ABSTRACT
The Philippines experienced many challenges brought about by the COVID-19 pandemic. In 2020, the country experienced a decline in economic growth. The agri-food sector's micro, small and medium enterprises (MSME) are amongst the country's most vulnerable. This study analyses the various policy constraints and enablers related to food manufacturing as well as the distribution in the agri-food supply chain. This study applied a mixed methods approach. Interviews with 30 agri-food enterprise owners and key officers were conducted and concept mapping was applied using Leximancer software. Key themes emerged including introduction of new products, increased online selling activity, limited supply of inputs and packaging materials, increased cost of production and delivery, and availability of government assistance. A subsequent survey (n=125) for the food manufacturers, logistics operators, traders, wholesalers, and retailers was also implemented. The effect of policy measures on enterprises' profitability was assessed using ordered probit regression. The results suggest that the likelihood of reporting profitability after the pandemic increases when the owner or key officer is male, the business is operating under a partnership, enterprises suspended their operations at some point during the pandemic, enterprises implemented health and safety protocols for their employees, there is no oversupply of employees during the lockdown period, and enterprises increased operation work hours during lockdown. The study also highlighted that manufacturing and distribution of food during the pandemic should be unhampered. However, MSMEs in the agri-food chain experienced delays and increases in prices of raw materials despite clear policy guidelines. Interregional trade was affected due to varying localised policies on health protocols and lockdowns. These policy constraints generally affected the profitability of the enterprises.
ABSTRACT
Introduction: Patients infected with SARS-Cov-2, the causative virus behind the coronavirus disease-19 (COVID-19) pandemic, have been increasing rapidly in New York City. New York City has the highest incidence in the United States and fully 45% of all deaths from COVID-19. Our medical center is located within a high-density region of cases in south Brooklyn and, in fact, three of our neighborhood zip codes are in the top seven in New York in incidence. As a result, our center has experienced a dramatic increase in hospitalizations, particularly respiratory distress secondary to COVID-19, which rapidly exceeded the capacity of our internal medicine service. This necessitated the formation of new COVID-19 units throughout the hospital, replacing all former service lines. These units employed management teams composed of residents from many medical and surgical disciplines, including general surgery residents. Methods: Our general surgery residency program established a surgical COVID-19 (SCOVID) management team. Initially, 4 surgical residents (2 senior and 2 junior), 1 attending surgeon, and 1 attending internal medicine physician were allocated to the initial SCOVID team. On day 3 of implementation, to achieve more rapid competence in the complex management of these patients, a senior medicine resident with direct experience in the care of COVID-19 patients was added in an advisory capacity. Results: The addition of an experienced senior medical resident and attending allowed for the quick adoption of uniform management protocols by surgical residents and attendings. Discussion: We describe a protocol for the establishment of COVID-19 management teams staffed with general surgical residents, as well as a strategy for the achievement of rapid increases in competency. The addition of a senior internal medicine resident and attending to our SCOVID team allowed for rapid achievement of competency in the care of COVID-19 patients in our large institution at the epicenter of the COVID-19 pandemic.