• The COVID-19 pandemic gives a new meaning to resilience thinking, with countries all over the world scrambling to find the best balance between eliminating the virus and minimizing social and economic damage.
  • Dr. Ronald Law, Chief of the Preparedness Division of the Department of Health-Health Emergency Management Bureau, shares his insights on the role of science and research to combat COVID-19 and the knowledge gaps that need to be addressed to implement timely public health interventions to control transmission and prevent resurgence of cases.
  •  This post is a commentary contribution and does not necessarily reflect the views of the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD).

 

If our well-being or survival in this pandemic were to depend on how much or little we know about the science of COVID-19, then we need to sound the alarm now for rapid, quality and equitable research on COVID-19. 

While we’re lost in the business (and busyness) of response, it is imperative for us to find our way to addressing knowledge gaps that when answered can shine a good light on what directions we need to take and how to go about the journey. We can’t forever grope in the dark--it’s a sure recipe for a disaster within a disaster. Science and resilience thinking should be that light with research paving the way.

Aside from political will, public health expertise, government resources, social capital and other “effective” interventions in the pandemic playbook being written across the globe, the role of research should be front and center especially now more than ever.

Almost 8 months from waking into this surreal if not harrowing world that is filled with uncertainties, the only thing certain about COVID-19 is that it is too complex that we have more questions than answers that science can find.

While all of humanity’s labors and hopes are pinned on the medical aspect of research—the discovery of a vaccine or a group of drugs to protect against the virus or quell the negative health effects of the disease, several public health aspects that pertain to transmission, prevention, control and risk management remain to be poorly elucidated.

Let us count the ways and measure how wide the knowledge gaps are.

There is evidence that COVID-19 is a zoonotic disease--can be passed from animals to humans but up to now, the animal reservoir or habitat where the virus thrives and other animal hosts in the chain of infection are not yet well-defined. Bats, rodents, cats, dogs, the list goes on.

It is established that the elderly population (above 60 years old) and those with underlying medical conditions are the high risk groups for infection.  However, the specific conditions--diseases, health status, predisposing factors and indicators for severe disease are not yet as clear.  It is perplexing to note why some young people can develop severe infections even without comorbid conditions.

It is known that transmission can happen 1-3 days before the onset of symptoms but there is still no data to describe the magnitude and extent of asymptomatic and pre-symptomatic transmission let alone the infectious dose of the virus.

Globally, only 1-3% of cases are attributed to the 0 to 19-year age group. Children show a lower risk of infections and when they do, the usual symptoms may not be observed. But just how susceptible and infectious they are compared to adults are still burning questions.

It is widely held that timely public health interventions are essential to control transmission and we know that countries which have employed a mix of public health and social measures have already been successful to a certain extent; but despite all the elaborate models that data scientists can churn out, what specific combination of interventions is needed to prevent the resurgence of cases? What is the impact of individual and combined public health and social measures on COVID-19 and non-COVID-19 issues alike?  These are not yet found in the vast literature.

We’ve seen that transmission is common in closed settings (hospitals, prisons, public transport) and super-spreading events are responsible for the exponential rise of cases. But key questions are: What are the characteristics of these settings? What are the main transmission routes? What are the risk factors of people in these settings?

In terms of infection prevention and control, we know that droplet spread is the main route of transmission and that masks of different kinds afford some protection from the virus. Recently, evidence on an airborne transmission is already coming to fore. But up to now, effectiveness, adverse events, and sustainability of the use of masks, respirators, and face shields still have to be investigated.  Likewise, in environmental health, we are still grappling with the ideas of the spread of the virus in water and fecal matter, the role of fomites (inanimate objects like doorknobs, mobile phones, elevator button) in spreading the disease and effective technologies for decontamination.

Lastly, we know that pandemic disproportionately affects the population. When it comes to strengthening response and addressing social justice, these questions linger: How uneven are the impacts to different social groups in specific settings and contexts? What is the importance of adaptation and the role of communities in response and mitigation? We still need to crunch some data to back up these relevant arguments so governments are properly guided on prioritization of target groups, resource allocation, and resilience planning in the new normal.

While (im)patiently waiting for the outcomes of massive global trials for vaccines and treatment, these public health research questions that span epidemiology, health policy, environmental health, and social sciences are more than enough to preoccupy the best minds of our scientific and medical communities the world over and in the Philippines.

More than enumerating these as part of a robust research agenda, the Philippine research community should commit to implementing relevant research that will support our collective pandemic response. This is the most “science-based” strategy as we can ever get. Also, the government is called to the challenge of mustering its energy and marshaling its resources to convene experts from different fields, disciplines, and institutions, to build on their rich trove of expertise, resources, and networks, to work on this ambitious but future-defining agenda.

Lastly, we need to adopt a research mindset that frames the success stories of other countries from a global perspective and perceives our own good practices on the ground as practical evidence that can make a big difference in our response. We can learn or unlearn a thing or two on this. And no one can argue with us on that.

 

Aside from his position in the DOH, the author is a professor of public health at the University of the Philippines-College of Public Health, UERM Memorial Medical Center Graduate School, Ateneo School of Medicine and Public Health and the University of Washington in the U.S.

He is a recent US-ASEAN Fulbright scholar focused on health security, emergencies, and disasters. He is also part of the technical working group working on the health resilience thread of the National Unified Health Research Agenda (NUHRA) and a member of the DOST-PCHRD Disaster Risk Reduction - Climate Change Adaptation (DRR-CCA) Program Technical Advisory Group. (Written by Ronald Law)

 

 

Source:http://www.pchrd.dost.gov.ph/index.php/news/6583-resilience-thinking-unlocking-the-science-of-covid-19-to-keep-the-virus-at-bay

In an effort to strengthen individual, institutional, and sectoral research capacity in the Philippines, the Department of Science and Technology – Philippine Council for Health Research and Development (DOST-PCHRD) partners with various host institutions, offering opportunities to researchers to benefit from and contribute to the development of new knowledge and drive innovation in the field of health research.

One of the long-standing partnerships formed by the Council is with the Department of Health - Health Policy Development and Planning Bureau (DOH-HPDPB) for the implementation of the DOH - Health Policy and Systems Research (DOH HPSR) Fellowship Program under the DOH - Advancing Health through Evidence-Assisted Decisions (DOH-AHEAD) strategy.

The two-year program aims to establish a cadre of young professionals with the appropriate knowledge, skills, and attitude to appraise and conduct high-quality health policy and systems research. DOST-PCHRD facilitates the applicant screening process, disbursement of financial incentives, and monitoring of the fellows’ development and progress all throughout the program.

Last June 29, a virtual research defense was conducted for the 2018-2020 DOH HPSR fellows and interns as one of their final requirements for the conferment of the program’s certificate of completion. Two study groups presented their completed research proposals to panelists from the DOH and external experts.

The first study group presented the current situation of public health financing schemes in terms of equitable access for family planning services. The second study group presented the assessment of the Philippine National AIDS Council’s implementation of a multisectoral approach on HIV/AIDS response in the country to gain an understanding of the elements that make multisectoral approaches function effectively to achieve the health sector goals.

Since 2012, the HPSR Fellowship Program was able to capacitate more than 200 young and emerging health research fellows whose research outputs have already been used in improving health programs and services for the Filipino people. Some of these outputs include research on “Rapid HIV Diagnostic Algorithm (rHIVda) for the Philippines,” “GeneXpert (Xpert MTB/Rif) in Multi-Drug Resistant Tuberculosis,” and “ECMO for Pulmonary Hemorrhage Secondary to Leptospirosis.”

 

Source:http://www.pchrd.dost.gov.ph/index.php/news/6582-2018-2020-doh-hpsr-fellows-complete-research-defense-to-soon-join-dost-pchrd-and-doh-s-cadre-of-young-health-policy-and-systems-researchers

The 2020 World Congress of Bioethics confers the Medard Hilhorst for Oceania region prize to the poster, “When Reviewers are Reviewed: obstacles and ethical dilemmas when ethics reviewers themselves are the subjects of study,” based on a study funded by the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD).

From the project “Gender Competence in Ethics Review in the Philippines” led by Professor Fatima Alvarez Castillo, current president of the Social Inquiry and Building Capacities in Research, Inc. (SIBCRI), the winning poster highlights ethical dilemmas encountered in the aforementioned study. The poster was authored by Daphne Joyce Maza and Joel Estacio who were assistant investigators of the project.

In the study, gender competence is defined as the “knowledge and ability to recognize risks, harm, vulnerabilities, discrimination, and other forms of unfairness for research participants that ensue from gender.” To examine gender competence in the Philippine ethics review, the researchers interviewed ethics reviewers and gender experts.

We realize that gender issues are often unrecognized or unseen even among those who are highly educated,” Prof. Castillo said about the team’s motivation in pursuing the project. This was affirmed by the results of the study which found that there is a need for considerable improvements in gender competence among ethics reviewers. Aside from misconceptions about gender, there were gaps in addressing gender issues in ethics review.

One recommendation of the research team is for the Philippine Health Research Ethics Board (PHREB) to create policies that could strengthen the gender competence of research ethics committees. The PHREB may identify gender competence as a mainstream competence among RECs, incorporating it in the accreditation processes of RECS as well as in capacity building activities and programs.

As the national coordinating agency for health research efforts in the country, we recognize ethics review as an equally important part of the research process,” said DOST-PCHRD Executive Director Jaime Montoya. “We must ensure that our health research community gears towards the advancement of healthcare without compromising the rights and welfare of research participants regardless of gender,” added Dr. Montoya.

From the team’s experience in joining the 2020 World Congress of Bioethics, Prof. Castillo encourages the country’s bioethics community to take an active role in fostering a robust ethical research culture in the country by continuing to study and address existing issues in ethics review. Having faced challenges as well in conducting their study, Prof. Castillo advises researchers to persevere and collaborate with their respective ethics committees to overcome obstacles.

The submission “Gender Competence in Ethics Review in the Philippines” was also shortlisted for the Mark Ehrenreich Prize in Healthcare Ethics for the Oceania region, a paper presentation category in the 2020 World Congress of Bioethics. The co-investigators of the study are Nimfa Bracamonte, Ernesto Gregorio Jr and Erlinda Palaganas. (Written by Alyana Kaye Bacarra)

Source: http://www.pchrd.dost.gov.ph/index.php/news/6581-pchrd-funded-study-wins-medard-hilhorst-prize-at-2020-world-congress-of-bioethics

As the Philippines enters the peak typhoon season, small islands like Marinduque are placed at a higher risk to extreme weather events — a looming plight that coincides with the still existing COVID-19 pandemic.

When there is an impending weather event, it is vital to assess its health risks to vulnerable communities. This will enable locals and officials to act and prepare with sufficient time to avoid threats to health, harm, and casualties. Coupled with early warning systems, populations at greater risk will be equipped with proper tools to get useful information for better disaster preparedness and response.

This is the impetus for Dr. Delia Senoro’s team at Mapua University in devising the eSalba mobile and web-based application that empowers both households and local government units (LGUs) to strengthen the health resiliency of small communities by enabling locals to report an incident to authorities, thereby allowing quicker and more coordinated disaster response of LGUs as it provides locations of reporters, responders, evacuation and health centers in the community.

          

As an assistive, modernized, and enhanced early warning and communication tool, one unique feature of eSalba is that it generates data for health vulnerability map of communities, allowing locals, decision-makers, and responders to view populations that are most vulnerable to health-related outcomes brought by disasters and other socioeconomic factors. 

With the capability to warn about possible health disease outbreaks in a specific area, the app will strengthen preparedness and management of LGUs to both impending disasters and health-related problems as it provides useful information needed for short-term response and long-term policymaking, development, and improvement.

Planned to benefit the LGUs, particularly barangay and municipal health workers, Disaster Risk Reduction and Management Offices (DRRMOs) at the municipal and provincial level, the eSalba is expected to reach the communities in Marinduque before September 2020. 

This initiative is a component of the program commonly referred to as D-HIVE (Development of Health Index: Vulnerability to Extreme Environmental Events) for Marinduque Island, funded under the Disaster Risk Reduction and Climate Change Adaptation (DRR-CCA) research program of the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD).

The app has undergone its first test run last June 29, 2020 which was participated in by 42 Marinduque locals composed of barangay officials, local health workers, SK Chairperson, MDRRMO staff, and D-HIVE Team. (Written by Christine Jane Gonzalez)

Source: http://www.pchrd.dost.gov.ph/index.php/news/6580-mapua-researchers-devise-new-disaster-warning-tool-for-marinduque-locals

Call for Research Proposals: AHEAD-HPSR Program

 

The Department of Health (DOH) and the Philippine Council for Health Research and Development (PCHRD) is pleased to announce the first call for research proposals for the Advancing Health through Evidence-Assisted Decisions with Health Policy and Systems Research (AHEAD-HPSR) Program.

Interested institutions, organizations, and researchers are invited to submit a full proposal on any of the topics listed below.



1. A Situational Analysis on the Drug Shortages and Stock-outs in the Philippines: Causes, Frequency, Impact and Management Strategies
2. Behavior Change, Social and Economic Outcomes of the Enhanced Community Quarantine (ECQ) and General Community Quarantine (GCQ): Phase 1- National Capital Region (NCR)

Interested institutions, organizations, and researchers are invited to submit a full proposal on any of the topics hereto attached.


Kindly submit your proposal and the following requirements to Ms. Guidita L. Gelera at This email address is being protected from spambots. You need JavaScript enabled to view it. or Ms. Clarissa B. Reyes at This email address is being protected from spambots. You need JavaScript enabled to view it.

  1. Letter of Intent
  2. Project Proposal following the PCHRD Detailed Proposal Form
  3. Workplan Schedule (Gantt Chart of Activities)
  4. Proposed Line-Item Budget (LIB)
  5. Informed Consent Form (for studies involving human subjects)
  6. Curriculum Vitae of lead proponent (Principal Investigator/Project Leader)
  7. Duties and Responsibilities of each project personnel
  8. Profile of the institution
  9. Endorsement of agency head

For queries, you may contact Ms. Clarissa B. Reyes.
 
 
 

Subcategories

Featured Links

PNHRS

http://www.healthresearch.ph

PCHRD

http://www.pchrd.dost.gov.ph

eHealth

http://www.ehealth.ph

Ethics

http://ethics.healthresearch.ph

ASEAN-NDI

http://www.asean-ndi.org

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