'Medical quarantine, not ECQ': Health professionals call for change in 'militaristic' lockdowns

MANILA, Philippines — A group of doctors on Sunday opposed a call for a return to enhanced community quarantine saying the way the quarantines have been implemented are "devoid of scientific sense and health purpose."

They did, however, echo an earlier call from medical professionals and frontliners urging the national government to reform and recalibrate its response to the COVID-19 pandemic.

On the 138th day since ECQ was first put in place, six medical frontliners in a "second opinion" said that the "Duterte-style enhanced community quarantine (ECQ) or lockdown" set by the Inter-Agency Task Force on Emerging Infectious Diseases has been unscientific and oppressive.  

The manifesto was signed by Doctors Gene Nisperos, Geneve Rivera-Reyes, Darby Santiago, Leonard Javier and Soraya Escandor, and Registered Nurse Sean Velchez.

"Doctors and healthcare workers must reclaim quarantine for what it should be: A public health measure aimed at saving lives by stopping the spread of disease. We must reject the distorted forms of 'community quarantine' being imposed on us, as these are devoid of scientific sense and health purpose, and serve only to oppress our people," they said.

"If we are to implement a quarantine, it must be a medical quarantine, with healthcare workers in the lead and with clear health goals and outcomes. To truly benefit our overburdened healthcare workers, a new framework and new leadership direction than the ones we currently have are imperative," they also said. 

'Public health, pro-people response'

President Rodrigo Duterte's enhanced community quarantine saw military personnel and elite police troopers manning quarantine points all over Metro Manila. 

ECQ was originally set to last until April 12, though the National Capital Region only reverted back to a more relaxed general community quarantine on June 1, after 78 days and repeated extensions. 

In their statement, the doctors prescribed the following courses of action that they said were "consistent with the six pillars of our healthcare system":  

1. Leadership: Immediate removal of Health Secretary Duque and all of the generals and "czars" infesting the Inter-Agency Task Force, replacing them with team players from health and related fields, who will immediately undertake a unified plan of action under a centralized leadership.
2. Human Resources: Active and aggressive recruitment of additional health workers (ie. 10,000 doctors and 20,000 nurses) by offering much better packages to attract them, including better terms and better working conditions, commensurate pay and benefits, and more support and protection.
3. Health financing: Immediate provision of substantial funding and financial support for both national and local government interventions, with clear transparency and accountability. An initial amount of 90 billion pesos will be a good start to fund health workers, COVID-related infrastructure and equipment, and community measures.
4. Service Delivery: Ensuring the continuity of care from the primary to the tertiary levels, and between public and private health facilities, and the provision of services for both COVID-19 and non-COVID-19 patients.
5. Health technologies: Enhancing capacities in testing, tracing, isolation, and treatment at the institutional and community level, and utilizing appropriate technologies in the promotion of preventive and public health measures.
6. Health Information: Immediate improvement of COVID-19 data processing and management, by full disclosure of sources and manner of processing, and depoliticizing COVID-19 data by providing better access. 

"Taking these six steps will put us in a better footing to protect our health workers as they try to save more lives. These also allow room for health workers to gather themselves, breathe, and be reinvigorated even as more long-term interventions are being put in place," the manifesto read. 

'Militaristic and fascist measures'

The Coalition for People's Right to Health in a separate statement also warned that another enhanced community quarantine would do little to help if the government does not take time to re-examine its strategies in preventing cases at the community level, calling for an end to what it called "a militarist handling instead of a medical approach to the pandemic" on the part of the national government, a statement echoed in the doctors' manifesto. 

CPRH had similar demands from the government, calling for: 

1. Mass hiring of health workers with regular positions and adequate compensation. benefits
2. Provision of complete, appropriate and high-quality PPEs
3. Free and regular rtPCR testing (every 2 weeks) for health workers
4. 48-hour duty in a week followed by 14-days quarantine, free hospitalization when sick, support for essential needs during quarantine, and P100,000 compensation for all COVID-19 positive health workers
5. Free mass testing for contacts and other vulnerable populations, adequate quarantine facilities
6. Free masks and free health care and medicine in public hospitals
7. Development and increase in numbers of testing centers
8. Increase in supplies and equipment such as ventilators in public hospitals
9. Systematization and pro-active coordination of DOH to hospitals
10. Community-based health care in all communities
11. Socio-economic assistance to workers, vulnerable populations
12. Change in the leadership of government positions 

"The government reneged on and neglected the people's welfare with the social amelioration program (SAP) during the first ECQ; the second tranche is still incomplete in its distribution. Moreover, a militarist handling instead of a medical approach to the pandemic wreaks fear among the people and proliferates human rights violations—while doing little, if not nothing, to curb the number of cases and spread of disease," the coalition said.

Within the IATF-EID, Social Welfare Secretary Rolando Bautista, a former military lieutenant general, and Interior Secretary Eduardo Eduardo Año, former chief of staff of the Armed Forces of the Philippines are former generals. The National Task Force against COVID-19's chief implementer, Carlito Galvez Jr., is also a retired general. 

Duterte has insisted on centralizing the "war" effort against the new pathogen within this small, ex-military circle because, he says, it ensures a systematic delivery of services. He also routinely refers to them by their military positions during task force meetings, betraying a militaristic preference that also translates on the ground. 

As it stands, law enforcement agencies including the national police, military, coast guard, and fire protection bureau have been put at the helm of the government's coronavirus quarantine enforcement under the Joint Task Force COVID Shield.

READ: No more warning before arrest under 'tighter' ECQ as PNP leads contact tracing | 'By the book': A look at quarantine incidents and police operational procedures

Cases of aggressive and overzealous enforcement piled up over the ECQ in the name of "punishing" the public for its "stubbornness" and "complacency" with quarantine regulations—the same rules that a number of government officials have, themselves, failed to follow and walked scot-free regardless. 

Most recently, law enforcement officials have broached the ideas of conducting house-to-house campaigns and repeating the administration's 2018 'anti-tambay' campaign. It has also deployed police supervisors per barangay for the "identification and monitoring of barangay residents on home quarantine."

"We call for an end to all militaristic and fascist measures being done in the name of quarantine," the doctors said. 

"Too many lives of healthcare workers have been needlessly lost due to the wrong priorities taken by this criminally-negligent, corrupt, and tyrannical government. To honor our fallen colleagues is to demand a radical shift from the present blundering response to a scientific, public health, and pro-people response."

READ: 'War' narrative in COVID-19 crisis fails to empower Filipinos, groups say

The Philippines is still under the longest quarantine in the world and has, according to former task force adviser Dr. Tony Leachon, one of the fastest “acceleration” of cases in Southeast Asia where it still leads the region in the number of active cases.