With the pressing need to continuously develop ways to prevent COVID-19 transmission especially among healthcare workers, the University of the Philippines - Manila (UPM), with support from the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD), will conduct the project: “SIBOL Personal Protective Equipment - Design and Development of Locally-Manufactured, Reusable, Powered, Air-Purifying Respirator (PAPR).”

The project proponents aim to design and develop an innovative PAPR as a chemical and biological protection for COVID-19 high-risk procedures such as intubation, endoscopies, sample collection and testing, among others. The equipment will serve as an additional personal protective equipment (PPE) for healthcare workers to reduce their risk of contracting COVID-19 while they care for the infected patients.

A PAPR uses a pump that moves contaminated air through a high-efficiency particulate (HEPA) filter which removes particulates through mechanical and electrostatic mechanisms. Built with three main components, the motor or air pump, the filter, and the mask or helmet, the PAPR provides contaminant-free air to the user.



Figure 1:  3D image of the SIBOL PAPR prototype


By conducting the project, we are aiming to offer additional protection for our healthcare workers, so that they may be able to carry out their tasks safely and comfortably,” says project leader Dr. Samuel Arsenio Grozman.

Our healthcare workers are at the core of our battle against COVID-19,” emphasizes DOST-PCHRD Executive Director Jaime C. Montoya. “It is imperative that we mobilize our resources and maximize our capacities to provide R&D solutions that will assist and protect them in this fight,” he adds.

Aside from developing a PAPR that will meet the standards set by the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), the project also aims to activate the supply chain towards the production and testing of PAPR in the country.

As a highly-communicable disease with no definitive treatment, COVID-19 continues to pose risks to public health, especially healthcare workers who work at the frontlines.

The coronavirus, not even a living thing, has transformed how the world works. Technically, all homes now are quarantine facilities. Since the start of the coronavirus pandemic in March, isolation became the new norm, with strict social distancing and “stay at home” policies, being critical to protect our physical health from a public health emergency.

But this might be taking a toll on our mental health, warns Balik Scientist Dr. Christian Gloria: “The COVID-19 pandemic is the initial crisis, followed by the economic crisis, and—now—we are beginning to see the coming wave of the mental health crisis as a consequence of the first two. At this point, the primary source of stress and anxiety—aside from the pandemic—is the question of “how will we survive through the quarantines, lockdowns, and joblessness for however long this will last?”

Being a public health expert himself, Dr. Gloria sees that it is critical to include mental health as part of public health response. This means that a holistic approach in responding to a health crisis is not a choice but a necessity, as cases of mental health disorders continue to spike along with the surge of COVID-19 infections worldwide.


Many people and families are without enough income, food, shelter, financial assistance, and healthcare for over three months. Everyday, we have been worrying about yesterday, today, tomorrow, and the uncertainties of when these struggles will end. These incredibly challenging times are chronically stressful, and it is well known in research that chronic stress significantly contributes to the development of mental health problems such as anxiety and depression disorders,” he added.

The good news is that this coming wave of mental health crisis is preventable, and one sure way of achieving that is for the government and other abled organizations to help the people meet their said needs. Enable people to survive these trying months by simply providing enough food, water, and funds, and we will effectively prevent many health problems from arising—mentally, physically, and socially.”

People are struggling [with mental health] and we need to help them. But before we can help them, we need data in order to understand where we are now and what programs and services are needed to ensure a healthy and bright future for all,” Dr. Gloria emphasized. This is his impetus for conducting mental health research in the Philippines, as part of his Balik Scientist engagement with the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD).

Curious about how mental health research is like through the lens of a public health expert, our team had the opportunity to discuss with Dr. Gloria on how we can communicate mental health with our audiences. Dr. Gloria let us in on his own insights, experiences, and personal thoughts, through another feature story which will be prepared by our expert himself. For now, let us get to know Dr. Christian Gloria.

 

Specializing in health behavior

Dr. Gloria is currently the Department Chair and Associate Professor of Public Health at Hawaii Pacific University (HPU). He earned his PhD, specializing in Health Behavior and Health Education, from The University of Texas at Austin in 2013. Four years prior, he obtained his Master’s degree in Health Education from the same University.

He relocated to Hawaii to “pursue his life’s calling of teaching, conducting research, and providing public health services in Asia and the Pacific.” Some of the courses he is currently teaching are related to public health research and communication, risk and resilience, health behavior theories, and public health program planning and leadership.

Dr. Gloria has also led various public health organizations in Hawaii. In 2017, he became the first Filipino-citizen to be elected as the President of the Hawaii Public Health Association (HPHA) since its founding in 1945. HPHA is one of the largest chapters of the American Public Health Association. He is currently the Vice-Chair of the Faculty Assembly at HPU’s College of Health & Society, which houses undergraduate and graduate programs in Nursing, Public Health, Social Work, and Physical Therapy. Many students from these programs are Filipino-Americans. He received the Progress Award for Education from the United Filipino Council of Hawaii in 2017 and was also recognized as the 2018 Friend of Social Work by the Hawaii Chapter of the National Association of Social Workers.

 

The research journey

In 2018, Dr. Gloria collaborated with Angeles University Foundation (AUF) in Angeles City, Pampanga, where he also became an Adjunct professor and worked as consultant for the Commission on Higher Education (CHED)-funded project Mental Health Across Ages: Identifying Issues and Trends in Pampanga. His research with AUF generated baseline data on mental health concerns, which will become the basis for the development and establishment of a mental health care program in Pampanga.

A year after, he became a DOST-PCHRD Balik Scientist which allowed him to share more of his expertise to the country. Currently, he is involved in three mental health research projects in the Philippines, one of which is a study about the mental health of healthcare workers amid the COVID-19 health crisis.


Dr. Gloria also published several research publications on various topics under public health, risk and resilience, and mental health in collaboration with other experts on health-related fields. One of the research projects he is currently working on is about identifying the mental health issues and trends across ages in Pampanga.

Among Dr. Gloria’s hobbies are practicing yoga, learning to play the ukulele, reading in coffee shops, and watching shows on Netflix.


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In an article published online, experts warned that the pandemic may lead to behavioral problems and mental illnesses, as COVID-19 is described to be a “traumatic event” that everyone is experiencing.

With plans to delve deeper into mental health research discussions, we are preparing another feature story about mental health research experiences authored by Dr. Gloria himself. We are also inviting everyone to participate in our online poll in DOST-PCHRD’s Facebook and Twitter pages, to determine which mental health-related topics are mostly preferred by our stakeholders for our future mental health communication campaigns.

Stay updated for future stories in our online channels here.


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The Balik Scientist Program

The Balik Scientist Program (BSP) is the brain gain initiative of the government which aims to tap into the ingenuity and expertise of Filipinos abroad to strengthen the S&T capabilities of local researchers in the academe, public and private sectors, and industry. The program was initiated to reverse the effects of brain drain, to provide researchers and scientists whose expertise are not available locally, and to accelerate the flow of new strategic technologies that are vital to national development.

BSP was established in 1975 and was later reinstated in DOST in 1993. Through the efforts of Senator Paolo Benigno “Bam” A. Aquino IV and Congressman Erico Aristotle C. Aumentado, their co-author, Congresswoman Divina Grace Yu, and all the legislators in the Senate and Congress, the Republic Act 11035 also known as an “Act Institutionalizing the Balik Scientist Program” was signed by President Rodrigo Roa Duterte on June 15, 2018. The enacted law strengthened the implementation of BSP by giving better incentives and benefits to returning Filipino experts, scientists, inventors, and engineers who would return and share their expertise.

With the passing of the law, a science, technology, or innovation (STI) expert or professional who is a Filipino citizen or a foreigner of Filipino descent can apply and undertake STI activities on his/her field of expertise through a host institution under short term, medium term, or long term engagement.

Developed with funding from the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD), the Axis Knee System was shown to attain correct mechanical axis on patients while costing 50%-100% less than its competitors in the research article entitled, “Clinical Evaluation of the Mechanical Axis Finder (MAF) by Radiologic Scanogram of 100 Consecutive Axis Total Knee Replacements.”

Mechanical axis refers to the proper alignment of the knee to the femural head (highest part of the thigh bone) when moved into different positions. 

Published in the Orthopedic Research Online Journal, the article written by Axis Knee lead developer Dr. Ramon Gustilo, Dr. Rupesh Man Sherchan, and Dr. Arlan Troncillo recorded a 93.3% correct mechanical axis rate among 100 procedures that used the mechanical axis finder or MAF, an instrument specific to the Axis Knee System. The MAF is used to locate the proper mechanical axis of the knee which improves functionality and durability of the implant for optimal use of the patient. 

The paper also highlights the Axis Knee System as a cost-effective option for total knee replacements in the country. Offering quality performance, it comes at a 50-100% lower cost than existing knee replacements in the country and 200-300% compared to its western counterparts.

The Axis Knee System was developed to address the high cost of knee implants in the country which poses a huge burden to patients in getting treatment. According to Dr. Ilustre Guloy, orthopedic surgeon at the Asian Hospital and Medical Center and one of the developers of Axis Knee System, the cost is a common reason why patients postpone or decline their surgery.

Priced at ₱60,000-₱70,000, the Axis Knee System makes world-class knee implants accessible to more Filipinos. “The Axis Knee System shows the DOST-PCHRD’s commitment to making lives better by providing high quality and affordable health solutions through research and development,” said DOST-PCHRD Executive Director Jaime Montoya.

The device has been in the market since 2015 through Orthopaedic International Inc. For more information about the Axis Knee System, you may visit this link: http://pchrd.dost.gov.ph/index.php/programs-and-services/create-article/6349-axis-knee-system-confidence-in-every-step



References

 

The Philippine Health Research Ethics Board (PHREB) launched the 2020 Standard Operating Procedures (SOPs) Workbook online last June 23, 2020, updating the first edition released in 2015. The document serves as a guide for institutions in establishing research ethics committees (RECs), applying for PHREB accreditation, and revising their current SOPs.
 
Emphasizing the importance of ensuring the rights, safety, and welfare of human participants in conducting health research, the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD) Executive Director Jaime Montoya referred to the workbook as a “testament to PHREB’s commitment to the universal principles for the protection of human participants in research.”
 
Authored by  former PHREB chair, Dr. Marita V.T. Reyes, the second edition of the workbook is a product of the critique and inputs of various institutions using the 2015 PHREB SOP Workbook. Dr. Reyes presented the amendments applied to the document which provides guidelines on streamlining ethical review processes and how they can be applied from the perspective of RECs. In this edition, the guidelines are reorganized and simplified to facilitate convenient referencing for its users.
 
With the updated SOPs, the current workbook addresses concerns the previous edition did not tackle. These include the policies on management of resubmissions, review of reportable negative events, management of applications for continuing review, management of appeals, and policies on exemption from review. New sections such as the glossary of terms and sample forms were also added which can be used as bases for the creation of SOPs specific to a certain REC.
 
“Ang workbook ay isang napakahalagang hakbang para sa professionalization ng ating ethics review (The workbook is a crucial contribution for the professionalization of ethics review),” said current PHREB Chair Dr. Leonardo de Castro. 
 
As of June 2020, there are currently 104 PHREB accredited RECs throughout the country.
 
The 2020 PHREB Standard Operating Procedures (SOPs) Workbook can now be downloaded through http://www.ethics.healthresearch.ph/.

As COVID-19 continues to be a public health burden with the lack of existing vaccines, the University of the Philippines - Philippine General Hospital (UP-PGH) with support from the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD) will conduct the project: “Convalescent Plasma as Adjunctive Therapy for Hospitalized Patients with COVID-19.”

 

Adjunctive therapy is a treatment used to support the main or primary treatment of diseases. As definite therapy for COVID-19 is still lacking, the project aims to evaluate the efficacy and safety of convalescent plasma transfusion as adjunctive therapy to prevent disease progression among hospitalized COVID-19 patients. Convalescent plasma is taken from the blood of patients who recovered from infection and contains neutralizing antibodies against it.

 

According to Dr. Michael Ryan, Executive Director of the Health Emergencies Program of the World Health Organization (WHO), the use of convalescent plasma transfusion is a valid approach in treating infectious diseases as demonstrated in previous outbreaks such as the H1N1 influenza virus pandemic, 2003 SARS-CoV-1 epidemic, and the 2012 MERS-CoV epidemic. In a press conference in Geneva last February, he explained that through the transfusion, “you're giving (the patients) a boost of antibodies to hopefully get them through the very difficult phase.

 

“For the past months, we have been mobilizing our resources and maximizing our capacities to help combat COVID-19. Through this project, we are hoping to provide supportive treatment to COVID-19 patients to avoid worst-case scenarios,” DOST-PCHRD Executive Director Jaime C. Montoya says. “If the project proves to be successful, we can also contribute to developing a treatment that will help reduce the mortality rate of COVID-19,” he adds.

 

Aside from potentially developing locally-produced convalescent plasma which may be used as part of the COVID-19 treatment regime, the project also aims to strengthen the capacities of healthcare professionals in its clinical use, not only for COVID-19, but also for other emerging infections in the future.

 

The team has started the call for blood donations from COVID-19 survivors last April 2020. The project will run for 12 months.

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