What Now for the Nation’s Health and Economy?
Challenges in the Time of COVID: What Now for the Nation’s Health and Economy?
On August 14th, Asia Society Philippines, gathered experts on health and economy to discuss the dilemma posed by the parallel need to reopen the economy and save the nation’s health. The question is: Can we win both sides of this war against COVID-19?
Challenges in the Time of COVID: What Now for the Nation’s Health and Economy? Brought together Dr. Ma. Naval Rivas,a pediatrician and professor at Ateneo School of Medicine and Public Health; Mr. JC Punongbayan, an economist and co-founder of UsapangEcon.com; and Dr. RJ Naguit, the founder of The Youth for Mental Health Coalition, Inc. and the National Chair of Akbayan Youth. The conversation was moderated by Dr. Albert Domingo, a Health Systems and Public Policy Consultant.
Frontliners for the Nation’s Health
The rising numbers of patients have left medical front liners struggling and thinly spread. Many have shared their stories and have expressed the challenges they face and their exhaustion. They are few considering the number of patients brought by the pandemic. Dr. Naguit shared that many colleagues are suffering from a form of moral injury as hospitals are no longer capable of handling and taking in COVID cases. This situation – of being unable to provide care due to limited hospital capacities - becomes frustrating for those who have sworn to help the sick. As older persons are at higher risk from the virus, the younger generation of medical front liners bear an additional burden as they take on longer hours battling the pandemic. Another challenge comes from the internal hierarchy of the medical field.
The Nation’s Economy
Mr. Punongbayan discussed several points of impact on the economy:
The Philippine Statistics Authority (PSA) reported that the Philippine economy contracted by 16.5%.This is considered the biggest single quarter contraction of the Philippines, even beating previous crises.
The PSA also reported a record high unemployment rate of 17.7% which accounts to 7.3 million Filipinos in the labor force.Alarming as this number projects those at risk to poverty.
The Social Weather Station (SWS) reports a historic record high (since 2014) of the incidence of hunger.
An SWS survey also shows another record high as adult Filipinos say their lives have worsened in the past 12 months.
These numbers can be seen through closing of restaurants and various establishments, the rise in locally stranded individuals (LSIs) and returning overseas Filipinos (ROFs), and the loss of income for those in the transport sector including one of the most impacted, jeepney drivers. On top of and contributing to this, the series and forms of lockdowns has left various industries and services to adapt or to completely shut down – the education system included. While tourism and transportation have hurt, the agriculture sector has seen a surprising growth and new trends have emerged. Including teleconsulting, increase in the use of e-commerce platforms, and the emergence of plantitos/plantitas. These however, also come with their own challenges. Teleconsulting, for example, does not afford the meticulousness that comes with physical consultations – with teleconsulting, physicians have to rely on epidemiologic data.
While people are at risk of COVID-19 in the same way, it is noteworthy to add, despite no further need of mentioning, that the economic impact of COVID-19 is not the same across various sectors.
Dr. Naguit notes that psychosocial supports become less accessible or even absent; the effects of isolation become doubly hard to cope with; and the impact of the circumstances on sectors such as the youth, the LGBT community, and women cannot be quantified and properly addressed.
“[While] negative emotions are usual during abnormal situations, we have to recognize positive and negative emotions. Social media can be a trigger [and] Zoom can also be tiring. We need short but regular conversations – these are essential [to reconnect]. We also need to be conscious for people working from home. We need a line from work and rest [and] we have to be mindful of those. We might not be a hundred percent okay, but we’re together.”– Dr. Naguit
Another unseen effect, Dr. Rivas adds, is on children’s coping and the development of children at the school age. While a baby or toddler’s development is focused in the home setting, a child requires the change of setting – to the school setting – as part of its development. As at this age, the child’s development includes meeting new people and developing its social skills. Additionally, for some children, the school setting acts as a safe space for children who have a traumatic dynamic at home. Dr. Rivas also notes that the mental health of parents should also be considered.
“Parents’ mental state are also affected by working at home but since we’re the adults, we should be able to manage our emotions better in terms of relating to our children and creating a better dynamic at home. It’s on us.” – Dr. Rivas
Health versus Economy
2/3 of the Philippine economy is run by consumption spending of private households and individuals. The reported Q2 contraction of the economy says a lot about the current spending considerations and capabilities of the private sector. Less or no jobs means less to no spending. At the same time, lockdowns and the fear of risk to the virus also contribute to the spending behavior. Additionally, 1 out of 10 Filipinos work abroad or are Overseas Filipino Workers (OFWs). OFWs constantly remit to their families in the Philippines and these remittances reflect in the nation’s consumption spending. While 2019 saw a record high in remittances from OFWs,this has contracted with double digits at 19.2% in the second quarter of 2020.
Economic managers have responded by easing quarantine restrictions to help alleviate the economy. They also argue that this is a means for people to return to their work to avoid the rise of hunger. The move came with health repercussions for the nation – as seen through the rapid rise of COVID cases.
Our panel of experts however counter that there is no trade-off between health and the economy.
“Actually, walang trade-off between health and the economy, and I agree, completely, with the point na kailangang tratuhin ito first and foremost as a health crisis rather than an economic crisis. Kasi ang ekonomiya natin ay magrerecover at magrerecover yan pero hangga’t hindi naaangkat ang pagkalat ng virus, hindi mo pwedeng buksan ang ekonomiya agad agad.” – Mr. Punongbayan
[Actually, there is no trade-off between health and the economy, and I agree, completely, with the point that we need to treat this first and foremost as a health crisis rather than an economic crisis. Because our economy will recover but as long as the spread of the virus has been stopped, you won’t be able to immediately open the economy.] – Mr. Punongbayan
Mr. Punongbayan furthers that the strategy of easing quarantine measures doesn’t work as it does not encourage people to continue their spending activities outside homes – as what economic managers predicted. He iterates that although this sentiment of health first before economy seems aloof to the nation’s economic managers, there are many economists and health experts who share his sentiments.
“There is no interconnection, there is no split; no economy first [or] health first because you need one for the other and vice versa – you need health for people to work and you need work for them to be healthy.” – Dr. Albert Domingo
Other countries have put in place strict lockdown measures with accompanying and sufficient aid to their people to ensure meeting basic needs or replacement of income. The aid comes as a measure to encourage people to stay at home. The Philippines has given aid in the form of the Bayanihan to Heal as One Actwith a budget of almost PhP275 billion and the recently ratified Bayanihan 2 with a budget of PhP162 billion.
“Pero ang nakikita natin ay takot ang economic managers gumastos dahil baka masaktan ang credit ratings natin, lumobo ang utang ng Pilipinas. I think, dapat sa panahon ngayon, hindi humindi and economic managers natin dahil kailangan sa sitwasyon natin – hindi maiiwasan ang lockdown. Kung gano’n, open all floodgates on spending on aid… Sa Bayanihan 2, 162 billion lang, utmost, ang gusto nilang gastusin but losses in the second quarter are at 700 billion. So that’s very unfortunate.” – Mr. Punongbayan
[But what we are seeing is that our economic managers are afraid to spend [on aid] because it may hurt our credit ratings [and] the Philippines’ debt increases. I think, what should be done at this time, is for our economic managers to not say no [to spending on aid] because it’s what we need for our situation – lockdowns cannot be avoided. [And] If that’s the case, then we should open all floodgates on spending on aid… In Bayanihan 2, they only want to spend 162 billion utmost but the losses in the second quarter are at 700 billion. So that’s very unfortunate.] – Mr. Punongbayan
Considering this budget for aid, other questions posed are: How the government will support RFOs and how ready is the government to support them? Does the aid reach other sectors and those in the grassroots?
Dr. Naguit reminds that one of the basic principles of aid is that those who need it most, receive it. He adds that aid is actually a great way of redistributing the nation’s resources. However, the responsibility of making sure that the delivery of aid is efficient and sufficient falls on the government. Officials and decision-makers should initiate and create participative and shared spaces to understand the plight of those on the ground. At the same time, there should be transparency of the process – people should be made informed of how aid is distributed.
“The top-down approach doesn’t empower people kasi hindi naa-address and mga issues. [The] government needs to address the issues corollary to the lockdown – katulad ng pagrequire sa mga tao na magsuot ng masks, kailangan magprovide ng gobyerno ng masks. But at the same time, people need to participate in terms of the government’s response.” – Dr. Naguit
[The top-down approach doesn’t empower people because the issues are not addressed. The government [also] needs to address the issues corollary to the lockdown - for example, the requirement for people to wear masks, [then] the government should provide masks. But at the same time, people need to participate in terms of the government’s response.] – Dr. Naguit
Mr. JC Punongbayan adds that the government must step up in its aid giving – it should be matched with the concept of bayanihanwhere the aid meets the amount of losses – and funds must be transparent and guarded. There is hope to once more open the nation’s economy but this must be complemented by government action to address the health aspect of the battle. Especially at a time when the nation’s resources are being depleted and front liners are exhausted. Further, clean data must be shown and must become the basis of clear policies that address the health crisis.
As transparent information is more vital than ever for people, Dr. Rivas suggests a stronger education campaign. She iterates: people with pre-existing conditions are at higher risk of severe symptoms of COVID and so if people they live with, or they themselves, still choose to go out unnecessarily because they do not see symptoms; then, the education campaign is not strong enough that people understand the risks from the virus.
“If this does not reach people, kulang tayo sa campaign na ‘yon. In journals, ang sinasabi na dapat i-focus [ay] ‘yong aspect of [the] virus in terms of its spread in venues, ventilation, and vocalization. Masks address vocalization but not ventilation. ‘Pag walang kaharap, hindi nagmamask, hindi nila alam na some of the virus is in the air – especially if ventilation is poor.” – Dr. Rivas
[If this does not reach people, we lack in that [education] campaign. In journals, they say we should focus on the aspect of the virus in terms of its spread in venues, ventilation, and vocalization. Maska address vocalization but not ventilation. [Some] Take off their masks when not talking to someone, [and] what they don’t know is that some of the virus [stays] in the air – especially if ventilation is poor.] – Dr. Rivas
The panel concluded a COVID-free Philippines may be realized with the hope of a vaccine. However questions remain: How will the vaccine reach Filipinos to attain herd immunity? Will the Philippines be able to mass produce the vaccine or will it be bought?
Clear targets, a baseline, and clear criteria that includes both health and economy such as support to and through aid workers and small businesses, inclusion of a participatory and multi-disciplinary approach by the government all contribute to creating a comprehensive and equitable response that is much needed.
Lastly, all sectors, not just the government, must come together in the battle for health and economy versus COVID-19.
GDP growth rate drops by 16.5 percent in the second quarter of 2020; the lowest starting 1981 serieshttp://www.psa.gov.ph/national-accounts
Employment Situation in April 2020 http://www.psa.gov.ph/content/employment-situation-april-2020
*As of August 17, 2020, the SWS reports a record of 45.5% adult joblessness.
1 out of 5 Pinoys have gone hungry in last 3 months, highest rate since 2014 - SWShttps://newsinfo.inquirer.net/1310045/1-of-5-pinoys-hungry-as-sws-recor…
SWS: Majority of Filipinos say life worsened in past 12 months https://www.manilatimes.net/2020/08/14/news/latest-stories/sws-majority…
OFW remittances hit record high of $33.5 billion in 2019 https://rappler.com/business/overseas-filipino-workers-remittances-2019
R.A. 11469: An Act Declaring the Existence of a Natoional Emergency Arising from the Coronavirus Disease 2019 (COVID-19) Situation and a National Policy in Connection Therewith, and Authorizing the President of the Republic of the Philippines for a Limited Period and Subject to Restrictions, to Exercise Powers Necessary and Proper to Carry Out the Declared National Policy and For Other Purposeshttps://www.officialgazette.gov.ph/2020/03/24/republic-act-no-11469/