"Are we setting ourselves up to be like the United States and United Kingdom?"
It was former President Barack Obama who revived the use of the term “shambolic” in public discourse when he slammed President Donald Trump’s governance over the past three years, specifically his management of the pandemic in America.
In a fundraiser for presumptive Democratic presidential candidate, Joe Biden, who was his vice-president in his two terms in office, Obama described Trump's style as "shambolic, disorganized, mean-spirited approach to governance" and his administration’s management of the coronavirus pandemic. Obama’s tirade may as well be directed at other leaders who continue to disappoint as their countries struggle in their efforts to contain COVID-19.
Just across the Atlantic, UK Prime Minister Boris Johnson’s handling of the pandemic has been variously described as slow and disorganized – punctuated by a “shambolic approach testing and contact tracing,” according to one expert. Close to 100 other scientists and medical practitioners have in fact come out openly, saying that Johnson and his crew have squandered public trust by “massaging data” and “spinning the facts.” They have, in their view, chosen to ignore evidence and experience in favor of expediency and political gimmickry.
The issue of testing and contact tracing which has seen the United Kingdom stumble from one tracing mode and contact app to another despite millions of funds thrown into the operation has only angered the public even more. In fact, an ongoing inquiry into the contracts negotiated by the government with private providers not only for testing and contract tracing but also for test kits and PPEs have been denounced by the opposition and a number of non-profits as smelling of “BorisGate if not ToryGate” as information crept in that a majority of those awardees were in fact either sitting Tory members of parliament or associated with incumbent ministers. Sound familiar?
Which is why the argument goes, the central government has been vigorously resisting the decentralization of responsibility for testing and tracing to local authorities using their own public health centers and teams. Or, outsourcing these tasks to locally accredited facilities. We are aware that public health specialists have often argued that testing, case detection, and contact tracing require not only medical but social, behavioral, and, in the case of countries like the Philippines, even political interventions. While there is a need for a uniform, the national standard of medical and health care, it is clear that implementation takes into consideration different locales and contexts requiring nimble and case-specific norms and teams with clear lines of organization, leadership, and accountability. Implementation cannot be a one size fits all, top-down operation. Speed of detection, testing, and isolation and knowledge of the terrain, so to speak, count most in cases such as this highly transmissible COVID-19 outbreak.
In Taiwan and Singapore, authorities imposed rigorous screening, testing, and tracing schemes all across the land. They did not wait for people to check in sick or show any kind of symptoms. They prepositioned testing centers, embedded apps in phones and other tech instruments, and organized tracer teams down to the local community levels. They actively looked for people who maybe infectious or communities which can be epicenters of the virus. The sooner cases are identified, the quicker they can be quarantined, and the fewer contacts there will be to trace. They didn’t wait for the virus to appear in a clinic or hospital – they went looking for it.
In Vietnam, their testing and contact tracing programs initially targeted incoming passengers at airports who had to agree to a temperature check and fill in a form giving their contact details and travel and health history. These measures were then extended to anyone entering a major city, government building or hospital. Anyone with suspicious signs or symptoms, such as a temperature over 38 degrees C was taken to a medical facility for thorough testing. Accessible testing stations were also set up across cities, while banks and apartment complexes established their own screening procedures. The transport systems and other essential services such as those in food markets and deliveries as well as utilities were also subjected to rigorous testing and tracing which included families of workers and their communities.
Likewise, Germany developed an aggressive case-detection
strategy, testing anyone with symptoms and using a public information call center to direct people to nearby local testing centers. In both countries, local public health centers which have long been part of the entire health and medical ecosystem were immediately activated complete with equipment and personnel to undertake the rigorous effort at isolating and mapping centers of affliction with the data harmonized with the call for gradual reopening of their economies.
To be clear, we had essentially the same plans and programs as these countries since President Duterte ordered the implementation of enhanced community quarantine four months ago. It was in the implementation where the breakdown – well, not yet a complete one, for sure – happened. After the formation of the Cabinet-level IATF and the initiation of the quarantine protocols, tell-tale signs of slow and disorganized implementation set in. There was the PPE and medical equipment fiasco. Then the laboratory and test kit issues. Then the enforcement and transport issues. Then the assistance and ayuda
issues. Then the OFW and LSI issues.
Perhaps in its earnestness, the IATF forgot that it was essentially a policy-making body and the implementation of policies needed to be devolved to the line agencies and, of necessity, the local governments which had very specific needs and constituents to take care of.
It took time before these implementing units were empowered with
the necessary guidelines, personnel, and resources to work with. So, an IATF implementing arm – the National IATF Task Force – was created which was initially tasked with accelerating the testing, isolation, and tracing processes.
Sub-teams to take care of specific tasks were also established but with little or no guidance and resources to ensure proper implementation. Then, we have regional task forces to get certain regions like Cebu and the Central Visayas up to task. Not content with these layers upon layers of authorities and implementers, we now have another set of Czars – four of them – to take care of the original, basic tasks of testing, tracking, and treating – the WHO T3 approach.
We have nothing against the activation of as many teams and operations as possible so long as these are focused on very clear, specific tasks. But can we now confidently say that with these new arrangements and empowered individuals we will soon see a one, united and coordinated effort to combat this deadly virus? Or, are we setting ourselves up to be just like the United States and UK with their shambolic operations? I really hope not.