Why Philippines became the worst place to be amid Covid

Why Philippines became the worst place to be amid Covid

This file photo taken on Sept 6, 2021 shows a nurse in a personal protective suit walking past patients suspected of having Covid-19 in a parking lot-turned-into ward outside a hospital in Binan, Laguna province, south of Manila. (AFP)

The Philippines fell to last place in Bloomberg’s Covid Resilience Ranking of the best and worst places to be amid the pandemic, capping a steady decline over the course of 2021.

The monthly snapshot — which measures where the virus is being handled the most effectively with the least social and economic upheaval — ranks 53 major economies on 12 datapoints related to virus containment, the economy and opening up.

The Philippines’ drop to No. 53 reflects the challenges it’s facing from the onslaught of the delta variant, which has hit Southeast Asia particularly hard amid difficulties containing the more contagious strain and slow vaccination rollouts. The region, which recently had the worst outbreak in the world, populates the September Ranking’s lowest rungs, with Indonesia, Thailand, Malaysia and Vietnam all in the bottom five.

President Rodrigo Duterte’s government is “not surprised” that the Philippines and other Southeast Asian nations landed at the bottom of the list, as richer countries get more vaccines, spokesman Harry Roque said in a statement Wednesday. The Ranking will help give more direction to the nation’s Covid response, Health Undersecretary Maria Rosario Vergeire said at a separate briefing, while adding that the vaccine rollout is improving.

What pushed the Philippines to last place?

The Philippines faces a perfect storm in that it’s grappling with the more ferocious delta variant at the same time as it works with an inadequate testing regime and sees disruptions to its economy and people’s livelihoods as the pandemic continues to rage.

The country scores low on all four of our metrics related to reopening, and with a vaccine coverage rate of 20% — among the lowest of those ranked — the Philippines is engaged in one of the most stringent lockdowns of the 53. Its Flight Capacity, which measures how far air travel has gotten back to normal, is 74% below 2019 levels and the Philippines’ borders remain sealed to visitors.

On Covid containment, the Philippines underperforms too. While its cases per capita over the past month are a fifth of what vaccine frontrunner Israel has seen, the Philippines had the second-worst positive test rate in the Ranking, at 27% — only better than Mexico. The metric indicates the government is only testing the sickest patients for Covid and that there’s likely high levels of undetected infection in the community.

The timing of delta’s arrival in the Philippines also mattered for its score this month. Setting aside Singapore’s recent surge in infections, the Philippines was the last of the Southeast Asian economies ranked to start seeing its delta wave ebb, reaching a peak in mid-September. In comparison, Indonesia and Malaysia — placed last in the Ranking in July and August respectively — hit their peaks in the corresponding month.

Meanwhile, the outbreak has extracted large economic and social costs, as shown in metrics related to quality of life. Community mobility remains 29% below a pre-pandemic benchmark, and the economy is forecast to grow 4.5% this year, less than estimated before delta’s spread. The Philippines also has weaker healthcare infrastructure compared to other ranked places, and a lower Human Development Index score to cushion the virus hit.

What is the Covid situation like on the ground now?

Infections in the Philippines remain elevated as delta continues to spread, bringing cases throughout the course of the pandemic to more than 2.5 million as of Tuesday — among the highest in the region.

The most significant impediment to the Philippines’ response has been its limited access to vaccines. The country has used a disparate range of shots to try and ramp up the rollout:

The Philippines’ handling of the pandemic was also hampered by a 1991 law that made city, town and village leaders responsible for the health system. Without uniform guidance, village-level health teams often follow rules set by mayors or chieftains, resulting in a fragmented response to Covid.

Even as one in every four tests turns out positive, tracing and testing remain slow in the Philippines, as local officials are in charge. Hospitals are understaffed and low on beds, forcing patients to queue. Although borders are closed to most foreigners, migrant workers can return, straining quarantine facilities.

Lingering lockdowns to quell the persistently high infections pushed the Philippines’ economy back into contraction in the second quarter from the previous three months.

The government has eased movement restrictions that have been in place to varying degrees since March last year, and fully-vaccinated people are being given more freedom but lockdowns are still being applied in a localised way. Restaurants and beauty salons were recently reopened, public transport is operational, and limited in-person classes will soon resume, though with vaccination so low that raises the risk of further transmission.

The Philippines earlier set a goal of inoculating all adults, or 70% of the population, this year, a target it is unlikely to meet at the current pace.

What does the Philippines need to do to improve its Ranking?

The Philippines needs to focus on ramping up its vaccination rate. Given the limited doses already in place, the government should seek further supplies either via programmes like the World Health Organization-backed Covax, or through bilateral agreements.

A case in point could be Malaysia, where 65% of the population are covered by vaccines now, more than triple the level of the Philippines. Malaysia does have a smaller population, however, making it easier to achieve a higher rate.

It’s also key for the Philippines to ensure vaccines are targeted at the most at-risk populations first to further weaken the link between cases and deaths. A WHO article a month ago highlighted the need for the country to prioritise the elderly and vulnerable populations with vaccines.

Bolstering the whole approach to testing would also enable the Philippines to better detect the spread of the virus and control the risk from incoming migrant workers.

The more targeted lockdowns are an improvement on blanket restrictions. Previously, lockdowns worsened inequality in the country with relatively affluent Filipinos able to work from home, order in groceries and reduce their exposure while others engaged in service sector employment faced greater risks or even lost their jobs. As shown by the countries in Europe now leading the Resilience Ranking, tying reopening and its privileges to vaccination status reduces the risks posed by normalisation.

What’s increasingly apparent is that the pandemic is far from over, so it’s important that the Philippines — together with the rest of the developing world, where vaccine coverage is much lower — stay vigilant and prepare to be fighting this foe for some time to come.