Early response to COVID-19 in the Philippines

@#Low- and middle-income countries (LMICs) with weak health systems are especially vulnerable during the COVID-19 pandemic. In this paper, we describe the challenges and early response of the Philippine Government, focusing on travel restrictions, community interventions, risk communication and testing, from 30 January 2020 when the first case was reported, to 21 March 2020. Our narrative provides a better understanding of the specific limitations of the Philippines and other LMICs, which could serve as basis for future action to improve national strategies for current and future public health outbreaks and emergencies.

Injuries after new years celebration seen at the National Orthopedic Hospital (January 1990) (With Addendum, January 1991)

By tradition, the Filipinos combine the Western New Year with the Asian custom of exploding fireworks. To estimate the number of injuries associated with fireworks, a descriptive study was done. We reviewed clinical records of outpatient and inpatients of the National Orthopedic Hospital (NOH) who sustained injuries because of fireworks from December 1, 1989 to January 6, 1990. Between December 22, 1989 and January 6, 1990 113 cases of firework injuries were seen at the NOH. One hundred eight (96%) were males. Seventy five (66%) were between 5 and 24 years. Seventy three (65%) of the cases were seen on January 1, 1990 between 12:00 midnight to 2:00 am. One hundred seven (95%) were self inflicted. Thirty four (30%) patients were hospitalized; none died. There were 178 injuries. Fifty four (48%) had multiple injuries. The hand was the body part most commonly affected. Amputation of fingers or wrists accounted 42 (24%) of the injuries; mostly in ages 5-14 years. Fractures accounted 24 (13%) of the injuries; mostly in ages 10-19 years. Avulsions accounted 23 (13%) of the injuries; mostly in ages 15-24 years. We concluded that the use of fireworks can cause debilitating injuries - - the more serious involved the age group 5-24 years. We thereby recommend that health education and preventive measures should be directed to these age group. Existing Philippine law absolutely prohibits the use of fireworks. However, this was hard to implement and illegal manufacturers make larger fireworks than when fireworks were legal. We recommend the selective legalization of small fireworks which may be more a practical way to prevent the severe injuries we documented.

Outbreak of febrile gastroenteritis in a five-star hotel in Metro Manila

In September 1989, a national tabloid reported that over 70 persons became ill with gastroenteritis shortly after attending a banquet in a five star hotel in Metro Manila. An epidemiologic investigation was immediately conducted. Illness was defined as diarrhea (passage of watery stool three or more times in a day) or vomiting. A total of 54 (35% of the 150 guests) were interviewed; 38 (70%) became ill and 16 (30%) did not. Salmonella sp. was isolated from the stool of one of the hospitalized cases. Analysis of food specific attack rates implicated steamed lapu-lapu with mayonnaise as the most likely vehicle of transmission (p 0.01). An infected egg may have been used in the preparation of mayonnaise. We presented our findings to Hotel X and we advised them against the use of cracked eggs.