DISCUSSION

Dilemma of Health Care Workers

Front liners face multiple challenges. This sudden epidemic outbreak leads to an
unexpected increase in workload, rising occupational exposure to violence, and the risk of
contracting the daunting COVID-19. However, while health care workers (HCW) may as well
accept the higher risk of infection as part of their profession and ethics, they are also concerned
about the risk of transmission to their beloved families. They might suffer from comorbidities,
the state of having multiple medical conditions at the same time, that put them at a higher risk of
infection and mortality. Thus, performance may be influenced by feelings of uncertainty,
increased psychological pressure, and the risk of stigma.

As for the Philippines, the government’s action towards the safety of our crucial front
liners has not been that well-received. In all actuality, a letter addressed to the President was a
plead supported by 100 medical groups healthcare workers that enumerated the reasons why they
united to sound off a distress call to the nation.

Firstly, workplace safety is assured only in a few, mostly high-income settings, but there
is a clear failure in most settings, especially among the poor. Second, the progressive easing of
quarantine restrictions has inadvertently fueled public misperception that the pandemic situation
is improving when it is most definitely not. The progressive decline in compliance will push the
to become the next New York, where patients die at home or in stretchers, unable to find help in
hospitals. Third, since hospitals in Metro Manila are being overwhelmed by COVID-19 cases,
the workforce is again effectively reduced because of the need for intermittent quarantine of
personnel, and isolation of many who have fallen ill- and many more the report added.

“The health sector cannot hold the line for much longer. Our health care workers should
not bear the burden of deciding who lives and who dies. If the health system collapses, it is
ultimately our poor who are most compromised. In the end, winning the war against COVID-19
relies heavily on being able to keep the health system capacitated to address the needs of all
Filipinos. We hope that our government heeds this plea,” it ended.
Allocation of Limited Resources

Governments, health agencies, and hospitals may it be public or private have an

obligation to ensure an adequate provision of health care for all. However, this may not always
be possible during a pandemic, when resources are most likely to be limited. Setting priorities
and rationing supplies in this context means making important yet tragic choices, but these
choices can be ethically justified. Such decisions may include access to hospitals, medical
machines, and medicines. Therefore, we have Bioethics. This segment briefly answers several
questions about the ethics of setting priorities for the allocation of resources during times of
scarcity.

For the Philippines, Republic Act No. 11469, or the Bayanihan to Heal As One Act,
provided President Duterte with emergency powers to deal with the crisis and to properly further
strengthen the government’s response during the COVID-19 State of National Emergency.

One of the prominent provisions of the Bayanihan Act is the granting of emergency
subsidy program or Social Amelioration Package (SAP), in the amount of P5,000 to P8,000 to 18
million households whose livelihood were greatly affected by the quarantine. The program
mainly targets daily- wage earners who work under the “no-work, no-pay” conditions, have no
social security and leave benefits and accumulate little savings. This is in correlation to what the
President have said, “Considering the limited resources of the government, it might be prudent to
prioritize allocating resources in accordance with RA No. 11469 to immediately assist the
poorest.”

With that in line, health care workers (caring for patients) and first responders can
justifiably be prioritized when allocating some resources because of their contribution to the
health and well-being of the community. Undeniably a fact, their optimal health helps preserve
the health of others.

Data Protection and Data Sharing

Efficient international cooperation and data sharing are two essential key components in
the advancement of medicine and human health for effectively responding to the ever-growing
global pandemic, the COVID-19. If the COVID-19 response is to be effective, it must be
reinforced by robust science and quick access to information. Some of this data will constitute
personal data and thus, be consequently regulated by data protection rules. Using this as a
context, the challenges of data protection remain but facilitating privacy with other recognized
legal principles is also as important, when responding to a public health emergency.

Research is an integral part of an outbreak response, but despite the sense of urgency,
research during an epidemic is still subject to the same core scientific and ethical requirements
that govern all research on human subjects. Standard exceptions to consent requirements for
secondary use of health data may have stronger ethical justification for research directed at
pandemic responses.

Therefore, issues in Bioethics persist to this date and more so now as COVID- 19 shifted
how the world should act. These challenges include biobanking in public health wherein the
genetic data would be primarily used for research and not for immediate public health response.
As such, such research may identify novel at-risk groups who may be the target of discrimination
and exclusion from employment or public space. In a similar vein, existing genetic datasets,
including those from biobanks, are uneven in their coverage of different ethnic groups. This
suggests an urgent need for ethicists and policymakers to reflect on ways to properly introduce
biobanking research into public health frameworks.

In the case for fellow countrymen, the Filipinos, the Philippine National Privacy
Commission (NPC) has been regularly issuing public health emergency bulletins since February
of this year in response to data privacy issues which have arisen in relation to COVID-19 testing
and contact-tracing efforts of the Philippine government. This is a great sign for our people
towards their privacy amidst this time of struggle and hardships. The NPC has consistently
emphasized that “…while data privacy is a right, the same should still be harmonized with the
requirements of public order and safety, and to protect the life and health of the data subject or
another person.” This should not, however, hinder public health authorities from processing
personal data only if necessary, to fulfil their mandates during an emergency.  

The NPC also urged the public and the media to be responsible in sharing and publishing
information. It is important to verify with official statistics before sharing information. The
organization has also denounced persons who publicize the personal data of confirmed and
suspected COVID-19 patients, exposing them to maltreatment, online bullying, and physical
violence.

Availability of Vaccines

Vaccines are a powerful measure to protect the health of individuals and to combat
outbreaks such as the COVID-19 pandemic. An ethical dilemma arises when one effective
vaccine has been successfully developed against an epidemic disease and researchers seek to
test the efficacy of another vaccine for the same pathogen in clinical trials involving human
subjects. On one hand, there are compelling reasons why it would be unethical to trial a
novel vaccine when an effective product exists already. On the other hand, it may be justified
to conduct a trial for a candidate vaccine if it is expected to have certain advantages
compared with the existing product.

The best chance of bringing the Coronavirus pandemic to an end with the least loss of
life and the greatest return to normality seems to be the introduction of an effective vaccine.
To be effective, particularly in protecting the most vulnerable in the population, it would
need to achieve herd immunity. There are huge logistical issues around finding a vaccine,
proving it to be safe, and then producing and administering it to the world’s population. Even
if those issues are resolved, the pandemic has come at a time where there is another growing
problem in public health: vaccine hesitancy even if a safe and effective vaccine is produced,
at best, herd immunity will be significantly delayed by vaccine hesitancy at a cost to both
lives and to the resumption of normal life, and at worst, it may never be achieved.

With regards to the Philippines, Russia expressed readiness to supply the Philippines
with coronavirus disease (COVID-19) vaccines, saying that results from the trials are turning
very promising. “The Russian side is ready to closely cooperate with the Philippine partners
in this field,” Russian Ambassador to the Philippines Igor Khovaev told in an online press
briefing. According to the ambassador, proposals for the clinical trials as well as the
production of the vaccine in the Philippines have already been submitted to the Department
of Foreign Affairs (DFA) and now under consideration.
Concerns and Disputes faced by the Philippine Government

???

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