COVID-19 testing controversy in the Philippines

The COVID-19 testing controversy was a controversy in the Philippines involving several government officials who were reported in media to have been tested for coronavirus disease 2019 (COVID-19) in the first months of the pandemic in the country.[1] This violated the triage algorithm used by the Department of Health (DOH),[2][3] which said that asymptomatic patients should not be tested, and should instead undergo a 14-day home quarantine.[4]

COVID-19 testing controversy
LocationPhilippines
CauseScarcity of COVID-19 test kits during the COVID-19 pandemic in the Philippines
ParticipantsSeveral government officials
(including their staffs and relatives)
Department of Health (DOH)

By March 24, 2020, the Philippines had only tested 1,793 people due to a lack of testing kits.[5]

In some instances, the controversy involved family or staff members of these government officials, who had reportedly also gotten testing in violation of the algorithm.

Public officials receiving quick results on their tests was perceived to be tantamount to receiving priority treatment as numerous people considered as actual patients under investigation – many of whom were frontliners – were dying before their test results were out.[6]

In September 2020, with the improvement of testing capabilities and change in algorithm that focuses on frontliners and people who were in contact with covid-infected patients, the government has reported that over 3 million people have been tested.[7]

Background

Scarcity of laboratories and test kits
Further information: Timeline of the COVID-19 pandemic in the Philippines

The Philippine government did not have the capacity to test for the SARS-CoV-2 virus until January 30, 2020, when the government-run Research Institute for Tropical Medicine (RITM) was finally able to run confirmatory tests. Until that date, samples from suspected COVID-19 cases had to be sent to Victorian Infectious Diseases Reference Laboratory in Melbourne, Australia for testing.[8]

However, there were still very few testing kits in the Philippines, and the RITM was still the only laboratory that had the ability to process test results. By March 9, 2020, only 200 to 250 tests could be processed per day.[9]

By March 23, 2020 the number had gone up to almost 1000 a day, as new laboratories gained the capacity to process test results and various entities donated about 100,000 test kits to the RITM. But the Philippines' overall capacity to do COVID-19 testing was still very limited given the national spread of the disease.[10]

On April 14, 2020, the Philippines' national government began "progressive mass testing" for COVID-19[11] after it received "tens of thousands of testing kits" from various donor countries,[12] and SARS-COV-2 test kits produced by the University of the Philippines' Philippine Genome Center became available.[13] To process these tests, the DOH reported that "dozens of testing laboratories" would come online within the month.[12]

Philippine triage decision algorithm

As soon as the government gained the ability to conduct COVID-19 tests locally, they developed a triage algorithm which would serve as a "decision tool." This would determine which patients would be allowed to use the few available test kits, and the processing time of the few Philippine laboratories capable of doing COVID-19 tests.[4]

The algorithm sorted people into "patients under investigation" (PUI), who would be given tests; and "persons under monitoring" (PUM), who would not be tested, but rather told to go into a 14-day self quarantine. As of January 30, 2020. PUIs are individuals with symptoms (fever, respiratory infection, or both) with history of travel to China for the past 14 days and/or exposure to another individual with confirmed COVID-19 infection. PUMs are individuals with travel history and/or known exposure to a confirmed case but exhibits no symptoms.[4]

Prioritized testing for government officials
See also: Cacique Democracy

While some VIPs were legitimately on the priority list for testing,[14] some of them who were not PUIs did not follow the medical protocol outlined by Department of Health's triage algorithm and were tested ahead of the symptomatic people who were in the priority list, hence the VIP treatment controversy.[15][2][16][17][18] This included family members and the staff of current and former government officials.[19][20]

DOH justified testing asymptomatic officials, citing the need to "preserve" certain high-ranking officials.[21]

Cavite Governor Jonvic Remulla admitted getting tested for COVID-19 despite being asymptomatic, bypassing the DOH's protocol and triage testing algorithm at the time, He later apologized to the public.[22][23][24]

The DOH later issued a statement saying that these tests were a "courtesy" rather than a "VIP treatment" saying that "there is no policy for VIP treatment and that all specimens are being processed on a first-in, first-out basis with courtesy accorded to officials holding positions of national security and public health."[25][26]

In March 2020, DOH Secretary Francisco Duque III admitted that some "VIPs" have made direct requests to the RITM to be tested first. A senator acknowledged that they got tested not because they were classified as "PUI" but because they were considered as "VIP".[27][28]

In May 2020, there is a pending House Bill No. 6707 which pushes for a baseline PCR testing for "vulnerable members of society" including "vulnerable asymptomatics". Senior Citizens Partylist Rep. Francisco Datol Jr. said that he supports the house bill but congressmen and their employees should get tested first since they too "pay their contributions to the Philippine Health Insurance Corporation (PhilHealth)". He claimed that more than 100 members of the Congress are considered senior citizens who are vulnerable to the disease and he expressed hopes that congressmen considered as senior citizens be prioritized for testing.[29]

Reactions

This bypassing of the testing protocol of supposed VIPs has resulted in public outcry, given the scarcity of COVID-19 testing kits available to the public. On March 22, 2020, the hashtags "#NoToVIPTesting" and "#CheckYourPrivilege" trended on Twitter, reflecting public anger on the issue.[30][22][31]

Some politicians issued apologies for getting tested, acknowledging that they "may have skipped" the protocols set by the DOH for determining which patients needed to get tested first.[23]

See also

References
  1. Concepcion, Pocholo. "Gov't officials crowd out patients for COVID-19 testing". The Philippine Daily Inquirer. Archived from the original on March 23, 2020. Retrieved April 16, 2020.
  2. Malasig, Jeline (March 19, 2020). "A closer look at DOH's triage system and why politicians, officials are getting tested for COVID-19". Interaksyon.
  3. Aguilar, Krissy. "Duque: VIPs made requests to be tested for COVID-19". The Philippine Daily Inquirer. Archived from the original on April 16, 2020. Retrieved April 16, 2020.
  4. "Decision Tool for Novel Coronavirus Assessment for Bureau of Quarantine and Hospitals (Version as of January 30, 2020)" (PDF). Government of the Philippines Department of Health. January 30, 2020.
  5. "Concerns in Philippines After Duterte Given Emergency Powers To Fight COVID-19 Spread". NPR.org. Retrieved May 25, 2020.
  6. Malasig, Jeline (March 31, 2020). "Conflicting statements on Bongbong Marcos' COVID-19 test results spark questions". Interaksyon. doi:10.1063/pt.5.029750. Archived from the original on April 2, 2020. Retrieved April 14, 2020.
  7. https://bcda.gov.ph/ph-surpasses-3-million-covid-19-tests
  8. "PH acquires confirmatory test kits for novel coronavirus". CNN Philippines. January 29, 2020.
  9. Magtulis, Prinz (March 9, 2020). "With only 250 people tested a day, Philippine health sector appears ill-prepared for COVID-19". The Philippine Star. Retrieved March 13, 2020.
  10. "DOH sends 100,000 test kits to RITM, testing centers nationwide". CNN Philippines. March 23, 2020. Retrieved March 23, 2020.
  11. "PH begins 'progressive' COVID-19 mass testing". CNN Philippines. Archived from the original on April 14, 2020. Retrieved April 14, 2020.
  12. Dancel, Raul (April 13, 2020). "Coronavirus deaths spike ahead of mass testing in Philippines". The Straits Times. Retrieved April 14, 2020.
  13. Diomampo-Grana, Rhia. "Meet the Filipino scientist who invented the low-cost COVID-19 testing kits". ABS-CBN News. Retrieved April 14, 2020.
  14. News, Mike Navallo, ABS-CBN. "Pimentel insists not yet PUI when he visited hospital". ABS-CBN News. Retrieved July 18, 2020.
  15. "Algorithm for Triage of Patients with Possible COVID-19 Infection in Healthcare Facilities". Facebook. Department of Health. March 10, 2020. Retrieved March 23, 2020.
  16. "Makati village urges Pacquiao, family to self-quarantine; senator says 'will always follow the law'". ABS-CBN News. March 27, 2020.
  17. Cepeda, Mara (March 22, 2020). "Hell on Earth: The agonizing confusion over coronavirus testing in PH". Rappler.
  18. McCarthy, Julie (March 24, 2020). "Concerns in Philippines After Duterte Given Emergency Powers To Fight COVID-19 Spread". NPR.
  19. "Bongbong Marcos' family, staff take COVID-19 tests which turn out negative". The Philippine Star. March 26, 2020.
  20. Garcia, Ma. Angelica (March 26, 2020). "Statement allegedly from Bongbong Marcos' wife says they got COVID-19 test results in a day". GMA News Online.
  21. Esguerra, Darryl John. "DOH justifies COVID-19 testing of asymptomatic gov't officials". Philippine Daily Inquirer. Retrieved May 21, 2020.
  22. Robles, Alan (March 25, 2020). "Coronavirus: in Philippines, leak shows politicians and relatives received 'VIP' testing". South China Morning Post.
  23. Malasig, Jeline (March 23, 2020). "Officials issuing apologies for availing of COVID-19 testing kits". Interaksyon.
  24. "Asymptomatic Cavite Governor says sorry for taking COVID-19 test amid shortage". Yahoo News. Coconuts Manila. March 19, 2020.
  25. Tan, Lara (March 29, 2020). "Health Dept. gives COVID-19 testing 'courtesy' to officials involved in nat'l security, public health". CNN Philippines.
  26. Sabillo, Kristine (March 23, 2020). "DOH denies expedited COVID-19 testing for VIPs, only extends 'courtesy' to some officials". ABS-CBN News.
  27. Aguilar, Krissy. "Duque: VIPs made requests to be tested for COVID-19". Philippine Daily Inquirer. Retrieved May 21, 2020.
  28. "Pimentel to DOJ: I was not a PUI when I went to Makati Med". Rappler. Retrieved July 18, 2020.
  29. Mercado, Neil Arwin. "Solon wants congressmen prioritized in COVID-19 testing". Philippine Daily Inquirer. Retrieved May 21, 2020.
  30. Malasig, Jeline (March 18, 2020). "Politicians and their families get tested for COVID-19, but some people are not having it". Interaksyon.
  31. Rita, Joviland (March 23, 2020). "Duque clarifies RITM director was not replaced amid alleged VIP testing for COVID-19". GMA News Online.
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