KAREN DAVILA: Secretary Nograles, good morning to you, sir.
CABSEC NOGRALES: Magandang umaga sa iyo, Karen. Good morning magandang umaga sa lahat.
KAREN DAVILA: All right, magandang umaga po, Secretary. Let’s start with what’s on everybody’s mind. Just recently, Health Secretary Francisco Duque said that Metro Manila would likely be placed under Alert Level 4 given the number of cases that have been coming up in the last few days. So possible po ba o iaanunsiyo na mag-a-Alert Level 4 po ang Metro Manila?
CABSEC NOGRALES: Ganito iyan, Karen, we are actively monitoring all of the metrics and parameters na dapat nating tingnan and even over and above that. As of the moment, hindi pa po siya tumatama doon sa tatlong metrics natin, enough for us to declare Alert Level 4. But immediately, kapag tumama po iyan, we will not hesitate to declare Alert Level 4, in any area or escalate any area to Alert Level 3. So, we are actively monitoring all of the numbers.
So, just to explain to the public, we are looking at three things:
- The first is the two-week growth rate na alam po natin, dito sa Metro Manila, mataas. Kita naman ninyo sa mga numbers, mataas, it’s high.
- Tinitingnan din namin iyong ADAR, Average Daily Attack Rate, which as we all can see from the numbers, it’s also high.
- But the third metric that we are looking at or parameter is the healthcare, the total beds utilization.
And for us to declare an area as Alert Level 4, dapat mataas ang two-week growth rate high, ang ADAR is also high. But total bed utilization should also be high. As of the moment, ang Metro Manila, nasa moderate pa tayo sa total bed utilization natin. So, it’s not enough for us to declare Alert Level 4.
Now, in the meantime, ang tanong, it’s okay, so what are we doing in the meantime? Which is why what we have instructed to do dito sa Metro Manila and all other areas including NCR Plus is number one:
- We must increase the bed capacities of our hospitals. In NCR Plus areas and even outside the NCR Plus areas ‘no, for all of the regions to increase bed capacities in hospitals.
- Number two, increase also the bed capacities of our TTMMFs, those are our Temporary Treatment and Maintenance and Monitoring Facilities; so dito tayo nag-I-isolate ng mga mild cases ng COVID. So hindi siya sa hospital, but we have isolation facilities, all around the countries. So we must increase the TTMMFs po natin.
- We must increase also the utilization of telemedicine and tele-health. So panawagan sa lahat ng mga LGUs to already prepare your telemedicine and tele-health facilities.
Now, isang nakikita rin natin sa Omicron, bagama’t hindi pa tumatama ng high ang ating bed utilization. We are also seeing many healthcare workers getting isolated, because nagka-mild or asymptomatic COVID or going into quarantine, because nga they got exposed, even in their own households or even in their communities get exposed to positive COVID cases. So, the protocol is for them to isolate if they are mild or asymptomatic or quarantine if they were exposed.
So right now, we are also looking at, including looking at updating the available healthcare workers natin to be made part of functional bed capacities. So, hindi lang siya dapat tingnan iyong physical beds available in hospitals. But also looking at how many healthcare workers are available. So, that will now become our equivalent of a functional bed capacity. So we are also monitoring that.
We are also asking all of the LGUs to activate and make functional your triage operations and triaging areas. Para mas maganda iyong navigation natin ng patients. Meaning to say, let’s navigate the patients, kung puwedeng mag home quarantine or home isolation, let’s do it, but make sure na may BHERTs ka, iyong Barangay Health Emergency Response Team, monitoring actively itong mga naka-home quarantine. Let’s prioritize for hospitalization those who need to be hospitalized especially the elderly, those with comorbidities and the vulnerable, A2 and A3 kumbaga.
So, then let’s conduct active case finding, down to the third generation, so that we can immediately detect kung sino iyong symptomatic, kahit iyong asymptomatic and then navigate the patients ‘no. And then of course, for the labs, we want to push the labs to increase their capacities especially iyong RT-PCR labs and speed up the applications also of new labs, para mas marami rin ang makakapagtulong sa atin doon sa RT-PCR testing natin.
And then finally increase vaccination especially outside of the NCR Plus areas. So we have to ramp up the vaccinations in preparation for the other regions if in case nga dumating rin iyong Omicron doon sa kanilang lugar.
KAREN DAVILA: Okay. So let’s start first—you started first with having more telemedicine ‘no. Pero ito muna tayo iyong Temporary Treatment and Monitoring Facilities, you mentioned itong TTMFs, who is in charge of that? Is it the LGUs, Secretary?
CABSEC NOGRALES: Yes. So if you recall, even at the start of this pandemic, we have been able to identify isolation facilities all over the country through the help of the DOH with and in collaboration with our LGUs. So, naka-pre identify na po iyong isolation areas natin. Some of them, you know, we just need to remind the LGUs to make them functional again. Kasi when we saw a decrease in the number of cases, baka some of the isolation facilities have stopped to become functional.
So we need to make them functional again, especially since Omicron were seeing for the vaccinated, for the fully vaccinated the symptoms for Omicron is mild or some even get asymptomatic. So, kung fully vaccinated at puwede namang mag home isolation, home isolation na lang ang ating gagawin, plus telemedicine. But if hindi conducive ang home, meaning to say, walang sariling kuwarto, walang sariling CR, bad ventilation or not adequate iyong ventilation, then we have to isolate them doon sa mga TTMFs, not sa hospital, because we have to reserve our hospital beds for those who are suffering from severe and critical. We have to reserve our hospital beds for those who are vulnerable, those who are senior citizens, those who are with comorbidities. So that ang dapat sa TTMFs, ina-navigate natin na ang nasa TTMFs iyon lang mga mild and hindi naman vulnerable, meaning to say not belonging to A2 and A3.
KAREN DAVILA: Pero Secretary ang mga nagkaka-COVID ngayon are families, families, clans. I mean, let’s face it, kapag ganoon ba, dapat pa ba mag-Temporary Isolation Facility or a family can frankly just isolate together at home? If you are both COVID positive or three of you are COVID positive, is it allowed that you are staying in one room for example and you are healing together?
CABSEC NOGRALES: This is where the wise judgment of the LGUs comes into play. We have to entrust to the LGUs the wisdom in their decisions in terms of patient navigation. But of course, many LGUs naman are not you know, are not health experts, they are not doctors, so it will always have to be in consultation with DOH. But on the ground really, it’s really the LGUs who are trained, who must be trained, who must be knowledgeable enough to know how to navigate the patients. Because, it’s not a one size fits all rule. On the ground, there are different circumstances and this is where the LGUs come to play and obviously they have naman their own local health officers also and that’s where they have the coordination between the local health officer and the DOH come into being the close coordination and then of course the guidance from the DOH. But on the ground, the LGUs, together with their local health officers will have to make the decisions on a case-to-case basis.
KAREN DAVILA: Okay. You mentioned three, essentially, factors before Metro Manila can go on Alert Level 4. You are talking about the two-week growth rate, average daily rate and the healthcare status ‘no, itong hospital bed utilization rate. Ano doon ang hindi pa frankly nagmi-meet kaya wala pa tayo sa Alert Level 4?
CABSEC NOGRALES: Iyong total bed utilization.
KAREN DAVILA: Iyon, oo.
CABSEC NOGRALES: So that’s not hitting the metrics yet because tayo sa NCR, we’re what, hundred percent, well not, you know, fully vaccinated if you look by the numbers of the population ‘no. So that’s where the value or the importance of fully vaccination comes into play. This is what we are seeing right now.
Those who are fully vaccinated only get mild symptoms or even asymptomatic, or are resolved at what, two days, three days. They catch COVID, by the second day, by the third day, kung fully vaccinated, mild na iyong symptoms and then by the third day, you know, anecdotally, they’re okay; they’re done, right? So this is where the effect of full vaccination comes into play.
So we’re seeing less hospitalization from fully vaccinated ‘no and those who are, anecdotally ‘no, severe symptoms are those who have, you know, comorbidities or it’s not strictly because of COVID but because of other conditions ‘no. Nagka-COVID lang sila din, then their comorbidities or their sicknesses come out. So anecdotally, that’s what we’re seeing, and that’s why iyong hospital utilization natin has not yet reached the high level of 71% and up.
So the point is, get yourself fully vaccinated because more and more of the people we know, you know, are telling us na buti na lang they are fully vaccinated because—
KAREN DAVILA: At nagka-booster. And the booster makes a difference.
CABSEC NOGRALES: And the booster, yes. And the booster as well. Get yourself boosted immediately because we hear more and more of friends and relatives telling us na buti na lang fully vaccinated ako or buti na lang naka-booster ako, ‘di ba.
So that’s what’s happening in NCR. What we are trying to do is also ramp up vaccination in other area as well because if Omicron comes to their areas outside of NCR Plus, we got to get more people vaccinated, fully vaccinated and boosted.
KAREN DAVILA: Okay, all right. So, Secretary, I’m going to ask you two things that are quite interesting observations given that we are two years into the pandemic already and we are seeing a surge right now. Other countries for home care, when you are COVID positive, they would have already a kit ready and it’s done in Latin American countries na nandoon na ang dosage ng vitamins, antibiotics, paracetamol, in some countries even Ivermectin. I think what’s surprising right now is people are scrambling. They don’t know what to do. They don’t know what to take. They’re calling their own doctors and they are spending their own money. With the budget that has been allotted for health, why isn’t there a COVID home kit with antibiotics, with things that are needed?
CABSEC NOGRALES: Well, first of all, for antibiotics ‘no, those are prescription drugs and only doctors will be able to prescribe that. So necessarily, you’ll have to go through telehealth, telemedicine to get prescriptions for those types of drugs ‘no, antibiotics especially. So what we want to do is, if you see what one of the things that we’re pushing for is the increase of telemedicine and telehealth through the LGUs—
KAREN DAVILA: No, but I’m saying ordinary Filipinos have to spend buying the medicines. Kumbaga bakit hindi ito magawa ng DOH na nakapakete na at positive ka, ito ang mga gamot mo?
CABSEC NOGRALES: Yes, so how we do the telemedicine and telehealth is through the LGUs. So here in Metro Manila, you will see a lot. Most if not all of our LGUs in Metro Manila have a telemedicine or a telehealth hotline. So wherever you are in Metro Manila, there’s a telemedicine and a telehealth hotline in your city in Metro Manila. That is the ideal that we want to be replicated in other provinces and cities, and that’s what we are pushing for.
So what’s happening now in Metro Manila is mayroon silang libre teleconsult. So sa libreng teleconsult, if you go into that hotline of your city in Metro Manila, may teleconsult na iyan, may telemedicine, telehealthcare who will guide you, who will ask you questions, and answer your questions—
KAREN DAVILA: Yes, but you still have to spend for your own vitamins, your supplements, that’s the problem.
CABSEC NOGRALES: Okay. So some LGUs have gone to the extent also of providing for medicines based on the capacity also of the LGUs. So iyon muna ‘no. Let’s focus first on the telemedicine, telehealthcare. And then, again, depende sa budget, the LGUs can on their own, especially with the new Mandanas Ruling wherein mas malaki na iyong budget na makukuha ng LGUs this year 2o22, then all the more reason for the LGUs to also integrate that into the telehealthcare that they’re giving their constituents ‘no.
As far as DOH is concerned, because siyempre mayroon ding delegation ‘no of functions, and healthcare is one of those delegated functions to the LGUs, so mas malaki na rin ang budget ng LGUs so hopefully the LGUs can come in and help also in this regard. For DOH, it will be something that will have to be discussed in DOH and look for available budget—
KAREN DAVILA: It’s quite delayed. Parang, Secretary, this is two years after the pandemic already, parang I can’t believe we’re still talking about home kits, ‘di ba.
CABSEC NOGRALES: Well, right now, sa Omicron, the way we’re seeing how Omicron works, we’re seeing na more and more again of the fully vaccinated are mild—
KAREN DAVILA: Recovering quickly, agree.
CABSEC NOGRALES: So right now, ang situation natin right now, this year 2022 and even the latter part of 2021, vaccination was ramping up. Many of our people have gotten vaccinated, unlike before that because many have not been vaccinated, then homecare wasn’t really an option. And because of the characteristic of the virus, parang ang default rule is to bring them to the TTMFs or to bring them to the hospital because many of our people were not fully vaccinated. But now, it’s the reverse now. The reverse now is mas marami na ang fully vaccinated; we are seeing more of those who catch COVID to be mild and so we are now focusing more on home isolation, telemedicine, telehealthcare, TTMFS and reserving the beds for those who are severe, critical and the vulnerable.
KAREN DAVILA: Okay, all right. Here is a question right now. Actually, this was a tweet from former Senator Chiz Escudero. He makes a good point, he says, “The Department of Health should make RT-PCR testing accessible, readily available and free. After two years and merely six trillion in borrowings, why is it that we cannot seem to do this?” And, Secretary Karlo, I mean, I know you don’t have the answer to this exactly, but other countries are doing RT-PCR for free. You drive to a site, it’s free. In the Philippines, we are paying for our own RT-PCR. It’s still a private enterprise. It’s a business that profits of the illness of people. Why are we still here? These labs that will be put up, Secretary, that are applying, it’s private; they’ll earn from it. Why aren’t we in a stage wherein I want an RT-PCR, libre ako? Why aren’t we there?
CABSEC NOGRALES: Well, sa atin, ang sistema dito sa atin, RT-PCR is free if you are symptomatic. So if you have symptoms and then i-RT-PCR ka, then it will be covered by PhilHealth. So iyon iyong set up natin dito. It’s not what I think some people are asking for is RT-PCR for free whether or not you’re symptomatic. So even those who have no symptoms, those who have no indications that they might have COVID or were exposed to COVID and are a threat of having COVID, parang some quarters want it free ‘no for, I guess, a hundred million Filipinos—
KAREN DAVILA: No, naman! But where is it free? Let’s say if you are symptomatic, clearly you will not go out of your house. So you have to call a lab and no lab has offered it for free.
CABSEC NOGRALES: Well, if you are in—as I know it ‘no, then this will have to check also for home isolation. But I know kasi PhilHealth also covers those who have COVID and who are doing home isolation. So, we’re also doing—we’re also pushing PhilHealth to increase the packages for home isolation—for home treatment. So, those who are treating themselves at home can also be covered by PhilHealth and the PhilHealth package also includes RT-PCR.
KAREN DAVILA: Okay. Secretary, there’s a viewer that’s watching. This viewer said, Karen, please ask the Secretary: With the limited budget of the Office of the Vice President, why are they able to give out COVID care kits and the DOH cannot? And the COVID care kits of the OVP already have medication on it – sipon, paracetamol, carbocisteine, cetirizine, butamirate, etc.?
So, I think this is really a question of the DOH’s performance in all this. And it even has oral hydration, so, I’ve never seen this, Secretary, just for the record, but there’s vitamin zinc, calcium, D3, kumbaga it’s free; may gargle pa daw nandoon sa home kit.
CABSEC NOGRALES: Well, we have to check ‘no and perhaps even ask the Office of the Vice President if these are charged to her budget in the OVP or are these through private initiatives and people who donate to her and private entities who donate through her office.
So, I don’t know. I have no answer to that, so I don’t know if it’s charged to her office directly or to the national budget or are these just private initiatives and private groups supporting her.
KAREN DAVILA: Okay. Another question is: Government offices, Secretary Nograles, are we seeing a reduction in onsite workforce with government forces? So, the public has an idea when they go to a government office, let’s say, to apply for anything. What are we going to see, Secretary, in the next few days?
CABSEC NOGRALES: Well, right now, a memo was issued by the Office of the President and the Office of the Executive Secretary, giving heads of departments and heads of national government agencies to also reduce workforce if they see that there’s a need to ‘no but we must ensure that public service does not suffer.
So, depending on the head of agency of they’re seeing that in their particular office mataas iyong COVID cases and there is a need to reduce their workforce, they must ensure that at the very least a skeleton workforce and at the very least nandiyan din iyong mga hotline or numbers that public can call so that public service does not suffer.
So, depends on the discretion ng head of office on how to do, what to do, with the workforce and iyong reporting and then of course we’re pushing for alternative work arrangements so that they can work from home and so that public service does not suffer.
KAREN DAVILA: Okay. I’m curious, what about public transportation, Secretary? Is there an update on this?
CABSEC NOGRALES: As of the moment, nothing has changed as far as the 70% rule of DOTr is concerned for public transportation. So, as it is now, I believe unless it is changed later on, it’s still 70%.
KAREN DAVILA: Okay. And the Department of Education has also released a list of schools that have suspended classes due to the rising COVID cases. Actually, there’s been a suspension, Secretary, even on online classes. So, I’m curious where are we in terms of this right now?
CABSEC NOGRALES: So, it’s DepEd who will make the assessment and I believe that for the pilot face-to-face classes in areas that they feel they should suspend face-to-face classes like for instance sa Metro Manila, I think they’ve already done that and they continue to monitor the situation.
And yes, as I know it there are private schools as well that have temporarily suspended classes even if it’s online because they’re seeing many of their teachers also catching COVID. So, again, it’s something that we continue to monitor but we continue to push also the people, our people, our kababayans to get fully vaccinated so that you know, this is for your protection as well.
KAREN DAVILA: Okay. And I think we need to announce also that you’ve added 14 more areas under Alert Level 3, Secretary Nograles?
CABSEC NOGRALES: Yeah, we made that announcement – Baguio City; Dagupan City; City of Santiago; Province of Cagayan; Angeles City; Province of Bataan; Olongapo City; Province of Pampanga; Zambales; Batangas; then Lucena City; Naga City; Iloilo City; and Lapu-Lapu City.
And then we continue to monitor the situation also on the ground. Any area that needs to be elevated to Alert Level 3 ay gagawin naman po agad namin.
KAREN DAVILA: Oo. I’m curious, with the areas you mentioned, what about border control or interzonal travel?
CABSEC NOGRALES: Some LGUs have actually started already or have reverted to their previous protocols na for those who want to travel have to present an RT-PCR negative test. So, kaniya-kaniyang LGUs mayroon na silang stricter border controls.
Basta dumaan sa Regional IATF at may pahintulot mula sa Regional IATF and it is not overly excessive, tulad niyan binalik iyong kailangang magpakita ng negative RT-PCR, those are well within the authority ng mga LGUs. And then it’s being ano naman eh, being coordinated with the Regional IATF also.
KAREN DAVILA: Okay. Is there a change in terms of quarantine for returning Filipinos, Secretary Nograles?
CABSEC NOGRALES: For traveling and returning overseas Filipinos, the quarantine rules remain the same. So, nandiyan pa rin iyong ‘Green List’, ‘Yellow, Red List’ countries, and then the protocols for those listed counties. We will have a new list of a new Red, Green and Yellow List by January 15.
So, we continue to monitor also the numbers per country and then presumably siguro mga January 13 or so, o we’ll release already the new list for the January 15 – January 31 Red, Green and Yellow–listed countries.
KAREN DAVILA: I see. So, this January 13, you’re going to release a new list?
CABSEC NOGRALES: Yes, for Jan. 15 to Jan. 31.
KAREN DAVILA: I see, okay. I’m curious, where is the IATF with the US CDC lessening the number of quarantine days for those who are asymptomatic but are COVID positive because the US CDC believes that infection transmission is highest on the first two days and then dramatically after five days, they allow them to go out with masks. Are we anywhere near there?
CABSEC NOGRALES: Okay. So, ang latest rule natin, isolation of COVID-19 cases shall be—this is isolation of positive – shall be ten days for asymptomatic and mild. For those severe and critical, it’s 21 days. So, these are our rules for isolation of COVID cases.
And then of course, iyong sa severe and critical although it’s 21 days, I guess it’s also as prescribed by the physician because ang severe and critical are already are in the hospital.
KAREN DAVILA: Oo. So, Secretary Nograles, last words before we go. I think you do have Metro Manila a little edgy, wondering—Actually, we have many people already expecting ironically Alert Level 4?
CABSEC NOGRALES: Yes. So, I guess the message that I have for everyone is that we have to be responsible for our actions. All of use, we have to be responsible for our actions. We’re in this battle against COVID for already two years now, so we pretty much know and we just have to keep on reminding ourselves about HUGAS, IWAS, MASK, BAKUNA, VENTILATION.
And we continue to monitor the situation and we continue to do whatever we can to prepare for every eventuality not just in NCR+ but all over, so we’re increasing bed capacities, we’re increasing capacities sa TTMFs natin. We will not hesitate to do Alert Level 4 if we see that it breaches the threshold.
As of the moment, it’s not reaching the threshold and we continue to manage the situation, so that we do not breach the threshold and that means making sure that our health capacity is well enough, is healthy enough, to accommodate those who need hospitalization; while those who are mild, we can home isolate if it’s needed, coordinate with the LGU, do telemedicine. If it’s not conducive for home isolation we have to bring you to the Temporary Treatment and Monitoring Facility then we’ll manage you from there.
So, everything, we’re managing the situation as much as we can but each and every one of us have also our responsibility to manage ourselves, manage our families, and manage the situation in our homes.
KAREN DAVILA: Alright. On that note, Cabinet Secretary Karlo Nograles, thank you for joining me today, sir. Have a good weekend.
CABSEC NOGRALES: Maraming salamat, Karen and God bless everyone.
SOURCE: PCOO-NIB (News and Information Bureau-Data Processing Center)