 Emergencies and epidemics have some commonalities with war and combat operations. During the Ebola outbreak in West Africa in 2014, we saw how military contingents of three countries fought the epidemic and was eventually quickly contained and stopped dead on its tracks. In January of 2020, the global pandemic of COVID-19 impacted the world and the Philippines. Again, we see former generals at the helm of the Interagency Task Force for Emerging Infectious Diseases take the lead in the country's fight against the epidemic. For this episode, we will tackle and discuss the incident command system and how combat operations are utilized in disaster medicine and pandemics like our current situation. This is your host, Dr. Teddy Herbosa, and welcome to Health Issues at TV UP. Our guest for this episode is a graduate of the Philippine Military Academy, NSM Marine, who I would call as the true frontliners in combat operations. However, today, our guest is assigned as the action officer of the National Incident Command Emergency Operations Center. Let's all welcome Lieutenant Clifford Basko. Clifford. Good morning, sir. Good afternoon, sir, and good afternoon to everybody, to all those listening and to all those watching during this fine afternoon. Good afternoon, Lieutenant Colonel Clifford. Let's discuss about your experiences as a Marine. Have you ever been in enhanced community quarantine-like situation like what we're trying to do this time? There have been instances, sir, where I have been in enhanced, you can call it enhanced community quarantine. The one most frequent I can think of is during combat operations that we were doing in New Province. This was the year a decade ago, 2010, and as you know, the situations on the ground during counter-terrorism or military operations is that it changes, the enemy adapts to what you're doing. We were running operations and then the enemy, the Abu Tayyaf group and the other insurgents changed their tactics to economic sabotage. So what they did was they started long-term regents all over the province of Tulumu to stop our military operations. And so effectively, it became a quarantine not only for us, but for the other citizens all over the province who couldn't bring their produce to the market. They couldn't move this also for fear of, because of the fear of all these terrorists and armed people moving around. And so it was the same maybe in a very small scale the same to what we were doing now. And then the danger was, of course, it's different armed terrorists, but the community quarantine was imposed involuntarily. It's the same as now, but back then the threat was more of armed people and terrorists. Correct. So it's very similar. Very similar and very the same. The enemy at that time is insurgents, but today it's biosecurity. It's a virus that we are fighting and the principles are the same. We quarantine for safety and protect the community so that the infection will not happen. So can you explain to me what incident command system is? Okay, so what an incident command system? This is the organization or the approach that we take if we want to do coordinated response and to respond to certain emergencies such as this pandemic. So what an incident command system or an incident command system does, it becomes the focal point for managing all these activities that we want to do. Emergency operation tempers are set up. This is the hub of the incident command system. And they are designed to facilitate critical activities for the mission in the military, critical activities for the mission, such as the command and control system. The command and control system is how you set up infrastructure and communications to be able to give instructions to those on the ground who are actually doing the fighting for you or in this case who are actually battling the virus in the hospitals, in the streets, and doing the quarantines. So the emergency operations center is staffed by other agencies in our case because it's at the national level, it's staffed by national government agencies, regional and non-government organizations. But for us it's the DILG, DSWD, DOT, name every government organization and it's probably in our emergency operation center right now. So it's the organizational framework that the whole of government uses to be able to implement a mission like for example, stop the spread or transmission of COVID-19, which is our main mission. And we use all the different agencies in government to be able to coordinate our efforts, right? Coordination to command and be able to develop. Is that correct? Yes, sir. Yes, sir. So the emergency operation center where we are right now, the national incident command becomes the central location for information gathering also. So all these government agencies collecting data bring it up to us, we analyze it, also a center for disaster analysis and this is where we coordinate our responses. So in normal times you have government agencies who work within their silos, within their own mandate. So the role, the biggest role of the emergency operations center is to bring all these government agencies together, pull all the resources and then coordinate and plan so that we will be up to one and not in an uncoordinated manner or in scattered responses to this crisis. So can you tell me what is the role of the emergency operations center? But there is usually what is called the incident commander. So in this particular case our boss is Secretary Galvestre, Secretary of National Defense, Secretary Anyo. So what is the role of the incident commanders? So sir, for this epidemic or for any incident the role of the incident commander is usually summarized into two. First, he has to be the one to collect and provide updated and real-time information and provide the strategic or the operational plan to be able to execute what our strategic leaders think of doing or have laid out the strategy for us. So first is the one who evaluates the available information, assess all incoming, all outgoing, determine if this information is accurate and act based on the best available information that's available. He also is the one who gathers the team, so he was the one responsible for hiring or gathering you and not in you to volunteer there. Thank you very much for your service. Thank you. And he's the one who makes sure the team members need to work together within that system, the incident command system. We need to work as a team because this is vital, it is vital for us for clear communications and for his decision making because ultimately our job is to make sure that he comes up with the best available decision that we can implement on the ground. And it's also his job to develop an operational plan which we have been doing sir for the past few days and right now the decision has been made at the strategic level from the IATF for the next few days and again our job is to come up with the operational plan to be able to execute it. So it's the job of our boss and so that's also one of his job and basically he's the one who also sets up what we call in the military at the bottom rhythm. It's the schedule or the operational tempo, it tells us to when to go slow or when to speed up our effort. So he's the one who... He's like the conductor of the orchestra. That right? He's like the conductor of the orchestra. He's the one who determines that these tasks are critical so we need to speed up on this and these tasks are not needed so or they are at the lowest level of importance so we make sure that we do not drift into into solutions or lose our focus on the goal. Correct. So it's the incident commander. So it's the incident commander that gives leadership, leadership to the whole mechanism of the command system. What are the theoretical components of the incident command system and then what are the ones that we're actually using our task groups that you created in the national task force? Yes sir. So theoretically for an incident command system to work of course you would have the command system which is the authority are you working on. So this is given to us by the national authority which is our president and then to the interagency task force and then to the national task force which he then delegates chief implementer as the incident commander for this pandemic. So we need to have the command, we need to have the authority to do what he does and then we need the incident command system also have sections like a planning section. Planning? Yes sir. Which is for our purpose is the operational planning group which is composed of the planning team that we have seen at the NIC and then we have an operations section which is now the one that execute. This is what we call in the military is our main effort. This is the one effort response to this pandemic. Planning? Operations? Then our structure. This is the task group on response operations. Correct. For the national task force and then for the response operation or the operations section to respond he has to be supported. It has to be supported. It has to have logistics. Logistics. And supply. Administration support. Human resources. Yes sir. Supplies. Human resources. Yes sir. So they have in order for him to do his job in the response he doesn't the ideal thing is he doesn't have to think about these things. Somebody provided for him, plans it for him, all the support that he needs that that group needs. So it's a logistics section or a resource management section or finance or administration section. So basically those are the components that you ideally have in an incident command system. So that's a very basic. So you need command. You need planning operations, logistics, finance and administrative support. So that creates the whole gamut and you can expand it. You can contract it right depending on what you need. Can you just describe how it's like here at the national incident command? Who are the agencies of government that are currently operating in the emergency operation center? Yes sir. So for our national incident command emergency operation center, of course we have our boss, the chief implementer, the secretary Galvez. We also have the deputy or the deputy and the chief of the secretary. He will take Polisima and then of course within that executive committee group of the NICE OC, our advisors who are very critical at what we are doing like you and Dr. Tony Leachon and Dr. Bueno and other advisors within the system leadership in the command. We call it the command section. Then we have four task groups. Yes. Four task groups under the NICE OT, which is a task group response operations headed by the secretary of health, Secretary Duque, with the DILG secretary. Then we have the task group on resource management and logistics headed by DFWD Secretary Bultista and the OCD as a secretariat. We have taskgroups.com now headed recently by just this morning by Secretary Duque, the presidential spokesperson and the secretariat is the PCOO under use of capacity. Then we have the task group on food security headed by the DA secretary, Secretary Dar. Within those task groups are numerous sub-task groups that also do specific things. For example, the task group on response under him are the sub-task groups on health, which deals with the health response for this crisis. Then we have the task group on peace and order, which is led by the PMT and all other uniformed services. Task group on repatriation, these are the sub-task groups that take care of the overseas Philippine workers and other overseas Filipinos returning. They also plan on the return to their home provinces of locally stranded individuals. These are the ones who have been caught up during the ESEC in Nila or in other provinces. Then we have the sub-task group on mitigation, which is led by the DSWD and these are the ones that provide the sub and other social amelioration programs. All these agencies, these are all big agencies and how do they relate to each other? As we mentioned, when we operate, we have the task group response as the main effort. Once a strategic plan has been set up or given to us by the IATF, we now create our own operational plans created by the planning group, which is under the command section. Then these are now cascaded to the different task groups to implement. These are now implemented by the different task groups through their own agency. This is the operational level or this is a step below the strategic level. But who are the specific entities that implement this? These are now the regional task forces down below, composed of the 17 regions that we have all over the country. These are being led by the OCD and all other regional directors that are in the disaster risk and reduction management system. That is already set up in place. What they do is they follow up on the local government units, the municipal or provincial social welfare offices, or the local offices of these agencies who are now the ones on the ground who are now the ones executing what we want done. So once this is done, they now report back to us back to the NIC or to their different task groups when the task groups then report to the national incident command to the command section under Secretary Galvez who then reports back to the national task force and of course to the president. So it's a very organized system and it also is insinuated into our NDRRMC framework, which is our disaster framework. So it was overlaid on that whole system. It was overlaid on that using existing government agencies, the SWD, the ILG, DOH, the Armed Forces of the Philippines, Office of Civil Defense, etc. So it's a whole of government. How different is this pandemic approach to combat operations you have experienced? Is it any different or is it the same? What are the differences? Yeah, what we have been talking about for a few minutes, sir, are the similarities to preparing for combat, but there are also differences. I think the foremost of which I can think of is the nature of the adversary because the virus, it presents a consistent threat. It presents a consistent threat. We know it's a threat, but we also have quantities to unmask it. So what I'm saying is that once we unmask it and we consistently and thoroughly do our implement our strategies, this virus can be defeated. Whereas in war or in enemies that we have, they adapt to our methods. Of course, I've been reading also that the virus also adapts, but in war whatever you do in war planning, whatever you do affects the enemy. So the enemy consistently also adapts to the operations or strategies, operational plans that you are implementing. For example, we were talking about the my ECQ in the province of Salud. So that was something we thought we were on the right side or on the right path because one of the main strategies we implemented them was one of the very good commanders that I worked with set up a strategy to support development in the province with a simple motto that where the road ends, insurgency begins. Correct. So that's the one that the motto, where the road ends, the insurgency begins. So what we did was lay out all these development projects, road projects throughout the whole island so that you can have farmers bringing all their produce to the market. So the enemy also adapted and of course we do not want development if the road now leads to the hinterlands where we have our supporters. This will make us to support sustain. Now they started bombing bridges, harassing construction workers. So we adapted to that. So those are one of the examples that they can pick up where in this pandemic is different to war operation. Well, actually it's not very different because it's the same thing when the virus infects people and they're brought to the hospital, they infect the doctors and the nurses and then we're also killed by the, we're also affected by this virus. So in a way it's actually very similar in analogy. Now what are the difficulties in terms of coordination, collaboration, because not all agencies are attuned to an incident command system. I'm in disaster medicine. We apply this for disaster but agencies like the other agencies, local government, they're very political, DSWD, it talks about social, social amelioration. How difficult it is to consolidate all of these efforts into one unified command? It is quite difficult sir. At first, of course, the first few weeks or the first few days are the most difficult and there are some issues that we need immediately to solve and we have to identify them immediately when we set up an interagency emergency operations center such as the one that we set up. So it of course you know sir that it wasn't running smoothly immediately. We had very very some bumps along the way and so some of the factors of this is first the foremost really one of the foremost obstacles is communication, transparent communication. Because first this agency, yes sir, these agencies have their own reporting system, have their own way of collecting and disseminating information and now because information, we say information is power, there is that reluctance to share it especially to other agencies that you think you might you don't need this. So that's one of the most the first obstacles we have in setting up an interagency operations center, transparent communication. Then so trust breaking other agencies, trust of the that information can be shared freely and openly to different organizations. So that's hard to begin trust. So can you describe to me your job as action officer? You're an action officer, isn't that exactly what the action officer does? He tries to gather all the information from all different areas and make sure that the command group is able to analyze and see all of this. Is that correct? Yes sir. So when we set this up, we also recognize that the chief implementer or the command section has to have information that is already how they call this collaborated or synthesized. He doesn't want curated one agency or one number. Yes sir, that's not coordinated with each task group. So there has to be somebody who has to be doing this, who has to make sure that when these task groups are doing their stuff, it's they are not working within within silos. They're not going back to working within their own mandate, but they're working to pursue or to achieve the objective of the chief implementer. So that's our job sir, to make sure that all these efforts are in sync, to make sure that the information that is being received is the one that's also that really the implementer needs for his decision making and that is already processed within all these systems, all these task groups that we have set up and it is all aligned to the mission or to the goal that the chief implementer has set out for us. So that's basically sir, my main job and and another one is also to make sure that the administrative setup within the NIC is has been set up so that of course these agencies or these representative agencies will come in and work within a system that is already set up because if the administrative, for example, the EOC is not set up in a manner that they will be successful, then you don't expect them to work as well as a team. So do you have issues and concerns other than what we have already discussed and more issues and concerns about incident command system and uniform services working side by side with civilian agencies and civilian employees? What I think the thumb might not understand sir is that as a military, in the military, we have always been working interagency. So if you go into a particular area, it's always that we realize early on during the early day of our career that if you want to be successful in doing your mission, you have to know or you have to learn to collaborate with different agencies at that level you are in. So if we are young lieutenant, it would be at the level of the municipal or provincial NGOs and NGOs or NGOs who are already in the area. So for us, it's really, I could say that we are very comfortable in doing this from the past experience that we've had. Other agencies might not. We have seen a lot of friction like that, but just to set them into them where they will be successful and then they recognize that we're not actually in your way. We're trying to help you do your job more efficiently and to coordinate with other agencies. So yes sir, that's it. So that's it and I think the key concept here is really the issue on communication. I think how do you solve the problem of making sure that all the different cogs in the wheel, all the different elements in the system are communicating with each other so that everyone will follow the playbook or the strategy or the tactics that are being deployed. What are the secrets in communications? There we have what we call the cheat sheets about to do it. One is we make a template and make them work through that template because ideally we would allocate, like in not in emergency situations, we would allocate time for different members of the task group to know each other, to get to know each other better before they work. But in this, when we came in, we had to keep the ground running because the crisis was running away from us so we could work together. So the best, one of the things that we had to do was set out a template in how to do things and that template was set out in a way that they had to coordinate and collaborate with each other and then we set up physical spaces in a way that they also need to collaborate and coordinate with each other. And of course the good thing also is it wasn't that difficult in this crisis because it's also the key also are the communicators that the agencies are sending. The one that's in charge of, for example, the whole DSWD, the whole DILG, these were like, they were sending under assistant secretaries who were really, really very good. Yeah, there were experience about the agency, how the agency operates and they had command as well. They actually had the authority to make their agency move. That's wonderful. It's been a pleasure for you to explain the incident command system to our viewers of PVUT. Any final words about how everybody should be helping the government and the whole of government fight our pandemic COVID-19? Yes, sir. So this fight is all about everybody. It's everybody's fight. It's not just a whole of government, not just asking the government what's the whole of society fight for everybody. We have laid out the minimum health standards that we need to do to be able to really, really win this fight that we are in. And everybody's cooperation is needed. Everybody's cooperation is needed and just think that if we can do this together, if we can work together, we can really defeat this invisible enemy that we are fighting right now. And also it's been a very, very good pleasure to be working with you, sir. It's not yet over. We have to get back to work after this. But it's really, really, I'm very, it's my pleasure to have met somebody with your expertise and with the knowledge that you have. And I'm actually learning every, every time that we are, we meet or we talk every time, I'm learning something new every day. Thank you very much also for giving me. Thank you very much. And I'm, I've also seen you work very hard as the action officer and taking notes in minutes of 12 hour long meetings. I'm also impressed at your dedication to your work and to your duty. And with that, I think I'd like to thank you very much for your service to our country and service to our people. Ladies and gentlemen, the fight for the pandemic is a very complex one. It is very similar to war and combat. The incident command system has been our very important tool to make sure that the goal and the mission of taking over and containing the virus is there. Thank you very much, everyone. This is Dr. Teddy Herbosa, your host for health issues at TV UP.