DOH: Low COVID-19 deaths in PH due to treatment guidelines crafted early in pandemic

MANILA— The Department of Health (DOH) on Friday said the relatively low COVID-19 fatality rate of the Philippines is partly due to clinical guidelines on how to manage coronavirus patients crafted by medical societies early into the pandemic.

“First of all we had a rough start because at that point in time we didn’t know a lot about the virus,” said Dr. Beverly Ho, director of the DOH Health Promotion and Communication Service during a virtual briefing with a partner company.

“We were very fortunate that we had really committed frontliners but also medical societies that rose to the challenge and said okay we will have interim clinical practice guidelines,” she said.

Ho explained that back in February, health workers could only offer supportive care for patients.

“Suero (fluid or medicine administered intravenously). That’s really what you do for a typical viral infection,” she said. 

“But by end of March we had a solid clinical practice guideline care of our medical societies,” Ho added.

The Philippines recorded its first COVID-19 case on January 30 and two more in February. But after the first 3 patients who were all Chinese nationals, it was only in early March that the first Filipino patient with COVID-19 was detected.

By the end of March, the DOH announced that it was adopting clinical practice guidelines of the Philippine Society for Microbiology and Infectious Diseases (PSMID). This includes supplemental oxygen therapy, fluid management, and antimicrobial treatment for those who also have pneumonia. 

There were also guidelines on how to manage septic shock and acute respiratory distress syndrome (ARDS), which are among the effects of COVID-19. 

The PSMID guidelines also included the investigational drugs that can be used to treat COVID. These were remdesivir, hydroxychloroquine, lopinavir-ritonavir, and tocilizumab. 

The first 3 drugs and drug combination were among those eventually picked by the World Health Organization for its multi-country clinical trials. However, hydroxychloroquine and lopinavir-ritonavir were dropped from the trials after they did not see any significant improvement in the patients who used them. Remdesivir though is still being used and tested. 

A management algorithm of the patients showed how doctors could check if a patient was eligible for certain drugs or if other drugs should be considered. 

“With that it became clear to the responder how to treat COVID-19 infections,” Ho said of clinical guidelines in general.

She said that while there is still no proven cure for COVID-19, it gave “confidence” to responders as they know what options they had for treatment.

Ho said it was also helpful that it became clear early on that the elderly were most at risk. 

“Early on we also learned that the infection was worse for certain age groups,” she said. “This is where an information campaign or a good public reminder has shown to be very important.”

Ho said because Filipinos give much importance to family, people heeded the warnings to keep the elderly at home. 

“Alam natin malaking sakripisyo yun for the elderly,” she said. “That contributed a lot to the improvement of our CFR (case fatality rate).”

She said Filipinos should continue to practice physical distancing and wearing masks as the country continues to deal with the pandemic. 

As of Thursday, out of the 276,289 confirmed COVID-19 cases in the Philippines, 4,785 or 1.7% have died.