 Magandang, magandang hapon po sa inyong lahat. Good morning, good afternoon, good evening everyone nasanman po kayo sa parte ng mundo. Welcome to the 70th installment number 70 of the Stop COVID-Dets webinar series and thank you for being part of another milestone webinar for our credible online community. For all of those who have just discovered us for the very first time today, welcome po at sa ating mga masusugid na avid viewers. Maraming maraming salamat po sa inyong suporta. With the National Capital Region, under the pilot implementation of the alert level system for the COVID-19 response, we are now going to take a look outside of the National Capital Region to find out what is going on in their areas. The places with the highest numbers of cases are Quezon City, Cavite, Laguna, Manila, and Bulacan. It is expected that efforts to control the spread of the virus have focused on these places. However, recent news reports point to increasing numbers of cases, high positivity rates, congested hospitals in the provinces. So ano po ba ang situasyon sa ating mga province? Ano po ba ang kanilang mga challenges pagdating po sa pagbabakuna, sa testing, contact tracing, treatment, at pag-angalagan ng mga paciente? Ano po ba ang kanilang mga ginawang sort of innovations? Paano po matugunan ang mga challenges na ito? And how are our front liners? Very, very important question. Coping, lalo na po dun sa province po. Dr. Susi Pineda Mercado. Dr. Susi? Hi, good afternoon Raymond. Maganda hapon po sa inon lahat. San man kayo na ron? We hope you're doing well. We know the situation is very challenging, Raymond. Very challenging situation for our front liners. But I can see we have our regular viewers from over the country, from the northern Philippines, from the Visayas. And I want to greet all those who are watching us from in the now and from different parts of the world. 70th. Raymond, I don't believe it. This is the 70th webinar that we've done. And we are here. Kami po ay nan dito dahil na dyan kayo. Kung hindi po sa inyo, wala po kaming. Hindi po namin magagawa itong webinar na ito. So we just want to thank everyone for staying with us. It's important for us to hear what's happening on the ground. And we also want to know if you have watch parties. Kasi we heard that in some hospitals a group are listening at the same time. So if you are, can you put that in the chat if you have a watch party? Even if dala walang kayo, watch party lang yun. So just put it in the chat if you've got a watch party. Because we want to know who we're reaching, how we're reaching. And of course, if you have suggestions how we can do better, we are most welcome to clear suggestions. So we have a very important topic as Raymond has said. Duma dami yung mga kasos sa mga provincia. And you're going to hear from some very, what should I say, some very important and very committed frontliners from different provinces who are facing many challenges now that we're seeing greater spread in the provinces and in the rural areas. So stay with us. We are certainly looking forward to new things to learn and to a good discussion later. So Raymond, over to you. Thank you, Dr. Susi. So for those who are wondering po, talagang marami po talagang clamor and call to augment our health systems capacity, decongest our hospitals, ensure strong triage and referral systems. And to essentially put our discussion in context, let's watch this very, very short video by TVUP, ang ating person on the street interview. Kaso ng COVID-19 sa provincia ng Kalbayog City, sa ngayon naman is hindi siya lumalala, kagaya ng ibang lugar. Average siguro may mga dosay ang gankin siaraw-araw na kaso. Hindi naman masyadong lumalala. So parang nakontrol na nila yung situation sa aming, sa aming, specifically sa city ng Katbalaga. Nga lugar po namin ay lumadangay po yung case ng COVID. Sa ngayon dito po sa Los Vanos, yun lumalaki po yung porcento ng pagtas ng COVID. Kasi marami naman sinaswab ng mga cases, pero yung mag-papacity ay isa lalaw, minsan nung wala. So sa tingin po, nakontrol na nila yung situation, mataas yung trapping at yung contact tracing. Lalo na kapag, halimbawa, may mga pumapasok masasakyan, tapos tagalob yung magsasalita. So talagang tinatanong nila kung, sa anang galing, kung anong gagawin or kung dadaan lang. Tapag, sabihin na mag-aiste sa city, talagang dinadala sila direct sa doon sa isolation facility ng city. Taobservas yung ko naman po. Kaya po kumakit po yung antaspo ng COVID dahil po sa mga tao, po sa aming matitigas po yung kulopo, lumalabas po na wala po ang kailangan. Wala po kong masyadong idea kung kailangan present at kung nababakunahan, pero nakitok naman, tulit-tulit naman yung vaccination na ginagawa. Akademismo na mga staff, mga ka-officina ko sa plan at siya kaya ang family members namin, ay nabakunahan na. So sa tingin po naman ay mataas yung commitment ng aming LGU sa vaccination program. So actualy kahit kaya hindi tagas sa amin, palimbawa yung mga ka-officina ko na pero dito sila naka-assigningin sa kakalogan, naka-accept din sila. So pinibigan sila na baka katao naman. So sa tingin po, ok naman yung vaccination program ng aming shodet. Sa ngayon po ay hindi pa po ako vaccinated, sa ngayon po, naka-register pa lang po ako ngayon sa aking pababaxinan po. Sa lugar naman po namin, halos po marami na po, 50% po, na-vaccinan na po. Anggang A4 na tinatanggap na nila ngayon nag A1, A2, A3, anggang A4 may roong ganan na na service siya sa COVID-19 at sa city ng Kalbayo. Ito na yung better, talagong ka better normal. Ito na yung normal. So na normalize siya sa communities namin, sa city namin, specifically, makikita mo talaga na ok na yung mga tao, naka-recover na siya. Marami na tao, sa park, marami na tao, sa calzada at nag-abide naman siya sa protocols ng aming municipio at ang aming shodad, specifically. So may nakatmas parin, nag-futage shield parin, at nandong pa rin yung acu-r codes na strictly ni-implement. Sa tingin po sa amin, medyo ok na siya, kasi yan nakakagandak na rin namin activity sa aming sa aming organization. Sana tulongan natin yung isatisa, kasi yung katawan natin talaga yung asset na maganda na meraon tayo. Magingat, lage, tulongan yung nasa sector na lumalaban ng COVID. Saka sumunod sa, kung ano yung makakabotin naman sa bawat isa. It's always nice to hear what's happening on the ground. And I mentioned earlier the watch parties. So thank you first TVUP for that great, that great interview, mga kababayan natin nang sa iba iban mga lugar. And we'd like to see more of your faces. I mentioned the watch parties earlier. If you send photos of your group who are in a watch party on Facebook, we're going to show them here on the on the webinar. Oh, Jen's participation, daw yung na diba. So we just want to have more, you know, we want to see more of you. So if you have a watch party or if you have a group photo that you want to share, put it on Facebook and we are going to acknowledge it on the webinar. So Raymond, over to you. Thank you, Dr. Susie. So para po sa ating mga nanon o dalo na po sa ating mga social media accounts for TVUP UP and stop COVID deaths. Marami-maraming salamat po. And you could participate po sa ating zoom poll or ating fun poll by going to www.menti.com at entering ang ating code. Ano po bang code natin today? There we go. The code is 6225-0629. That is 6225-0629. So if you are let's say outside of the zoom you can still participate in our fun poll and we will be flashing the fun quiz in a little bit for those who are asking para naman po sa ating certificate of attendance. Those will be given to those who have watched at least 50% of the webinar duration po. Meron po ba tayong there we go, okay? So yam po ang ityura na essentially of what you will be receiving as an electronic certificate. We are continuing to answer po requests especially for those who have not received any certificate na feeling po nila ay dapat po na kalesib sila for the last 69 webinars that we have had. So please contact us at stopcovid debts at up.edu.ph. So we'd be able to answer each and every one of your questions po. For those who are attending naman po for the very first time for today the structure of our webinar is a set of speakers and then a set of reactions po and then we'll have the Q&A session. We will be entertaining questions not just from the zoom but also coming in from the YouTube channel where we are being live streamed sa TV UP po and also sa ating Facebook. Okay. So without further ado I'll turn the floor over to Dr. Susie. Thank you very much Raymond. I think the participation and we have fun questions not in today are kind of fun so we'll wait for that but today we're going to have a round table discussion and I know there's a lot of still a lot of misinformation out there particularly in relation to what's happening what's happening outside of Metro Manila so today you're going to hear it first hand from some leading frontliners from different provinces we're going to open our webinar with a with some words from the chancellor of the University of the Philippines in Diliman who is in fact a mathematician and is joining us today Dr. Fidel Arnimenso Fidel, Chansey Fidel welcomes to the webinar. Good morning good morning Dr. Susie Dr. Raymond. Hi, hi Chansey where are you now? Where are you now? Paano? Anandita ako ngayon sa PGH na battling COVID. I'm confined here. Okay naman ako at dahil bakunado na ako at tingin ko mayad lang ang akong mga symptoms kong ting lagnat ubo sa kitang ulo pero ako nanatiling okay ang aking mga oxygen level UP doctors and nurses are taking care of me Good to hear Good to hear sir Good to hear Chansey and Good to see you even if you have COVID that you're able to join us just chose us that for the great My pleasure Yeah, you're able to do it. Okay so please go ahead with your with your introductory marks. Go ahead please. Good afternoon everyone. I'd like to thank Dr. Raymond and Chancellor Padilya for inviting me to give today's opening the marks now. Alamino these are not ideal circumstances but there's a reason to be thankful that we are all here while the cases of COVID continue to rise every day. We have an opportunity today to share experiences of responding to the pandemic. Webinars such as this not only document our struggle but also become a ground for harnessing and sharpening what we have learned from that struggle. This is a chance to show that our university is resilient and confront can confront the challenges before us. Alamno my terms as Chancellor started in March 2020 and I was given a most unusual welcome by the pandemic. One of my first decisions was to form the UP Dilliman COVID-19 Task Force in response to the public health emergency. Our task force is composed of faculty, staff, students and health workers who come from different perspectives who lend their expertise to provide multi-dimensional perspectives to the pandemic which is a complex and fast moving problem and given the uniqueness of UP Dilliman as a community malaki po to we count not only our students faculty and staff but also a population of about 56,000 residents from within and surrounding the campus. So it's become more obvious to us that the university does not exist outside the larger community. Whatever happens in the community affects us whatever happens on campus also impacts the communities around us. Like the rest of our country we have had little preparation and have had to learn along the way. Early on we realized that ours should be a community-based response to the pandemic. For UP Dilliman this response entailed the following. One understanding and monitoring the emerging needs of UP constituents as the pandemic unfolded. Two tapping the various expertise available in our university community. And three capacitating the university on pandemic response through self-learning, collaboration and piloting. So ang response po namin sa pandemic was diverse, it was widespread and integrated. It was developed over time and took many minds in months of discussion to consolidate. Ang aming task force po ang mula nung March 2020 ay nagmimit without fail every Wednesday. And we have mobilized and committed the resources of our university to mount and sustain our work. Aside from creating a task force we have also set up monitoring teams and designated health liaison officers in all units. Alam yusay, you could demand there are 27 colleges and many non-degree non-degree granting centers. There are over 100 buildings charged with implementing and monitoring health protocols and pandemic response activities. We also make sure that we comply with guidelines of DOH and IITF. Using the public health framework of test, trace and isolate we conducted a targeted threat testing of personnel who perform high and very high risk functions. This was followed by a mass testing of all our personnel during a search. All this was based on risk assessments of the different university units. Ang contact tracing po namin na ginagwan ng aming public health unit supported by a pool of volunteer contact tracers from our residential communities. To quarantine and isolate the sick we have converted three buildings the biggest building Palma Hall kilalan ng manami as the AS building our molavid dorm and kamiadorm we have converted this into isolation facilities. Since April 2021 UP Dileman is in partnership with the Kesson City Government has also been operating a vaccination site at our College of Human Kinetics Gymnasium to help in the overall effort to protect citizens of the city against COVID-19. To date our vaccination site we call it Bakunahan Dileman has vaccinated about 15,000 Kesson City Balangay residents and UP personnel and constituents. From these initiatives we have demonstrated the value of collaboration and partnership with LGUs non-government organizations community groups and individual volunteers. Our kamiadorm isolation facility for example is being run in collaboration with the Kesson City Government and the Philippine Red Cross. Our Bakunahan sa Dileman is not only a partnership with Kesson City but is fully run by medical and community volunteers. For this we have mobilized more than 400 volunteers. Likewise we should also mention the contribution of workers union vendors associations and other community based groups in these efforts. In following the approach of testing isolating and contact tracing UP Dileman has demonstrated the effectiveness of the public health response identified by local and national governments as well as international agencies such as the WHO. Moreover we have been able to test the critical value of our community engagement in public health crisis. The work of our volunteers has sought to mitigate the impact of the pandemic on the more vulnerable members of our community such as our ambulant vendors our kidney drivers the informal settlers contributing to the efforts to provide social protection to poor households. In addition our community information and education campaigns assist in local and national public health information campaigns. With the biggest surge we have seen so far a big challenge for us is how to present evidence-based information about COVID health and the pandemic of the public could better understand and more importantly relate to their everyday lives. The research that we're doing is important. In fact UP Dileman will soon be participating in a collaborative research with UP Manila to study vaccine effectiveness using data from our vaccination site. We hope that this research will shed light on how vaccines work in our context and given the vulnerabilities of our communities. This collaboration is in addition to ongoing collaboration between UP Manila doctors and researchers with UP Dileman engineers to develop affordable technologies to help combat the pandemic. So more than ever the university's role as a patient and sympathetic teacher and educator is needed. Sa panahong ito na may pandemia ng COVID-19 kasabay din ito ang pandemiyan ng misinformation kaya mahalaga ang papel ng UP sa kagpapaliwanan ng mga bagong kalaman tungkol sa pandemiyan nito kailangan na pipakita na ang agham ay nakakatulong nakakatulong sa tao na ibig sabihin mahalaga makalaking hamon ko sa ating mga doktor mga scientist na isalin ng alkam sa legwahing mamalapit sa nakakarami clearly our new context requires us to explore new ways of doing things. This webinar series is one way of reaching out to the public by sharing information and insights from our collective experience of the pandemic. Yunan po marami salamat lahat marami salamat paglahok sa webinar na ito. Okay, thank you very much that is our Chancellor B.P. Dilliman Chancellor Fidel Nemenzo and thank you for your words. Thank you for joining us despite the fact that you're in the hospital and Chancellor Fidel look in the chat box. That's why we really love this online community. We are a community. This group, everybody's wishing you well. Everyone's hoping that you get well soon. It's a very caring community and so find some comfort in the chat box. So we will have you in the panel later and hope that this doesn't tire you so much. Thank you so much for joining us from the Philippine General Hospital. All right, over to Yunan. Okay, thank you so much. Dr. Sucia and Chancellor Fidel Sir, take short breaks lang po. And we hope you'll be able to still join us during the Q&A panel. Okay. So for this webinar po, we will be choosing presentations, sorry, upvoted questions for a chance to ask your question live to our panel by opening your camera and well, essentially opening your audio and being able to address each of our panelists po. So we encourage everyone to start typing in your questions now in the Q&A box ng ating zoom or in the comment section ng ating mga Facebook pages or in the YouTube channel. Before we proceed, may we ask everyone to participate in our fun quiz? It's been flashed dito po sa zoom, sa mente, eto na po iyon. We have two questions right now. Medyo na miss po namin ni doctor. Himon, parang a-question natin yung geography ano. O nga po eh. Kaka medyo naka miss Dr. Sucia ano. Yung mga icon, icon natin last week. Pero anyway, the first question reads, what is the population of Sulu? Does anyone know the population po of Sulu? Fun quiz lang po, no? So kahit di na po ay mag-google, parang lang po, magsagotan ng ating ating fun quiz. Options are, option A, 340,000, option B, 500,000, option C, 1 million, option B, 1.5 million and option E, 2 million. Okay. So habang pungapasok po ang inyong mga kasagotan, let me take this opportunity to greet those who are joining us from Radio Pilipinas Dagupan in Bonuan, Gueset, Dagupan, the Provincial Health Office in Nueva Isija in Kaanawan, Dupaks District Hospital in Dupaks, Del Norte, Nueva Biscaya, Philippine Association of Medical Technologies in Talisa, Isibu and Gregorio Lyuch, I hope I'm pronouncing that correctly, Memorial Hospital in Iligan City, Lano, Del Norte. Also, who have registered internationally from the Chonin Hospital in Taipei, Taiwan, Nguyen Thai Hock Clinic in Kanto, Vietnam, Penang Malaysia, Oman College of Health Sciences in Muscat, Oman, University of Haile, Saudi Arabia, Dubai, United Arab Emirates, Lunichi Ali University of Glida II, Algeria, University of Fiji, Laotoka and the UP International Nursing and Healthcare Forum from Lexington, Virginia. Maraming-maraming salamat po for our second question. Ito damang po, population naman po ng Queen City of the South, Sibu City po, would you know, without Googling po, without Googling, option A340,000, option B500,000, option C1 million, option D1.5 million, option E2 million. So we hope you'd be able to continue to participate po, we'll leave our zoom poll and our mentor open as we get to niyo on with our program. Our speakers will comment correct answers during the panel discussion. Some are answering in the chat box. Teach them how to go to the poll. Okay po, so if you are going to the poll, there's a it's being flash on the screen, if you're in zoom po, at least you should be able to see what is labeled as pre-webinar questions. Dito naman po sa menti meter, you'll have to open your internet browser, go to www.menti.com and then enter po ang ating code which is flash on the screen 625.0629, that's 625.0629. If they're on the zoom, tignan nyo dun sa babanong screen nyo, meron nakalagay participants chat, share screen tapos polling. Iklit nyo yun, may lalabas na questions yun. Yes po, so you should be able to see it, baka medyo mahirap po pag nasa phone pero we hope you'll be able to enter your answers. Okay, over to you Dr. Susie. Okay, thank you very much Raymond. So we go to the meet of our topic. Today and as you know, we have been talking about what's happening in the provinces and lately there have been reports of really surges in the provinces na pukunong mga hospital, nga wala ng oxygen, pumipilang mga ambulansya, nga ubusan ng kama, marami tayong narebinin. Now we will be talking about that but we will also be talking about what are the innovations, what are the things that we are doing well. So we are going to celebrate also the good things that are happening despite this, nang tutulong-tulongan ng mga hospital na toa. And this is part of really our community of wanting to solve the problems. So whatever we are, we try to do what we can. And I think as you get to know each other more, it becomes easier to network, share information and you will love our speakers today. So for our first speaker, I am very honored to introduce to somebody who I know who I would say is one of the best, if not the best field epidemiologist in the country today. Not many people know it but I saw him go through the racks, was a star in the field epidemiology training program of the Department of Health when he was much younger and currently I'm so happy that he is the regional director of the Department of Health. A difficult region, region two, the Kageyan Valley Center for Health Development. Let's welcome Dr. Riyo Magpantay. Riyo, welcome to the webinar. Maraming-maraming, salamat po. Ma'am Susie, it's good to see you and it's good to hear from you. It's been a long time. Salamat po sa mga papuri. Parang naniliit po ako dito maliit ng alalukang nandili. Maraming- Riyo, Riyo, you deserve much more. I'm always delighted to have you guys who I know are working very quietly behind the scenes. Sometimes maraming banat sa Department of Health, but if only people knew about the work that people like Riyo Magpantay do, then, you know, I think it would be different. So, Riyo, this is, we would love to hear from you ang balita ko and when we had our little conversation, sabi mo nga maraming mga kaso, no? So what's your situation in region two? Please go ahead with your presentation, Riyo. Maraming salamat po at magadangapon po sa ating lahat. Again, Doc Suzy, Doc Raymond at sa lahat po ng ating mga audience ang katerba nakikita po natin na nakatunin sa atin. Isapong napakaganda umaga, mayinit po rito, sana sa ining lugar mayinit din. At ang ating panganoon ay peiniting pa rin po natin dahil napakaganda po ng ating mga tapis ngayon. Kami po ay nagpapasalamat dahil kami po yung invita para maipakita po naman namin ang situation dito sa region two. Alam ni naman, halos NCR lang ang lagi po nabibigyan ng attention in terms of news, pero we would like to everyone to know what's happening in our region. Riyo, Riyo, tekasin nalai, I'm going to interrupt. Whoever's manipulating your slides, put it on a slideshow. Kasi what we're seeing we're seeing your, we're seeing the ano yan. Pwede mo siyang a slideshow, yun-yun-yun, parang presentation. Yes ma'am, hold on. It's okay. Hindi pa, I'm still seeing it's not yet on presentation mode. Lapit na yan na yan na. That one, that one director, director Riyo. Yung pang parang baso sa baba, sir, yung kanina. Yung mo ang, ano, that one sir. It's functioning. I don't know why. So, hindi po ito may to subtract sa aking oras po ha. Kau pa, no way. Riyo, you take your time. You're covering some provinces. There you go. There we go, there we go. Perfect na, perfect na. Go na Riyo. As I was saying, marami salamat po and this time I'll be discussing the situation of my beloved, our beloved to the un-body and how it stood at the test of time of this pandemic. Aro po, it's a challenge and it has become a daily learning experience for everyone. Lalo-lalo na po kasi ito sa aming rehinon. We have learned to capacitate each one's strength and have worked in partnership with everyone, including the community involved in the fight. Kagayan Bali is composed of five provinces po with 3.6 million and it's located in the northeastern section of the Luzon Island. Baka hindi po po kasi alam at might wish kayo kung saan nakalagay ito. Kagayan Bali. It's composed of Batanes, Kagayan, Nabila, Nueva Vizcaya and Kirino. I'd like to discuss to you ilan na hubo ang naging kasi namin dito sa rehinon. As of yesterday, meron na po tayong confirmed cases na $88,679 at madagdag nga po kaha po po ang highest namin since we started doing the survey. 1,324 cases for a day. With 2,676 deaths, medyo mataas po ang ating case fatality rate of 3.01 and nakakagulatin po ang pasitivity rate namin which is up to 32.8%. Record hypo siya dito po sa aming rehinon. This slide will show the epidemic curve in our region from January 2021 up to the present. It is noteworthy that our areas with Outback are our four centers of trade namely, Santiago City, Tugaygaro City, Kawayan City and Ilagan City. Nakikitarin po natin dito sa ating timeline that the peak of cases were seen to have followed the detection of the local variants of concern. First in March with the detection of the beta and the alpha variant and followed in the month of July with the detection of the first case of the delta variant. If we talk about the epidemic risk classification of the entire region, it falls under high risk. Santiago City, which is an independent city located in region 2 also falls falls under critical risk. The province of Isabela, Nueva Vizcaya and Kirino remains at high risk specification including Batanes which is now flagged as high risk due to the detection of three new cases of COVID. We also would like to say that recently siya po ay naapektuhan ng bagyo at kasalo ko yung nag-recover po mayo. Kagyan province is at moderate risk. The healthcare utilization rate is at 85.98% while ICU utilization rate is at 88.83%. Going to critical na po kami. Today, meru na po tayong 122 recorded delta cases in the region. All provinces have recorded cases except for Batanes. Overall po, the entire region is at alert level 4. Maganda po ang participasyon nang ating government hospitals as well as private hospitals. Don't po sa itinalagan natin na dapat po meron siyong at least 50% bed na ia-allocate po sa COVID for government and 30% for private. You could see in this slide that it surpassed for the government the number of beds at 50.43% and it surpassed 15% of ICU beds with 21.72%. COVID mortality trend shows that deaths peak in the month of August though it is seen in the graph that it's already started to increase in April when local variants of concern have been detected. Sa ngayun po, metyo dumadami talaga po ang namamata and it's very, very sad to hear and see that there are still cases dying particularly even in level 3 of course and our private hospitals which are level 2 hospitals. For the information of everyone there are only 3 level 3 hospitals in the region and these are all DOH retained hospitals. One in Kagayan province, Kagayan Valley Medical Center, one in Isabella which is decent, southern Isabella Medical Center and one in Nueva Vizcaya the region 2 trauma and medical center. Testing capacity of region 2 has increased and is now at 4,442 per day with 5 molecular laboratories in the region. This is attributable to the trace, test and trip or the P3 program which targets to ramp up the testing capacity. However there are testing challenges namely number 1 jida areas of difficulty or even have no access to RTPC or laboratories. There's limited RTPC or testing kits and rapid antigen test kits. There's also shortage of laboratory staff due to them being infected with COVID-19 leading to longer turnaround time. Again it's very sad to say na there's a lot of healthcare workers now being positive and of course if their colleagues are close contacts na uboosan na din po ng health workers dito po sa ating rahiyon na magdyu-duti po sa ating mga hospital. This is the greatest challenge that I am facing right now. And the last among the testing challenges, number 4 is that na doi walang po ang provincia na meron kami molecular lab which is kagayan in Isabella and the other provinces Batanes, Kirina, Nueva Vizcaya have yet to put up at least a single or just one molecular laboratory. Tingnan naman po natin ang ating vaccine statistics in line with our prevent, detect, isolate, treat and integrate plus strategy ang plus point vaccination. Vaccine statistics show that our vaccination coverage is at 16.54% of our target population which is 2.585 million. This is 70% of the population. And we think that it's still very low. With a breakdown of coverage we could see that among the frontline health care workers, senior citizens, persons with comorbidities, essential sectors in daigin population and priority group BNC are shown on this bottom part of the slide. Senior citizens having the most number of fully vaccinated individuals at 204,745. This is the latest data as of yesterday. Now, let me have some innovations. Let me discuss some innovations for vaccination which include the flying vaccination teams which are composed of our own stuff from the regional office, assisting in areas with very low coverage, mostly hard to reach areas. Some wills initiated again by the Department of Aboriginal Office No. 2 pinartner ko namin siya doon sa Philippine Red Cross Baccuna Bus to reach geographically isolated and disadvantaged areas or the Gita areas. And promising, morami ko talaga ang kung punta dahil gusto na ko nila talaga ang magpabakuna. Ang maalaga lang sana, madagdagan pa po ang bakuna ng anong region. At madagdagan pa rin po ang aming vaccination teams considering there's a lot of health care workers nga po na nagpapositi. For a more appealing and easy to remember facts on vaccination, naglaunch ko kami ng ResBaccuna Jinger which was composed by our own staff and a TikTok challenge so it's also done for all the local government juniors who wish to join. Some LGUs also have set up ResBaccuna Pantry giving ayuda to those who have been vaccinated and those who wish to be vaccinated and provided transportation assistance to vaccinees going to vaccination sites. Social media posting on best practices on vaccination was done to encourage local government juniors to do the same or to do better in vaccination. Innovations and extraordinary measures taken at the regional, provincial and municipal level on the PDIPR strategies include the following on prevention. Number one, in the past months local transmission has been seen in workplaces with poor administrative and engineering protocol and in order to address this an initiative of our own region regional task force and interagency task force is the creation of a sub-task group on workplace management composed of several agencies to name a few, the Office of Civil Defense, of course the Department of Health, Department of Trade and Industry, Department of Labor and Employment and the Civil Service Commission. This monitors implementation of minimum public health standards in workplace settings. Empowering national government agencies, DOCCs and private institutions and even state universities to have their own COVID response teams called COVID worth which stands for Workplace Response Teams for Health has greatly helped decrease workplace transmission by early detection and isolation of cases. To add, we also have initiated the COVID wars meaning workplace alert system which notifies the COVID response teams of symptomatic or close contact employees. The establishment of communication bureau which includes local government units, national government agencies, information officers, media and other stakeholders which aims to inform and educate the community at the ground level by focusing on IEC campaigns that are translated to our very own dialects was also established. That's for the prevention. Now let me go to the for the detect strategy. These are the innovations. We created our own COVID-19 information system in region to enable all this is reporting units access real time data including release of RTPCR results. We also established the collaborating centers for disease prevention and control again in our own office which is composed of the Kagayan Valley Epidemiology Center its training component diagnostic laboratory center also located in our regional office and the disaster reduction for health center. The centers are responsible for the coordinated COVID-19 response approach. In addition, we launched the conduct of the applied epidemiology training program and data management and analytics training to equip our epidemiology and surveillance units both at the regional provincial and local levels, other local levels to conduct prompt and efficient surveillance and epidemiology investigations. This is actually a nine month program modular and this ensures act which stands for accurate, complete and timely data. And lastly we have organized a regional contact training team specific for variants of concern composed of interagency personnel in order to strengthen and improve the efficiency of contact tracing of VOCs or variants of concern. For the treatment strategy as an initiative, the one line or offering nonstop health services and empowered linkages in nations emergencies and disasters was established at the regional level and provincial level in order to hasten the referral process and avoid delay in patient care. We also have the mental health network services which includes the following components of NAYAN. This is the regional mental health council during COVID-19 pandemic. The UNAWA, the application of MHGAP strategy in COVID-19 management. The MTSA, the supporting health facilities and LGU mental networking program initiatives. And of course our networking for all the mental health and psychosocial support training for NGAs. Now let me discuss the LGU innovations on prevent strategies. The different medium for IEC materials used include the use of Bandilyo social media platform regular radio aiding and local TV programs, among others. For the detect strategy, the LGUs use of the academic developed contact tracing applications such as health guard was utilized. Ilagan City, which is a city in Isabella established its own COVID-19 molecular laboratory. Other LGU innovations we strengthen partnership with volunteer doctors in the region for patients and quarantine to conduct telemedicine and teleconsultations. Mental health services provided in the community such as quarantine therapy for batanes, ikumustahan for Nueva Vizcaya and the adoption of project GABAI in all provinces. LGUs recognize the importance of mental health as part of COVID-19 response. As an ending slide, the COVID-19 pandemic has really shaken heavily everyone of us. It became a global health crisis that has affected how we see the world and how we get to spend our daily lives. But as they say, we should never lose hope as to what the future may bring. The most important thing now is how we get up together to win this battle. Maraming-maraming salamat po and I am sure we will recover as one. Mabalo which is thank you in imana. Okay, thank you very much. Let's talk to Rio Magpantay. My goodness, Rio with an excellent invitation. Very clear, very logical. We can see how you're thinking you think through all the different aspects of the pandemic and I was really so happy that you accepted the invitation to speak because I think a lot of people don't know this but really the success of the department of health is with the regional directors. And as you can see, even if there are limitations, Rio, I'm a little shocked. You only have my goodness for 2.5 million people. Kulang talaga ng suporta pero ang ganda ng presentation I think. And guys you can all see na Rio presents you with numbers. As I told you, he's the best field epidemiologist in the department of health in the Philippines. Sige, thanks Rio. We hope you'll join us later for the salamat po again. Next Rio. Okay, so we'll go to Raymond. Thank you director Magpantay. Excellent presentation sir. For our next speaker in our round table, he is trained in internal medicine and sub-specialty in infectious diseases from the Philippine general hospital and graduated doctor of medicine from UP. He's a medical specialist too at Vicente Soto Memorial Medical Center and faculty at Sibu Doctors University College of Medicine. As well as research coordinator for Chonghua Hospital in Mandawa, consultant for Sibu City Emergency Education Center in Project Balik Buhay as well as Infection Control Chair and Infection Disease Practitioner in Virus Hospitals in Sibu. Let's welcome to the webinar Dr. Brian Albert Lim. Yes, a very good morning everyone. I'll just share my slides. Okay, so malaming salamat po. Thank you for the invitation. It's truly an honor to be able to be given this opportunity to share hard lessons in Sibu City. I think in the course of this pandemic we make mistakes along the way but I think it's all right because as long as we learn from those mistakes and we keep on moving forward. So before I start, just like a few disclaimers, so the views are my own. I do not represent the various institutions that I am affiliated with. So COVID response is dynamic. So kahit na gumanganda yung situation namin ngayon, hindi ko talaga garanti ito na kami forever. So it's very important to acknowledge that. And I do not carry the monopoly of viewpoints. So differences are moved to welcome and I really would like to acknowledge Dr. McBrande. It's truly an honor listening to him as well. I am not affiliated with any political party I keep on saying this because people have asked me so many times since I work with both sides in the course of this pandemic there's only one side that matters the side of saving lives. O may perspective as Dr. Cermen to as mention this is what I would like to bring to the table. So I am a clinician so I take care of COVID patients in both public and private hospitals. So I was there in the forefront in transforming some of the hospitals here in Cebu in preparing for COVID. So from the very start wala talagang hospital na handa alam naman natin before the pandemic yung mga isolation rooms natin malili it lang. But of course we have to make do with what we have. And of course I'm a consultant of different LGUs. I think it's important to help and to guide our leaders in the best way we can. And managers have set up a number of temporary treatment and monitoring facilities here in Cebu. And currently I'm working with the Project Balik Puhay. It's a consortium. It's an alliance of different chambers of commerce here in Cebu to better balance the health economy. So I would like to apologize if this is not the right political term search or spike. Forgive me, I'm not an epidemiologist but I would just like to show you our journey from last year up to now. As you can really see there are three surges that Cebu has encountered. The search last year was the most painful professionally and personally I lost my dad last year, last August to COVID-19 and I almost lost my mother. So it was truly a veritomotus situation. During the time, andami panaming walang alam and I'm sure the rest of the world were on how to learn and how to adapt to this new virus. We were put on ECQ last year twice. Of course we did not waste that time and we set up a number of innovations which I shall share with you and some of these really echo the efforts in different parts of the country. And however, we thought na okay na kami, so we had a very good Christmas, nakapabakasyon ako and then come February, March, April like around kami ng second surge. But I will tell you here what happened here because I have to admit we let our guards down especially even in our stock because akala mo okay na. So some of the contact tracers na pinuloy ang contract and then medyo lumobo but I will tell you what, share a few slides later on comparing the first and second surge and the impact of creating all of these health system reforms in saving of course the most important thing is being able to save the most number of lives. And here we are now what happened was we are now in our third surge delta-driven surge here in Sibu and as you can see but I am glad because a very up na ngayon medyo kumoting na talaga ang mga kaso namin masaya ko sa regional namin, dati punong puno ngayon po 52% na lang po yung occupancy kasi bumababan na po talaga ang kaso. And as you can see here we have learned also so many lessons during this third surge which I will share with you. So I'm allowing me to be candid to the slamer tayo kasi of course dito, kapag we are sharing our lessons napat the entire story should be said so we learn from both our mistakes and our successes. So if I may during the first and second surge here in Sibu we monitor apart from the DOH bed tracker we monitor the actual capacity so may dalawang arms po yan the private sector monitors it and then the private sector also monitors. And allow me to share ito lang kasi alam naman natin na mas marami po talaga ang private hospitals kais sa sub public so allow me to share the data during the first surge in the private hospitals we reached up to 86.3 capacity utilization but during the second surge kahit na mas manami yung cases namin our hospitals were not over one during the second surge the glaring is really mortality in our first surge our mortality was very glaring one of the highest in the country kami datin I think our case mortality rate nung umabot kami ng 6.6% but during our third surge highest namin was 1.1% so ano talaga magkita mo yung difference and I would be sharing with you how I think on my personal opinion we were able to achieve this the story changed when delta arrived talaga itong delta nakakakiritan so parang ano talaga we were caught off guard and I shall share with you those lessons as well ito po yung situasyon namin sa Sibu and I'm sure I resonate this with the rest of my colleagues na talaga yung health system natin hindi po talaga tayong handa sa pandemic so implementation of national policies were unclear nagipaibap or LGU COVID changes as it crosses borders the LGUs were still adjusting organization structure alam na po natin yan sa ating city health department communicable division communicable disease division they handle all the different infectious diseases pag ito na sa COVID parang biglahan nakibana lahat so ito kawal huge challenge iba-ibap po mga boss natin sa district provincial, uh retain sa private, iba-ibap po mga boss and alam po natin in terms of all this integrated referral system it barely existed and gaps in the understanding of the science na upakarami po hindi panayitihan din din dihan yung infectiousness yung wala kang symptoms kahawa, science of testing ito kawal but repeated engagement so important to make leaders to enlighten leaders and the masses as well and the different political affiliations mistrust was a lot of noise and the challenges in communicating policies to the masses were very difficult however we were able to we were able to pull through i have to say the national agencies the LGUs in the private sector ang mo like to dwell a little bit about this the national agencies nung medyo nag-esecured kami ang padala sila ng very cute people I have to mention their names but the only two people I will mention three people I will mention kasi ito tala for me are the cornerstone in the game changer in the way we manage COVID general Feliciano and his wife Feliciano was the national government we need to have a third party person coming to Sibu kasi during that time kailangan namin na sa man-neutral para we needed people that people can trust and the blessing there the wife of general Feliciano Mamia Feliciano is a nurse and for me sobrang will po ito kasi siya po yung nag-abolong kand-general kapag merong hindi masyadong clear and they became really the voice of multiple sectors and came from outside and the office of the presidential assistant to Visayas was also very very helpful and the good thing there this was synergy in the local government units during that time you were thinking siguro dapat doctor ang head of emergency operations center but I'm glad hindi kasi when you talk about implementation for me hindi the best yung doctor to lead in terms of community response yung may alam sa politico may alam how things are implemented and who can pre-empt who can pre-empt when things can go wrong here in Sibu ito in the person of councilor Garkaniera and I really support him and recommended him to the group, to the regional IETF kasi he was a barang gay captain for several years and he really knew implement all of these things in the ground kasi as we always say here in Sibu kong hindi alam ng mga tao-in-the-ground yung community response natin hindi talaga matatapos in o pandemic napakalaga po talaga ng community response and of course I would like to mention the synergy with the private sector the private sector I'm very happy I'm part of project Balik Puhay and even early on last year we would meet on a daily basis because you wanted to update I think the key here in the pandemic is dapat meno talagang collaboration, may clarity, my synergy and the important things to be able to bridge these gaps so I would just like to share a few innovations of this collaboration as a testament to this synergy ito po yung part enjoy namin sa Sibu City alam naman natin sa Sibu may Metro Sibu, may provincial Sibu iba-iba po yun, iba-iba po mga leaders I shall focus on Sibu City because that's where my work really is but of course I shall touch on some innovations in Metro Sibu and Sibu province ito po yung nakita talaga namin napagaganda po yung mga policies natin at a national level but the lacking there is how to translate that on a step-by-step cookbook type of of manual natin kong contact tracing team ilang ba ang kailangan ang mga qualities na dapat ng kunid may mong kukuhan ng data ilang ba anong data bang dapat kukunid, paano ba siya dapat ina-analyze in how will it achieve how will it change policy I'm proud of this manual that has been a product of multiple authors from the police from the barangay captains and from policy makers from doctors etc so we established the emergency operations center and it has been adopted in multiple cities algorithms of course the algorithms recommended by PSMID unified protocols which cuts across most of course have been followed but of course there are certain modifications centralized data so it's very important our emergency operations center will be acquires all of this data on a daily basis so I'm very proud of every morning they would meet every day at 8 to 9, 8 to 10 p.m to analyze the cases at contact tracing cases para yung game plan nila and strategy nila for the day are evidence based data driven so very important po yung real time information so pati po yung crematoriums yung funeral homes yung ambulance yung police ilang healthcare worker ang na-covid ilang actual bed capacity nila po yung bed na binibilang yung talagang kaya ng hospital e na-monitor po natin yan and of course the good thing there is to design and implement data driven culturally sensitive policies so example, kapag maghita natin ay dumadami yung COVID natin sa industry na ito so kinakausap natin hindi natin pinapahia pero kinakausap natin para po ma-tulungan para maprevent ang future outbreaks so contact tracing, karamihan po ay ginagawa siya sa gabit para po hindi mapahia ang ating mga kababayan namin yung chismis kapag may nakakawarantin sa bahay kinakausap natin yung mga nasa barangga ang gali po na mga kapitan pakingin ang mga napakisumbong tataka sila, it's quite effective talagang napagarami po innovations ito mga kapitan natin lap nalap po namin ito mga kapitan namin kasi talagang in the forefront of the pandemic na dun po sila another product of this synergy is Bayanihan Sibu so as you can see there's the national government there's also the different event church groups are here kasi dati wala pang temporary treatment and monitoring facility yung hindi pa po na gusto yung mga isolation center gumawa na po kami sa Sibu ginawa namin nun modified isolation center po siya ibig sabihin, ina admit po namin para hindi po po munta sa hospital na para po how to ensure that they would follow and they would not bypass the referral system, may incentive po if they follow this system, the triage system kapag mo progress po sila to severe may assured bed po sila sa tertiary so may ganoon po kami mga mowa sa mga tertiary hospital if anyone progresses ay alagaan po ipapprioritize ina yung very proud kasi I came from UP also UP Medical Alumni Society of Sibu has been in the forefront of all of these so reassuring po imagine sa isolation center na ito may obigayin ne, may endocrinologist may pulmonologist, may infectious disease may orthopedic surgeon para po talaga na holistic at may assure po may reassure natin ng ati kababayan na hindi po sila ipapawa lang dahala sa treatment facility na ito at ang maganda po nito kapag mo they follow this mechanism may menu din po sila ayuda may grocery po sa bahay kapag na admit sila dito sa itong facility para lang po hindi mo overwhelm ati ng hospital. In another product if I may with this synergy is as I mentioned practically kuhay which is a consortium of different chambers of commerce the private sector really step in in our vaccination program the various church groups, universities hospitals and of course my dear opmas is also a partner so ginagawa nito yung vaccination namin yung paghakot, mechanism sa paghakot is pre-industry so may choice po kapag si Buano ka, pwede po kayong mag-paregister sa LG yun nyo or if you are working in a company or in an industry even in SM East pwede po via the company ang pag-register ang maghantan nito yun na mong serve namin nakakarong na pa rang packets of herd immunity in this industries. Imagine if lad ng empleado isang bagsakan po yung sa isang factory bumabapo talaga yung nakukovid sa industry na yun so I'm proud of this talagang tumutulong po atang mga na nito but you're working in Medawe City if you are vaccinated in any of the Project Balik Buhay sites regardless of where you come from you will be catered too so may convenience po siya so I'm very happy na may ganitong initiative sa amin and ito po latest sa initiative of Project Balik Buhay kasi with all the the morale is low especially sa surge na pakadaming problema at in mga nurses just ko kawawa talaga and may maraming issues sa benefits I'm very proud na the private sector step in na bibigay po ang private sector na additional 15,000 per month per front-liner working in the COVID-19 this will not solve really the issue of low wages but I think this is a good example of solidarity and I think in this pandemic we have to encourage those acts of kindness so again do na maputayong sa health service delivery na pakahalaga po nito dati talagang yung primary care hindi po talagang norm kasi dumindiretyo sa mga specialies devolution talagang napakihilap po talaga down real fair loss not well accepted patients bypass primary in secondary hospitals in contact tracing was a challenge so lo po yung mga ginawan namin dito sa Sibu dito talaga so daily trackings of course there is the DOH bed tracker but we also track the actual bed capacity and daily tracking of the proportion of patients according to severity kasi for example ang hospital nito maraming mild or maraming moderate talagang tinitriage na po namin papalipat sa ibang district or sa TTMF and daily tracking of inventories so every day all the hospitals their supplies are being monitored so alam po namin kung anong hospital wala ng oxygen wala ng high flow so resources can be allocated accordingly the next strategy is coordination we have within eight things with the DOH treatment at provincial hospitals napakalaga po talaga ito mga huddle nito lumalabas yung mga issues at natutugunan po nating daily endorsement and mentorship so nakapoblima kami dito nung nag third way kami naganon na dumami kasi yung cases sa Sibu province and in the provincial area so of course bagong problema ito kasi delta kasi napaka infectious ginawa po natin nung the Philippine College of Physicians menopot tayong partnership with the provincial hospitals na yung IDS infectious disease at pulmo minimentor po natin yung mga colleagues natin sa provincial hospitals via telemedicine so I'm very proud to say sa Osloop District Hospital napakalay kung saan yung mga whale sharks sa Sibu nakakamanage po tayo ng mga severe don at may mga marami pang nabuhay na may isang kaming 70% yung auto saturation pag namanage po ng Osloop District Hospital at nabuhay po yung paciente so via the Soto I'm very proud of our regional Tires Regional Hospital our IM graduates kasi required po kasi yung return of service and they chose to serve in the provincial hospital so they became our leaders there they become our coordinators kasi natrain na po natin yan na sa regional makaling ng mga bata so weekly analysis of logistical and inventory issues importante po yung na hindi lang po puro-reclam mo rather than ano bang specific problem at anong yung pointing solution na kaming makawa and of course weekly meetings with our vaccination partners tapak halaga po nito proud of this of a 70% to our dear medical director Dr. Akinno Gerardo Akinno had the foresight inayos tapo namin minu po ang oxygen a production plant ang SIBO so the oxygen plant namin can produce up to 800 tanks a day so hindi po kami evernut shortage sa oxygen during the third search maraming gusto maghort and we have to reassure them wag kayong matakot may oxygen production plant tayo sa regional on top of the private distributors so we can easily cater to around 2,000 oxygen tanks a day so when really na wala po yung horting namin na minimize po yung horting and I'm also very happy yung when the third wave that happened support in the province was also given by the provincial government they bought 40 hyphro nasal cannulas and several MacVent the regional hospital we also have 100 mechanical ventilators and of course I think 70 hyphro nasal cannulas already so talagang it's a numbers game the pandemic is a war on logistics logistics po talagang but of course tocilisomab naman ang issue ngayon but hopefully now the cases are going down kaya hindi talagang po yung mga fourth surge kasi wala pang tocilisomab napakahirap na kakukawa and malapin na po kong matapos pa city and the health service delivery triage ito po yung sinasabi natin yung public schools ginagawa natin barang isolation centers for the mild and asymptomatic and the TTMF po yung mga modified TTMF teleporary treatment ang non-inferring facilities and some of the hotels have already been leveled up mga hotels may mga doctor at nurses and even laboratory na rin po kasi para hindi po mo overwhelm ang ating hospitals nagapproblema kami sasibu sa third surge kasi maynong kami 3 mega TTMF that was able to cater to 500 people for moderate cases sinara po namin ito kasi we transform that into vaccination mega centers kasi ako sa kalan namin na ok na but then delta happen now the future direction of sibu is to have a permanent fixture na talagang in-entain dyan para for future surges and pandemics so testing sibu we have eight testing sites testing laboratories I mean testing laboratories because there are up to 7000 RTTC artists a day and the most important thing here is menon po kaming mga free swab testing sa different cities Mandaway has da pulap po has even the province has but for me the most extensive is sibu city kasi ito yung pinakamalake we have cluster clinics putta ka lang doon is a swab cap and we even place this the picture here is in pit post no it's a mountain barang guide because the challenge of transportation et cetera na dumadami din po yung cases sa mountain barang guys so we place a cluster clinic there para naman doon na sila mag paswap they have symptoms so I think testing is so important it has to be accessible so even our SOTO our beloved regional hospital may drive through din po and those of the private hospitals may drive through the PCR testing information talaga ala na po nating data scattered coordination is difficult so really for me the turning point in sibu is really the real time data collection so talaga in the morning from 8 to 10 a.m. grabe po yung nakokulek na data na karedi na po kasi nak-excel na yan lahat tapos automatic na po yung graph para copy and paste na lang yung staff sumabilis po siya so we can create evidence-based data-driven policies on a real time and for example sa si Capitan na ito dumadami ang barang guide niya din na kausap natin na tutubunan and at human resource ito po yung problema na naubusak kami ng nurses and I'm sure we are all having this problem so of course DOH sub-evented the staff pero misang kulang talaga wala na po kami yung mahaya na nurses so ngayon we have analyzed na gumawa kami ng time in motion study on the work of the nurses and as you can see 40 to 50% of the work of nurses is not really related to nursing a lot of those is coding the laboratory coordinating with the patient's relatives so ngayon we are now hiring nurse assistants at para yung trabaho ng nurse talaga is just patient care hindi na po yung dapat inasikaso yung mga kawak-tawap niyan para po mamamaksimize natin na ating mga health human resources and of course now we have telegabay na inspiring kami sa PGH magami salamat po pero yung gabay namin yung buy yung Sivuanon na buy and our students are also helping in terms of medica students and our doctors are also helping in telemedicine consultation and home management but I think the good thing about this platform is na ka-link po siya sa referral system so kung yung tinatawagan na ng telegabay na avail nun e mag-progress ready na po yung hospital para po ma-accomodate itong nag-follow ng health ng referral system ipotang di po talaga ma-incentivize natin e kung sumunod ka sa proper protocol na pa-priority ka parong ganon so don't worry yung follow us yung follow the process if you progress don't take care of you so may ganon po tayo ito po yung three little pigs na napakacute po na picture na to talagang I like this because this represents the three surges we learn lessons along the way and I think I'm very positive about this is it's really long term resiliency recourse adaptive learning ka hindi ako masyatong judgmental kung may nakakamali hindi tayo dapat masyadong very gali of course na pang ano tayo but the key here is to acknowledge the mistake and move forward and I think I love that in the Sibuano spirit of resiliency Humility and sincerity are the cornerstones for meaningful collaboration mahalaga po talaga na we swallow our pride more often than not kasi may point po talaga ang mga sectors natin at systems beyond the DOH hindi po talaga kaya na DOH na nito it requires private sector engagement it requires guidance of academia it requires police security economic transformation et cetera we are all interdependent and the health system needs to radically evolve so what's the next steps for Sibu? this is my last slide we're setting up a multi sector resiliency plan hindi na po kami papaya you have to minimize the impact of the search we plan to democratize testing so we're still planning different models on how this is to be done and use of policies our counselors are already creating policies in the use of open spaces and in this Monday we have invited Dr. Dan Snotoni and Mam Inday the use of CO2 detection as a proxy in assessing a well ventilated space so may maganupo tayong innovations capacitating hospitals and streamlining referral systems I see this personally as growing pains of universal health care now more than ever our mayors in our provincial government is now more than aware and really on board in planning the long term development of our health care system and of course vaccinate, vaccinate, vaccinate and we intend to have closer collaboration with the business sector and I'm glad that our chambers of commerce are on board and they have helped us allowed during this pandemic and of course educating consumers and the masses umagawa kami ng app na parang travel advisor na yung mga establishment na nang fafalo ng minimum health standards makikita mo so you know where to eat na safe so we plan yung mga communicators namin dito we plan to create a brand that if you go to a facility where in the employees are vaccinated may tatak safe ka sa mandawe ginagawa na nilayan may safety seal if merong open space proper yung pang divide may HEPA filter may malaking ventilation may CO2 detection may special seal ang mandawe city na ito safe tayo dito when we're dining in this space so I think very important because in the new norm infection control is the new brand thank you oh my goodness thank you so much napakahu say my goodness Brian Lim Dr. Brian Albert Lim of Sibu Doctor's University Hospital such a passionate presentation and really so great to hear all these innovations in Sibu from the free testing to the additional funds that are given to the nurses on the front line this is amazing amazing so I think you know Brian Brian Brian di mo alam na alam ko tohan mo Brian is a clinical epidemiologist as well hindi po infectious disease po ako ma'am infectious disease pero nag ano ka na clinical epidemiology ka di ba? ay nag development economics po ako ma'am sa school of echo and disease po hindi ko po na tapos dahil nagpandemi ok so your mentor Dr. Noel Huban was just texting me and saying you're really great from the very beginning ang husa yung say and I think our audience can see you know how how impassioned you are and how this spirit that you bring is really what we need kasi ano parang we cannot stop with our limitations we have to move forward and keep on moving on and that's what I see I see in your eyes when you're speaking so thank you very much Brian we're going to our next speaker alright so from Illigan City and you know Illigan City is a little bit close to my heart I guess you guys remember Sendong when there was like 7 to 10 meters of water that hit kagayon the oro in Illigan City and I was part of a team that tried to help out there and I was asking one of my classmates who's a cardiologist in Illigan City Miriam Timonera so kusina bang pwedeng magsalita dyan kasi mukhang maraming kaso ang ano ang Northern Indian ang kagayon the oro in Illigan City and she gave me one name she said you have to talk to Dr. Lionel Albert Kitos our kits and we are very very privileged to have kits with us he's internal medicine adult infectious disease fellow also trained at the Philippine General Hospital he is in Illigan City Lanao del Norte kits over to you thank you very much thank you for this opportunity to speak this is my first time to speak to this large audience so I'll just share my screen go ahead kits Dr. Suzie I think Dr. Kits is the only please correct me if I'm wrong kits infectious disease specialist in Northern Mindanao tama ba? Hindi po in Illigan City Illigan City okay oh oh palaga this is the one he's the one I want he's the one who knows okay take it away kits see po so I am Dr. Lionel Albert Kitos I'm an adult infectious disease specialist practicing here in Illigan City and I'm going to give you a picture of the Illigan situation so it's like this a blank slate because I think we're still in square one so unfortunately so I'm here not speaking on behalf of the Illigan local government you need nor the regional DOH I'm not even speaking on behalf of the local IATF because I'm not part of it I'm not part of the making of the protocols I'm also not speaking on behalf of the medical society although we have already given a lot of recommendations to the local IATF so I think my role here is to express my opinion of the Illigan situation as a healthcare worker as a frontliner and as a private clinician so I think I'm just going to express my frustrations that I think I share with a lot of my colleagues with I think not just in our locality but with other LGUs also so to orient everyone Illigan city is one of the cities in northern Mindanao it is around 90 kilometers away from again the Oro city which is the more popular city in our region so as you can see this part of Lanao del Norte is a lone district so we are independently administered it is surrounded by Lanao del Sur by Misamis Oriental parts of Bukidnon also with Marawi City and we we are catering to a lot of patients I have catered to patients coming from Zamboanga coming from Kotabato Bukidnon so Illigan city cater to all these neighboring places it is known as the city of Waterfalls so if you can visit here post pandemic then you can really appreciate the Waterfalls and it is one of the gateways to northern Mindanao I think this is one of the problems also since one of the gateways we cannot control the movement of the people we have a population of 372,770 as of the local statistics last 2020 and last year we detected I handled the very first COVID-19 confirmed case in Mindanao who was PH 40 and he was transferred to the Northern Midanao Medical Center in Kageyanti, Oro where he expired I think he was also one of the first fatalities outside of NCR and last year Illigan City was a bit popular because we were the only city which underwent the most strict quarantine classification by that time and then that was around a year ago so kung sa naman kami this year this year we are still at a high risk with an average daily attack rate of 10.9% two-week growth rate of 26.19% so DOH Region 10 classified our city as a high risk area so this is where it gets bloody around September 14 around mga three days ago we hit our first 1,000 mark for the total active cases and then most of them are in isolation facilities but many a good number are admitted and in here I'm very sad to say that Illigan City has I think Illigan City has the highest death rate of around 7.36% and it is way higher compared to the regional death rate compared to the national and the global death rate so we're really doing we're really in a mess here in Illigan City and look at our bed occupancy as of yesterday we have a 94.11% occupancy in our COVID beds and if you would like to look at the highlighted red figures you can see here that our hospitals are catering more than the bed capacities that they have allocated so maybe you're asking also doc where are the other patients you said 100 plus lang yung admitted say niyo so where are the others no actually I don't know kung saan yung iba but what I know is some are in Amai Pagpag Medical Center Amai Pagpag Medical Center is located in Marawi City in Lannado Sur and it is a DOH retained hospital what's good will Amai Pagpag Medical Center is that they have a training program for IM and the other specialties they are they are more equipped and they have more bed capacities I think they can cater to around 200 200 COVID confirmed cases so last September 7 Illigan City was residents from Illigan City was able to occupy 39 percent of the COVID beds in Amai Pagpag Medical Center I think shortly there after their medical chief posted a memo wherein they want to close their doors to Nan Marawi Nan Lannado Sur residents because they want to cater to their own and I really understand so also Marawi City is around 40 40 minutes away from Illigan City so many of the patients would prefer to be admitted there because they know they have better care they have more medicines, more treatments and they have seen in social media posts how good the patients were taken care of so going back to our beloved city in Illigan at GTLMH is this is the New York huge Memorial Hospital this is our local local government hospital here in Illigan City last September 14 we had total of 45 confirmed cases and with those admitted cases only one was fully vaccinated and three were partially vaccinated and majority were unvaccinated and we must take note also know that of the patients who were in severe or critical COVID-19 those were the partially and the unvaccinated and September 14 was a very sad day for us because we had seven mortalities in 24 hours so we looked at them we looked at their vaccination status and all of the seven mortalities were really unvaccinated and we looked at their status they were in the A3 A4 A2 A3 priorities of the COVID-19 vaccination so it's very sad that they were not able to get their jobs and during that time also we ran out of tanks as in literally ran out of tanks zero so those patients who were under high flow were removed from the machine and they were unhooked and they were placed in regular O2 from 15 liters lang ang mga NRMs natin and then two were also mechanically ventilated by that time and then sadly no they really succumbed to the effects of hypox to show I'm showing you here the how how under equipped illegal city is no remember that we have around 370,000 residents here in illegal city but we only have functional mechanical ventilators and we have only 12 functional high flow so how can we cater to a lot of these people now with just this scarcity of equipments and in illegal city sadly we have a lot of home debts because some of them were not catered in hospitals some of them refused to go to hospitals because of the fear of to be labeled as COVID-19 and then just prefer to die at home so going back to our death rate or 7.36% now that's very high and I think what really contributed to this high death rate is the under testing in our locality also the global death rate is just 2% so we really need to step up our testing here in our in our city so this is our testing center this is our molecular laboratory located in GTLMH the setup was started last December 2020 but unfortunately up to this day nine months later it is still not operational does not have an LTO so I cannot comment further on what really happened but this is really sad because it's there and we just need to comply the necessary requirements so siguro if this is up and running maybe we can step up our testing and then we can we can test early so that we can treat early so that the outcome would be better for these patients then I really agree with Dr. Brandon on their statements where testing is really vital here testing capacity so I ask the the institution here in charge of the testing capacity and I ask them regarding the positivity rate I ask them on the number of samples stated and this is what they gave me now they gave me nothing they gave me a blank blank so I cannot say anything on the testing capacity because this is really reflective of how poor our testing is here in our city so let's go to one of the also sad aspects here in our city is the low vaccination coverage if you if you would look at this data this was last around August 31 region 10 had 14.12% of vaccination coverage and then leading ang kagayan dioro but nang mungulalat po ang ilegansity at around 11.78% lang so I ask again the institution that is in charge with the vaccination here in our locality and this is what they gave me as of September 13 if you'd look at the right side of the figure parang medyo okay naman A100% coverage sa A2 nasa 52% tayo and then sa A3 nasa 75% so I think we're doing great but no we're not doing great because the denominator here is the master listed so for example our A2 our senior citizens we have 40,000 senior citizens here in ilegansity and only 25% roughly above half are master listed and with only 52% coverage so I'm saying here na baka we're only testing around 1 fourth of our sorry we are only vaccinating 1 fourth of our senior citizens here and that's very unfortunate and scary because we know senior citizens naman who are really vulnerable to develop the severe disease and who are really likely to die no so by this time around September 13 our vaccination coverage again nang mababa pa din around 12.70% na so pero ito naman I have some good news naman I was able to get some data from three institutions here from three private hospitals and sadly medyo mababa yung vaccination coverage nung sa and then maraming nag-refuse nung sa kabila na and then dito po tinan natin yung mga breakthrough infections among those who were fully vaccinated and medyo alarming for AMCI around 24.7% had breakthrough infection and some naman dalawa develop severe disease na but luckily these two patients these two healthcare workers were very responsive to our treatment nobody underwent chemo-perfusion yung isa received tosilizumam nag-high flow and then nag-improve naman the following days yung isa naman is a doctor who develop severe disease severe disease niya was very responsive to tosilizumab after the first dose nag-ok na siya so luckily for illegal CT nobody died no among the vaccinated healthcare workers so in summary illegal CT needs more COVID beds we need more manpower siguro we need a Brian Lim here we need a doctor magpantay a lot of them we need them here we need lifesaving treatments and illegal CT needs its own testing center again testing is very important in our COVID-19 response no so when we test early we would again we would treat them early and then we will have a better outcome for them and then illegal CT needs to step up on the vaccination rollout no and then no this is the good side in my top that vaccines really save the lives of our healthcare workers here in illegal CT so that's all thank you very much okay thank you very much another very good presentation from doctor kits kitos who is an infectious disease specialist in illegal CT and really highlighting oh so many issues problems with testing vaccination low coverage no thank you kits for a very candid presentation because I think and I like the point where you're talking about the denominators that it looks like there's high vaccination because it's the master list that's not the good that's not the way that that's not the way that you compute that's not the denominator that you use for for these things so I think it's very important that you brought out some of these some of these very very challenging issues really very happy to have you here on the webinar and I know you collected information from different sources but thank you so much for that great presentation okay over to you Raymond one more we have one more speaker yes one more speaker thank you doctor kits especially for that infographic on illegal CT very very important just to compare it how illegal CT performs in the situation with regards to the other kapit bahay po nyang mga provincia okay for our I believe our last but not the least speaker po for today alam nyo na po kung sino yung sasagot ng isasamang katanuhan sa ating zoom poll kanina po yun din yung question sa ating mentimeter she will now be talking about the situation in sulu province please welcome to the webinar Dr. Farra Tanomar Dr. Farra you're on mute mam okay there we go okay good afternoon everyone thank you for this opportunity to share and learn from all the speakers so this is sulu an archipelago of more than 100 islands it is one of the provinces in the Bangsa Moro autonomous region in mostly Mindanao or the barn is located in southwestern Mindanao sulu is home to almost a million tauso predominantly Muslims it is a second class province with 410 barang guys in 19 municipalities it is mainly agricultural poverty index is high at 75% there are 10 hospitals majority are classified as infirmary and some of level 1 total bed capacity is 425 note that there are no private hospitals as of yesterday September 16 there are 695 confirmed cases of which 21 are active we had 24 deaths this is the number of cases per month note the increase in October of last year where most of the patients were health workers from the sulu sanitarium there were spikes also in May and June of this year 17 of the 19 municipalities have been affected with the highest number in the capital town of holo followed by the adjacent municipalities RTPCR testing is processed in Zambonga city medical center or at a private hospital we swab suspects admitted for seeing of the OPD and send a specimen by commercial specimens processed at the DCMZ are free of charge but it takes 2-3 days before results are released testing in the private hospital cost 3,500 pesos and we get the results after 24 hours in April of this year the Philippine Red Cross holo chapter started collecting specimens both saliva and swab they are sent to PRD Zambonga city where results are released after 2-3 days cost of saliva test is 2,000 pesos and 3,500 pesos for the swab test they have collected a total of 11,444 specimens over a period of 5 months a negative RTPCR test is required for entry to Zambonga city we pass Zambonga if we go to Manila, Cebu, Potabato and elsewhere this stringent policy of Zambonga city has actually controlled the country of possible spreaders to the province of Zulu this is the provincial isolation facility with 96 bed capacity from the Bayanihan Fund of the national government operation started in April 28 of this year prior to this construction schools were used as big task COVID centers this is the newly built RTPCR laboratory funded by the Ministry of Health Groundwork for application for LTO is ongoing we started vaccination in March of this year we have received a total of 159,170 doses of vaccines Sinovac, AstraZeneca, Janssen and Sinofarm we have fully vaccinated all the health workers 15% of the senior citizens and a significant number of adults with comorbidities 55% of the vaccine supply have been given and 12% of the total population are fully vaccinated this is where we store our vaccines here are some pictures of the vaccination activities many areas are hard to reach this is a Bajau senior citizen who received a course we are not devoted to the LGU as we are directly under the supervision of the Ministry of Health environment yet the LGUs from the provincial, municipal and Panangay levels have been very supportive they provided the venue usually a gym including the tables, chairs turbulence, alcohol food and water for the health workers and volunteers and security there have been 28 breakthrough infections recorded majority are asymptomatic nobody required hospitalizations now the challenges early interpandemic we did not even have test kits nor access to testing we did not know how to properly collect and transport specimens all of us doctors were cramming to update ourselves since the provincial hospital is only a level 1 facility there is no provision for an ICU COVID-19 is highly infectious that we cannot refer to higher centers in Zambuang city as the LGU would not allow entry we manage patients in our own areas including in municipal and district hospitals initially we did not have coveralls we only had face masks and gloves because of the lockdown we cannot buy when finally we were able to access masks it cost 1,700 pesos per piece oxygen tanks also come from Zambuang city even if cargo boats were allowed travel was limited to 2-3 times a week instead of daily then there is this refusal of relatives to bury suspects without the Muslim rights of washing and shrouding the COVID-19 care significantly reduced hospitalizations in rural health units so immunization rates and antenatal care decline there was full follow-up of patients with chronic illnesses including tuberculosis hospital admissions decreased even graveyard workers refused to bury suspects field health workers were overwhelmed with monitoring of PUI later on of close contact on home quarantine and contact tracing the contact tracers hired by MI-LG for 6 months were not really of help this time of the vaccination misinformation has cost refusal people do not show up for those too they have also become too safe for the single dose vaccines sending of a specimen to Zambuang city have been tiring how did we face the challenges the Sulu interagency task force was cohesive with the strong leadership and full support of the governor he requested DOH-9 resu staff to train our personnel on swabbing and handling of specimens they were flown in by the ASP in a special flight that was actually our recommendation and local officials listened to us law enforcers helped in various ways they mined the checkpoints apprehended violators even helped in burial of suspects they also joined the monitoring team to check compliance to quarantine the IATF in the municipal levels are responsive the LGUs facilitated distribution of Ayuda including food assistance or frontliners when we could not access suppliers the governor purchased a plain load of PPE and supplies they were transported from Manila to Holo by the Philippine Air Force we updated ourselves through social media the ulama and other Muslim religious leaders helped in information campaign as they command a following in the community this included teachings of Islam regarding burial without the rights the provincial health office district and municipal hospitals and RHS on protocols which were changing from time to time finally despite the fear of exposure RHS staff did door to door service delivery like immunization of children and senior citizens antenatal care and even insertions of sub-dermal implants some pictures this is one of the many meetings at ISOLU interagency task force this is Ayuda distribution in a municipality sako yung mga bigas kilo kilo and then it's a very great for recipient all frontliners not just health workers were given one sack of rice each two times during the lockdown these are the PPE and medical supplies from the provincial government this is bringing services to the homes amid the pandemic senior citizens given PPE with 23 we had to catch up with immunization we opened here of opportunities and universities like the online selling of pastries and food plants, home decor and other businesses the pandemic was also an opportunity for the province to showcase its natural resources like the pristine beaches to reduce boredom and stress from travel restrictions the people started to explore SELU which became a lot more peaceful that locals would even stay overnight in beaches without fear of being abducted poverty rate may be high by standard measures but I think people here are more comfortable compared to those in cities like Metro Manila because food is cheap, delicious and of very high quality this rock formation in another beach has also become a favorite during this time of the pandemic thank you for your kind attention alam mo alay humi okay thank you very much another very very good presentation from Dr. Faratan Omar the chief of the integrated provincial hospital of SELU under the Ministry of Health of the Bank Samoro Autonomous Region of Muslim Indanao so for those who are not aware they are not under the Department of Health they have their own Ministry of Health and as you can see they have had to do their own innovations nagsikap talaga sila and you can also see the issues in relation to not having testing facility ngayon palang naitatayon testing facility nila and of course they're doing vaccinations but really Farra thank you for joining us for putting all those photographs together and giving us a picture of what is happening out there in SELU which is such a beautiful beautiful place and I'm glad you are you're there alright so we are going to call all our panelists back so we're going to ask Chanse Fidel to join us Rio Brian and Farra and Kits to join us in the panel but before we talk before we have our panel discussion we have our public service announcement from TVUP TVUP Overview oh ako mukang malalib niyang iniesin mo ka mula ka magpasuk ngayon malap ko may disinfection kasi sa grocery agan ba wala rin kayong pasukahabong matinong isang aga sana makabalik na ako sa terbaho oh siya siya din na muna kitayin store buen at mukang malalib iniesin mo look magpabakuna na kaya tayo ah wala ang problema ang malahan mo lang ako wala dahil mal ko kayo magpapabakuna ako magpapalik magpapapakuna ko muna magpapalik mo sa papaapulHAN magpapalik inisin mo sa saloon kung s Halo isang Doctor Rafara mga ako siya makapamit? ang s Lu proses ang 1 million 129k 1 million letter C which is well at least for Zoompon 30% of our respondents selected letter C and then for Dr. Brian, Brian what's the population of Sibu City which is our second question? Honestly hindi ko alam na, di ba? It says here almost 1 million but that's 2015 data po eh. So yeah, I think it's about a million for Sibu City. So I think really we wanted to have these little fun questions because you see these two places are almost the same size. But you can see the difference in what should I say in capacity and support that's been given despite a similar population base. So these are some of the things we have to address over the long haul kasi hindi talaga para may disparity. How do we say that in Filipino? Hindi pantay-pantay ang kakayahan ng mga provincia natin. Kaya importante talaga na mayroon tayong plan na lahat ng provincia ay umangat, hindi po po hindi lang ang mga malalaking shouldad lang. Anyway Raymond, do we have any question from our audience that we want to take up? Unfortunately we're almost at the top of the hour so yeah, you can take one question. Most of our questions po kasi have already been answered by, ano ano. I'm trying to figure what's still one, there's one more open and I think maybe Dr. Kitz wants to answer this one. This comes from one of our avid followers. Simula pa lang po Dr. Joseph Tertona and his question reads, Cool the reason behind the rising cases in the provinces be due to people traveling back to the provinces trying to escape the rising cases in NCR and what was the role of smuggling quote-unquote people trying to return to the provinces in one way or another by delivery trucks or et cetera. Maybe Dr. Kitz has an answer. Asiguro sa first part of the pandemic, we really had that problem. Many of the residents, our returning residents from Manila or from NCR, they were traveling by land. Our returning here in our city and we had a lot of cases because of that exposure. Asiguro sa first few months of the pandemic, siguro ganun. But now, I think the rise of cases would be attributed to the, sa local na po. Sa local, we again know Iligasity is a gateway to northern Mindanao. So marami po naka-travel. Merong mga OFWs, may mga from Zon, Visayas and even from Mindanao itself. Being a gateway actually would really be the culprit of the rise of cases here. Aside from that siguro, poor public awareness is adin because a lot are still non-believers here. That's why we have a very low vaccination coverage. So regarding sa smuggling naman, I don't think it happens here ang sa mga smuggling. So again, I would attribute the increase of cases here in Iligasity due to ito locally acquired na po. Okay, thank you Dr. Gitz. Is that a fairly similar situation ba? I think border control is always very tricky in an archipelago. So that's why here in Sibu, we always say that we need to find, we need to assume that it's already happening na may mga nakakalusot talaga. So I think the cornerstone really is community response. So kung maayos yung contact tracing, yung testing, yung isolation, may nakakalusot, pwede po natin mahule. But again, for our provinces who are listening, please take the Delta variant very seriously. I think learning namin sa Sibu akala namin, okay na sa Second Surge, napakaloon na mortality, akala namin okay na. But when the Delta variant came, it really tested the systems that were in place. So we continue to learn. So please do not take this lightly, consider this as a warning. Iba klasi ang Delta variant. Thank you, Brian. We'd like to go on and have more discussion, but it's the top of the hour. So we're going to give all our speakers a couple of seconds to compose your last few words, a very, very short message. You have nurses, doctors, health workers, hospital workers from all over the country who are watching you right now. And what's your parting message to them? But before that, we have an evaluation. So Raymond, let's put our evaluation up. Okay, thank you so much. So we'll give a reprieve po, just take a break para sa ating mga panelist to let's say just compose their final messages to our audience as we read po our assessment poll. Again, wala put tayong nerelease na evaluation link. This is the assessment for each of the webinars that we have been putting out. So we encourage our more than 1,300 or around their about 1,300 attendees sa zoom to participate in this evaluation. The questions to read, number one, the panelist demonstrated thorough knowledge of the topic. It's a like-word scale po, no? Strongly agree, agree, disagree, strongly disagree. So please just select your input and answers po, no? Number two, the panelist were well-prepared and organized. Number three, the panelist spoke clearly and audibly. Number four, the panelist is used appropriate language with technical medical jargos adequately explained. And number five, the panelist contributed to new perspectives and knowledge on managing virus KCOVID-19 health issues. We will not be closing ang ating evaluation poll. We hope that ang ating mga attendees who are still in the zoom will be able to input their answers as we go back to our panelists. Okay, let's go to our panelists now and let's have our parting words from Dr. Farah of Zoom. Farah, go ahead. Okay, first of all, I really am very grateful for this invitation. It was highly informative. Saminga, pareh lang kami lang population almost ng sebu pero ang parang opposite sides of the spectrum. Tapos, listening to Dr. Lim, to Dr. Sini earlier. Liyo. To talk to speakers, it was very informative. Pwede yung sunabinit, Chancellor, parang dami mong matututunan. So, maraming salamat. This is one way of really keeping in touch, even upgrading ourselves in terms of knowledge and information. Magandang platform, especially for us, very far from manila na buti nalang daragang kahit nagpandemiya, meron na rin social media. Ngayon kung merong tinurong lesson dito ang pandemic na ito yung resilience nang hindi lang ng health workers, ng mga tao, kung anong nga eisip para to cope yung nga sa aming earlier na sinabi ko yung mga na hindi yung pinupuntaan dati. Walang pumupunta. Hindi pinagkakitaan. Privately owned, at yung mga owners and private individuals. Pero ngayon kasi hindi na kakalabas, hindi na kapunta ng sambuangam. Mahirap umunta ng sambuangam mga tao. Within solo, enjoy na enjoy na kami. Parang must peaceful pangangayon. So, God has really, hindi natin talaga ma-question yung plan ng God. Ano lang? Sabayan lang natin yung anong anong. So, maraming salamat to TBU, please. Thank you so much. Thank you very much. That's Dr. Sarat and Omar for those words of wisdom. Let's go to kids. Kids kitos in Illigan City. Kids. Thank you very much, Dingoano, for giving me this opportunity to siguro to air out the frustrations of health care workers, frustrations of those who are in the province na yung masyadong fortunate to have the luxury of testing centers or the luxury of having great minds like Dr. Brian Lehm, Dr. Magpantay, Dr. Omar. I really hope that we have those sets of minds here sa amin. It may appear that I'm just ranting, but again, this is just me airing some frustrations and siguro pandemic patay. Siguro serve, right? Paran ganan yung anong serve, right? But no, these two shall pass. So, we're never stopping sa pagpray namin. This will end. And so that we can see each other face to face. No, not in Zoom meetings na. Hopefully. So again, thank you very much. God bless everyone. At least stay safe. Thank you very much. Thank you very much, kids. Illigan city is very fortunate to have you there. So, just hang on. Hang in there. I know it's difficult, but thank you so much. Let's go to Brian. Brian from Sibu. Thank you so much. I mean, I took up infectious diseases because I thought it's going to be benign. When I saw that, dati kasi pinili ko yun niyan. Subspect sa I am. Ano ba yung pinakakawanting paciente? Infectious disease tayo. Chill lang to chill. My quality of life. So, nagsisi na kami. Ni kids, noon. And the infectious disease. But apparently, God plays us where we are for our reason. And in this pandemic, as a country, I see it as the growing pains of universal healthcare. I think I see this as an opportunity to rebuild and radically transform our healthcare system. I think never in our history is our society more aware and most aware of the importance of the health system than it is now. And I think I'm looking forward that we as a social in our society will be able to realize this. And I've learned some five lessons. First is we are all interdependent. Walang kanya-kanya. Walang nabubuhay ng mag-isa. And medicine is really truly more of a social science than it is a clinical medicine. Health is really beyond the DOH. We di dapat inaasa lahat sa DOH. Kawawa ang DOH ko, lahat na problema may be begin natin doon. So many, so many solutions can be done when we link up different sectors. And that's what I have seen first hand. And humility is key. Kilang beses na nipo ako pinagalita ang sinigawan pero lunukla ng lunok, nopasipo, even if our recommendations may not be accepted at a particular time, hindi tayo dapat nagagalin ako, kung sila ng push to tulong pa niyan kasi I always see that there is always an opportunity to serve. Even with people that we disagree with. Communication, I think community response and I would like to borrow Dr. Cordero that we need to really deviate from the hospital centric. I am from, I'm a hospital person, I'm a clinician but I have seen if you focus on the community level if you if you pour money to the barangay captains, you support the contact tracers, you make even the chismosas in the barangay gamitin mo at them on board for me that's a more lasting solution than focusing so much on hospital care. And I think long term we should start planning for long term resiliency and I encourage all the listeners please form them now. Hindi po excuse na ngayon we are struggling with Delta na hindi na natin ini-isip kung ano yung long term resiliency plan ng ating mga provinciak. So toto lang tayo tayo lang din ang magbudulungay. Salamat po. Thank you very much Brian Lim thank you so much for those inspiring words. Doctor Ryo magpantay Ryo. Pasensya na po talagang dapat peitingin ang Wi-Fi connection dito sa ame. Gusto kong gamitin Doctora Susi yung PD-ITR pero tagalong po yung ilalagay kung makahulu gamitong prevent the tech isolate treat and reintegrate for p dapat peitingin ang disciplina at itaguyod ang tama at responsable ang aksyon laban sa pandemia. Sino ang dapat peitingin ang disciplina mula sa baba hanggang sa taas. Everyone knows hindi naman na po ng tao ay discipline to do what is right. Everyone knows alam natin kung ang dapat natin peitingin pa tungkol sa disciplina mula po sa mga mamaya na na sa loob ng kanilang gaway hanggang sa mga natataguyod ang ating mga local government units ang ating local chief executives ang mga politico ang mga namumuno hindi lang sa agawaran ng kalusugan kung di sa lahat po ng mga ahensya dapat sama-sama ko tayong may disciplina. Itaguyod ang tama at responsable ang aksyon. Ano ba yung tama? Ano ba yung responsable? Marami ko tayong experton. Marami ko tayong mga linya ng mga magagalrin na talaga po nang binibigay ang sarili nila para maitama po ang mali at para maging responsable po tayong na. Kung lahat po yung ayintindihin lahat ang mga nakakahintindi at lahat ang hindi nakakahintindi then we'll have a better nation. Hindi ho mag-end ang pandemya bukas hindi rin po sa makalua hindi po natin alam kung kela at kung hindi po tayo piktilos bilang isa bilang isang wala humang nyayari sa ating lahat ng mga action. Marami po sa alamat sa opportunity at ako po yung natutuwa at nakasama kung lahat po kayo mga speakers natin kahit po sa virtual, sana ay lahirin tayong magmimbit at eventually soon when this ends pero hindi po soon ito ay I'm sure ang that tayo rin po ay makikita buhay, masaya isa pang magandang hapon sa ating pang lahat. Thank you very much Rio for those heartfelt words. Let's go to Chancellor Fidel Nemenso. Chansey? Sir, you're on mute. Ayano kay, sir. Go ahead, sir. Lama sabi kundi saludo ako sa inyo docks para kids riot riyo na. What steep learning curves we've gone through and I really admire the work you've been doing in your communities. Malaki ang pasasalamat ng Bumbayan sa mga front line ang kagayon yung sa audience kagayap mo marami din kayong natutunan at sana iba haginin nyo ang bagong koalaman sa iba. Manami salamat Doc Suzy and Doc Raymond nga hapon sa lahat. Thank you very much. That's UPD Laman Chancellor Dr. Fidel Demento. Okay. So our closing remarks will be done by our very inspiring Chancellor of UP Manila who is able to bring together all these details into a rapid a rapid conclusion. So may I call on Chancellor of UP Manila Menchit Carmencita Padilla. Menchit, please take the phone. Thank you, Doc Suzy. Our webinar today was opened by Dr. Fidel Nemento, Chancellor of UP Laman. And he started a session with reminding us that there are reasons to be thankful and we are given the opportunity to share experiences as we document our struggles and use these as grounds for sharpening our lessons. In UP Laman they demonstrated UP resilience though not a health campus they participated actively in the COVID pandemic. Early on he set up the multi-dimensional COVID task force to respond to the needs of his faculty, students and staff as well as the residents within Bileman. Here are the realizations of Chancellor Fidel. One, we need a community-based response very similar to what our doctors shared with us. Number two, there is a need to capacitate the university on pandemic response. And three, with a hundred buildings, there is a need to set up monitoring teams using measures that are compliant with DOH and IAPF. UP Laman did its share. They have set up quarantine facilities at Palma Hall, Kanya and Malava. They have a vaccination site and they also appreciated the value of collaboration with LGUs, NGOs and individual volunteers. So the university can have a very active role in the whole picture and I think you know UP Laman has been able to demonstrate that. And you know he ends by saying that there is, it's not just a COVID, it's not just a COVID pandemic. We have the pandemic of misinformation and he said that you know, agham ay makakatulong. Now all our panelists had the very interesting sharing and I will not be able to capture all of them and I encourage you to actually watch the replay and what I will do today is maybe group them for the first two speakers, Dr. Vio and Dr. Brian, alumics just to share the innovations that I have put in. I mean all of them gave the statistics, the scenario, the challenges in their own provinces or cities. But in the interest of time, alumics just to concentrate on these points. In Kageyan, they had the flying vaccination teams less bakuna on wheels, complimenting the PRC bakuna bus, they had the rest bakuna jindo, the TikTok challenge and rest bakuna pantry. They had one line command center and several hashtags. Hashtag Ognayan, Hashtag Unawa, Hashtag Nitsa and Hashtag Networking. At the end of the day, Dr. Vio said that we have to get up together and we have to recover as one. In Cebu, Dr. Brian gave the hard lessons in Cebu and allow me just to concentrate now on the innovations. He starts up by saying that there's a need for synergy, clarity and collaboration of the private sector, the LGUs and the national agencies. There are times you don't need a doctor. You need somebody down there in the community to put us all together. But some of the interesting innovations in Cebu will be the Emergency Operations Center Manual, a step-by-step book on how to set up the emergency protocols, the unified protocols, algorithms and so on. Number two is the Bayanian Cebu, a modified isolation facility with a two-edge system, guaranteeing admission to a tertiary hospital when needed. And of course, we then ayuda if you're part of the system. Number three is Balikbuhay. The Chamber of Commerce, the panghakot by industry, by registration, we're able to form a certain form of herd community in a particular industry. I like this, PBB, Selbabida Program and additional 15,000 to the healthcare workers, showing solidarity to the private sector. And the last one is Teligabay. Now, our last two speakers, Dr. Kitas and Dr. Fala, gave us a situation in Mindanao and I'm sure that all of us appreciate their struggle being very far from the metro cities. We heard their frustrations, lack of testing, resources, demand power, the overtired nurses and doctors in the hospitals and in the RHUs, the lack of ventilators, the very need for testing, the need for more COVID beds, so many life-saving equipment that must be available even in the farthest island of the Philippines. But we thank them. We thank them for staying in their provinces because we need people like you to stay put in your own places so that we can continue to serve the rest of the Filipino people. With the four presentations, we appreciated the vast differences across the country despite the same population. In terms of level of testing, level of vaccination, availability of resources from beds to ventilators. But one thing is also clear in all of our presentations, we appreciated the value of collaboration among the various sectors, both private and public. So, indeed, it is a whole-of-society and a whole-of-government approach that will help us combat at the COVID-19 pandemic. But as Dr. Riyo Magpantay said, we never lose hope. Magantang happen po sa inyong lahat and back to you, Dr. C. Thank you very much. That's UP Manila. UP Manila Chancellor Menchit Hadilya. I think, am I on? Yes, you are, Dr. Susi. Okay, okay. So, that's our Chancellor Menchit Hadilya. Thank you so much for that Menchit. Putting together all of those different pieces into a singular message. Maraming salamat. Okay, next week, very exciting topic. Don't miss it next Friday. We will talk about booster shots. Ano ba yung booster? So, we're going to talk about that. Don't miss it. Invite people to join us. We're going to bring you some experts who will talk about what we know at this point in times. There's still a lot that we don't know about what we call booster shots. But we will try to understand that. So, I also mentioned earlier if you have watch parties, please put up your photos on Facebook and we will show them on the webinar. Okay, over to you, Raymond. Thank you for that excellent round up and closing remarks, Dr. Hadilya, our Chancellor. And we are also seeing on the screen the results of the assessment poll. Obviously, very, very consistent with what our previous webinars have had, although slightly higher, just because at least 92% of the respondents. Wala po tayong strongly disagree or disagree this time, Dr. Susie. So, that's a good sign. Maraming, maraming salamat po. Sa lahat po ng respondents, 944. Wow. So, I think that would be representative at least po of those who were in the Zoom webinar kasi 82% po ang nag-participate for our Zoom poll. Before we conclude our program, let us first acknowledge the very hardworking team po without each and every one of you. This learning series and our credible online community will not be created and will not be passed. Finally, all of the 69 episodes of the SOP COVID-19 webinar series, including this episode, right after this one, will be archived in the YouTube channel of TVUP. So, yan po, may kita niyo po lahat ng ating webinars po. Nanandon lang po sila sa YouTube channel so you'd be able to play them again and learn from each and every webinar again. So, as mentioned, makita kita po tayo ulit next week. Same time, from 12 noon to 2 pm, every Friday, we hope that our credible online community continues to grow and we look forward to your company again next Friday. It's a date. Together, we can stop COVID-19. So, keep safe, keep healthy and see you online. The enemy remains unseen. I'll keep you hand in mind. Let's say a prayer one more time. I know you long for home but I am here, you're not alone. I'll stay with you until the coast is clear. The other's pain before my fears. The other's lives before my tears but right behind the mask. I look into myself and ask do I have strength to carry on oh God, oh Lord, when things go wrong and need you here to keep me strong I'm here to hold the line I'll keep my human until my... Just hold on to the word he gave this time we'll come to pass because this salvation makes a last you'll carry you to see the break of day. The other's pain before my fears. The other's lives before my tears but right behind the mask I look into myself and ask do I have strength to carry on oh God, oh Lord, when things go wrong and need you here to keep me strong I'm here to hold the line I'll keep my word until my head's dying the other's lives before my tears but right behind the mask I look into myself and ask do I have strength to carry on oh God, oh Lord, when things go wrong and need you here to keep me strong I'll keep my word you see other's pain before my tears pushing on the spite of tears when things go wrong