MANILA—An office worker snapped back at the policeman bearing bad news in a phone call last May: her test came out positive for COVID-19 and she needed to be fetched for mandatory quarantine in Navotas City.

But the officer wasn’t done. With the help of village health workers, he needed to trace the woman’s movements over the past few days, and identify everyone she had come in direct contact with, a task made even more difficult by the patient who suddenly turned uncooperative.

Employing some gentle persuasion, and a heavy dose of patience, he eventually managed to calm her down until she began giving names.

Fear of an ensuing stigma, and being forced out of work for the time being, have forced some patients to clam up, complicating efforts to track down their contacts and prevent potential infections.

“People are still scared of the discrimination that is still very prevalent,” Valenzuela Mayor Rex Gatchalian told ABS-CBN News.

The Philippines has overtaken Indonesia with the worst coronavirus outbreak in Southeast Asia. It had the most number of COVID-19 cases in the region at 136,638 as of Monday.

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The government has promised to drastically improve contact tracing during a crucial 2-week period when Metro Manila and 4 neighboring provinces returned to stricter lockdowns.

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“Parang nanliligaw 'to na kahit basted ka na, tuluy-tuloy ka lang talaga kasi nga, gusto mong makakuha ng impormasyon,” said Col. Rolly Balasabas, police chief of Navotas, describing a contact-tracing technique inspired by the Magalong model in Baguio City.

(It's like courtship. Even if you're been rejected, you don't stop until to get the information.)

The formula, developed by Mayor Benjamin Magalong, employs police investigation skills and a more personal approach to gather accurate data of a COVID patient’s whereabouts and his close contacts.

• 'Best practice': Baguio City's aggressive contact tracing explained

In Valenzuela City, contact tracing is also hampered when some residents who would take swab tests, but disappear afterward for fear of the stigma that a positive result might bring.

Some would give a different address or a phone number that belonged to someone else, said Dr. Maria Elizabeth Cruz, a member of the city’s epidemiology surveillance unit.

“Ilang beses kami nasigawan,” she said, citing initial reactions from some patients when health officers called to inform them of the positive test results. Others, she recalled, were still in denial thinking it was prank.

(We've been shouted at a number of times.)

STIGMA

The city’s health officers in protective gear pick up COVID-positive patients at home where the rest of the family members are swabbed. While awaiting results, which are expected in 2 to 3 days, the house is placed on lockdown, with a policeman or a village watcher stationed in a tent outside.

“Yung stigma ba na alam ng mga kapit-bahay mo, ‘Ah, may positive dyan kaya nagpa-test sila,’” Gatchalian said.

(It's the stigma that ensues when your neighbors learn about a positive case, which explains why the rest of the family are tested as well.)

In Navotas, the city government set a target of 24 to 48 hours to complete contact tracing, which is complicated when residents don’t provide accurate information, said Mayor Toby Tiangco.

Beyond that, he said it would be difficult to conduct tracing since more cases would be confirmed the following day requiring the same procedure.

“Patong nang patong yan kaya 'di pwedeng ma-delay,” he told ABS-CBN News.

(The numbers compound so we can't afford any delay.)

Each of the city’s 13 contact-tracing teams includes a policeman and a health care worker, said Balasibas, who trained his men on their pandemic-specific assignment when Navotas adopted the Magalong formula early during the outbreak.

But some residents were still hard to reach, some of them changing numbers or moving house after taking swab tests, said Tiangco, who warned that the city would look for such unresponsive patients by posting their names and photos on its social media accounts.

“Hindi naman ako nananakot. Tototohanin ko talaga yan,” he said. Navotas had 1,688 active cases as of Monday.

(I'm not threatening. I will really do it.)