OVERVIEW OF THE NATIONAL ACTION PLAN (NAP) AGAINST COVID-19
The National Action Plan (NAP) Against COVID-19 provides the national strategy which prescribes guidelines on how to contain and prevent the spread and ultimately eliminate the threat of the Coronavirus Disease 19 (COVID-19). Its ultimate goal is to safeguard the Filipino People and mitigate the social, economic, and security impact brought about by the pandemic.
NAP outlines the national strategy and broad guidelines to contain and prevent the spread and eliminate the threat of COVID-19. Further, this NAP articulates the strategic objectives, illustrates the strategic actions, and presents the imperatives of the government to address and manage the COVID-19 pandemic crisis in the country.
It also shows how coordinated responses are forged among the established government mechanisms against COVID-19 stemming from the policy guidelines issued by the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) and as executed by the National Task Force against COVID-19 and its Regional and Local Task Forces.
The NAP includes several phases: Phase I ran from March to June 2020, primarily focused on Preventing, Containing, and Eliminating COVID-19 while mitigating the social, economic, and security impacts. Phase II, which ran from July to September 2020, brought further refinement to the strategies adopted to improve the health situation by keeping the number of COVID-19 related fatalities low while also enacting measures to foster the Economic Recovery of the country. Phase III, which ran from October to December 2020, focused on sustaining the economic and health security gains since the start of the NAP’s implementation.
PHASE I OF THE NATIONAL ACTION PLAN
Phase I of the NAP ran from March to June 2020, and it focused on the following strategic objectives:
1.Provide clear, accurate, and timely information to support operations against COVID-19
2. Contain and mitigate the spread of COVID-19
3. Sustain the conduct of operations against COVID-19
4. Mitigate the consequences and impact of COVID-19
In the implementation of this Phase I of the NAP, the government adopted a simplified strategic design where all COVID-19 efforts are aligned. The strategic design of the response to this national emergency situation looked into the condition in the Philippines in terms of the following: trajectory and risk-level of the spread of the virus; readiness of the country’s public health system; the social, economic, security impact; and the capacity of the government to deliver essential services during the public health emergency.
As illustrated in the diagram below, by knowing the condition, appropriate lines of effort were implemented. These include pre-emptive responses such as community quarantines; enhanced monitoring and response interventions; responsive sustainment and crisis communication; mitigation efforts that alleviated the impact on the people and the economy — all in consideration of the resumption of the normal operations of government institutions, the private sector, and other entities within a working environment that require adapting to the “new normal”.
The operational concept of the End-to-End T3 Management System is Trace-Test-Treat. The concept is subdivided into six lines of effort: prevent, detect, isolate, treat, reintegrate and adapt to the new normal. It was identified that the country’s best defense against COVID-19 is the establishment and observance of the minimum health standards of personal and community hygiene, social distancing, and personal protective gear like face masks, gloves, and face shield. Tracing and testing served as our primary offensive tactics in order to isolate and treat the spreaders.
In summary, the following are the strategic actions taken under NAP Phase I:
Strategic Action 1: Rapid establishment of national coordination response to deliver strategic, technical, and operational support through existing mechanisms and partnerships.
Strategic Action 2: Scaling up country’s preparedness and response operations, including strengthening readiness to rapidly identify, diagnose and treat cases; identification, containment, and monitoring of contacts with priority given to high‑risk settings such as healthcare facilities; infection prevention and control in healthcare settings; implementation of health measures for travelers; and awareness-raising in the population through risk communication and community engagement.
Strategic Action 3: Community quarantine to immobilize potential carriers, limit contagion to localized scale, and allow contact tracing and tracking.
Strategic Action 4: Enhanced monitoring and response interventions to have a speedy identification of suspect, probable, and confirmed cases; application of the right protocols on the environment where the suspected and confirmed carriers are located; relocation of the COVID-19 carriers to the designated isolation or quarantine facilities, and treatment of the carriers until their reintegration to their communities.
Strategic Action 5: Responsive sustainment to sustain the provision of supplies and logistics requirements to the frontliners; delivery of basic and essential services to the affected populace; and strengthen the ability to sustain the economy.
Strategic Action 6: Crisis communication to hasten the exchange of information from the decision-makers to its intended target audience by reducing the bureaucratic processes using all available platforms of communication.
Strategic Action 7: Accelerating priority research and innovation to support clear and transparent global process to set research and innovation priorities, and to fast track and scale‑up research and development, including the equitable availability of therapeutics, vaccines, and diagnostics. This is to build a common platform for standardized health processes, protocols, and tools to facilitate multi-disciplinary and collaborative research-based response.
PHASE II OF THE NATIONAL ACTION PLAN
The NAP Phase II covered the period of July until September 2020. It was anchored on the Prevent-Detect-Isolate-Treat-Reintegrate-Mainstream (PDITRM) strategy with Prevention and Containment as its main components.
The focus was on the establishment and observance of the minimum public health standards of personal and community hygiene, social distancing, and the wearing of personal protective gear like face masks and face-shields. Testing and tracing served as the primary tasks in isolating and containing the spread of the disease. The government thus increased its resources allotted to testing and tracing.
Phase II of the NAP focused on the country’s transition from the Hammer to Dance strategy. To support this transition, Phase II has the following key features:
1. Promoting change in people’s mindset with a strong focus on health and disease prevention.
2. Striking a strategic balance between health and economic objectives.
3. Mainstreaming the Prevent-Detect-Isolate-Treat-Reintegrate Strategy and Zoning Containment Strategy at the regional, provincial, and city levels
4. Sustain private and public partnership.
5. Emphasizing strict observance to health standards and protocols through risk communication and community engagements.
6. Putting a premium on business continuity and sustainability plans for both the private and public sectors.
7. Managing of the Returning Overseas Filipinos, Locally Stranded Individuals, and local travelers, and ensuring their safe return to their home provinces.
8. Conducting expanded testing and aggressive contact tracing in order to gradually allow travel, tourism, and non-disruption of work.
The framework of the NAP Phase II is still largely anchored to the original framework of Phase I of the NAP. Taking into account the lessons learned during the first few months of the COVID-19 response, it expanded several of its components.
The framework for the Phase II of the NAP continued to pursue the original five (5) strategic objectives:
1. Contain and manage emerging new cases (especially in the areas of Cebu, NCR, Region IVA, Region III, and Region IV).
2. Sustain our gains, learn from good practices, and continue increasing our capacity.
3. Rebalance the health and economic objectives (Hammer-and-Dance Theory).
4. Localize the response.
5. Keep the fatality rate low including non-COVID19 cases.
One of the changes that were added to the original framework is the expansion of the Lines of Efforts from the original five (Response, Resource Management and Logistics, Food Security, Management of the Returning Overseas Filipinos, And Strategic Communication) to six with the addition of Recovery (Economic, Social, and Governance).
The framework seek to balance our Health and Economic Welfare (Transition from Hammer to Dance) in the implementation of a people-centered, nationally supported, and locally-led Zoning and Containment Strategy that will foster Localization and promote Public-Private Partnership. Furthermore, Phase 2 continued to pursue the Public-Private End-to-End T3 (Trace-Test-Treat) Management System.
In summary, the Phase II of the NAP can be encapsulated in three broad statements:
1. Sustain the Gains – Phase II shall sustain gains by continuously building the capacity of the country’s health system, capacitating the local government units down to the lowest level to effectively and efficiently handle COVID-19 efforts through the timely provision of supplies;
2. Address the Resurgence – Phase II shall cover the conduct of expanded and targeted testing aggressive contact tracing and by accelerating the process of accreditation and improving the efficiency of testing laboratories. With capacitated health system and support from the local governments, Phase II shall be able to address resurgence with the infusion of clear, accurate, and timely data on COVID-19; effective management of Returning Overseas Filipino (ROFs) and local travelers (as the virus is transmitted with the movement of unchecked people) and the institutionalization of the Prevent-Detect-Isolate-Treat-Reintegrate (PDITR) strategy down to the lowest level with emphasis on prevention and contact tracing;
3. Recover the Economy – Phase II shall also continue the process of economic recovery by slowly reopening our public transportation systems as well as implementing even more flexible restrictions on economic activities so that businesses across the country can again profitably operate while maintaining safe health standards.See National Action Plan Phase II
PHASE III OF NATIONAL ACTION PLAN
Phase III of the NAP ran from October to December 2020, it primarily focused on sustaining the gains from the previous phases while providing an equilibrium both on health safety and economic recovery. The third phase also kick-started the development and early implementation of the Philippine National COVID-19 Vaccine Roadmap. The NAP Phase III served as the transition plan to the “new normal” from the last quarter of 2020 to the first quarter of 2021.
In consonance with the foregoing IATF policy directions, the NAP’s Phase Ill remained anchored on the Prevent-Detect-Isolate-Treat-Reintegrate (PDITR) Strategy of the Government, with prevention and containment as its main components.
In order to breathe life into and gradually open the economy, the following key areas were focused on: First, the need to further strengthen the PDITR strategy particularly the prevention and detection side. Active case finding in the communities to proactively detect possible cases even without testing is necessary to ramp up the detection capacity. Secondly, the imperative to secure sufficient quarantine and isolation facilities where the COVID cases can stay until they fully recover. The “No Home Quarantine” policy was strictly implemented. As seen in the experiences of Cebu, Navotas, and other parts of NCR, such policy has greatly reduced the active cases in the said areas. And lastly, the maintenance of continued collaboration with the private sector.
During this Phase, the Coordinated Operations to Defeat Epidemic (CODE), a patient- and community-focused response strategy with key elements incorporated from the Prevent-Detect-Isolate-Test-Treat strategy was activated. The CODE provides support to the LGUs who need it the most, especially those with an increase in cases or clusters of cases, and those that have limited resources. Inter-agency CODE Teams were organized to assess the high-risk LGUs for compliance to key policies pertaining to PDITR; provide technical assistance and recommendatory action plan for the implementing LGUs; handhold the initial implementation; and generate reports on the status of key indicators and the implementation of the action plans of the identified LGUs. Key components of CODE include (1) community engagement activities to promote preventive behaviors, (2) active case finding via house-to-house symptom checks, (3) RT-PCR testing for symptomatic patients, and (4) Oplan Kalinga application for those needing quarantine and isolation.
The OPLAN Kalinga was also launched by the national government, it is an initiative to accommodate COVID-19 patients who do not have their own room and own toilet where they can isolate themselves, or for those who have household members who are elderly, with existing diseases, and pregnant women. This is to reduce the risk of more infections in the household and communities and to identify and isolate infected individuals in proper isolation and quarantine facilities. The Regional Task Forces and the Local Task Forces were encouraged to set-up their Oplan Kalinga facility to improve the isolation efforts of the Government.
Moreover, in order to improve the treatment services and referral mechanism for the COVID-19 patients, the One Hospital Command Center (OHCC) was set up. The Center facilitates a comprehensive and coordinated response to the COVID-19 pandemic by ensuring effective and efficient health facility referral in Metro Manila. The OHCC also facilitates medical transport and patient pick-up arrangements, provides health system capacity data analytics and risk communications, and optimizes the use of critical care services of every hospital in the area.
In a nutshell, the key features of NAP-COVID-19 Phase Ill are:
1. Focus on Response and Early Recovery with the gradual reopening of the economy
2. Enhanced PDITR Strategy to be responsive to emerging realities
3. Continuous delivery of social programs while observing the minimum health standards
4. Inclusion of vulnerable groups in digital transformation to lessen the digital divide
5. Formulation and early implementation of the National COVID-19 Vaccine Roadmap
6. Strengthened Data and Information Management
7. Improved structure that will facilitate the implementation of the NAP Phase Ill
8. Intensified risk communication down to the barangay level
9. Intensified capacity and capability building of NGAs and LGUs
10. Localization of national efforts such as CODE, One Hospital Command Center, Oplan Kalinga, and Operation Listo for the management of emerging and infectious diseases
11. People-centered, LGU-led, and nationally-enabled approach
12. Strengthened multi-stakeholder partnership (public and private)
13. Strengthened Monitoring and Evaluation system
The overall goal of the NAP COVID-19 Phase Ill is to contain, prevent, and/or eliminate the threat of COVID-19, and mitigate its social, economic, environmental, and security impact. Its specific objectives are:
A. Reduce the number of cases and the rate of transmission
B. Improve the healthcare system capacity
C. Implement the National COVID-19 Immunization Roadmap
D. Provide safe and sufficient transportation to the public
E. Reduce underemployment and unemployment rates
F. Ensure business and service continuity
G. Mitigate socio-economic contraction