7  ALLOCATION OF SAFE ISOLATION OR QUARANTINE FACILITIES
The various levels of quarantine that continue to be enforced in different parts of the country are meant to isolate people who are infected and thereby minimize or control the spread of SARS‐CoV‐2. Obviously, isolation and quarantine should go hand in hand with testing. Otherwise one would not know who is capable of transmitting the infection and who should be isolated from whom. But testing has been scarce and inequitably distributed. The onset of testing in the country immediately showcased one source of inequity as government officials jumped the queue and had their swabs processed ahead of everybody else. Mostly asymptomatic government officials and their family members were tested even when healthcare institutions could not yet provide testing kits for many symptomatic and suspected patients.85 Concepcion, P. (2020, March 23). Gov’t Officials Crowd out Patients for COVID‐19 Testing. Inquirer.net. Retrieved May 13, 2020, from https://newsinfo.inquirer.net/1246714/govt‐officials‐crowd‐out‐patients‐for‐covid‐19‐testing
Meanwhile, a 34‐year‐old cardiology fellow died from the virus, amidst reports that his COVID‐19 test result came only after he died.86 Pasion, P. (2020, March 28). Last updated 2020, March 28. ‘Doki’ to the Barrios: Dr. Israel Bactol’s Commitment to Serve. Rappler. Retrieved April 29, 2020, from https://www.rappler.com/move‐ph/256145‐israel‐bactol‐doki‐doctor‐to‐the‐barrios
, 87 Arias, J. (2020, March 23). #NoToVIPTesting: on Politicians Abusing their Power to Get COVID‐19 Tests. Preen.ph. Retrieved April 29, 2020, from https://preen.ph/107493/vip‐testing‐politicians‐covid19‐philippines
Timely test results could significantly help in patient management, and possibly save lives. Of course, it is the rich who can more easily afford to pay for tests if they choose to. Power and wealth have been influential and if the situation is allowed to prevail we cannot hope to achieve the equitable allocation of healthcare resources that is a necessary condition for pandemic preparedness. Meanwhile, the insufficiency of testing kits is being manifested in the prevalence of online selling of kits unauthorized by the Food and Drug Administration.88 Magsino, D. (2020, March 13). FDA Warns Public Vs. Unregistered COVID‐19 Test Kits in Philippines. GMA News Online. Retrieved July 2, 2020, from https://www.gmanetwork.com/news/news/nation/729568/fda‐warns‐public‐vs‐unregistered‐covid‐19‐test‐kits‐in‐philippines/story/
Problematic and inequitable testing is worsened by problematic and inequitable isolation of the sick. This section of the paper discusses the Philippines’ quarantine problems in crowded residences and prisons.
In private residences, economically privileged people can readily provide the necessary spaces to separate their family members from one another and prevent the possible transmission of the offending virus. On the other hand, many of those who belong to the economically challenged segments do not have houses of their own. A large segment of the population has to rent living spaces in crowded locations. Those who cannot afford to pay rent end up as informal settlers in tiny spaces where isolation or self‐quarantine is impossible. Out of 106.7 million Filipinos, 16.6% live below the poverty threshold while 5.2% cannot meet the basic food needs to stay healthy.89 Mapa, C. (2019, December 6). Proportion of Poor Filipinos Was Estimated at 16.6 percent in 2018. Philippine Statistics Office. Retrieved April 27, 2020, from https://psa.gov.ph/poverty‐press‐releases/nid/144752
Among families, 12.1 percent belong to the poor, which is equivalent to around 3 million families. Around 4.5 million Filipinos are either homeless or living in informal settlements. Of this number, about 3 million are living in Metro Manila.90 Chandran, R. (2018, June 7). Slum Dwellers in the Philippines Build Homes through Community Programs. The Christian Science Monitor. Retrieved May 18, 2020, from https://www.csmonitor.com/World/Asia‐South‐Central/2018/0607/Slum‐dwellers‐in‐the‐Philippines‐build‐homes‐through‐community‐programs
Within the Metropolitan Manila area, the city of Manila has been rated as the most densely populated city in the world with 66,000 people per square kilometer, 6 times as much as New York City’s 11,000.91 United Nations Statistics Division. (2015). Demographic and Social Statistics. Demographic Yearbook 2015. Retrieved May 22, 2020, from https://unstats.un.org/unsd/demographic‐social/products/dyb/dyb_2015.cshtml
It is not difficult to see what this translates into at the community level.
In the 16,000 households in Baseco, a village in Manila, it is normal for a family of 10 to live in a 20 sqm make‐shift hut.92 Tenolete, J., & Racelis, M. (2020, March 27). Coronavirus in Baseco: a Community Leader’s Assessment. Rappler. Retrieved April 27, 2020, from https://www.rappler.com/move‐ph/ispeak/256081‐opinion‐coronavirus‐baseco‐community‐leader‐assessment
Due to hot weather, boredom, and hunger, people in the shanties wander around in their alleys not minding the threat of the virus. It is common to find “shacks no bigger than a flatbed truck [that] house large families whose members sleep side‐by‐side on wooden or cement floors.”93 Coronel, S. (2020, March 24). Philippines: Covid‐19 Will Devastate the Poor. The Interpreter. Retrieved May 17, 2020, from https://www.lowyinstitute.org/the‐interpreter/philippines‐covid‐19‐will‐devastate‐poor
Obviously, “where people are packed like bees in a hive, there is no such thing as social distancing.”94 Ibid.
For some people, finding space to live in is close to impossible, so they have to sleep on top of graves even before they die.95 Billing, L. (2020, March 21). Graveyard Living: Inside the 'Cemetery Slums' of Manila. The Guardian. Retrieved May 18, 2020, from https://www.theguardian.com/cities/2018/mar/21/cemetery‐slums‐life‐manilas‐graveyard‐settlements‐philippines
It does not matter whether we are talking about normal times or pandemic emergencies. There are serious inequities to address, and if we continue to have an unfair distribution of dwelling places in our communities, we will have ready‐made disasters for the next epidemic. We know that we need to allocate societal resources for housing fairly to avoid this. If we do not realize how inequities have aggravated our public healthcare situation in the context of the current pandemic, we will not learn our lesson ever.
In order to accommodate the rising number of persons needing isolation and quarantine facilities, the national government has coordinated with local governments and the private sector in converting hotels, sports facilities, school buildings, and churches into temporary quarantine sites.96 Esguerra, D. (2020, March 20). Gov’t to Convert Sports Facilities, Schools, Churches into COVID‐19 Quarantine Sites. Inquirer.net. Retrieved April 27, 2020, from: https://newsinfo.inquirer.net/1250807/govt‐moving‐to‐convert‐sports‐facilities‐schools‐churches‐to‐covid‐19‐quarantine‐sites
The facilities are meant to accommodate asymptomatic or mildly symptomatic patients who are either homeless or whose dwelling units do not have enough spaces to allow isolation. The temporary facilities may suffice for now, but certainly not for the near future. These facilities will be eventually returned to their original use; a more sustainable and long‐term solution must be developed.
The problem with living spaces has somehow spilled over into the country’s prisons, a second area where chronic congestion issues are being magnified by the pandemic. Separated from the rest of the population, persons deprived of liberty (PDLs) could not be physically isolated from one another. One account describes how, in a jail dormitory, “518 men crowded into a space meant for 170” so that “inmates were cupped into each other, limbs draped over a neighbour’s waist or knee, feet tucked against someone else’s head, too tightly packed to toss and turn in the sweltering heat.”97 Almendral, A. (2019, January 7). Where 518 Inmates Sleep in Space for 170, and Gangs Hold it Together. The New York Times. Retrieved May 18, 2020, from https://www.nytimes.com/2019/01/07/world/asia/philippines‐manila‐jail‐overcrowding.html
This way of living inside prisons is unsurprising given that in November 2019, there were 215,000 PDLs in facilities that could only house 40,610.98 Anonymous. (No date). Philippines World Prison Brief Data. World Prison Brief. Retrieved May 20, 2020, from https://www.prisonstudies.org/country/philippines
On April 17 of this year, The Bureau of Jail Management and Penology (BJMP) reported that the national congestion rate of the prison system was 534 percent.99 Batnag, D. (2020, April 17). Coronavirus: Philippines Scrambling to Head off Public Health Crisis in Prisons. The Straits Times. Retrieved May 20, 2020, from https://www.straitstimes.com/asia/se‐asia/coronavirus‐philippines‐scrambling‐to‐head‐off‐public‐health‐crisis‐in‐prisons
As of May 20 of this year, the Philippines had the second highest prison occupancy level in the world.100 Anonymous. (No date). Highest to Lowest ‐ Occupancy Level (Based on Official Capacity). World Prison Brief. Retrieved May 20, 2020, from https://www.prisonstudies.org/highest‐to‐lowest/occupancy‐level?field_region_taxonomy_tid=All
Given this state of the country’s penal system, how detrimental has the impact of COVID‐19 been? In April of this year, one inmate from the New Bilibid Prison (NBP) died due to the SARS‐CoV‐2 virus as confirmed by the BJMP.101 CNN Philippines Staff. (2020, April 24). New Bilibid Prison Inmate Dies of COVID‐19. CNN Philippines. Retrieved April 27, 2020, from https://www.cnnphilippines.com/news/2020/4/24/New‐Bilibid‐Prison‐inmate‐die‐COVID‐19‐.html
Furthermore, 27 PDLs from the Correctional Institute for Women (CIW) had been infected.102 CNN Philippines Staff. (2020, April 25). 27 Women’s Correctional Inmates Test Positive for COVID‐19. CNN Philippines. Retrieved April 27, 2020, from: https://www.cnnphilippines.com/news/2020/4/25/27‐women‐correctional‐inmates‐positive‐covid.html
As of May 1, as many as 332 PDLs in Cebu City Jail had tested positive for COVID‐19.103 Macasero, R. (2020, May 1). Last updated 2020, May 1. 125 New Coronavirus Cases Confirmed at Cebu City Jail. Rappler. Retrieved May 20, 2020, from https://www.rappler.com/nation/259573‐cebu‐city‐jail‐coronavirus‐april‐30‐2020#cxrecs_s
As of May 4, at least four inmates had died.104 Santos, A.P. (2020, May 4). 'Waiting to Die': Coronavirus Enters Congested Philippine Jails. Aljazeera. Retrieved May 19, 2020, from https://www.aljazeera.com/news/2020/05/die‐coronavirus‐enters‐congested‐philippine‐jails‐200504025823176.html
As of May 25, the number of infected PDLs had risen to 517 in 10 different prisons.105 Gregorio, X. (2020, May 25). 517 Prisoners Contract COVID‐19 in Jails. CNN Philippines. Retrieved May 26, 2020, from https://cnnphilippines.com/news/2020/5/25/prisoners‐COVID‐19‐jails‐Philippines.html?fbclid=IwAR05Up7YsZH9gZNaCrdbj0YteHrnhH8HYnqtJj5CBcav3PulGfuH31xadKc
These statistics have worsened despite the measures that have been undertaken to combat the spread of the pandemic in jails, considering that on March 20, 2020, over 400 facilities were already locked down by the BJMP.106 Santos, op. cit. note 104.
To separate the sick and at‐risk PDLs from those who are not, the former have been quarantined in certain designated rooms within the correctional facilities to which they belong.107 CNN Philippines Staff. (2020, April 21). Last updated 2020, April 21. 18 Inmates, One Jail Worker in Women’s Correctional Contract COVID‐19. CNN Philippines. Retrieved April 22, 2020, from https://www.cnnphilippines.com/news/2020/4/21/Women‐s‐Correctional‐more‐COVID‐19‐infections.html
Quarantine structures for PDLs have also been arranged around Metro Manila.108 Batnag. D. (2020, April 20). Coronavirus: Philippines Acts to Avert Public Health Crisis in Jails. The Straits Times. Retrieved April 22, 2020, from https://www.straitstimes.com/asia/se‐asia/philippines‐acts‐to‐avert‐public‐health‐crisis‐in‐jails
In addition, quarantine facilities that can hold around 500 people have been set up by the International Committee of the Red Cross in certain prisons.109 Santos, op. cit. note 104.
Despite these quarantine measures, problems still arise. A 61‐year‐old febrile PDL reported that he was transferred to a cell designed for two, but actually housed 11 people; still, his reaction was one of relief: "It's better than sleeping on the stairs, piled up on top of one another."110 Ibid.
While face masks are being provided to all PDLs, prisoners often do not wear them due to the scorching summer temperatures.111 Ibid.
Most recently, to address the problem of severely congested prisons, the Supreme Court of the Philippines ordered the release of around 10,000 prisoners.112 McCarthy, J. (2020, May 5). As COVID‐19 Fears Grow, 10,000 Prisoners Are Freed from Overcrowded Philippine Jails. npr.org. Retrieved May 18, 2020, from https://www.npr.org/sections/coronavirus‐live‐updates/2020/05/05/850513762/as‐covid‐19‐fears‐grow‐10‐000‐prisoners‐are‐freed‐from‐overcrowded‐philippine‐ja
The problems that are now being experienced in crowded residences and prisons are dramatic iterations of socio‐economic inequities that have existed over a long period of time. Huge parts of the population do not have proper living spaces and do not actively pursue housing opportunities perhaps because, as a society, we have seen the disparity in housing conditions as a situation that has been entrenched by chance rather than as a matter of fair allocation over which we exercise control, and which we should clamor for the government to make an urgent priority. The manifestations of these inequities that have come to the fore recently are hurriedly being addressed now because of the impact that the lopsided housing situation has had on the ability of the country to cope with problems arising from the pandemic. The response measures are proving very costly and yet the infrastructure being built is only for temporary use. The same amount of money could perhaps have been used earlier on for durable facilities that would have reduced housing inequity and hence, the harm brought about by SARS‐CoV‐2. The experiences we have been going through constitute compelling evidence that the neglect cannot be allowed to continue. It is up to us to act on our responsibility and try to exercise control over the situation by putting pressure on authorities to promote the fair allocation of resources. Otherwise, the consequences can be even more costly in terms of economic development and the further loss of human lives.
It is about time we realized that the need for safe and healthy housing for all is a concern not only for the economically challenged but also for every other member of the community. In times of pandemic emergencies, anyone and everyone can be affected by the lack of safe and healthy housing suffered by disadvantaged sectors of society. When people get infected by a highly contagious virus and they have no safe isolation space to which they can withdraw, everybody else can be adversely affected as they radiate beyond their household. In a world of interconnected and interrelated human beings, anyone’s virus has the potential to infect everybody else.