 Okay. Good morning, good afternoon, good evening, everyone. Welcome to our episode number 62, our 62nd installment of the Stop COVID-Dets webinar series. So we are glad that you continue to support and choose to learn about this COVID-19 journey with us every Friday from 12 noon to 2 pm. So last week po, no, we had our third virtual international conference about the Delta variant and today will be sort of a continuation of that discussion regarding our preparations for the Delta variant but slightly different from last week wherein we learned the different scenarios from our international guests. Our speakers for this webinar will be coming in from several different parts of the country and today our focus will be on our situation and our preparedness of our different hospitals here in the Philippines. I'm Dr. Raymond Francis Sarmiento, director of the National Telehealth Center, National Institutes of Health University of the Philippines Manila. Always a pleasure to be with all of you during our regular Friday lunch date. I always look forward to our Fridays naman po, no? And not just because I'm able to join each and every one of you dito po sa ating regular Friday lunch habit but also especially because I'm able to share hosting duties with my mentor and my partner, Dr. Susie Pinada-Mercado who has always really regaled us with all of these different insights po for our webinar. Dr. Susie. Hi Raymond, good afternoon. Magandang hapon po sa inyong lahat. Wherever you are, we're greeting you. We hope you're all okay. This is your credible online community and it's credible not because of the speakers but because of you, our frontliners na talaga naman anonong masugid. Raymond na tagahanap ng tamang informasyon at talagang nakakatulong sa mga nga ilangan ng tamang informasyon. So today, nako Raymond, I'm so starstruck by our lineup of guests. You're going to meet some of our outstanding hospital directors in the Philippines and today we're going to not, we're not going to have a series of presentations but more, wentuhan, more a conversation around ano ba, ready na ba tayo, ano bang kilangan malaman ng ating mga frontliners tungkol dito sa Delta variant chakapano bang pag-ahanda natin. So please stay with us. This is going to be a great, I think it's going to be a great webinar. We've got some very interesting and nakikita ko nga yung mga ibang hospitals, yung happen niyo nan dito kaya nanunod kayo, very good kayo ha. So it's great to have all the Metro Manila hospitals around, a lot watching from in the now. And I think Raymond will tell us later who's watching from outside the Philippines. Over to you, Raymond. Thank you so much, Doctor Susi. So for those who are joining us for the very first time, our webinar episode for today will be a little bit unconventional in the sense that it will just be really, well, informal if you want to call it a conversation among all of the different leaders and directors of the different hospitals here in the Philippines as we prepare for the Delta variant po, which is really top of mind for us for a few weeks now. So wag po kayong magugulat kung ganun po ang ating really a set up or arrangement because that's really very, very different from what we have been doing for the past 61 webinars. Speaking of 61 webinars po, for those who are asking, all 61 webinars are archived or can be viewed po in the playback of the YouTube channel ng TVUP. So if you go to www.youtube.com and then type in the search bar TVUP, you'll be able to see all the 61 previous web episodes or webinar episodes po natin para dito sa stop COVID-19 webinar series. I'd also like to acknowledge po, baka we might not have time just because it will be really a jam-packed webinar to acknowledge the very hard working team behind the stop COVID-19 webinar series po. Maraming-maraming salamat po to each and every one of you and for those who are asking, I know we have been receiving really tens of inquiries as it relates to the certificates po. Eto po ang itchura ng certificate na we will be handing out at least for those who are eligible to receive it and to be eligible, you should have spent at least 50% of the webinar duration dito po sa Zoom and if you feel that you should have received or we may have missed sending out your certificate for any of the previous 61 webinars, please let us know. Please note na hindi po namin sinasubmit it sa isang araw po lahat ng certificates because there's a limit to the number of certificates that we can send out in a day. So please bear with us if some of your friends or family members have been able to receive theirs but yours po ay maybe stuck in the mail or got delayed in the mail po kung baka. Okay, sige po. Dr. Susie? Okay, thank you very much Raymond. I think for today we really are going to try to understand a little bit more what kind of preparedness we need to do on the ground in the field. And we will have, we will have, nakikita mo nga dito sa chat, parang daming mga nakikimig na from the hospitals represented by our hospital chief. So this is really great. I'd like you to use the chat box and the Q&A box for questions and I'm not sure Raymond if later we have some time to pick up questions from the audience but live. But we certainly will look at the questions that you ask in the Q&A and we can direct your questions to our special guests and panelists and we'll all learn. I think we are in for a lot of learning about what's happening in different parts of the Philippines. So without further ado, let me start by, okay, so our introductory speaker is not new to you. He is in fact one of the organizers of Stop COVID Deaths and I am very honored to welcome the special advisor of the National Task Force against COVID-19, Dr. Ted Herbosa. Ted, welcome. Hi Susie and thank you for asking me to do the welcome again and good morning to everybody. Good afternoon already to everybody. Can I go ahead Susie? Go ahead. So Susie, Raymond, Yusek Dumama, Chancellor, Benchit Padilla of UP Manila, our speakers, former secretary now with the Red Cross, Secretary Pauline Ubyal, our hospital directors, Dr. Jose Chan of the Northern Mindanao Medical Center, Dr. Julius Derlon of Corazon, Montelibano Medical Center, Dr. Vincent Balanag of the Lang Center of the Philippines, oh my colleague Dr. Raul Winston Andutan of Maria Reina Hospital, the Savior University and of course Dr. Rahina Berba of the head of our Hospital Infection Control Unit at the UPPGH. And to all of you participants, the regulars and the new ones, welcome to this webinar hosted by the University of the Philippines. Ready na ba kayo sa Delta variant? We have the Delta variant or the B1.61.7.2 detected last October 2020 in India. Now it is found in over 93 countries. We saw very vivid images of the Delta surge in that overwhelmed the health system of India. We saw graphic pictures of people lining up for hospitals, emergency rooms that were filled up, and several funeral fires in public places, which were very graphic images of how the Delta variant can actually create havoc in a health system. Currently, we still have the lowest number of active cases of COVID-19, less than 50,000 in the whole country, whereas all other countries around us in the region, in Southeast Asia, have higher numbers. Our daily cases have plateaued to about 6,000 for several weeks, but our neighbors have over five to ten times that number of daily cases in Indonesia, in Myanmar, in Thailand, and in Malaysia. They are all struggling to fight this vicious variant. We too cannot be complacent as we start to suffer a pandemic fatigue. This marathon of a pandemic battle against SARS-CoV-2 and its later variants are beginning to have a toll on all of us. To date, we have identified through the UP Philippine Genome Center 47 cases of the Delta variant in over 8,000 samples that underwent full genome sequencing. Prior to last week, only 19 Delta variants were found among mostly returning Filipinos, and there was no community transmission, yet identified all were imported cases. And they had one death last week. However, the Philippine Genome Center and the Department of Health reported an additional 16 cases of the Delta variant identified by full genome sequencing. And 11 cases were found to be samples from the community. Only five were from returning OFW. So those 11 cases had no history of travel. As our epidemiologist conduct intensive case investigation and aggressive contact tracing to document the epidemiologic linkages, the DOH and PGC just yesterday reported another 12 cases of the Delta variant identified in the Philippine Genome, full genome sequencing. Six of whom actually come from Region 3 and this brings our total to 47 cases and today I think already three deaths. So how many Delta variants are now ongoing transmission in our different regions? It seems it has been found in almost all the three major island groups. We need to do aggressive surveillance, test, trace, treat. We need to do the PDITR and we need to actually vaccinate. PDITR stands for Prevent, Detect, Isolate, Treat and Reintegrate, but we need to vaccinate, vaccinate, vaccinate. Obviously the April surge we experienced from the alpha and the beta variants are just dress rehearsals for the Delta that is about to come. Today we will hear from the USEC of the Visayas Mindanao, the five hospital directors, two are from Luzon, one from the Visayas, and two from Mindanao. We will hear how they are all bracing for the uptick of cases of a variant with a reported reproductive number anywhere from five to six. So let's all learn and listen as we prepare our health facilities and our health system for this oncoming Delta surge. Let's stop COVID Delta deaths. Let's plan, prepare and prevail. Good afternoon and mabuhay to everyone. Okay, thank you very much. Let's Dr. Ted Robosa, the Special Advisor of the National Task Force on COVID-19. And Ted, please join us for the panel. We're going to have a very interesting discussion. So before we go to our first speaker, we are going to have a video of our webinar last week. Apparently, Raymond, ilan yung manuod ng webinar natin on the playback? At least for the playback, mga mereng 6000 na po ay when I was viewing it, at least for the playback. So that does not even count everyone who was actually watching it live, those other views in our other social media accounts. So maraming-maraming salamat po sa latpon ng mga nanuod last week for our third virtual international conference. At least for this webinar, Dr. Suzy, we have more than 3000 registrants and we understand that there are multiple watch parties going on. So thank you po, Oly. O, lalo na yung mga watch parties sa Corazon Loxy Montilibano Memorial Center, maraming at saka yung sa Lang Center. Okay, so all right. So for those who missed it or just to refresh our memory, TVUP has prepared a summary, like katulad ng mga sa TV series na last week o di ba, last week on Stop COVID Deaths eto na. Okay, so TVUP, over to you. I would surmise that there is hardly a person who is not personally affected by this pandemic. Could we have done better? Local cases of the Delta variant have been detected. The Delta variant was first detected in late 2020 and you have heard from Dr. Franko that it carries actually quite a number of mutations. We need to be very, very vigilant. What actually is very sinister about the Delta variant is because it carries these four mutations. This one is showing that the more contagious the variant, the higher the basic production numbers. Delta is 50% more transmissible than alpha. So why do mutations occur? It occurs because it's part of the evolution of the virus. It is more contagious. It's more transmissible and with the Delta variant, there has to be a shift in strategy against this changing enemy. I saw once more how important it is to have a good healthcare system. Once you achieve herd immunity, the transmission is minimized even if there are no restrictions, even if there's no mask. The higher the percentage of vaccination, the harder for the virus to transmit in the unvaccinated community. In summary, you have great protection against severe disease, including hospitalization and deaths among all vaccines against all variants. The household transmission is lower and decreased mutations compared to unvaccinated. So the trust now is on three fronts. Testing, contact tracing and vaccination. We need to emphasize on testing, isolating, treating and vaccinating people. The first thing we should do is actually vaccinate, vaccinate, vaccinate. The pandemic fatigue is quite high, the level of stress. So that aspect of mental health also need to be taken into consideration. Testing, I think, is more important and the way forward would be to go for cheaper testing. So that's why besides PCR testing, we will now roll out point of care testing which will be cheap available. There's hope. Always keep yourself healthy and safe. Like when you are taking care of others, it is equally important that you take care of yourself as well, follow all the universal precautions, get vaccinated and keep your family also protected. Thank you. Eventually we will overcome this and other variants. We learn from experience and we must continue to be vigilant. The universal healthcare is indeed promising and a must as we continue to face the COVID pandemic and prepare for the next pandemic. We just have to be ready to adopt, recalibrate and make changes in the policies as we move and face the new variant. We will be able to manage COVID pandemic better if universal healthcare is in place. So as we fight this pandemic, let us also continue to work for the full implementation of universal healthcare in the Philippines. Thank you so much TVUP for that really very very quick overview of our episode last week for our third virtual international conference. For this week's episode, we have a total of seven speakers coming in from Luzon, Visayas and Mindanao. So we found it just really appropriate that our first speaker will be the one to brief us on what we are supposed to do in case of a surge especially because he's an undersecretary from the Department of Health. So please welcome to the webinar po, undersecretary for Field Implementation and Coordination Team for Visayas and Mindanao, Dr. Abdulad Domama. Yusek Oka, welcome to the webinar sir. Imon, can you see me or hear me? We can hear you sir but we cannot see your, there we go. Okay. Okay. I'm sorry but I really had a hard time connecting doh. So anyway I may start ko na doh kasi anong tayo sa oras. Anyway. Yes sir. Go ahead sir with your talk. Yes, yes. How do we blame the satan or Jim? Bismillahirrahmanirrahim. Allow me first to extend my courtesies to everyone, to my colleagues, to the other guests, to the experts who are still with us today. Friends, ladies and gentlemen, magandang hapon po sa inyong lahat, mayong hapong kaninyong tanan. I'd like to thank the convener of this event for inviting us, most especially to our boss Yusek Susi Mercado, to shed some light on concerns regarding COVID-19, response and management, especially now that the borderline and Delta variant is loomir around the country. As you may all know, this variant is of utmost concern, not only by our local authorities but globally as well. Even the WHO experts are explicitly saying that this variant should be taken more seamlessly because unlike the former variant, this is highly infectious and causes more severe impacts to those who get infected. Anyway, let me take off from a different note. I think I sounded like too threatening at the start. It was an intentional pull. I was just simply sharing insights and information for the benefit of everyone. It pays to be informed and more importantly, if the information is translated into positive behavioral change. Moving on, let me say that the Department of Health in cooperation with the IETF is framed at addressing this situation from both preventive and curative or treatment aspect. As the national action plan against COVID-19 is executed using the PDIDR framework, the DOH is intensifying its campaign on infection and prevention control through the Vida solution and Vida Bastunero Bastunera initiatives. Hindi na po, lingid sa ating kalaman ng, ito po yung minimum public health protocols na madalas nating inanunso na dapat sundin ng mamamayan. Number one, B, bawal ang walang mass official. Number two, I, is sanitize ang kamay ng madalas o kaya iwas sa crowded areas. Number three, the mis-tancia ng at least sub-metro sa katabih o alamin ang A, alamin ng tamang information. Ang mga nagbangkit ko po ay hindi ito katang hinsip. Ito ay napatunayan ang mga experton na ligtas, efektivo at madaling mga paraan upang maputul ang chain of infection. Kapag gamang ito ay nakawgali ako na naging habit ng pawat isa, magiging matagumpay ang ating laban sa COVID-19. Merong haka-haka night, it only takes 21 days to form a habit. Maybe we all should try learning this one. And I mean, it's a good habit to learn. At kaya naman, ay meron ng ganitong habit, kung maari ay maging Vida Bastunero Bastunero ng rin tayo. Ito po yung may apat po itong component kung baga. Number one, inform, correct, remind, and appreciate. Meron po akong ginawa ito, ICRA, ICRA, ito, gada rilang pung-entendihin ito. Ipaalam, inform, Ipaalam sa mga kasamahan natin ang concept ko ng Vida Solution kung hindi pa dilaito alam. Number two, correct, iwas to ang maliap pagsuay sa minimum public health protocols. Marami ho sa ating mga kumabayan na ang kanilang mas, ay umabot na sa baba. Yung kanilang mga face-shed inagawang talo ito, talo ito, ten visor. Ten visor, ten visor. Kaya yun, yun, yun, yun. Kailangan natin iwas to yun. And remind, ipalala sa mga nakalimot ang paksunod sa Vida Solution. Of course, number four is appreciate. Pahalagaan ho natin, okina lang ni natin, yung mga may matutuwin, matusubusunod sa aliton So muli ang prevention strategy ay naging, yag yung tabugon pa ilaman ko ang bawat individual ay susunod o makipag-operate ko. However, I would be too naive to say that everyone will abide by the rules. That would be too good to be true. Hence, the department is also into vaccinating our eligible population as part of its preventive measures. It is clear that we do acknowledge the contribution of our healthcare workers. Thus, they come on top of the list to be vaccinated first. This is the manifestation of the government's concern for safety, security, welfare of our frontliners, not to mention the science behind the decision. So in general, it is imperative that in any worst case scenario, the health system should be the last if not never to break down. And the HRH as part of the entire health system should be taken care of accordingly. Uhat naman sa national data, pinapakita na pinapatas na patality ng COVID-19 nasa mga senior citizens at mga comorbidities. So sa pagsurput ng Delta Bar, kailangan natin paiktingin at bilista nang pagpabakuna po sa kanila. At kapag naging maagap tayo sa pagpabakura sa kanila, babawasan yung kusibleng hospitalization. Thus, reducing hospital congestion. Thus, helping our healthcare system. Thus, helping our frontliners. Let us prevent them from getting infected and avoid them from suffering severe effects of COVID-19. How? By getting them vaccinated immediately. Otherwise, if we don't vaccinate more, A2 and A3, priority group hospitals will be congested again. Since these groups are at most risk for hospitalization and death. Karagdagan po sa prevention strategy ng Department of Health ay yung pakipagtuluhan sa mga local napamahalaan, upamapay ding ang surveillance sa lahat ng lugar sa Pilipinas. Hindi lang ako sa Bisayas Pinalaw, lahat ko ng lugar sa Pilipinas. Kailangan natin maunahan ng Delta Bar yan, bago pa manito manalasa at maghasik ng bagim sa pamamagitan ng National Government Enabled Responses, local government led responses, and people-centered responses. Ngayon, na yung nais ko po nipin lang po ito, baka alam ng yuto, na nais ko ang iba hagi yung four door strategies na ating pinapatupan. Number one na pinto, ito po ay pag-implement ng travel restriction as a separate and primary level of defense to supplement the currently implemented health protocols. Yung pagpuban po, ginagawa na ho natin ito. Number two is making sure yung door two that safeguards are implemented such as screening, testing, quarantine at points of entry to lessen the risk of incoming travelers from triggering the local spread of the variants of concert. Yung tapangat ng pinto po ay yung door three is para sa mga RGU to strengthen the implementation of PDITR. Alam natin ito, prevention, detection, isolation treatment and rehabilitation recovery strategies to immediately detect and isolate probable possible COVID-19 cases. Number four po, apang apat na pinto is having a strong health system and critical capacity system versus a surge of cases to ensure a prompt and proper COVID-19 management and most importantly continuity of essential services. Ang lahat po natin binanggit ay yung puntong prevention palamang. On the other hand, the treatment strategy, the DOH is improving and increasing the number of facilities which can accommodate and handle COVID-19 cases including po yung public sector. Bag natin kalimutan, napakalapang importanting partner po yung. The infrastructure side of things are also already in motion likewise making sure of the availability of life-saving drugs, medicines and equipment of course and the PPE. Yung HRA complement po natin is also being addressed. The department has called to duty other professionals from different national government agencies like the BNP, BFP and the AFP. We have also identified several modes of additional allowances for them. Just to be care of them, including but not limited to specialist allowance. These are actually small amounts for the sacrifices they are enduring. In addition to money's possible surge, we need to ensure the health system is prepared regardless of community quarantine qualification. We need to have enough COVID-19 beds in PTMFs and of course ICUs including medicines and even oxygen tanks. We need layers of protection against COVID-19 especially the Delta variant. No single strategy is enough to protect the people and to protect our health system. Strict adherence, nakakarindi na po ito but to topo ito, is strict adherence to MHPS coupled with vaccination will help us win the race. But more importantly to win this battle means we need to win the undecided. Those who are undecided to get vaccinated must be persuaded to get their jobs now. Let those who have completed their inoculation be the living witnesses and testimonies of the vaccine's safety and efficacy. Together, let us win the undecided and together let us win the race. Thank you very much for listening. Salam alaykum morah matunglahi talawa. Okay, thank you very much. That's Idol, Undersecretary Okang Dumama. Alam niyan si Usec. Okang napakabisin yan. I've been with him in the field for polio, measles and he's on the ground, he knows what's happening and what's going on. So, I think our audience particularly, kaokang ang Minda Nau hospitals, Sambuanga, Bukidnon, makikita nyo sa Outpatabato, so many of them are watching and it's really great to have you here at magandang nakikita-kitang nakakurbata. Pag nakikita-kitang, parang panggera na. Thank you so much for your message. I think it's really great to have you here. Usec. Okang is in charge of field operations of Visayas and Minda Nau. And so, okay, Raymond said earlier what we're going to do is a little different. We're going to go straight into a panel discussion. So, allow me to introduce our star-studded panelists for today. We're going to start with former Health Secretary Pauline Obial. So, Pao, please open your camera. And she's now head of the Biomolecular Laboratories of the Philippine Red Cross but is also handing vaccination. Of course, from the Corazon, Loxin, Monteribano Memorial Regional Hospital, which has the most participants, I think today, very well-known Dr. Dr. Julius Drillon, the Medical Center Chief from Bacolod City, Negros Occidental. We also have from the Philippine General Hospital, Sukipunaten, si Dr. Nina Berba. And we all are very calm when we listen to Nina because she's so soft-spoken. Pero talagang ito lumalaban talaga sa virus dito, head of the Philippine General Hospital Infection Control Unit. From Mindanao, Dr. Raul Winston Andutan, Medical Director of the Maria Reyna Javier University Hospital, Kagayande Oro City, Misamis, Oriental. Dr. Jose Chan, the Medical Center Chief of Northern Mindanao Medical Center, Kagayande Oro also, Misamis, Oriental. And from Metro Manila. Again, suki na ito, nagikita sa Dr. Vince Balanag of the Philippine Lang Center. Welcome everyone. And we're going to start with our first question. What we're going to do is Raymond and I will fire different questions and any of you can answer the questions. We'd like to ask you to open your video. I think, Ted, her boss had to leave. Ted, are you still here? Okay, so I think. I'm still here. I'm still here. Okay, join us mo na as we're speaking engagement pa to si Ted. Pero while you're here, please join us. All right, so first question. When you heard, so we selected hospitals where there was known cases of the Delta variant. And I think the first question is, when you heard that Delta variant is found in your city or your province, what came to your mind, what was your first reaction? So we're going to start with Dr. Julius Drilon of Bacolod City. What came to your mind when they said na kung meron dito sa region 6? Naraming salamat TV UP for having me. It's really an honor. And good afternoon Suzy and to my fellow panelists. Honestly, personally, we were expecting it already when you say, how do we feel? We were expecting it because our philosophy is to assume that it's already in the community and we have to strengthen our defenses. So, hindi actually po kami nagulat na mayro ng Delta variant roaming around Western Visayas. And we do not really know where they are, primarily because we lack the genomic surveillance in Western Visayas to be sent to the Philippine Genome Center. So whatever variant that is, we have doubled our defenses primarily geared towards our healthcare workers. So for us, it was not surprising to be honest. Oh, yeah. From Kagey and Dioros, we have the two hospital chiefs from both a government hospital and from a private hospital. Raulikaw muna. Nung narinig mong big land depressed? We have one. I don't know if it was fortunate that we have one. So we can be given the opportunity to experience how to handle Delta cases. And the first thing I did was communicate with the seats. Oh, if there is really additional measures, communicate with the stakeholders in the hospital and overwhelming answer was no additional measures for the Delta. So I thought that maybe our priority in the private hospital is not really the logistics, the physical structures, but the priority should be on how to hold on to our nurses. We all know that nurses are being pirated and how to maintain their health and how to maintain their mental health to be motivated. So those are the things that came into my mind. Those are my priorities. It's not stacking up on respirators, stacking up on oxygen, but I give premium to my manpower because I believe that every logistic, every additional physical structure will be useless unless you have a dedicated manpower. Thank you. Thank you, Raul. Dr. Jore of Northern Mindana Medical Center, Cagandi Oro also. What went through your head? What were you thinking when they said, oh, surprise ko ang merong region 10? Good morning, Dr. Susi. Regarding the Delta, I didn't expect that to happen, to arrive that fast in Cagandi Oro. If ever there's a Delta, it should be there in Metro Manila first. It should be the last to know that happening in Cagandi Oro. Actually, we didn't expect that to be here this soon already. So only also to know that the cases here, some of the cases have no history of travel. So probably it has been here for a while already. But according to the data, those index cases has no history yet for those who have been close contact with them to be pacifist for the variant. So that's how I look at it. And when we learned that there's a Delta again in the Oro, it kept us thinking that we have to act again and redo something for what we have been doing for the last one year. So that's how we look at Delta now. Okay. Thank you, Dr. Jore Chan of the Northern Mindana Medical Center. Vince Balanang of the Lang Center, meron ba kayong kasos sa Lang Center? Well, not allowed to say. As far as what I can say is meron capacity na test sa amin. Okay. So that's all I can give. But well, Lang Center has been facing several surges already. And for us, probably a rise in Delta variants would signal another surge and a lot of cases coming to our hospitals. Yun na lang yung naisip namin kasi regardless of the cost or regardless of the variant, we will treat these patients the same way. So basically, it will just mean perhaps an increase in the number of cases we will have. Yeah. Thank you. Thank you, Dr. Vince Balanang. Nina, Nina Berba of PGH. Nina, were you surprised na meron ng Delta variant o alam mo na nung ba? So kami, ako ang natakot ako talaga. Medyo intense yung fear ko kasi although we were really expecting na magkakaroonan ng Delta very soon. Fortunately, medyo prepared kami and I'm very glad. Medyo na close namin yung mga cases. So, I think pwede ko naman sabihin na dun sa first week when Dr. Ted said di ba may 11 cases na local. Tatlu dun nag-fall sa PGH and I'm very glad that our healthcare workers were behaving themselves, lahat nag-follow ng usual protocol so wala pung na-infect sa amin despite the exposure to the original three cases na Delta. Okay. Thank you, Nina. Dr. Pauline Obyal, pao. Syempre yung Red Cross all over the country. What were your thoughts when you heard there was Delta variant in the Philippines? I was thinking when we were listening to the news. It's not that we don't have Delta variant at that point in time. It's just that we don't detect it because even as we have 271 laboratories right now for testing COVID, our testing rates are still very low. It's 30,000 to 40,000 per day when our target at the start of the pandemic was 50,000 to 60,000. We have not attained that even now that we have more laboratories. I think that we need to ramp up testing. If we're not reporting Delta or ilan lang, 47 lang na re-report natin na Delta because we're not testing enough. Okay. So the importance of testing. Let's go to that, to testing. Are we, okay, so we're not testing enough and what is the situation on the ground? So prior to our coming on the air, we were having this conversation and Dr. Drillon, we were talking about discrepancies in testing. Would you like to talk about that a little bit more? Thank you. Thank you, Suzy. The situation in our area, primarily Corazon-Loxin, let me give you a little rundown on our coverage area. Corazon-Loxin is located in Macaulod City. It has a population of around 600,000, more or less, to 615,000. So our molecular lab, which is a collaboration between Macaulod City and the Department of Health in Corazon-Loxin, handles most of the samples given by the Macaulod City Epidemiologic Surveillance Unit or the Macaulod SESU. 90% of the samples in the community are sent to us. And at the height of the positivity rate around June and July, we noticed that the testing are not sufficient. I think that validates my former secretary's observation that the testing remains to be decided. It defies the epidemiologic theory that the more positives that you have, the more aggressive that you should be. But we have not reached the minimum as we have calculated of around 500 tests a day. And the maximum we had was only like 300 in one day. And if we are going to, without going to the details, if we are going to look at the graph of our testings, it's like a roller coaster curve. So it's an up and down, up and down, never up, never platuz in terms of testing. And we are not getting the real picture of the community in that case. So in terms of testing, I think the overall rate should increase so that we will know the status in the community. It was very important to us because we also base our predictions and forecasting based on this testing. So we closely monitor the testing numbers, the positivity rate, so that we can prepare our facility better if we are seeing a lot of individuals being tested. As of now, the case fatality rate is quite high. It's around 2.32. The numbers are not really nice to look at. We have increased the number of our COVID beds just in case. We will be seeing another spike in the positivity rate. But overall, we still need a lot of tests as advocated by the experts all over the world about testing. So that is what's happening with us, Susie. Thank you, Dr. Julius. Let me ask our two doctors for kagayan de oro. Is this the same thing you're experiencing na mukhang pulangan testing and that you have more patients who are dying? Anyone, Raul or Jore, whoever wants to take the question first? I may question first is who should be tested? In our hospital, we only have a maximum capacity of 160 tests a day. So I don't know if that is significant to test a majority of the population. So do we have strategy on who should be tested first? Okay. How about Raul, sorry. I can answer that. We have to focus testing because we cannot test everyone. So the number one priority in testing are the frontliners, yung mga healthcare workers. We test them every two weeks with or without exposure, with or without symptoms. We test frontliners every two weeks so that we protect the patients and we protect the community of frontliners. Then the second priority would be the general population with symptoms. Basta part ka ng general population yung develop symptoms, test immediately. You are a priority. Once nag-positive yan, you test all their contacts. Yung yung contact tracing. We don't just test anybody on the street that's full-hardy. Hindi wise use of resources yan. So that's why testing should be focused on the frontliners regularly tested and on people with symptoms and their contacts. You said okang. What is your view on this? I agree with all the statements of our co-panelists. Akin lang po, if...siguro the question there is what is the requirement or what is the requirement para ma-test mo and know that if you're looking for a delta variant. Para sa akin, una-una we should be able to locate the first, with the case first of which area kung nasan yung delta variant. Yung pangalawak kaya ko nang sagasabi ni former secretary Pao. That's ways of resources kung lahat ho natin-lato ay pag-gabibigyan natin-test natin. Let us all take a look at the capacity of our BGCs. The claiming 750 samples lang po ang natin-test nila in five days. So kung 1000 nang darating yan, it's yung 750 next round na po yun. So may mix sure na yung ating merong mga areas that there are suspicious delta variant existence, yun nang i-prioritize din po natin so that we will be able to pick up somehow the cases of delta. Thank you. Thank you, Dr. Suzy. In connection to the statement made by Yusek Okang, can we maybe get po... I mean, I'm just pulling out from one of the Q&A's Yusek Okang. Any specific plans of the government in terms of increasing genomic sequencing? What are exactly limiting po in terms of the limiting factors in terms of increasing our genomic sequencing efforts? Is it about do we have insufficient machines? What's the target percentage of sequencing that should be done, et cetera, et cetera? And are there any budgetary requirements put? May one. May be answer some of those. I'm sure yung mga delta-gabibigyan natin-test natin. Yusek pao. Secretary pao. Now, yung limitation nung ating PGC, it's only in just like what our brother direct doctor Julius did not mention earlier. Metro Manila, Visayas, and Dabao. Yesterday I was trying to contact the PGC, Philippine Genome Center in Dabao, but I failed to contact them. Ngayon pinapakontak ko po, pero sigurado ko po ako. Ang limitation nyan is the PGC is only in the nas in the insoluson. Wala ho sa Visayas at saka, wala ho sa minnanaw na functional. So feeling ko kung pwede natin kata pa damihin, pabigyan natin ng conting atensyon na baka pwede tayong, pwede natin yi-assess o evaluate kung ano yung mga pangailangan nila doon at punan natin, we will do that. In fact, during meeting po natin nung sang araw, nung Friday, I was thinking of prioritizing that kasi talaga naman kailangan na ho ng Visayas at minnanaw at hindi na ho kailangan isend pa sa Manila. In fact, in bakolod nga sabi ni Julius doon pa pinapadala sa CHD na kailangan kapang tumawin ng lagad. At dito sa minnanaw only in Dabao at baka pagkanas na kiladjoutyan ang sample, abutin pa ng 6 na oras po. So we need to somehow ang pinakamaganda is to be able to put up more genome centers in areas strategically located. I just want to share with the group that when we planned the genome center more than 10 years ago, that was the message, time will come when the borders are closed. So we're very happy that government funded it. But it's a very expensive center. So the strategy was to start with Manila to cover all parts of the country. But luckily, about I think 2 years ago, we already started the PGC minnanaw in the PGC Visayas. Actually they're helping already right now. They have the skills, but then there are different levels of genomic testing. So ang ating hinahanap ngayon, up to the level of this level of analyte and delta variants, it needs additional equipment. So I think that's already being addressed by the government right now. But right now they're helping already ang ating PGC Visayas at PGC minnanaw tumutulong na. I totally agree we have to increase and I think the government is listening to us and then eventually that will happen. So ako po yung nagpapasalamat sa kubiwala because they listened to us 10 years ago and then 2 years ago they agreed to fund PGC Visayas and PGC minnanaw. Back to you Susie. So kusabihin, yung sinasabing 750 tests, I think their turn around time is about 3 days right now. So tama kayo kapanagpadala na 1,000 may backlog doon talagang parang 250. And the correct term for the sampling is purposive because you cannot afford to test everybody. Okay. So I think Menchie can you explain that a little bit more because people now have the expectation that they want to know if they have the delta variant. That's not problem, ni ba? If you remember the lecture last week, Dr. Posen was talking about it needs a certain level of sequencing of testing. So pagkatapos pa natin na nagpasitive sa RTPCR, ipapadala po yan sa genome center. And by understanding is that you can actually connect with your RESU and CESU and then they will facilitate the transfer of the material to the Philippine Genome Center. So ang may understanding also is that the Epidemiology Bureau is the one assisting the genome center in selecting on which one will be tested for the sequencing. Purposive sampling po ang ginagawa, kamukapon ang sinabi kanina ni Secretary Pau na we can attest everybody so we'll have to decide how they are chosen. And I think there is a criteria and I trust that they work on this. When we have more testing machines to determine the variants, I think we'll be able to do that at the community level at a bigger scale. Okay. So it's like at the beginning of the pandemic when we also are very limited testing. We should get to a point where we have more genome sequencing. But short of that, I'd like to ask Nina to talk about do we know like for the frontliners, we have doctors and nurses who are listening here right now. Is there a profile for those with the Delta variant? I saw a video where they were saying that one of the symptoms that they're seeing in Delta that they're not seeing, they didn't see in Alpha was sinisipon. Sinisipon, Rani knows. I don't know how true this is. And what is the parang, you know, is there a rapid course? Because I'm going to ask this question again, I sort of ask the question but anecdotally we're hearing that people get to the ER and it's too late. Does it happen all of a sudden that people cannot breathe? What do we see in the Delta variant that's a bit different from what we saw in the past with the Alpha variant? So Nina, please go ahead. So, well, ako, I've experienced very few deltas, less than five cases. Pero it seems like the incubation period is much shorter. Tapos, talagang highly transmissible. So the patient might tell you that more of the household members were presenting with similar symptoms. Tapos, pero ngayon talaga yung, I think yung pinaka-cleansure is kung fully vaccinated and then you come down with something that sounds like COVID-19 and then eventually you're tested positive with the RT-PCR pero fully vaccinated. So whatever vaccine you receive talagang dapat magduda na tayo na baka Delta variant yun. So for us in PGH, those are some of the guides that we use. So use sa lahat na mga healthcare workers namin na fully vaccinated and come down with COVID-19 confirmed. We actually lined them up for sending to the PGC for whole genome sequencing. In addition to their exposures, co-mericina, exposures to travelers or they had travel to countries that have confirmed cases of Delta also. Dr. Jore, it's racing you, san. Go ahead. Dr. Jore, go ahead. Not listening. Aggression ng handi. Aggression ng handi. Regarding the experience of juniors, medyo mababa yung sinabi mo 300 a day. We are at 500,000 a day here. Our positivity is 28.8%. Sinabi mo 40%. So I think mayro ng despipansi dyan sa Bakolo. That's our experience here in our molecular laboratory. Marang mas maraming kasos sa Bakolo. Is that what you're saying, Dr. Jore? Well, if Dr. Julius will be heard of his statement about 40% na positivity rate, maraming kaso yan. So ours is 28.8% at 500 to 1,000 a day. Go ahead, Bob. Join in. Yung positivity rate is dependent on the volume of testing also. If you're testing a lot, your positivity rate is low. Like for us here in the Red Cross, our positivity rate is 5%. Because our testing is about 11,000 per day. And we test, walk in, patience. Yung mga gustong mag-test, wala lang, gusto lang nila malaman. Parang yan yung nature ng testing ng Red Cross. But if you're testing like patience, symptomatic, talagang tatas yung positivity rate mo. But that's what we're asking government na sana when there's one positive, meron 40 na contacts for everyone positive na mag-test that would ensure that we capture all the possible contacts or spread, parang extent of spread of that particular COVID case. Kasi where will COVID come from? From a COVID case. So I think that's consistent with what Nina is saying. That as far as the variant is concerned, one of the things they're seeing is more household infection. And then the other thing she said was if you're fully vaccinated and you test positive on an RTPCR, most likely COVID variant. I'm going to ask Vince. Kasi if Vince salang center, nagkaroon din kayo ng Delta variant, did you notice anything different in the symptoms, the profile or the course of the disease in the patient? Dr. Vince. Parang nawala yata si Raymond. Nawala ba si Dr. Balanan? Yeah. I'm here. Nawala. Okay. We'll come back to him when he joins us again. I think he's here. Dr. Suzy. The same question for Nina because you've seen Delta variant cases in the lang center. Was there anything different that you noticed? What you're saying is, okay, hulang tayo sa testing. So we can't and we can't test everyone but are there other indicators that give us a higher index of suspicion na baka may kumakalat na Delta variant and is there a difference in the symptoms? Is there a difference in the course? What do you see that's different? So Vince, go ahead. Ano experiences lang center? Salang center, we regularly send samples to the Philippine Genome Center. But ang sinisend lang namin, yung mga threshold cycle of 20 or less, yan yung mga mabilis ang number of virus. So in terms of the Delta, as far as I know, there's just one patient that we have and it was just tested sa atin and isolated outside. So we really don't know if we have more Delta right now to say as far as I know, isang case palang yung nandito. So I cannot probably answer ang distinguishing factor for Delta variants. But sa amin, pag mababa yung cycle threshold 20 or less, we send them to the Genome Center as a possible variant sila. Okay, thank you Vince. I'm just going to go back to Nina quickly and then turn over to Reemun. So Nina, if any of our hospital chiefs see asad and surge, parang big lang dumami yung mga kaso. Because these hospital chiefs are in areas where the variant has been identified. Do we assume that that is the Delta variant spreading? Ako po kasi yung mindset ko is that when we manage and we also try to protect our healthcare workers and everybody else from the COVID-19, it probably doesn't really matter kung Delta siya o hindi e kasi the infection control, the infection control precautions should be the same. We really need to just be parang fortify all parts of entry, lahat ng pwede gawin to protect ourselves from getting the COVID-19, whether Delta siya o hindi. Parang ganoon ko dapat, I think yung message kasi impossible talaga for us to send as much as we can. I think the PGC is really trying its best also to cope with the amounts of requests to process whole genome sequencing, pero impasible po talaga. So on the ground, ano nalang natin, asyong at this point that there is already local transmission, asyong na everybody who's COVID positive is potentially a Delta variant and protect ourselves and everybody else around us accordingly. Parang ganoon, I think ganoon po yung mindset and that's what we're trying to tell all our healthcare workers here in BGH. Yeah. I just like to add. What we try to do here at the Red Cross to protect our staff is yung sabi ni Dr. Nina Berbana. You assume that the Delta variant is here. So number one, we stop allowing them to go on leave. Nobody goes home. So they go to the lab and then go to their lab and quarters lang for the next four months. They don't eat together. Bawal ng kumain together. So we have food. You get your food, you eat in your corner. And of course the minimum health protocols, no touch policy. Wear your mask, wear hygiene, hand hygiene and the careful use of PPEs when you're in the lab or when you're collecting the swab or saliva samples. Okay. Thank you, Pao. Raymond, go ahead. Yes, thank you, Dr. Suzie. There are multiple questions as it relates to the vaccines pa, and their efficacy. So I'll try to consolidate those questions. Number one would be maybe this is just a reiteration of what we learned last week. Can someone comment on the effectiveness of the vaccines, especially given that Sinovac is the dominant vaccine given to the Filipino population? Kaya pagkanabakanahan na rawpuba ng Delta does it also cover for other variants of the COVID-19 virus? And are there any reports naman po with regards to the level of resistance of the virus given all of the mutations po? Raymond. Right now. Yes, Raymond. According to studies, these are recent studies, wala pang resistance to any of the vaccines that have been developed. So all the vaccines Sinovac or whatever vaccines are still useful to protect you from the virus. But yung sabi natin, they don't protect you from getting the virus. They protect you 100% from getting severe disease. So pwede ka pa rin magkaroon ng virus even if you're vaccinated. But yung kailangan natin matandaan, yung critical mass, yung herd immunity or population protection. The more people that are vaccinated, the less the chances of spread of any of the variants. Right. So okay. So I think that's a good segue to talk about vaccination in the areas where our hospital chiefs are. Because in the last webinar, that was the main message, vaccinate, vaccinate, vaccinate. When you vaccinate as pauses, you could get COVID, it doesn't protect you from not getting COVID, but you won't get seriously ill and you won't die of it. Of course, there are probably a few cases where that happens for different reasons, but in general, you don't get severe disease. You have a very low viral load, and therefore you don't infect other people. And the household attack rate is less than 50%. So where are we on vaccinations? I'm going to go to Dr. Julius in Bakolod City. Kamusta naman ang vaccinations sa inyo? Okay. Mga last June, our healthcare workers, mga 90% na po anabakunahan. Mostly, we have Sinovac and AstraZeneca. We have extended this categories to their immediate families and their household members, which we will start by Monday next week. I think it's worth mentioning. Dung first batch namin, Sinovac na kasekendos sila. And we did some antibody testing two weeks after the second dose. And we have very good results. Mga 96% as develop antibody above the recommended numbers from our controls. So it showed that even now that almost 15% of our healthcare workers has been affected since January. Wala pa po ang pumunta sa moderate to severe or directly sokom to COVID. We have two actually fully vaccinated that went into severe infection. But we were able to but because of other inherent disease entity and one actually died but not because of COVID. So that is basically our problem because our vaccine supplies are not within our controls. So kung anuman ang available binibigay po namin. Overall, I think I don't know the whole status of Negros Occidental but we would definitely need to have a food race against COVID kung sino mas mabilis yun po ang dapat puha natin. But basically the race is on. Pabilisan po ng bakuna versus the spread. So at this point I think we really have to ramp up our supplies and more vaccinators and should be employed and we should vaccinate as fast as we can the vulnerable sector of our society. And that way we can prevent that the hospital system will not be overwhelmed. So that's the story in our locality but we are just thankful that we have sufficient supplies of vaccines for our healthcare workers. Okay, well that's good to hear. How about kagay ang deoro? Jore or Raul, kamustang vaccinations sa ino? Sushi po, we have vaccinated about 98% of our personnel about 1,750 of them and we also help the city in the vaccination campaign. We have a team of vaccinators in our hospitals. We are assigned in a mall. We have so far vaccinated around more than 30,000 in addition to the 100,000 that has been done by the city their target is about 518,000 percent of the 750 population of the city kagay ang deoro. So that's how we contribute to the city as a whole in terms of campaign for vaccination. We have already polyvaccinated 10,000 of the city residents and 20,000 for the first dose. That's for Sinovax, Sputnik, AstraZeneca and Spicer including ZNJ starting yesterday. Yes, Sushi, currently in the entire country we have 17% vaccinated with first doses and only 8% with full vaccination of the entire country's adult population. Here in NCR we're 30% vaccinated with one dose and 16.7% for fully vaccinated. So it's still very, very low. Raymond, you had three questions. So I think some of the questions one of the questions got answered but what were the other two questions? The other questions po is that I've already dismissed it but the other one was if you are vaccinated does it only cover certain variants or does it cover all of the variants? I think that was one of the important ones. There's another question po as it relates to the efficacy of the vaccines and is it high time for us to consider booster doses that sort of thing. So yun po are the questions as it relates to vaccines. Raymond, go ahead po. There's no study showing that we need booster doses at the moment. So what we actually need is to ramp up vaccination for the population especially ang pinaka I think we're lagging behind is vaccinating the senior citizens and those with comorbidities because if you compare that with the general population hindi nagkakalayo if our vaccination for the general population is 8% fully vaccinated yun sa senior mga 10% to 11% palang when they should be at least like healthcare workers mga 90 to 95% na at least point in time. So I think that's where our healthcare workers should really concentrate on vaccinating the vulnerable the senior citizens and those with comorbidities. Siguro I'll throw that question to paokang to our usek usek, pano ba natin mababakunaan ang senior nating mukhang yan talaga yung pinaka importantin but what do you see because I know you're always at the field there what is it that works in terms of getting the senior citizens vaccinated? Yes Ma'am before that I'd like to paint a better picture doon sa mga percentage na minigayin isek tau para hong makita yung absolute number para kasi kung percentage baka mahirapan silang So by this time it has july 21 patpuna day tato so it must have hit 16 million already and seg pao is true na mahirapan tayo sa priority two which is the senior citizen we only have first dose 2.8 million of this priority group has been vaccinated fully box na complete doses po is 1.3 million pa lang tamaho roughly 10% pa lang first dose and then much lower ang second dose So sa first dose po sa lahat hong priority group 1, 2, 3, 4, 5 10,722 pa lang ang first dose was this yung completed second dose tungkol naman po regarding the second question I might say this is really the key to winning the race in mga senior citizen are still considered undecided according to Pulse Asia Survey po most vaccinated most of the Pilipinas opted not to get vaccinated or who are undecided said they would change their mind once they see their circulated family members and friends in safe condition So tayo we should be kaya nung sinabi ko po kanina we as vaccinated individuals be the walking testimonies that vaccines are safe and effective I think yung yun naman kita rila it will surely work yung pung mga sa pamilya nila yung mga senior citizen they would look at their sons and daughters to mga unang muna kayo yung samba and then after you kami naman nang susunod I think that's a good yung pabayong natin at paparoon natin sila ihikayan Thank you very much you said yung naman I'm going to ask what should I say a bit of a provocative question kasi here in the United States where they saw surges of Delta like Missouri were places where there was very low vaccination and doon talaga it was like the beginning of the pandemic yung pila-pila yung mga ambulan siya sa labas ng hospital they were asking the other states to help them and wala ng ventilator wala ng space sa room ng hospital so my question is this for your particular locality what do you think is the most important thing you need to prepare but if we do go into a surge where talagang pipila naman ang ambulan siya sa likod sa driveway nyo what's the most important thing you need to prepare in your locality so this will differ from place to place but I like to get a sense of in terms of projecting or forecasting what is needed what do you think you need to prepare I'm going to start in a different way I think I'm going to ask for the red cross what do you think you need to prepare just in case let us say that because we saw this last week in the webinar that the spread was really exponential it starts low but within weeks and then months yes I'd just like to add hello go ahead I can see you for the senior citizens the strategy of the red cross is to use our mobile bus services kasi alam naman natin they're not techie they're having a hard time to go to the bus get our bus I think we lost hello we have our audio please go ahead okay internet connection is unstable but anyway what we do is to use our mobile bus and we station it in one corner and then we call all the senior citizens to get vaccinated and we can get as much as 600-700 in one setting so dapat siguro inovative tayo when it comes to senior citizens they cannot be all brought to the vacuna center the other thing that we do kagayong ginagawa ng muntinlupa I think is that when the senior citizen come to our facility we also vaccinate the companion para may added bonus yung mga senior citizens and their caregivers and their family members sinasaman namin so I think that's one of the strategies we can add now in terms of the red cross initiatives we're putting up oxygen generating I know the hospitals in Mindanao actually we did that as assistant secretary for Mindanao and instead of relying on the supplier for oxygen we put up oxygen generating plants in most of the DOH hospitals in Mindanao and now there's COVID they're actually self-sufficient they can produce their own oxygen and here in red cross we're putting up two oxygen generating plants in Subic and here in Manila okay thank you Pao Nina was raising her hand Nina go ahead I wanted to show our numbers can I share my screen of course go ahead wait lang so what we did was panang before pero kami ganito tapas in Filipina PowerPoint and infographics para madaling maka intindi lahat tapas I think ito yung isang parang we wanted to share kasi as you see we've reached 6000 plus vaccinated persons in our hospital so that represents 85% plus among our PGH personnel UPPGH personnel and you can see COVID-19 cases dramatically dropped in the last few months from parang logarithmic ngayong drop tapas ngayon this month we're down to like 17 cases na lang from in the time of the surge close to 300 over a month so siguro kong may ganito tayong data sa ating mga hospitals and we can share this with patients na may hesitation baka makonvins na sila to get vaccinated that's what I wanted to share and I also congratulate yung Philippine Red Cross for all those initiatives secretari pao kasi parang maganda sila to reach out to the senior citizens who are really very vulnerable and it's a very interesting dialogue going on in the chat box about mobile vaccinations so pao, I think there's a great appreciation for the mobile vaccination and I'm sure that our hospital chiefs can also help do that but Nina, let me ask you that question if there's a surge in the next few weeks what is it that PGH really needs to prepare well namin we're really trying to get all our beds ready for the surge di ba kaka surge lang kasi so yung wards and areas that we've sort of closed muna to preserve our manpower pero we've kept them prepared to be reopened as soon as the surge comes to being tapas a very new isolation facility supposedly state of the art siya and we're going to be ready to open that in a few weeks so that's part of our preparation for this upcoming surge or potential if there's something that you think you might lack in a surge what do you think it will be? ang namin ng more nurses paaw paaw mga nurses who are available and willing to be part of our staffing across the country yung kailangan willing personnel that's similar to what Raul said earlier you can have all kinds of technology but if you don't have people then you can't do anything what do you think you need if there's going to be a surge? well what we need is additional manpower because we are hard on that the DOHs has given us additional nurses but these nurses are usually not trained so perhaps the DOHs can give us additional or trained to handle COVID patients or we probably need more quick training more training so that people can be immediately trained to handle COVID don't Julius kayo yes thank you Suzy as early as December meronak po kaming hinanda na surge capacity preparation which at this point there were three plans actually plan A, plan B and right now we are on plan B na iniimplement na po namin we have also cross-trained our nurses for critical care and intensive care process but you painted a very bad scenario yung sinasabi nyo po Suzy na nakita mo sa television not one state na humingin na sila ng tulong sa ebang state right now we have around 500 staff na strategy namin na just in case or surge may marong kami ibabataw na 500 na total medical, paramedical, nurses and all of that worst case scenario yung sinasabi mo bad picture hard question hard answer if you may allow Suzy kung talaga magkaubusan na ng resources we will apply the principle of mass casualty and that is kung sino ang fites to survive yun ang unahin namin would that decision was made that was last year and yun po kung talaga wala na kami ibebegay na resources human resource beds et cetera we will apply that principle hard as it may be but that is the last recourse and I hope and I pray that we will not come into that but I like to add Suzy as early as October we know that COVID is here to stay it is not just just a simple allocation of human resource but right now we are having stated we are already having a pandemic fatigue and that takes a toll on emotional and mental health issues that is going on I am pretty sure in all hospitals so that is the other challenge that we have to face that we have to keep our organization robust to become resilient in order for them to be resilient all aspects of human life should be addressed and we are trying really hard to address this especially the mental health issues we have most of us has not taken a leave for a year so now we are as mandated by the Department of Health which we are under the Department of Health when a red alert status is raised all leaves and other things are but right now we feel that we should slacken those rules a little bit number two number two concern that I have and I am sure all hospitals in the country including Red Cross is the financial sustainability to sustain this long term operationally draining COVID so again feel health reimbursement remains to be desired that's that's a subtle word but how do we sustain this logistically and that's the other thing that I think should be should be we should tackle we should not be thinking of first two months or three months that those those things are really of our concern right now how to sustain our operation we know the economic ramification of this from the very start but now it's becoming apparent it's very hard now to support the operation with a very bigger resources especially the financial component so thank you thank you Susie for thank you thank you Julius for that very thoughtful insight which is more strategic long term that we can't just think of a few a few months we have to think about parang marathon it's not a sprint it's a marathon let's go to the Lang Center Vince sa tingin mo ano ang magiging pangangailangan nyo kung magkakaran ng search well 80% of our cases actually are severe and critical so basically we would want to expand yung mga ICU beds namin so of course it's expensive to run these ICU beds in terms of the monitoring they need the medicines as well as the health worker complement ang kailangan so that's what we are trying to build up right now increasing our ICU beds getting enough supply of the drugs during the surge na medyo nagkakulangan sa rib desivir tosili sumab and hemopropusion for our severe critically ill patients so that's what we would want to ensure in case of another surge in terms of beds meron kami inaantay na completion of a 106 bed modular hospital this is being built by the DPWH and hopefully it will be finished by August so that in terms of total number we will have 100 more beds for COVID patients if there's in case of a surge but we really need to increase our ICU bed capacity also thank you that's Vince Balanab of the Philippine Art Center ah, Doc Jore kayo anong tigin nyo dyan sa kagayang deoro ano ang magiging pangangailangan mo? We're all criminal to the rest of the panilist it will be the same, it's still people your doctors or your nurses because regardless of whether you are fully complemented with stuff the moment they get COVID even if they are vaccinated you have to excuse them from work you have to be isolated so it's the same as being not vaccinated you have to isolate them even if it's mild or symptomatic so you you lost part of your people for a time because you cannot let them get back to work yet so it's the scenario that can thank you very much Raymond, over to you thank you, Doctor Susie Can I Oh yes sir, go ahead you say ko akang go ahead sir Okay, to add to that yung if you wait naman na initially Sorry, hindi ko kaya na tanong ha We started giving up our hospital and we know hospitals and other facilities both private and public hospitals I have been calling Doctor Joe and Doctor Julius at gabi mga infesting surge so we would like to ask them to please increase aggressively increase the dedicated COVID beds especially the ICU senior areas ensure the availability of life-saving supplies meds, oxygen event PPEs yung HRH augmentation is perinial emergency hiring we're doing emergency hiring we're doing emergency deployment in non-surge areas yung puk-puk deep up even in the hospitals we suggest or we recommend yung accordion principle you must have heard of that to use or utilize HRH equipment drug share medicine to surge areas coming from the non-surge areas even in the department of doctor can be assigned to and the nurses can be assigned to the surge area I also agree with Doctor Bains kanina yung spaces also is a limitation spaces in the hospital kapag walakan na talagang even if you want to expand pero pagwala ng space at walang ng budget it's going to be very very difficult it's really important also it may pabayaan na yung may OB doon tatanggalin yung OB will not accept OBGYN patients anymore or pediyayo some have done that already ma'am susi yung mga surgical wards nila yung mga orto wards nila we're converted into ICU's and then of course we also would like to ensure the availability of testing kits even the testing laboratory and personnel pa rin in the laboratory is very important because 3CPS pa rin yan so magpafatig pa rin alam mo yung K. Julius na sinasabi niya na merong pandemic patig yung mga health plantliners natin hindi lang yung plantliners na nagkaroon ng pandemic patig now pati may din is mo yung community nakamag mask wala rin naman tayong tayong brother meron ng zoom patig para na kami para na tayong mga pusa kaka-kain sa kanto kaka-kain sa kaka kaya na ito continue yung ating pan boss yung ating detection yung detection natin buka pwede yung contact tracers natin talagang hindi sabi nga ni magalong 1 is to 3 na lang ngayon minsan 1 is to 1 lang ngayon dapat talagang kung pwede 15 is to 1 pa rin so dapat we have should actively look for cases best all of these people through RTPCR of course naging kita na natin yung entusiasum ng ating LGOs to put up additional number of TTMFs pero hindi pa rin sila po hindi pa rin pagamero pa rin mga LGOs na tama na sa amin to may hospital naman so that's what the department of health is doing to come up with a strategy to be able to engage with these LGOs na to because this we know that this is a national government enabled pero LGO ano naman to LGO LGO LGO led LGO led and then people centered yung initiative so I hope magagawa ito lahat in fact yung mga hospital natin especially pinakang mahirap sa lahat yung private hospitals to convince them to please increase aggressively yung capacity po in fact merong mga regions na 12% lang ang increase tangano supposed to be about 20% or 30% yung mga public po natin wala problema in double region medical center 50% 600 bedsya 50% dedicated na to ano to COVID so this are the some of the the OHS my brother yung nga ang problema yung ating fill health reimbursement rate yun ang malaking problema kaya mam hindi na rin masustain ng mga private hospital to increase the number of beds kasi ala na rin silang tao pangalua meski mayroon silang pangswell daw ala na rin silang mahire and kung mayroon naman silang mahire ay you know iilan lang because we have to understand that they have to maintain the balance between their their income and and their and their capacity to pay so basically it's the sustainability it's sa compliance I assure you my my boss that sa yung sa yung what I call this sa mayong mga SACOP which is Visayasiminda now every every period, kama and exclamation point ay sinusunod po namin alaho kayong problema sa mga DOH hospital but again the DOH hospital has its own limits also and remember hindi namin pwede pikitin yung aming mga mata doon sa mga patient na nga ngay na hindi COVID na nga nga ilangan din ng hospital care no and if I may interject yung yung aming mga programa naantala ng 2020 ay puspusan namin binabalik ngayon like yung aming kidney transplant and cardiovascular program ay ibabalik namin ngayon despite the COVID and aming philosophy ay we will not let COVID imprison us we will find ways to continually serve these people who are in need in the community so doble po ang exposure ng aming sustainability yung non-COVID at saka yung COVID but this COVID thing is eating up our resources and the main source of our financial sustainability is field health so medyo mahabahabahong usapan yan and at least these things are not in control we are not in control of this so probably we can we can also do something about this so that we can survive this together and be well together so thank you thank you I think Sek Pao is also saying in the chat that you know field health needs to pay for all testing okay Rayman yes thank you last question last question doctor Susie and this address po doon sa ating mga may testing centers based on your based on the data that you currently have what's the percentage po of breakthrough infections among vaccinated individuals I understand that in the new case investigation form whether the person that is going to be tested tinatonong na po kung nabakunahan na po siya or hindi so have you looked into ilan po ba yung nag-positive sa inyong mga samples as nag-indicate siya na nabakunahan na po siya or fully vaccinated na po siya I'll address that to Philippine Red Cross, Sek Pao and then any other speakers can chime in po wala pa kaming data but I think FDA is getting all the data FDA and they're investigating actually all those na nag-positive na COVID and vaccinated they do a very thorough investigation na gulat nga kami they check the cold chain they check the lot number of the vaccine and even go back to the bakuna center kung anong nagkamali sa bakuna center so it's not just about the numbers inyong sinasabi ko about Indonesia and the sign of vaccine na maraming nag-sakit it's not just about the numbers it's about maayus ba ang cold chain maayus ba ang pagbabakuna what were the situations in the hospital baka naman mataas yung viral load et cetera That question po kasi Sek Pao came about just because there are individuals who have been vaccinated po and then have been asking if I'm fully vaccinated and I get exposed but I don't have any symptoms that sort of thing I have to do the testing on the fifth day or on the seventh day so may aling langan pa yung pulo kasi parang I don't want to call it complacency but let's call it as such na kapag nabakunahan all good parang ganun mam what's your opinion with regards to that po Just to inform everybody we have had our medtex and our staff na nabakunahan na nagkarun pa rin ng COVID so we treat them like it's a new infection it's entirely parang walang special treatment yung mga nabakunahan na na nagkak COVID parang you start with day zero and then you isolate them you do everything you watch out for signs and symptoms so yung parin yung but I was telling you kanina we report that to the OH they do a very thorough investigation what happened to that particular case okay thank you very much I think we're close to the number now and we're going to ask oh it's sige Dr. Raul has a rejoinder if I may share with our experience with one in only Delta case well the particular caregiver was fully vaccinated and he developed only mild symptoms and the five close contacts in the hospital were all negative for COVID test so I hope that this can reassure the public the impact of vaccination okay thank you very much we are at the top of the hour and we're going to give our finalist a few minutes to think about their last short last words to our audience mainly frontliners from all over the country who are watching you and really appreciating all the things that you're saying while we're giving you that chance to talk Raymond's going to do the evaluation go ahead Raymond thank you Dr. Susie so we will not be taking this down even after I've gone through the questions so we hope that our nearly 2000 who are logged into zoom will be able to answer this assessment questionnaire I cannot vote panellist mayo you sick oka ngayon so the panellist demonstrated knowledge of the topic the panellist are well prepared and organized panellist spoke clearly and audibly panellist used appropriate language with technical medical jargon adequately explained the panellist contributed to new perspectives and knowledge on managing various key COVID-19 health issues we are seeing a whole lot of our zoom attendees answering so please key in your answers po but before we go into our final message I think Dr. Nina Berba had the one final rejoinder Dr. Susie before we go to the final message Dr. Nina doon sa tanong nareduce yung incidence and prevalence of the COVID-19 so because before we used to have hospital wide testing so during that time yung wala pang vaccines mga we run around one to two percent prevalence of COVID-19 angayon we're down to 0.6% sa PGH so i think that's a significant drop also in the number of infections that we're encountering because of vaccination okay thank you very much Nina alright we're going to have our final short messages from our guest today we'll start with Vince Balanag the Executive Director of the Lang Center of the Philippines Vince we need to assure the public that we are doing preparations for any possible surge so but ang appeal lang natin is of course have yourself vaccinated so that we will there will be less chance that you will be symptomatic and of course if you have symptoms you have yourself checked immediately so that if ever you have COVID then this can be managed immediately in severe or critical condition that's all thank you thank you very much Dr. Vince Balanag let's go to Dr. Jore of the Northern Mindanao Medical Center in Cabean, New Oro Dr. Jore good afternoon again thank you for your support Katie you gave us to voice out and hearing things on the ground about COVID-19 and especially this new thing about delta variant we have to stay and as Dr. Jules Rilon said we have to attend to COVID and COVID patients thank you let's go to Dr. Raul Andutan the Medical Director of Mariana Xavier University Hospital also in Cabean, New Oro we have been talking about increasing hospital capacity increasing vigilance, increasing vaccination but I think the message is we have to inform the public that the battle is not in the hospital the battle is in the community and the main challenge actually is how to increase the sense of responsibility of the public to protect themselves and to prevent the spread of the virus and to the people in Cabean, New Oro and Northern Mindanao I just would like to reassure that there is a good referral system at all hospitals and we are ready for any surge thank you very much Dr. Raul let's go to Nina Burba of PGH Nina so my final message to everybody is that we need to keep everybody brace themselves for a possible surge kasi lahat naman tayo maybe most of us in the audience are part of some kind of system or a health system or a health network we need to tell everybody that we assume na lang natin na everybody or all the cases may potentially be a delta variant yung yung isang case na nakita namin sa PGH which ended up as a mortality na delta case it could have been parang naging problematic but our emergency room doctors and nurses were all just di pa nila alam na COVID pero the suspicion was high the level of suspicion was high and everybody really protected themselves and in the end even kung sabang daming nangyaring procedures na code sila they tried to save the patient po lang na infect precautions are effective we just need to really use them we need to always be vigilant and that's the message to all our health care workers to be always on top of the situation universally practicing all the precautions that we have in place thank you very much thank you to all of us thank you that's Nina Berba of the Philippine General Hospital Dr. Julius Drillon of the Corazon Memorial Regional Hospital Dr. Julius thank you TVUP for having me it's really an honor and a privilege to join you in this very prestigious webinar I only have three Susie one is this situation is bigger than ourselves bigger than anything else bigger than our understanding um so which I've been always doing this one is pray pray and pray hard and thanks for the blessings that we're having and the opportunity that we're having right now two i would like to thank my fellow workers in Corazon they've been very brave they've been very resilient and I want to let them know that I'm very proud to be and honored to be working with them and three to our community we assure you that Corazon will be on the top of the situation to be honest with you we are your best hope if you get COVID in in Nagros and we will give you the optimum care that one is so thank you very much for this opportunity thank you very much this Dr. Julius Dr. Lon Dr. Pao Obial of the Philippine Red Cross Pauline, go ahead thank you very much Susie and TVUP for this opportunity again to be part of this webinar before I started talking I was moved we lost you for a few seconds go ahead again mukang bouncy ang internet pao pao Dr. Julius Dr. Lon hello go ahead we lost you for a few seconds so I was just touched by the words of Dr. Julius Dr. Lon but I think all of us are in this stage really trying to do our best and I would like to thank all the frontliners out there for keeping up and doing a good job and I think the positive thing in this webinar is what Dr. Berba said that even if they face delta variant it can be stopped it can be controlled you just follow protocols practice universal percussion and stay safe and then the message again is to pray because this is beyond us if God will sit it will happen thank you last but not least under secretary okang dumama please go ahead salam aleikum again good afternoon once again I wish to thank everyone for sharing and being active participants especially our viewers who are very enthusiastic in throwing their questions to the panelists thank you very much for the explanation it was really enlightening ma'am Susie and TBHUP and so I appreciate the invitation I'm so glad to be here also I'd like to say this that I'm so happy to see my former boss secretary Paulino Diaz and for my parting messages I wish to reiterate the minimum public health protocols ma'am nag-reindilit physical distancing aware your face mask and face shields send tizer hands and more more frequently and get vaccinated now like I said our efforts are only as good as the people's compliance all of us need to cooperate and do our own share to break the chain of infection otherwise we might have to content ourselves living in this kind of condition until a definite cure is available meanwhile in close coordination with the LCLG use we would like to strengthen our border control measures and improve further our surveillance and contact tracing we need to intensify our PDITR strategies to ensure that we manage COVID-19 promptly and properly maguha yung magalala ang Department of Health po ay gagawin, ginagawa at one po yung ating mga haaya and lastly I'm appealing to all the eligible populations who are still extremely skeptical of the safety and efficacy of the COVID-19 vaccine let me say this if you are still having second thoughts on what is the best vaccine my answer would be you must have heard of this all the time the best vaccine is the one in your arm on getting anxious about adverse effects or event following immunization or AFI my reply is you are more likely to get infected with COVID-19 than getting the AFI therefore may rest vaccination sites and get your jobs now thank you and have a wonderful day to all okay thank you very much that's under secretary of Andumama of the Department of Health and before we have our closing remarks from Chancellor Manchip Padilla we have our public service announcement from TVUP again our reminder reminder to have our seniors vaccinated go ahead TVUP thank you thank you thank you oh my child put it aside so that I can explain to the citizens I can give you that I can see that your family is very dear to you that's right that's why I remember how this pandemic ended umpisahan na ninyo magpabakuna na kayo okay thank you very much TVUP for that again very touching touching public service announcement okay so we will now go to our closing remarks from Chancellor Dr. Manchip Padilla today's webinar was open by Dr. Ted Herboza who said that the graphic images of the Hava created by the Delta variant in other countries remind us of the continuing challenges with the Philippines still still the lowest in the region with daily numbers plateauing at 6000 we should continue aggressive measures aggressive testing, contact tracing treatment and isolation so Dr. Ted said that this plan prevent and prevail thank you TVUP for preparing a recap of last week's webinar where Delta variant was extensively discussed so if you haven't watched it go check the replay and get the extensive discussion on the Delta variant Usik the mama gave us an overview of the strategies and he said that it pays to be informed but this information need to be translated to positive behavior change what's interesting he said that it only takes 21 days to form a habit and he challenged us to actually look at the advice coming from DOH so please go check the DOH website and learn again about the PDITR BIDA Solution BIDA BASTONERA the ICRA as well as the four door policy he emphasized the importance of the partnership with the national and local government as well as the people now going to our guest they what I've done is I've actually grouped their answers and it's interesting on how they responded to the questions so all of them were asked about their feelings and expectations with announcement of the Delta variant some were expecting it some did not expect it to come this soon but what I'd like to share with you is the sharing of Dr. Nina Burba and she said she had the feeling of fear and relief first three cases of Delta landing in PGH despite the fear and uncertainty whether it was Delta and eventually became Delta no health worker was infected and this means that the health workers are following the health protocols now there was a big discussion on the current the concerns, the urgent concerns among the hospitals and repeatedly our guest we heard from our guest we are not testing enough and if there are patients without the variant we do not know who they are and where they are but we also heard from them that considering the limitation of testing capability in the Philippines testing must be focused now on the issue of genomic surveillance yes, genomic surveillance has not reached the community extensively in the real picture in the community so for the information of our viewers we have three UP Genome Centers one in Manila one in the Visayas one in UP Visayas and one in UP Mindanao but only the UP Philippine Genome Center in Manila can perform the sequencing and the bioinformatics analysis these are very highly skilled skills these are skills that will need extensive training the trend around for testing is actually 750 tests every three to four days now PGC Visayas and PGC Mindanao have the skills the human skills but they need to upgrade the equipment to allow them to perform the sequencing and the bioinformatics so I'm really hoping that the funds are urgently allocated to PGC Visayas and PGC Mindanao so that we can respond to the demand from the rest of the country so yes we need more genome centers a final major concern is the long-term planning for sustainability of COVID and non-COVID operations considering the bigger resources especially among the government hospitals and again again and again it means that we need more health workers equipped to manage COVID patients and do not forget we're talking about COVID and non-COVID patients such as some final take home messages for our viewers no single strategy is sufficient to protect our people so we must remember that the battle is not only in the hospital it is also in the community must have a sense of responsibility to prevent the spread of the virus so remember universal protection is most important regardless of the variant and yes we need more testing at ang pinakamag importanting mensaje magpabakuna tayong lahat Marami salamat po and back to you Doc Suzy and Bayman Thank you very much that's our Chancellor of UP Manila Next week Raymond, did you want to show the poll results or that just pop up? Well, it's similar to what we have in the previous webinars po wherein we have majority leaning towards strongly agree and agree I also saw in the chat that there was at least I think two who indicated strongly disagree but ang pag-tindo it should have been strongly agree Thank you so much to the 1474 who were able to key in their answers po I also like to thank I think it's opportunity to thank those of our nearly 3500 registrants all across the country and also globally who have expressed their interest and have attended po All the way from Natonin, RHU in Mountain Province in Calderdera Associations Municipal Health Officers in Iriga City in Bicol Lorenzo de Zaycog District Hospital in Negros Occidental the Philippine Rheumatology Association in Malay-Balay-Bokidnon also internationally Liverpool Hospital in New South Wales in Australia si Nagawa City in Tokyo sa mga Nagalympics po Goodluck Vietnam, Doha, Qatar Dubai, UAE, Alkobar, Saudi Arabia North Deline, India Tanbridge, Wales in England Lautoka Hospital in Fiji and Niagara Falls in Ontario, Canada Over to you, Dr. Susie Thank you very much Raymond I personally want to thank all of our reactors are very distinguished hospital chiefs from around the country and I think medyo na papalagay ang log ng mga nahikimigsakin pag nahikita kayo your care for our frontliners kasi talagang lumabas din ito sa mga pinag-usap na napapagod na rin ang mga health workers and the community is also tired but we fight we go on and we will work to stop COVID deaths Anyway, next week na ko we have a very exciting webinar please don't miss it You know sabi natin dito sa webinar na ito lahat ng klasing talino ng mga Pilipino ay kailangan natin para mapuksan natin itong pandemia and there are some scientists who have been quietly working on new technology created by Filipino scientists world-class Filipino scientists and we're going to have this conversation will be led by Raul Destura who is the deputy director for strategic initiatives and emerging programs yung pung gumawa ng unang Philippine test kits Raul Destura is going to be leading this discussion but we have several scientists who have our own Philippine versions of a ventilator sanipad o pang disinfect ng mga health workers natin PPE at marami pang iba so next week po do not miss it dapad kinikilala talaga natin ang gumalaban talaga dito hindi lang front line hindi lang yung second line yung third line pero meron ding mga nagisip paano ba tayong gagawa ng technology na abot kaya ng lahat ng hospital ng health center ng mga districts dahil so do not miss it it's called Laging and World Class Filipino COVID-19 Innovations that will be next Friday Raymond, over to you Thank you so much Dr. Susie, I think before we adjourn I'd like to take this opportunity po to also greet those who are watching us in the Facebook pages I think there are those watching in the different pages po at least in one page numbering more than 600 there are those watching in YouTube maraming-maraming salamat po please note that all of our webinars are archived in those social media accounts po that you are logging in especially in Facebook the University of Philippines the top COVID debts and the TVUP Facebook accounts as well as the YouTube channel po of TVUP so again very very exciting topic po for next week we will be talking about innovations ano po ba ang ating mga naay ang bag in terms of biopreparedness our decalidad po world class po na mga Filipino scientists really contributing in the fight against COVID-19 so makita kita po tayo ulit next week same time same channel from Friday to 12 noon to 2pm it's a date together we can stop COVID deaths so keep safe keep healthy and see you online but right behind the mask I look into myself and ask do I have strength to carry on oh god how long has this gone on and leave you here to keep me strong I'm here to hold the line I'll keep my until my say his name to read just hold on to the word he gave this time we'll come to pass because this salvation makes the last you carry you to see the break up the others pained from my fears the other styles before my tears but right behind the mask I look into myself and ask do I have strength to carry on oh god how long has this gone on and leave you here to keep me strong I'm here to hold the line I'll keep my until my my fears the other styles before my tears but right behind the mask I look into myself and ask do I have strength to carry on oh god how long has this gone on and leave you here to keep me strong I'll keep my word I'll keep my until my say his name to read just hold on to the word he gave this time we'll come to pass because this salvation makes the last you carry you to see the break up the other styles before my tears but right behind the mask I look into myself and ask