 | ||
The 2009 flu pandemic in the Philippines is a part of larger global flu epidemic that involves new Influenza A virus strain, H1N1. The pandemic reached the Philippines on May 21, 2009 when a young Filipina girl first contracted the A(H1N1) virus while vacationing in Houston, Texas, US. In the following days, several local cases were reported to be caused by contact with two infected Taiwanese women who attended a wedding ceremony in Zambales.
Contents
- Confirmation
- Release from the hospital
- Opening of classes
- Orders of class suspensions
- Presidential actions
- Travel bans and advisories
- Changes in mass rituals
- Policy of mitigation
- Vaccine issues and benefits
- Infected schools
- Affected regions
- References
The 10-year-old Filipina girl arrived at the country on May 18 and was hospitalized the day after at the Research Institute for Tropical Medicine in Muntinlupa City. On May 21, Department of Health (DOH) secretary Francisco Duque confirmed the case being the first Philippine swine flu case. On a May 22 press conference at World Health Organization Regional Office in Manila, Secretary Duque announced the first A(H1N1) case in the country:
The DOH confirms today the first case of A(H1N1) in the Philippines. She is a female traveler who arrived in the country on May 18 from the United States, whose throat specimen tested positive based on results from the Research Institute for Tropical Medicine.
Since the outbreak of A(H1N1) in the Americas, President Gloria Macapagal-Arroyo urged the Department of Health, the Bureau of Immigration, the Bureau of Quarantine and other concerned agencies to control monitor airport and seaport arrivals for possible flu infection. Thermal imaging equipment were installed at major airports to screen passengers coming from infected countries for flu symptoms. The Philippines may quarantine travelers arriving from Mexico with fever. Also, the importation of hogs from the U.S. and Mexico was manned, and the restriction of swine influenza vaccine use was retracted. First death was reported on June 19, 2009, a 49-year-old Filipina employee of the Congress, as well as the first death in Asia.
Confirmation
On May 18, 2009, a Filipino family coming from a trip in Houston, Texas arrived in the country. Though infected by the flu, their ten-year-old female child did not exhibit any symptoms except a day after arrival. Due to this, her parents decided to inform the local health authorities about it, prompting Department of Health (DOH) representatives to require the girl to undergo laboratory testing at the RITM.
On Thursday, May 21, health authorities and the RITM were able to confirm that the girl was and the first virus "carrier" through throat specimen tests, and the first A(H1N1) infected in the Philippines.
The next day, Health Secretary Duque announced the first flu case at a conference of the World Health Organization (WHO) in Geneva. He then assured members of the media that there is no outbreak so far in the Philippines. However, health authorities did not publicize information regarding the name of the child and her family.
Release from the hospital
The Director of the National Epidemiology Center, Dr. Eric Tayag, said that the girl's immune system had a positive response to oseltamivir (Tamiflu) and other anti-viral drugs. By May 24, she no longer exhibited fever and cough but still suffered from a sore throat. The 10-year-old was discharged last May 28 by the DOH together with the second A(H1N1) patient, a 50-year-old female from Chicago.
Opening of classes
The day after the confirmation of the first case in the country, the Department of Education (DepEd) indicated that classes will continue to start on June 1 as scheduled. In consulting with Secretary Duque, both he and Education Secretary Jesli Lapus reached a decision to go on with the original scheduled date of the opening of classes. Dr. Tayag also said that there is no reason for class suspension unless there is an actual outbreak in the country.
According to DepEd-National Capital Region director Teresita Domalanta, Secretary Lapus has instructed them to order schools to carry out seminars and launch an information campaign about the symptoms and virus prevention among schools.
In line with this, Secretary Duque issued on May 30 a response alert system on when schools should suspend their classes. Based on the response alert system set by the DOH, the Philippines is under response alert level four.
Orders of class suspensions
As of June 6, 2009, because of the said incident, the Commission on Higher Education (CHEd) moved the opening of classes for all colleges and universities nationwide from June 8 to June 15, 2009.
CHED Chairman Emmanuel Angeles said that this postponement of classes will enable the students, especially those coming from abroad vacations, ample time to check their health and go on self-quarantine in case of any virus symptoms will exhibit.
Presidential actions
In a press conference, Press Secretary Cerge Remonde said that President Arroyo has reiterated her instructions to the DOH, the Bureau of Immigration and all other concerned agencies to be on the top of the situation for regular updates.
The president also ensured that the government is ready to give one million capsules of Tamiflu in case of an epidemic.
Despite the increasing number of cases of A(H1N1) in the country, Press Secretary Remonde said that the Palace is not alarmed with the sudden surge of disease in the Philippines.
Travel bans and advisories
As of 24 May, Department of Tourism so not issued a travel ban on the country in accordance with the reported flu cases of A(H1N1). Tourism secretary Joseph Ace Durano in his travel advisory said that there are no reported cancellations in any tourism booking so far.
On the other hand, the government issued travel advisories for Mexico, the United States and other mostly-infected areas, advising Filipinos to refrain from making unnecessary travel.
Changes in mass rituals
On June 5, Manila Archbishop Cardinal Gaudencio Rosales through instructions to Fr. Genaro Diwa of the Ministry of the Liturgical Affairs of the Archdiocese of Manila, issued an advisory ordering priests to temporarily give communion only by the hand, instead of the traditional mouth; and that holding hands during singing of Our Father (Ama Namin) will be discouraged. During the Mass for the 5th anniversary of Pondo ng Pinoy at the Xavier School gymnasium in Greenhills, San Juan, the directive was announced before the start of the celebration of the Eucharist.
In line with this, the Manila Archbishop ordered the continuation of earlier commanded Oratio Imperata On H1N1, revisioning the obligatory prayer from its original version-centered on the virus-infected country of Mexico. He added that the Philippines should be included, and other countries in the prayer.
On June 23, the Archbishop of Jaro (in Iloilo) Angel Lagdameo ordered local churches to empty holy water stoups whereas churchgoers are strongly advised to do sign of the cross instead of using holy water.
Around two months after the memorandum ordering extra precautions on the mob regarding catching flu in churches, the Catholic Bishops Conference of the Philippines (CBCP) announced that the new flu strain failed to drag Filipino believers out of churches. According to Msgr. Achilles Dakay of the Roman Catholic Archdiocese of Cebu, church attendance in the archdiocese remained normal despite advisories.
Policy of mitigation
Though the influenza virus is now treated mild, DOH will only then treat it like an ordinary flu, whereas it is no longer an obligation to follow all sick persons. According to Duque, if they shall continue their containment policy, the DOH will lose all their resources. He added, "Ituturing na lamang namin ito na parang [isang] karaniwang trangkaso na lamang. Mahirap namang babantayan mo[/natin] lahat ng [mga] 'yan[g pasyente]." (We shall treat this disease like an ordinary influenza). It is so difficult, as you think, to follow and trace all of them (the patients).
On the other hand, DOH shifted into policy of mitigation where patients with symptoms anomaly exhibiting swine flu will just go see a doctor.
Vaccine issues and benefits
Dr. Lyndon Lee Suy, head of the Emerging and Re-emerging Infectious Diseases Program of the Department of Health (DOH), said that the Philippine government, on July 5, still cannot afford to buy mass vaccine, which is estimated to cost PhP 1,000 per dosage. He said that the elderly, among the high-risk group in the Philippines, has a population of around 3.6 million, and vaccination among them requires PhP 3.6 billion (which is a tentative equivalent for the health department's three-year budget). Dr. Lee Suy also added that the stocked 1.5 million anti-viral medicines such as Tamiflu by the DOH is not enough for possible epidemic since most of them are given free to discourage uncontrolled and panic buying. He also said that high-risked group does not only includes elderly, but individuals 5 years and below and with naturally harmful diseases.
On July 7, Roche Philippines announced that it would cut down prices of Tamiflu from PhP 1,000 to PhP 880, to ensure adequate supply of the said anti-viral drug in the Philippines and the rest of the world.
The same day, in a hearing at the Philippine House of Representatives (Congress), Health secretary Francisco Duque requested PhP 19.8 billion fund for H1N1 resistance. He said that the money will be used for buying vaccines (PhP 16 billion), subsidizing poor patients and assistance to the families of poor victims (PhP 3 billion), and implementing rules and rehabilitation of target hospitals for H1N1 patients (PhP 800 million). The Congress questioned the amount of fund largely it is too huge to award and that there are no vaccine yet to buy. On the same hand, Iloilo Representative Ferjenel Biron, also the chairman of the House Committee on Health, asked the secretary to cut its requested budget down to 10% or PhP 2 billion.
On July 27, 2009, the Department of Health announced that the doctors and other health workers such as nurses, aides and volunteers that helped the government to assist H1N1 patients and victims will be among the group that will become the first recipient of 100,000 H1N1 vaccine from the World Health Organization. The vaccine is expected to be out from United States by mid-October.
On August 2, San Juan City officials created a city ordinance seeking PhP 1 million budget seeking for an immediate purchase for health workers in the said city. The resolution will be known as “Battle Against Swine Flu Virus” Ordinance. At the same time, around 3,500 employees of the Caloocan City Hall were given free ant-flu vaccine shots, "to strengthen local government employees' immune system against seasonal flu".
Infected schools
The first Philippine school to contract A(H1N1) case was in De La Salle University (Manila) presumably on June 3, followed by suspension of classes effective June 4 ending then on June 14. A few days before, on May 30, a mysterious swine flu-like illness was spotted into 29 students of Hilera Elementary School in Jaen, Nueva Ecija which eventually climbed to 40, six days after. The continuous transmission of A(H1N1) in barangay Hilera mystifies health officials, where immediately spread to 19 person, urging DOH to declare community outbreak by June 15 and Nueva Ecija provincial government a state of calamity the following day.
Affected regions
Currently, there are over 50 infected provinces and cities in the Philippines (excluding Metro Manila component cities):
On the same hand, Metro Manila has the following infected cities: