Objectives

Generally, this research aims to assess the socio-economic impact of the Covid 19 responses in selected urban and rural communities.

Specifically, this study aims to:

1. Determine the understanding of people from poor urban and rural communities that underwent ECQ on Covid 19 and the responses to it;
2. Assess the responses of the families and communities to the Covid 19 epidemic.
3. Assess the impact of the Covid 19 interventions on the socio-economic life of the poor and marginalized families in urban and rural communities
4. Identify mitigation measures to reduce the adverse effects of the Covid 19 interventions and ways to recover the socio-economic life from the impact of the epidemic.

Significance of the proposal

The lack of economic security and the new measures imposed during this quarantine period is now slowly taking its toll on the urban poor workers (The star, 2020).  At the initial stage, a footage from MovePH shows the long queues of workers stranded at a checkpoint in Philcoa, Quezon City because public utility vehicles were suspended under the enhance community quarantine measure and commuters were left without choice but to rush and scramble to climb on to the back of a small truck whose driver was kind enough to give them a ride (Ratcliffe and Fonbuena, 2020).  Likewise, ABS-CBN featured in their TV Patrol report and news online some male laborers who attempted to walk from Parañque to Tarlac after their company told them that they have to stop operation due to the enhanced community quarantine. Leonardo, one of the laborers said  “Sobrang apektado kami, ang hirap, yung pag lock down, di namin inexpect na titigil trabaho namin. Nagdeclare na tigil operation, nagpursige kami umuwi. Kesa mabaon kami sa utang sa kumpanya sa barracks namin. Syempre pinapakain kami ng boss, di pwedeng di namin bayaran yon “(Manahan, 2020).

On the other hand, on the issue of social distancing according to a Estrelieta Bagasbas, chairperson of Kadamay San Roque,  “The only thing they can follow with social distancing is minimising the beso-beso – a traditional hug or kiss on the cheek” this is because their dilapidated houses are small and located in a densely populated area in their community without running water sometimes to wash their hands (Aspinwall, 2020).

Considering these initial outcomes of the community quarantine, it essential to have this kind of study that deals with the people who are directly affected by the Covid 19 interventions. While the control of the Covid 19 is the primary goal of the epidemic response, it is imperative to look at the socio-economic impact of the responses to reduce adverse consequences that make the lives of the people more difficult. This will help in modifying approaches to epidemic at present and in the future as policy makers and implementers gain better understanding of the socio-economic impact of intervention against Covid 19.

Literature Review

A. Responses to Past Epidemics and Disease Outbreaks

Before 2019-nCov, the Philippines has been hit by other deadly diseases. Top of the list would be the Cholera (1820 and 1961), Spanish Flu (1918-1919), SARS (2003), and A(H1N1) (2009-2010). These diseases revealed social behaviors and government actions that seem to reverberate how the Philippine government and its citizens face Covid-19.

A cholera epidemic in the Philippines was reported to occur in 1820. No clear statistics (total cases and deaths) are available. It was reported, the government supplied a mixture of brandy and quinine – an attempted cure whose effect was worse that the cholera itself. What is more troubling, this resulted to murders allegedly instigated by a mob 3,000 Filipinos. Around 30 foreigners (non-Chinese) and 8 Chinese were victims of the murder. It was believed that the motive was revenge, as the mob believed the foreigners introduced the disease by poisoning Pasig river and other water sources. There is also an account saying that the massacre and rumors about foreigners in Manila were actually perpetuated by Spaniards envious of foreigners establishing trade relations in the country[1][2].

The Spanish Flu (1918-1919) killed an estimated 50 million including approximately 85,000 Filipinos. During that time, the number of health personnel was lacking as some were mobilized by the American government for war. In high density locations, such as military camps during WWI, high density of cases were observed. Camp Claudio, in Paranaque City, was believed to had played a part in the spread of the Spanish flu. Some soldiers from this camp were infected and were sent home to their hometowns still carrying the flu virus. As a response, the camp, as well as surrounding areas were quarantined, mass gatherings were halted, sea and land travel were restricted. In addition, schools were converted to temporary hospitals and teachers assisted patients. These efforts were hampered by blame-shifting among top health officials and lack of funds, personnel, and medical equipment[3][4][5].

In September 1961, the first patient of El-Tor-type cholera in the Philippines was admitted in San Lazaro Hospital in Manila. The El-Tor-type cholera hit other regions in Asia (Sulawesi, South Borneo, Sarawak, Macao, South China and Hong Kong) that year. A total of 423 cases were reported in the Philippines. This time, a treatment regimen developed by the U.S. Navy was used – a prelude to disease outbreak protocols to be in place in the Philippines. Upon admission, patients were questioned about their diet, (e.g. previous other illnesses, symptoms prior to admission, demographics, and family (health) history). Patients were then observed clinically (i.e several laboratory tests were conducted) and monitored while they were in the hospital[6].

SARS (2003), a 21^st century epidemic that spread in Southern China, infected more than 8,000 individuals in 26 countries. In the Philippines, 14 cases were reported, the lowest among affected countries. This is very small in comparison to other countries. Total number cases for China was 5,327. This was followed by Hong Kong with 1,755, Taiwan with 665 and Singapore with 238. Former health Secretary Dayrit said, SARS, at that time, was unprecedented but the government has guidelines for such circumstance following the 1961 cholera outbreak. IN general, the guideline is to do surveillance, do case detection, and do clinical care of patient. The Philippine government responded with heightened screening of individuals coming from foreign travel using thermal scanners. Isolation areas were identified. Public Regional Hospitals, RITM, San Lazaro Hospital (Manila), and Lung Center of the Philippines, were designated as SARS hospitals. The Philippine government also issued EO 201 which defines the powers, functions and responsibilities of government agencies in response to severe acute respiratory syndrome contagion[7]. In addition, Proclamation No. 366 was issued which declared May 5 to 9, 2003, as a National Anti-SARS consciousness and clean-up week[8]. It should be noted, there was a Mayor who refused to allow an ambulance carrying a SARS patient pass his/her municipality. The fear was founded on incomplete information about the disease[9][10].

A(H1N1) (2009-2010) or swine flu infected approximately 700 million to 1.4 billion people and 203,000 lead to death. In the Philippines, there were 2,668 cases reported which led to three deaths. As a response, alert was raised in airports – screening of passengers was done and travel advisories were issued more frequently. At that time, a vaccine was available. It has been reported that WHO donated 3.4 million doses of vaccine. The government prioritized frontline health workers and other vulnerable groups – young, elderly, pregnant, and people with underlying disease.

More recently, the Philippines was confronted by outbreaks of dengue, diphtheria, measles, and polio. Dengue was declared an epidemic in August 2019 by DOH[11]. Diphtheria, measles and polio are vaccine-preventable diseases. Before 2019, the Philippines has been polio free for 19 years. This suggest insufficient vaccination rates. The timing of the Dengavaxia controversy, recurrence of these vaccine-preventable diseases, and decrease in immunization coverage[12] supports the notion that mistrust over Dengvaxia spilled over all vaccines in general.

B. Socio-economic impacts of past epidemics and pandemic

The health issues brought by diseases mentioned had various attendant socio-economic problems. Indeed, much can be learned from history. We see that antipathy and racism can be fueled by wrong information. Such is the case with the cholera (1820) epidemic. Spanish flu (1918-1919) taught us that governance – effective coordination among agencies, clear chain of command, is crucial in implementing health measures at a national scale. Also, funding, adequate personnel and equipment should be available in advance – anticipating that epidemics are just around the corner. The Philippines seemed to have handled SARS (2003) and A(H1N1) (2009-2010) better, in comparison to other countries, if we only look at total cases and total deaths. SARS (2003) showed us the importance of strict monitoring in points of travels. Complete and accurate information about the disease being made available to the public is also important as this guides social relations between infected and uninfected individuals. All these had varying economics impacts as travel and trade were affected.

Needless to say, death, which implies loss of income and psychosocial issues for families left behind was an obvious impact of these diseases. In the case of the Spanish flu, death rate per 100,000 of population (for selected provinces with available data) ranged from 19.1 to 29.6 within 1904 to 1917. When Spanish flu struck the Philippines in 1918, death rate was 40.79, almost double of recent years’ death rates[13]. Total death in the Philippines increased from 753 to 71,243 from 1917 to 1918[14].

During the SARS (2003) outbreak, there was “virus of fear and panic”, which according to Former secretary Dayrit, sometimes travel faster than the virus itself[15]. As a result, people did not want to travel and people started panic-buying. Hence, while the SARS (2003) outbreak was handled relatively well in the Philippines, in terms of total cases and deaths, the social impact of fear, uncertainty and discontinued routine for livelihood were observed.

During A(H1N1), it was reported that some schools suspended classes[16]. Special instructions were given by then Manila Archbishop Cardinal Rosales, restricting holding of hands during religious activities[17][18][19]. Similar with SARS (2003), while A(H1N1) was handled relatively well, it resulted to disruption in routine and slight changes to religious activities.

C.Covid19 Socio-Economic Impact

The mass media and social media are instrumental in recoding reports and narratives about the Covid 19 epidemic. Initial reviews have shown that the Covid19 pandemic quickly became a human rights concern in the Philippines. Elements of human rights such as non-discrimination, transparency, and respect for human dignity had been compromised with the implementation of draconian ‘social distancing’, absence of mass testing and contact tracing, and unequal distribution of relief and preferential treatment of those perceived to be allies of the president.

The primary and initial mitigating measure of the Philippine administration was to put the National Capital Region (NCR) on lockdown. This was considered a draconian measure[20][21], but justified to restrict some rights[22] due to the public health threat of the pandemic. It should be noted, UN expressed alarm that the lockdown design includes the military and police as primary enforcers[23]. But as the lockdown was implemented, reports of possible human rights violations put to question whether the imposed lockdown, including the manner it was implemented, is proportionate to the desire to achieve other human rights obligations. It became all the more worrisome when President Duterte threatened to shoot lockdown violators[24]. The concept of proportionality, in the context of human rights, guides us during emergencies, calamities, and unwanted situations when rights conflict with each other. Three elements to be examined to determine proportionality are 1) Adequacy, 2) Least intrusiveness, and 3) Proportionate stricto sensu. A detailed commentary on this was provided by Salem (2020)[25].

Over 136,517 have been reported to have violated lockdown protocols.[26]. Many of whom are poor and were forced to ‘violate’ lockdown to address their families’ hunger. Such is the story of Jek-Jek, who was part of “San Roque 21”, moniker for a group of 21 individuals in San Roque who was arrested for violating lockdown/quarantine protocols, while waiting for relief goods.[27]. The poor who are usually a “no-work-no-pay” status, could not afford to be out of work even for a day. With no clear food relief program to complement the lockdown, people are forced to violate lockdown protocols or they risk their lives due to hunger[28].

Some of those who were arrested were subjected to humiliation. In Pandacaqui, Pampanga, three LGBT were arrested and ordered to “kiss, dance, and do push-ups on live video broadcast via social media”. Their identities were not protected as the Data Privacy (2002) law requires.[29].

Add to this, the strict implementation of the lockdown protocols seem to apply to some but not to others. Allies to the president who violated lockdown protocols were either shown compassion[30] or the administration chose a “hands off” policy[31]. It gets worse when NCRPO chief Major General Sinas violated the protocols he has been strictly enforcing on others[32], which, as mentioned, resulted to further sufferings.

On April 21, 2020, Winston Ragos, a former military man was shot by QC Police Master Sergeant Florendo Jr. Ragos was apprehended for violating lockdown protocols – he went to a store to buy cigarettes and coke. Master Sergeant Florendo taught Ragos was carrying a gun. Ragos was fataly shot.[33] On May 14, 2020, a report says the NBI found no weapon on Ragos[34].

In summary, the lost of jobs, humiliation, and even loss of life should lead one to question if the design of the lockdown and its implementation adheres to proportionality principle of human rights. The lockdown features full lockdown, one member of household is entitled to a ‘quarantine pass’, there is no clear complement of aid – monetary of food, trade routes were also closed. The manner of implementation is militarized, fueled by the President’s threats of ‘shoot to kill’ for violators.