Dr. Roberto V. Anastacio: Icon of excellence

After 78 days on lockdown, I am repeating my recommendation to create a permanent agency for disaster and emergency preparedness

What will probably stay longest in my memory about the new coronavirus disease (COVID-19) lockdown experience is that I lost five good friends and a close relative in the past two and a half months without being able to visit any of them or even attend their wakes (there weren’t any). Three of them succumbed to the virus, and the other three died of other illnesses.

I want to pay a fitting tribute to one of them. He was a doctor, a top expert in cardiology who received many accolades for his life’s work, among which was a TOYM (Ten Outstanding Young Men) award in medicine early in his professional career. He was a dedicated mentor to many medical students who are now themselves mentors to others. At 80, he was a front-liner in the fight against COVID-19 and became a victim himself while helping others to survive. He was my high school classmate and friend, Dr. Roberto V. Anastacio, known to his many friends as Dr. Bobby.

The hallmark trait of Dr. Bobby that many of his classmates will remember most was his extreme thoughtfulness to those of us who went to him for consultation. Whenever he saw a former classmate, whether close to him or not, waiting in line outside his clinic, Dr. Bobby would quietly lead him to his private office beside his consulting room and attend to him immediately. And his classmate-patients learned not to even raise the matter of a professional fee for fear of offending him.

Personally, my most memorable experience of Dr. Bobby’s medical acuity was when I was rushed to Makati Med after rupturing my Achilles tendon while playing in a tennis tournament. Because I was allergic to many medications including anesthesia, my attending doctors were at a loss on how to proceed with the needed surgery.

So there I was, impatiently lying in bed for several days until Dr. Bobby appeared, apparently hearing of my situation. He took charge immediately, giving instructions to cover me against any drug allergy with doses of an injected steroid for 24 hours, and then to proceed with the operation. Thanks to his decisive action, I got over that medical challenge safely without any further delay.

Dr. Bobby was an icon of excellence in all the hospitals where he practiced. But more than this, he was an excellent human being, a medical hero who, at 80 years old, did not hesitate to put himself in harm’s way to help save lives, ultimately at the cost of his own. From all of us whose lives you touched, thank you, Bobby.

And may all the front-liners who selflessly continue to risk their lives daily be assured of the adequate protective equipment and safeguards they deserve, recognizing that we have had one of the highest casualty rates for front-line health-care workers in the ongoing battle against the virus.

Abdication

On May 31, Metro Manila will be completing the third extension of what is the longest and strictest lockdown, euphemistically called enhanced community quarantine, lately downgraded to modified enhanced community quarantine, a total of 78 days.

In comparison, the original source of the COVID-19 pandemic, Wuhan City in China, was locked down for 75 days before reopening. Lately, after experiencing a resurgence of infections, Wuhan’s officials ambitiously announced they would test all of the city’s 11 million inhabitants in 10 days, conducting more than one million tests per day.

In the Philippines, as of

May 17, after more than three months, the Department of Health (DOH) reported having tested a meager total of 207,823 “unique individuals” (mainly people with symptoms and those exposed to them). Mass testing (at least 1 percent or 1.1 million out of our 110 million population), originally recommended by the World Health Organization and medical experts, is apparently beyond our reach.

A DOH official recently said on TV that our approach is “targeted” testing, ostensibly admitting our country’s limited testing capacity, which experts agree is a key to containment. In fact, in a May 17 news article in the Inquirer, the government has largely abdicated this primary health-care role by announcing that it was leaving it up to private companies to do the testing of their own employees (which it did not require), due to the lack of funds.

Passing the buck

Passing the buck to the private sector in this important public health function highlights the glaring unpreparedness and inadequacy of public health-care resources to cope with emergencies like what we have today.

It is ironic that we find ourselves scraping the bottom of the health-care barrel while still struggling to get rid of the congressional “pork barrel” which keeps surfacing in different guises in the national budget.

To top it all, corruption has once more reared its ugly head with various allegations of scandalous overpricing in the purchase of testing kits and machines and personal protective equipment for health-care workers.

We are now in the third extension of the strict lockdown in Metro Manila and other selected areas, for a total of 78 days by today, May 31.

Based on the standard quarantine requirement of 14 days (to allow enough time for symptoms to manifest), these areas have already gone through more than five cycles of quarantine time. Even allowing for some non-noncompliance, lapses and asymptomatic cases, it is not unreasonable to assume that by now there should already be a significant downward trajectory of new cases and deaths, which other countries have achieved earlier.

Far from ready

The big difference, however, between us and other countries is the very low number of tests we have been able to do during the prolonged lockdown, primarily focused on “unique individuals” which meant very limited tracing, isolating and treatment, precluding a wider and deeper tracking of the contagion.

An Inquirer news article on May 24 quoting a DOH official reported that the most number of tests done in a single day was on May 14—11,508 tests, a little over half of the modest but for some reason elusive target of 20,000 announced very early on. Let’s keep our fingers crossed that we have done enough.

Today we are far from ready for a prompt and thorough response to any national crisis.

But there is nothing to prevent the government from preparing properly for the inevitable next challenge. I am repeating my serious recommendation to create a permanent agency for disaster and emergency preparedness (in place of the usual ad hoc task force), and to rehabilitate our grossly inadequate public health-care infrastructure, made obvious by recent events.

These observations do not in any way detract from the ceaseless heroic efforts of our government workers—from the highest to the lowest in rank in every agency involved—to protect and save their countrymen during this crisis, despite the odds.