As a highly-communicable disease, COVID-19 has affected various aspects of people's lives globally and has significantly changed the way our systems currently work. With countries imposing nationwide lockdowns as a precaution against the pandemic, travel is highly restricted, office employees work from home, and access to commercial establishments becomes limited, among others. As the country prepares to transition to the ‘new normal,’ it is vital to understand how the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted from one person to another to avoid the further spread of the infection.

How does COVID-19 spread?

According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), COVID-19 is primarily spread from person to person through respiratory droplets.

1. Respiratory Droplets - COVID-19 can be transmitted when an infected person coughs, sneezes, or talks. Anyone within 3 feet of the infected person may inhale these droplets into their lungs. The virus can also be transmitted through close contact such as when shaking hands or caring for the sick.
2. Surface Transmission - Surface transmission happens when a person touches contaminated surfaces that an infected person has coughed or sneezed on. Research shows that the virus can live on surfaces like plastic and stainless steel for several days.

What can I do to protect myself from COVID-19?

1. Continue practicing physical distancing- Maintain a distance of at least three feet from other people. Accordingly, avoid going to social gatherings or in crowded places.
2. Maintain good personal hygiene. Avoid touching your eyes, nose and mouth, and constantly wash your hands with soap and water. In case these are not available, use a hand sanitizer with at least 70% alcohol.
3. Wear Personal Protective Equipment. Wear face masks that cover your mouth and nose when going out, or when with other people. Non-medical fabric masks may also help, as long as they are not damaged, clean and are worn properly. Never share your face mask with other people.
4. Clean and Disinfect. Using a household disinfectant, clean and disinfect frequently touched surfaces daily. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19.
5. Observe stricter precautions for individuals at higher risk. Older people, and people with chronic medical conditions, such as diabetes and heart disease, tend to be more at risk of developing severe symptoms. It is highly relevant for the immuno-compromised or those who belong to high-risk groups to stay at home as much as possible, and practice stricter precautions as iterated above.

Understanding the transmission patterns and practicing these specified precautionary measures could mean saving our lives and the people we love. Equipped with the right information and proper health practices, together, we can help fight to end this pandemic.

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 Written by:

Catherrine Joy Dimailig
Jwynne Gwyneth Macan

Health care workers in the Philippine General Hospital (PGH) can now connect with their patients without physically being present in COVID wards, thanks to telepresence devices that “limit exposure, conserve personal protective equipment (PPE), and provide clear communication with a friendly face.

These telepresence devices not only help nurses and doctors, anxious and lonely patients isolated from their families and moral support system can also remotely communicate with their loved ones during their fight to survive the disease.



This
technology solution was developed by the University of the Philippines Manila – College of Medicine Surgical Innovation and Biotechnology Laboratory or UPM-CM SIBOL COVID Task Force composed of collaborating clinicians from UP Manila and engineers, scientists, and artists from UP Diliman funded by the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD).

COVID-19 is projected to require a massive inventory of medical supplies. This was the impetus for us to convene the SIBOL COVID Task Force,” according to Dr. Edward Wang, lead of the SIBOL team. The Task Force, recently formed to support the fight against coronavirus pandemic,  is composed of three teams working on Disinfection, PPE, and Telemonitoring.

SIBOL, a Filipino term for germination, is an existing program of DOST-PCHRD which originally aims to “use locally sourced material and technology to produce much needed surgical and medical devices in the country” (Wang, 2020).

The telepresence device is the first SIBOL product deployed by the team at PGH after two weeks of collaboration. “Inspired by triage booths initially set-up to screen ambulatory patients, the team led by Dr. Nathaniel Orillaza Jr. (Orthopedics), Dr. Pros Naval (Computer Science), and Dr. Luis Sison and Dr. Roel Ocampo (Electronics & Electrical Engineering Institute) assembled devices which allowed health care workers to connect to patients remotely,” said Dr. Wang.

The telepresence devices are “computers programmed to automatically answer calls from authorized accounts using available teleconferencing and remote-control applications, thus minimizing contamination and allowing effortless access even by patients with no technological know-how.”  Materials used for initial deployment were sponsored by Xavier School Class of 1975 while wooden stands were designed, manufactured, and subsidized by Projektzulu Co.  The team also acknowledges the Department of Orthopedics for providing headquarters and logistical support for this SIBOL Telemonitoring project.


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To accelerate COVID-19 mass testing in the Philippines while protecting frontline healthcare workers during specimen collection, the Department of Science and Technology (DOST) delivered and installed 132 specimen collection booths (SCBs) to 89 DOH-identified hospitals and healthcare facilities across the country.


As of May 23, the booths were successfully distributed to nine cities in NCR and 37 provinces in Luzon, Visayas, and Mindanao. Fabrication of the SCBs was facilitated since April by Mr. Augusto Martinez III and his team at the Futuristic Aviation and Maritime Enterprise (FAME) Inc. 


Inspired by the telephone booth-style swab collection facilities in other Asian countries, the SCB is equipped with a transparent front window, ventilation, and caster wheels for easier mobility. For added safety and protection, it also comes with pressure and infrared temperature sensors which can be used for remote monitoring of the patient and separate disinfection agents inside and outside the swab booth.


Each booth contains two holes at the front panel which allows the healthcare worker, in proper PPE, to collect the patient’s samples. Five minutes is then allotted to disinfect the booth before receiving the next patient. 


Designed to reduce the exposure of frontline health workers to suspected COVID-19 patients, the fabrication and distribution of SCBs were sponsored by DOST-attached agencies, Philippine Council for Health Research and Development (PCHRD) and Philippine Council for Industry, Energy, and Emerging Technology Research and Development (PCIEERD). The Philippine Coast Guard provided assistance in the delivery of some of the units to Visayas and Mindanao.


The recipients of SCBs also received instructional materials, videos, and document manuals on how to install and use the booths. The design was also made available publicly for free and disseminated through the DOST Regional Offices, in case other entities would like to fabricate their own booths.


The public can access the design through this link:http://pcieerd.dost.gov.ph/library/fame-design.



As the Philippines hopes to transition from the COVID-19-induced community quarantine to the new normal, it is imperative that targeted mass testing is in place in order to contain further spread of the SARS-CoV2 virus. While national and local efforts to source diagnostic kits have been successful, there is an imminent testing bottleneck in the country due to the lack of capable qPCR instruments on which to run these specialized kits.

Recognizing this problem, the Department of Science and Technology through the Philippine Council for Health Research and Development (DOST-PCHRD) has signified support to the “Accelerated development of a cost-efficient microPCR (miPCR) and lateral flow diagnostic (LFD) system to enable expanded near-point-of-care testing for COVID-19” or the AMPLiFieD System to be developed by a multi-disciplinary team of biologists, clinicians and engineers led by Dr. Jeremie de Guzman, Dr. Keith Moore, and Mr. Ricardo Jose S. Guerrero, PhD Cand from the Ateneo Research Institute for Science and Engineering (ARISE).

The AMPLiFieD system will combine the outputs of two newly-initiated DOST-PCHRD supported projects  ---the miPCR Project, a microfluidic PCR device for portable DNA/RNA amplification and the ADDS Project, an amplified DNA detection system based on low-cost lateral flow diagnostic (LFD) strips to selectively detect the viral nucleic acids that are the output of the miPCR device.

Once the team has fabricated the proof of concept devices, further validation and verification of these devices will be conducted to ensure reliability and robustness. If successful, AMPLiFieD could provide a functional alternative to commercial qPCR instruments at a significantly lower cost and a much smaller size. The availability of this alternative system can also potentially lead to creating more cost-effective, more distributed testing laboratories and provide the much-needed testing infrastructure for more responsive testing and tracing of suspected COVID-19 cases.

The World Health Organization (WHO) cites the Philippines as a model for low- to middle-income countries with a comprehensive national strategy for health research based on the Health Evidence Network (HEN) report, “What is the evidence on policies, interventions and tools for establishing and/or strengthening national health research systems and their effectiveness?” which elaborates the importance of collaborative and cross-cutting health research strategies as key in the achievement of national health goals.

Emphasizing the challenge in building and sustaining the growth of a continuously evolving health research landscape, the HEN report identifies the Philippines as among the countries which made significant progress in line with the institutionalization of the Philippine National Health Research System (PNHRS) through the Republic Act 10532 in 2013.


Defining and articulating a vision for the NHRS is important in providing an overall direction and purpose for the activities involved in establishing and strengthening the system,” the report asserts. Referring to the country’s AmBisyon Natin 2040, the report explained that the “22-year vision for the nation provided a framework within which to develop a long-term vision for the country’s health research.”


The report also highlights the support given to research projects aligned with the National Unified Health Research Agenda (NUHRA) and the accreditation of research ethics committees (RECs). In 2016, the report notes that the country was able to address 45 of the 56 priority topics in health. This includes the country’s focus on innovation, particularly with its Tuklas Lunas program which leverages on the country’s biodiversity. On accreditation of RECs, through the Philippine Health Research Ethics Board (PHREB), the country was able to accredit a total of 48 RECs in 2016. To date, there are 95 accredited RECs across all regions in the country.


Collaborative efforts and partnerships were also identified as key in achieving the country's health goals. The report illustrates the partnership between the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD) and the United States National Institutes of Health to create a platform for a coordinated approach to tuberculosis research, and with the United Kingdom’s Medical Research Council for infectious disease projects in institutions in both countries.


Recognizing that “the way in which health research evidence is produced can increase the chance that it will be used in the health system,” the report also underscores the country’s efforts to advance health research publication in line with its partnership with the Asia Pacific Association of Medical Editors (APAME). In collaboration with the APAME, DOST-PCHRD holds biannual medical writing workshops to strengthen the publishing capacity of health researchers in the country.


"A health research strategy plays a key role in creating an overall system that is stronger because it combines diverse interventions related to specific functions," the report concludes.


The PNHRS, through its implementing institutions --- Department of Health (DOH), Department of Science and Technology (DOST), Commission on Higher Education (CHED) and the University of the Philippines Manila (UPM), is a national framework and convergent strategy that aims to promote cooperation and integration of all health research efforts in the country to ensure that research contributes to evidence-informed health policies and actions.


Written by: Jwynne Gwyneth Macan
Contributor: Christine Jane Gonzalez