agencies have been proactive in providing information on COVID-19, the same cannot be said for many local government units. Ilagan (2020) further noted that ‘[un]like frontline agencies at the national level, local governments do not proactively publish data on their websites’. Information about plans to combat the impact of the virus are usually available, but more prodding is needed to find out how these plans are being implemented and funded. Camus (2020) also reported that journalists were prohibited from covering what is happening in hospitals and other high-risk areas. More and more press briefings have thus taken place online, but reporters have found it harder to demand answers because officials and their staff often screen questions. For instance, Camus (2020) wrote that some questions from journalists were ignored while official reports from the government were consistently discussed.

Moreover, we observe that the pandemic has taken a toll on both the physical and mental well-being of journalists. Reported cases of journalists experiencing high levels of stress, undergoing self-quarantines, and at least one news anchor contracting the virus point to the need for broader safety measures at the organizational level of news outlets. The National Union of Journalists of the Philippines (NUJP) lamented the limited mental health support for journalists by saying that ‘there are hardly any readily available and sustained support systems for colleagues experiencing mental health issues’ ( Adel, 2020 ). Safeguarding the physical and psychological well-being of journalists during pandemics or any type of crisis does not rest on individuals alone but should be demanded from news organizations and advocated for by professional associations. Yet some journalists have been able to navigate the consequences of COVID-19 on the profession by reimagining newsgathering, taking advantage of online resources as well as doing collaborations.

First, journalists have been coping with the challenge of limited access to information by interviewing sources through phones and attending webinars with experts to learn more about the pandemic ( Tantuco, 2020 ). Bolledo (2020) said that journalists had to adapt in light of the global health crisis changing media operations. By adapting, he referred to Reuters’ approaches to comprehensive newsgathering, which focus on open-source and non-mainstream techniques such as ‘citizen and collaborative journalism’ and ‘social journalism’. In practice, this set of methods includes monitoring Facebook and Twitter feeds, joining Facebook groups created for a specific cause or geographical area, following hashtags and using keywording to find leads and sources. Bolledo (2020) also emphasized the need to fact-check information gathered using these methods, highlighting the importance of news values and the 5Ws and one H in reporting. Second, to address the barriers in online press briefings, journalists organized themselves to raise their unanswered questions in media group chats of government organizations ( Ilagan, 2020 ). Third, the NUJP organized peer support networks critical for minimizing stress and trauma among journalists who reported about and during COVID-19. Finally, in an effort to prevent contracting and spreading the virus among co-workers, journalists are maintaining records of their activities and a list of sources whom they interacted for purposes of contact tracing ( Camus, 2020 ). The new methods employed in health reporting, as creative responses to the constraints brought upon by COVID-19, partly illustrate how an emerging practice may turn into professional norm ( Henderson and Hilton, 2018 ) in health reporting during pandemic.

Double-edged sword

At the onset of COVID-19, journalism in the Philippines has struggled with ongoing technological changes that bring about double-edged consequences. On one hand, digital media has enabled journalists to help Filipinos make better sense of the pandemic – from reporting infections and deaths regularly to covering press conferences organized by agencies at the frontlines of COVID-19 response. Through Facebook live videos, Zoom , and other video conferencing applications, journalists are able to talk about their lived experiences in covering COVID-19. Various groups inside and outside of the Philippines have been hosting a series of webinars on how to cover the pandemic. Media groups in the Philippines meanwhile have also organized press briefings that tackle the state of news reporting in the country. In the forum titled ‘Intrepid Journalism in the Time of Corona’ organized by This Side Up Manila , two journalists discussed the state of news from the early stages of the pandemic to the declaration of enhanced community quarantine (ECQ). Early in the live video, they shared their frustrations about the consequences of COVID-19 on fieldwork and storytelling. According to the reporters, covering COVID-19 is different from reporting about natural disasters or conflict zones because they felt that there was no end in sight to the pandemic. As a result, they reminded themselves and their colleagues to find a balance and slow down as the pandemic may be prolonged and even put the lives of their families at risk. These webinars, which are in theory accessible to anyone in the world, also allow journalists to share their experiences with and learn from their counterparts in other countries. For instance, Hivos organized a webinar titled ‘Data Driven Reporting During Covid-19’ with journalists from the Philippines, Kenya, and Mexico to find out how they have been affected by and coping with the pandemic. The journalists said they have found collaboration or working with other journalists and members of the academe and civil society as key in reporting when fieldwork is not possible. Like the Philippines, too, Kenya and Mexico also experience barriers in accessing and reporting information while their governments too are also mandating policies that could restrict press freedom ( Hivos, 2020 ).

On the other hand, digital media has complicated the work of journalists as they had to deal with the spread of health mis- and/or disinformation. To partly explain the diffusion of online fake news (e.g. mass testing and vaccines), we engage with Tandoc et al. (2018) who emphasized the characteristics of technology and the role of audiences. For instance, social media made it challenging for journalists to delineate information sources from each other, especially given the evolving science of COVID-19. Because science is evolving, journalists tend to rely heavily on expert opinion, without verifying the experts’ assumptions. Correcting mis- and/ or disinformation about the pandemic was likewise difficult because journalists had limited understanding of what counted as fake news among Filipinos. Another problem that journalists had to contend with while working during the pandemic is the recent ‘data breach’ that used Facebook profiles of real people ( Robles et al., 2020 ). The rise of fake Facebook accounts is counterproductive not just to fight against health mis- and/or disinformation but also places the identities of journalists at risk. To a large extent, the proliferation of health mis- and/ or disinformation is inextricably connected to the social context not just of COVID-19 but also the Philippines. As Tandoc et al. (2018) pointed out, ‘fake news needs the nourishment of troubled times in order to take root. Social tumult and divisions facilitate our willingness to believe news that confirms our enmity toward another group’ (p. 149). While it created new issues, COVID-19 has also reinforced existing problems in the country and one of those is the shrinking space for free speech.

Shutdowns, suspensions, and shrinking spaces

The pandemic is also laying bare pre-existing conditions hounding the Philippine press in a supposed democracy. For instance, the government passed ‘The Bayanihan to Heal as One Act’ (Republic Act No. 11469) to give the president emergency powers that would enable him to quickly respond to COVID-19. Human rights and media advocates criticized this law as it included a provision penalizing ‘fake news’, which can easily be used and abused by those in power to file complaints against individuals, including journalists ( Freedom for Media, Freedom for All Network, 2020 ). Again this posed another challenge to journalists and the audience who both use social media as a means to get and share information. In similar vein, the passage of the ‘ Anti-Terrorism Act of 2020 ’ (Republic Act No. 11479) received pushback for its broad provisions. Human rights groups also say that the law has essentially also criminalized intent, which could send a chilling effect especially among journalists who might be working on stories critical of the government.

On 5 May 2020, ABS-CBN, the country’s largest media network, went off-air after its broadcast franchise expired. The House of Representatives, which oversees the granting of franchises, refused ABS-CBN’s bid for a renewal, which ultimately led the media giant to close its broadcast operations and lay off thousands of employees. This development comes after the conviction of Rappler executive editor Maria Ressa and former researcher-writer Reynaldo Santos Jr for supposedly violating the Cybercrime Prevention Act of 2012 (Republic Act No. 10175). The shutdown is seen as the latest in a series of attacks and threats against news organizations deemed as critical of the current administration ( Gutierrez, 2020 ; Pago, 2020 ). Community journalism is neither spared. At least half of some 60 community newspapers have suspended or ceased printing due to economic losses caused by the quarantine, according to estimates from the Philippine Press Institute, the national association of newspapers. The NUJP also raised economic difficulties confronting many freelance journalists, especially those who work on contract in broadcast, since the start of the lockdown. Suspension of operations means that contractual media workers would not be able to earn because work is not available. The halt in the production of news by ABS-CBN and various papers across the archipelago means that people, especially those in far-flung areas, have fewer sources of news at a time when getting information is most crucial. Again, these developments point to how pandemic reportage may be tied to political landscape in the country ( Henderson and Hilton, 2018 ).

COVID-19 is transforming the practice and business of journalism. On one hand, the pandemic and the ensuing quarantine restrictions have prompted news organizations and journalists to adapt and take advantage of digital media to continue gathering and presenting news. On the other hand, the pandemic has also exposed journalists and audiences alike to further mis- and/ or disinformation as well as to government’s new efforts to stamp out ‘fake news’. These developments run in parallel with threats to press freedom and journalist safety. In a pandemic, journalists are not mere observers or mere reporters as they also face the same risks everyone else is exposed to ( CNN Philippines, 2020b ). By laying out the current media environment in this essay, we hope to expand and deepen the conversation between and among journalists, policymakers, and healthcare professionals about public health reporting. In line with Larsson et al. (2003) , we encourage further conversations between journalists and healthcare professionals to collectively identify gaps in health reporting and broaden understanding of ‘fake news’ and how it thrives in social media. Consistent with Tandoc et al. (2018) , we also recommend that journalists and healthcare professionals listen to their audience to help understand what counts as health-related ‘fake news’ for them. Moreover, we invite policymakers to protect democratic spaces that enable journalists, healthcare professionals, and citizens alike to gather and share information related to COVID-19. At a time when disseminating reliable information and holding the powerful to account have never been more critical, we deem it necessary to understand where journalists are coming from to understand both the long-standing and emerging issues they have to grapple with in a pandemic.

Authors’ note: The views provided in this essay do not represent the official views of the authors’ institutional affiliations.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Covid made the Philippines’ hunger crisis worse. So why does hardly anyone want a vaccine?

With nine children and one grandchild, life was hard for Mona Liza Vito and her family even before the pandemic.

Vito used to work long hours peeling sacks of garlic, making about $2 a day, while her husband worked as a day laborer in construction. But now their work has dried up, a casualty of an economic downturn in the Philippines after multiple coronavirus lockdowns. And trying to feed so many mouths has become a daily struggle for survival.

“We don’t have anything for my children’s food, for our daily expenses,” Vito said. “Sometimes, at night, we don’t have anything to eat, we can only wait for the next day.”

Vito lives in Baseco Compound, one of the poorest areas of Manila, where almost 60,000 people are crammed onto a patch of reclaimed land in the capital’s port area. The sprawling settlement relies almost exclusively on the economic activity around the dock – most of which has ground to a halt. And the lockdowns have included bans on fishing in the sea, a lifeline for many.

Mona Liza Vito struggles to feed her family.

“If they don’t catch fish, there is nothing to eat. Some just live on burnt rice and salt with water,” said Nadja de Vera, project coordinator of local organization Tulong Anakpawis. “It remains shocking with the amount of poverty here.”

The Philippines was one of Asia’s poorest countries even before the pandemic. Toward the end of 2020, nearly a quarter of Filipinos were living in poverty, surviving on about $3 a day, according to the World Bank.

More than 3 million children in the Philippines have stunted growth, and 618,000 children are classed as “wasted” – defined by the World Health Organization as low weight for height, which usually occurs due to lack of adequate food or prolonged illnesses. That’s among the highest rates in the world – and the figures were recorded before the most recent lockdown that started in March.

Desperate to avoid more lockdowns and kickstart the faltering economy, the government is now pinning its hopes on vaccines.

But while health experts say vaccination is a crucial tool in bringing an end to the pandemic, many Filipinos are skeptical, and vaccination take-up remains dangerously low.

Baseco Compound is one of the poorest areas of Manila.

‘Eating one meal a day’

The economic turmoil began last March when Philippines President Rodrigo Duterte imposed a strict lockdown in the capital Manila and surrounding areas that lasted for months.

Since then, restrictions have eased and tightened according to case numbers. The last nationwide lockdown, imposed in March, started to ease in mid-May, after the number of daily cases fell from a high of more than 10,000.

Yet, with more than 5,000 Covid-19 cases per day, the threat of the virus lingers, as does the economic hardship.

Vera, from Tulong Anakpawis, organizes a community kitchen that feeds the hungry in Baseco. It’s one of hundreds of food banks that have popped up across the country to help counter a growing hunger crisis. The community kitchens take donations from farmers and fishermen, and anyone who can afford it, then distribute the food to whoever needs it most. Their motto is: “Give what you can, take what you need.”

When word spreads that the kitchen is coming, hundreds line up at dawn for the chance to receive a small bag of food. The desperation is sometimes visible as people jostle to get a ticket, and there are never enough to go round. “What these people need is urgent,” Vera said. “Many people here can only afford to eat once a day.”

Vera says the kitchens are bringing communities together, giving hungry families the staples they need to survive when government support is minimal.

“We have no choice but organize something like this,” Vera said. “I hope the government will learn that this is a call to action to them, that the people are willing to help each other, and we hope that the right amount of resources will finally reach those who really need it.”

During the pandemic, the government has distributed food parcels sand provided several cash handouts of 4,000 pesos ($80) to the poor. Vito said she used that money to pay off her store debts, buy medicine, and cover some of the family’s living expenses.

But she said it’s not nearly enough, so the community kitchens have become her family’s only regular form of sustenance.

“I am grateful,” Vito said. “Our rice and vegetables are free. My children are no longer hungry.”

Vaccine hesitancy

The Philippines government knows vaccinating the population is the only way out of the current crisis, but it’s struggling to convince people to take the vaccine.

Less than 1% of the country’s 108 million people have been fully inoculated, according to data compiled by CNN.

The country announced last week it had received 8.2 million doses, but so far only 4 million people have received at least one injection. Some Filipinos say they won’t take it at all.

According to a Social Weather Stations (SWS) survey of 1,200 people in May, 68% of respondents were uncertain or unwilling to get the vaccine. Their biggest concern was possible side effects, or that they might die from the vaccine. For comparison, a global survey by Gallup of thousands of people in 116 countries and areas during 2020 found 32% of people wouldn’t take the vaccine.

Mistrust of vaccines is major issue in the Philippines, and a dengue vaccine controversy hangs over the country’s efforts to immunize against Covid-19.

In 2017, the Philippines suspended a large-scale vaccination drive after the French drugmaker Sanofi Pasteur found that its dengue vaccine, Dengvaxia, could have unintended consequences in patients who had never been infected with the mosquito-borne virus.

Analysis found people who received the vaccine could suffer a more serious case of dengue if they were later infected. By the time the rollout was stopped, more than 730,000 Filipinos had received Dengavaxia.

Filipinos’ reluctance to take the Covid-19 vaccine could derail any hopes of the country reaching herd immunity – or even the government’s own target of vaccinating 50 million to 70 million people by the end of the year.

Related article As China awaits WHO approval for its vaccines, one country is sending theirs back

The government started rolling out its Covid-19 vaccine program in March, and progress has also been slow – medics are still in the first phase of vaccinating health care workers, the elderly and those with pre-existing medical conditions.

To increase public confidence in vaccines, Philippine President Rodrigo Duterte took a dose from Chinese drugmaker Sinopharm in early May, an event broadcast on national television. But the public display backfired, and Duterte halted the Sinopharm deployment a few days later after critics pointed out the vaccine had not been approved by the country’s drug regulator.

The Philippines has also ordered vaccines from Sinovac, AstraZeneca, Pfizer, and Russia’s Sputnik.

Millions of doses are scheduled to arrive in June, the government says.

Treating Covid with ginger and honey

Officials and health workers are using public messaging to improve confidence in the vaccines.

But Dr. Mike Marasigan, a medical officer from the Quezon City Health Department, said the hardest groups to reach are the poorest communities.

“We’ve been having a hard time targeting those in the depressed areas,” Marasigan said. “They were also our problem when asked to report their symptoms, and they’re also the ones we’ve been having a hard time convincing that they need to get vaccinated.”

Retired seamstress Letty Zambrona, 65, from Paranaque City, Manila, says she won’t take a vaccine, despite being in a vulnerable age group, and suffering from diabetes and high blood pressure.

“It is really because of the side effects that I don’t want to get vaccinated,” Zambrona said. “Because I keep hearing this news on TV, like some had blood clots in their brains.”

She said her husband feels the same, and they’d both rather take their chances with herbal remedies.

“We don’t get worried if we suddenly have that kind of symptoms,” Zambrona said. “In fact, they say it’s better to treat it with ginger, lemon, honey, that’s all we take.”

Marasigan said some Filipinos think they can’t catch the virus.

“When they are exposed to the elements, to pollution and everything, they think they’re immune,” he said.

Filipinos are not only enduring a pandemic, but the country’s worst economic slowdown since 1947. The economy shrank 9.5% in 2020 , and contracted 4.2% in the first quarter this year.

For some, food is becoming unaffordable. A Social Weather Station (SWS) hunger survey in September 2020 showed 30.7% of Filipino families experienced hunger and 8.7% suffered severe hunger – the highest levels recorded in 20 years.

“The whole of the government is seeking ways and means to continue and sustain implementation of their various health and nutrition services while adapting to the new normal situation targeting to alleviate the most vulnerable from hunger and malnutrition,” said Jovita B. Raval, chief of the Nutrition Information and Education Division at the government’s National Nutrition Council.

Hungry Filipinos are turning to community kitchens for meals.

Back in Baseco, Vito’s expenses have gone up with everyone staying at home. Most days, the family can only afford to share one bottle of water to drink between them. And online learning due to school closures means families have to pay up to $19 per month for internet access – a huge sum of money for those without income.

It often means a hard choice between lessons or food. “If we can’t put in the money, they can’t go to class,” Vito said.

“I would rather spend that money so that the children can have breakfast.”

Returning home after receiving her donation from the community kitchen – some green beans, rice and a few other vegetables – Vito knows she has to stretch a small amount of food a very long way.

For many of these families, the fear of coronavirus will never compare to the more acute daily threat of hunger.

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Biden Aims to Project United Front Against China at White House Summit

President Biden discussed security in the South China Sea with the leaders of Japan and the Philippines at the White House.

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By Michael D. Shear

Reporting from Washington

President Biden used a first-ever joint meeting with the leaders of Japan and the Philippines on Thursday to expand a web of security and economic alliances in the Indo-Pacific that American officials believe will serve as a shield against Chinese aggression.

Flanked by his counterparts and his top diplomatic aides at the White House, Mr. Biden said the countries were “deepening our maritime and security ties” and offered a blunt message clearly aimed at China’s actions in the South China Sea.

“I want to be clear, the United States defense commitments to Japan and to the Philippines are ironclad,” Mr. Biden said.

Jake Sullivan, the White House national security adviser, has described the diplomatic effort in Southeast Asia as one of a series of endeavors by like-minded nations to push back against China’s activities in trade, technology and military aggression.

The goal is different than that in Europe, where nations came together after World War II in a single alliance known as NATO. Instead of a single group, the United States and countries in the region are forming smaller, overlapping partnerships aimed at ensuring they can withstand Chinese pressure, analysts say.

“China uses a quite powerful mix of coercion, international trade, along with its growing naval power,” said Rana Mitter, a professor at the Harvard Kennedy School of Government. He said that the United States, Japan and the Philippines are seeking to demonstrate that they “have an ecosystem of different allies trying to give an answer” to that kind of pressure.

That strategy was on display Thursday when all three leaders stressed the necessity of unity, even though none called out China by name.

Prime Minister Fumio Kishida of Japan declared that “multilayered cooperation is essential” to the future of the region. President Ferdinand Marcos Jr. of the Philippines said the meeting highlights three countries “linked by a profound respect for democracy, good governance and the rule of law.”

Mr. Biden concluded: “When we stand as one, we are able to forge a better peace for all.”

It is unlikely that bolstering the alliances would provide a short-term solution to the problem of Beijing’s harassment of Philippine ships in the South China Sea, which the United States and its allies have said is a violation of international law and must stop.

But Biden administration officials said the meeting of the three leaders demonstrated to China even stronger military and diplomatic unity among the leaders of the three allies.

Chinese coast guard ships have been ramming Philippine vessels, blasting them with water cannons and aiming lasers at their crews in what the United States condemns as “coercive and unlawful tactics” in one of the most crucial waterways in the world.

So far, the Chinese provocations have fallen short of the kinds of attacks that would trigger the military defense pact that the United States and the Philippines signed in 1951.

One U.S. official, speaking on the condition of anonymity to discuss the meeting before it convened, called the issue of security in the South China Sea a “pillar” of the discussions.

“The U.S., Japan and the Philippines are three closely aligned maritime democracies with increasingly convergent strategic objectives and interests,” Mr. Sullivan said on Tuesday. “Just this past week, our three countries and Australia held joint naval drills in the South China Sea.”

Officials said there would be similar drills in the months ahead as the nations continue to assert the freedom of travel through international waters that China claims as its own.

Mr. Mitter said that the prospect of future naval drills — potentially near the Philippines — would be one of the strongest messages the three countries could send. China has asserted greater control over the South China Sea over the years, trying to expand its military footprint in the region.

“I think they would take it seriously,” he said of the Chinese leadership, noting that the demonstration of military unity could prompt the government there to scale back the harassment in the short run.

But he added that in the long run, Japan and the Philippines were increasingly eager to establish a web of alliances with each other that could survive even if the United States were to scale back its engagement under a more isolationist administration if former President Donald J. Trump won a second term.

“That could be very difficult,” he said about a possible victory by Mr. Trump. “America’s allies in the region are very keen for the U.S. to stay in the region and have a presence there.”

The meeting of the three leaders comes a day after Mr. Biden hosted Mr. Kishida at the White House for meetings and a state dinner. The two men discussed China’s military and economic aggression but also announced a series of new initiatives to foster more cooperation on the economy, space exploration, technology and research.

Officials for the three countries issued a similar list of announcements after Thursday’s meeting.

The officials said the countries would make new investments in infrastructure projects in the Philippines aimed at improving what they called “high-impact” projects such as ports, rail, clean energy and semiconductor supply chains.

They also unveiled new efforts by the United States and Japan to install radio access network technology in the Philippines, a modernization aiming to improve wireless communications throughout the region.

The officials also promised new collaborations among the three nations on global humanitarian assistance efforts and even greater cooperation among the countries’ militaries.

Michael D. Shear is a White House correspondent for The New York Times, covering President Biden and his administration. He has reported on politics for more than 30 years. More about Michael D. Shear