- [PDF] How Businesses are Adapting to the COVID-19 Crisis
- [PODCAST] COVID-19 & BPO Outsourcing – Business Risk Analysis
- Why COVID-19 is not the Common Cold or the Seasonal Flu – Contribution by an MD who wished to remain anonymous
- PSA’s Advice to Individuals
- Other Advice for Individuals
- Consolidated Advice on Finding Available Hospital Capacity for COVID-19 Cases
- Triage Guidelines for the Department of Health
- Home Quarantine Guidelines – Caring for a Potential Covid-19 Case
- Useful Infographics
(!) Click on the bullet points to quickly navigate the page.
[PDF] How Businesses are Adapting to the COVID-19 Crisis
PSA expects some level of business disruptions for at least 18 months, until the COVID-19 vaccine is developed, tested, and distributed. This article discusses the kinds of changes that are likely to continue, and how businesses can adapat, using specific best practices across industries from different countries.
[PODCAST] COVID-19 & BPO Outsourcing – Business Risk Analysis
PSA’s Director of Business Intelligence, Greg Wyatt, discusses the impact of COVID-19 on the Philippine Economy and particularly the BPO industry on the Outsource Accelerator Podcast.
Why COVID-19 is not the Common Cold or the Seasonal Flu – Contribution by an MD who wished to remain anonymous
COVID-19 is the disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has infected nearly 200,000 people all over the world in a span of 4 months. The hallmark of the disease is pneumonia, an infection of the lungs. It spreads through droplets in the air expectorated in a six-foot radius by a patient who is typically coughing or sneezing, but may also be spread through direct contact among asymptomatic patients.
Symptoms typically present 2-7 days (incubation period) after a patient is first infected with the virus. The most common symptoms are similar to those of the seasonal flu and these are fever (94 percent), cough (79 percent), fatigue (23 percent), and muscle pains (15 percent). Rapid breathing (more than 24 breaths per minute) is an ominous sign because it is seen more often (63 percent) in patients who die of the disease. In contrast to the common cold, COVID-19 presents with rhinorrhea or colds in less than 15 percent of patients . Therefore, patients who complain of just a cold or a sore throat are unlikely to have COVID-19. Similarly, patients who present with fever, cough, and shortness of breath should consult in a healthcare facility.
81 percent of patients follow a mild course, presenting with no or very minimal pneumonia. The rest of the patients typically require in-hospital management. Patients at risk of more severe disease and death include older patients (median of 69 years old) and those with significant co-morbidities like hypertension and heart disease.
Case Fatality Rate
COVID-19 is 10-80 times more deadly than the seasonal flu. The case fatality rate (CFR, calculated as the number of deaths from a disease divided by the number of total cases from the specified disease) of the flu is 0.1 percent. South Korea has a CFR of 0.9 percent, which is one of the lowest in the world and is attributed to its government’s rapid and aggressive containment of the disease. Italy has a CFR of 7.95 percent, owing to its overwhelmed healthcare system. The Philippines has a CFR of 7.4 percent with 14 deaths and 187 cases as of March 18th, 2020. The notion that COVID-19 will cause as many deaths as the seasonal flu is dangerously inaccurate. Because of its rapid spread and high CFR, COVID-19 may potentially infect 160-240 million and kill 200,000 – 1.7 million people in America alone, as compared to 34,000 patients who succumbed to the flu in 2018.
The management of most viral cases of pneumonia is supportive in nature. These include hydration to maintain blood pressure and oxygen or ventilator support as needed for difficulties in breathing. Antivirals used for the flu (Tamiflu) are ineffective for COVID-19. Numerous antiviral regimens with promising efficacy are being used both locally and abroad for the treatment of COVID-19. These are generally reserved for severe cases of the disease and the consensus among physicians is that mild cases of COVID-19 do not need antiviral medications.
PSA’s Advice to Individuals
A Doctor at the Philippine General Hospital provided the following advice to PSA about how to minimize exposure to the virus during shopping trips.
- Grocery Shopping should be done once every two to three weeks.
- Use only one pair of shoes to go outside.
- One person should do the grocery shopping.
- Offer to do grocery shopping for any neighbors, particularly the elderly or the vulnerable.
Other Advice for Individuals
Continue to prioritize personal preventative measures. These types of measures sound simple but it takes time to develop them as habits. Fear is useful to instill these types of measures as habits. Panic is not useful.
- Stay at home as much as you can.
- Learn how to wash your hands correctly and do so. Some studies have shown that as few as 5 percent of people wash their hands correctly when they go to the bathroom. 20 seconds with soap and water. Watch a tutorial on how to wash your hands if you haven’t already done so.
- Practice not touching your face until you have cleaned your hands. This is very difficult to do without practice.
- Use fist bumps, bows, hand over your heart, or elbow bumps to greet people. Don’t shake hands or do beso-beso. This takes practice, particularly when you meet someone who wants to shake hands with you. But teaching them to fistbump can also be a sign that you care about them.
- Practice good coughing and sneezing etiquette. Cough into your elbow, sneeze into tissues.
- Make sure to keep your flu vaccinations up to date. The vaccination won’t protect against SARS-CoV-2. However if seriously ill from COVID-19, you may be more vulnerable to secondary infections from other respiratory illnesses. Secondary infections are a frequent cause of death. Also, vaccination against the flu may protect against unnecessary quarantine.
- Clients are also advised to consider taking their own temperature daily two times a day, to facilitate their self-quarantine if needed. For example, going into self-quarantine on your own terms is more preferable than your residence denying you entry.
- Clients are strongly advised to prepare a seven-day emergency food supply for the possibility of community lockdowns if they have not already done so. Don’t hoard food or get more than you need for seven days, but you don’t want to be caught in the rush if the government orders a community lockdown. You also want to give the supply chain time to restock, by purchasing your emergency supply early, so that more people have the chance to purchase a supply themselves. Hoarding toilet paper is counterproductive and very little toilet paper will be needed over the course of any potential lockdown. Slowly over a period of time consider building a larger emergency food supply of up to 14 days.
- Protect the elderly and the vulnerable. Take extra care to protect those who are in the at-risk categories for severe and potentially fatal cases. Be sure to follow the personal protective guidelines in order to minimize any chance that you could infect them. Help the vulnerable minimize their exposure.
Consolidated Advice on Finding Available Hospital Capacity for COVID-19 Cases
After receiving several anecdotal reports of individuals experiencing difficulties finding a hospital to admit them for COVID-19 treatment, PSA is releasing its consolidated advice on how to identify available hospital capacity.
In general, based upon official government metrics, announcements of individual hospitals, and anecdotal reports, it appears that many private hospitals are unable to admit new COVID-19 cases, but additional capacity still remains in government hospitals. In general, hospitals still appear to be able to admit non-COVID-19 emergency cases.
A. Contact the One Hospital Command Center
The Government has created the One Hospital Command Center to coordinate the admission and treatment of COVID-19 cases. The center is designed to provide a brief telemedicine consultation, and then refer the COVID-19 patients as needed to quarantine centers or hospitals with available capacity.
PSA notes that, if a patient is experiencing mild symptoms, they will be referred to quarantine centers. Meanwhile, those experiencing critical or severe symptoms will be referred to hospitals for admission.
As it is a new service, PSA is not in a position to gauge whether or not the service is effective. However, some individuals have told us that no one is picking up when they call.
B. Refer to the Philstar Database on Hospital Capacity
PhilStar has created a database showing real-time data of hospitals in Metro Manila, Bulacan, Laguna, Cavite, and Tarlac. This database shows the list of hospitals and details on whether or not these hospitals are available to administer testing or admission of COVID-19 patients.
PSA cannot guarantee the accuracy of the Philstar database. However, in cases, it does appear that Philstar is updating the database when reports of individual hospitals being full are made.
C. Contact your Local Government Units For Assistance
PSA notes that Local Government Units should have capacity to assist their citizens when they are experiencing symptoms. For example, in Makati City, citizens can call 168 or (02) 8236-5790 if they are experiencing symptoms of fever, cough, cold, and diarrhea. An ambulance personnel will pick up the person for admission.
PSA is not in a position to gauge whether or not the service is effective.
Triage Guidelines for the Department of Health
The DOH released new triage guidelines on March 19, 2020. These guidelines make it explicit that mild cases of COVID-19 will be home quarantined and do not need to be formally tested.
Home Quarantine Guidelines – Caring for a Potential Covid-19 Case
(Based on DOH Department Memorandum 2020-0090, dated 17 February 2020)
A. Room Isolation and Contacts of Person Under Monitoring (PUM)
- Place the PUM alone in a well-ventilated room, preferably with toilet and bathroom. If this is not possible, maintain a distance of at least 1 meter from the PUM (e.g. sleep on a different bed).
- Assign one person who is in good health as caretaker of the PUM.
- Visitors, family members, and even caregivers are not allowed in the PUM’s room, if possible.
- Confine activities of the PUM in his/her room only. If this is not possible, ensure that shared spaces (e.g. kitchen, bathroom) are well-ventilated (e.g. keep windows open).
B. Use of Disposable Surgical Mask
- The PUM should wear a surgical mask fitted lightly to the nose, mouth, chin when in the same room with another househod or when talking to other people. The use of masks is not required for the person/s the PUM is/are interacting with.
- If alone, the PUM is not required to wear a mask.
- Masks should not be touched or handled during use. If the mask gets wet or dirty with secretions, it must be changed immediately and disposed properly
- Discard the used mask after a maximum use of 8 hours. Masks are not reusable and should not be washed. After removal of mask, wash hands using water and soap, or rub hands with 70% alcohol or any disinfectant.
C. Hand Hygience Practice for All
- All PUMs and household members should perform hand hygiene following contact with PUM or if in contact with their immediate environment.
- Perform hand hygiene by washing hands with soap and water. If hands are not visibly soiled, 70% 70% alcohol or any alcohol-based hand rub can be used.
- When using soap and water, disposable paper towels to dry hands is desirable. If not available, use dedicated cloth towels and replace them when they become wet.
- Hand hygiene should be performed before and after preparing food, before eating, after using the toilet, and whenever hands look dirty.
- Address safety concerns (e.g. accidental ingestion by children and fire hazards) on the use of alcohol-based hand rubs.
D. Respiratory Hygiene and Standard Precaution for ALL
- Respirayory hygiene/cough etiquette should be practiced by all at all times. Respiratory hygiene refers to covering the mouth and nose during coughing or sneezing using surgical masks, tissues, flexed elbow, sleeves of clothes, or inside the neckline of shirts, followed by hand hygiene.
- Avoid direct contact with body fluids, particularly oral or respiratory secretions and feces. Use disposable gloves to provide oral or respiratory care and when handling feces, urine, and waste. Wash hands before putting on and after removing gloves.
- Avoid other types of possible exposure to PUM or contaminated items in their immediate environment (e.g. avoid sharing toothbrushes, cigarettes, towels, washcloths, bed line).
E. Food Handling of PUM on Home Quarantine
- The assigned caretake of the PUM shall serve their plates/meal trays only up to the room door.
- After eating, plates/meal trays hsould be picked up at the room door by the caretaker using disposable gloves to avoid contamination. Perform hand hygiene afterwards.
- Eating utensils and dishes should be cleaned with soap and detergent and water after use, and may be re-used instead of being discarded.
- Do not share eating utensils, dishes, and drinks with PUM.
F. Disposal of Used Gloves, Tissue Papers, and Masks
- Immediately discard materials used to cover the mouth or nose into the trash or clean reusable items appropriately after use (e.g. wash handkerchiefs using regular soap or detergent and water).
- Gloves, tissues, masks, and other waste generated by PUM should be placed in a container in PUM’s room before disposal with other household waste.
G. Cleaning and Disinfection
- PUMs are encouraged to clean and disinfect frequently touched surfaces such as bedside table, doorknobs, bed frames, and other bedroom furniture daily with regular household disinfectant containing a diluted bleach solution (1-part bleach to 99 parts water).
- Clean and disinfect bathroom and toilet at least once daily with regular household disinfectant containing a diluted bleach solution (1-part bleach to 99-parts water).
- Clean clothes, bedclothes, bath, and hand towels, etc., of PUM using regular laundry soap and water on machine wash at 60-90-C with common household detergent, and sun-dry. Place used linen into a laundry bag. Do not shake soaked laundy. Additional measures may be needed to prevent unhygienic reuse of globes, masks, avoid direct contact of the skin and clothes with contaminated materials.
- Use disposable gloves and protective clothing (e.g. plastic aprons) when cleaning or handling surfaces, clothing, or linen soiled with body fluids. Perform hand hygiene before and after removing gloves.
- PUM who develop symptoms should be reported to the Regional Epidemiology and Surveillance Unit (RESU) or Local Surveillance Officer for transport to the nearest facility.
- All household members of PUM should be advised to seek immediate medical care when signs and symptoms develop.