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How Baguio Became a Contact-Tracing Model: Phone Calls and Persuasion

Hello, it's the mayor calling.
by Joel Guinto
Aug 8, 2020
Photo/s: Baguio City Public Information Office Facebook

During strict lockdowns earlier this year, close contacts of COVID-19 patients in Baguio would get a call from their mayor, retired police general Benjamin Magalong, asking them to comply with pandemic protocols. The intelligence veteran now in charge of contact-tracing for the entire country said the tactic worked and the city is now among the country's models of containment.

"It's very effective," Magalong told reportr. "Use your negotiation skills." As the Philippines earliet this week overtook Indonesia to become the Southeast Asian nation with the most number of COVID-19 infections, Baguio as of Friday had just 152.

With the right tools, training and a mindset shift, the country can increase contact-tracing capability by roughly 600 percent. This would allow authorities to test and isolate thousands who could be spreading the virus unwittingly. Magalong at the start of the quarantines in March even tapped artificial intelligence and cloud technology to help diagnose patients.

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Direct phone calls from the testing czar would be an "impossible task" at this point, he said. "In Baguio, I have already created a team to talk personally to the positive patients. I have so much work now," Magalong said.

Baguio has contained the pandemic to a point that it signaled partial reopening to tourists by September. Magalong said he was working to make the screening of tourists easier. It shouldn't feel like applying for a visa, he said.

Fast-rising cases forced a return to strict quarantines for Metro Manila, Bulacan, Laguna, Rizal and Cavite until Aug. 18. This is meant to buy authorities time to rethink the government's pandemic-fighting strategy. On Thursday, the Philippines surpassed Indonesia to lead Southeast Asia with the most number of COVID-19 cases. Second quarter gross domestic product data also confirmed that the economy had entered a recession.

"Talagang kailangan natin bilisan. Crunch time ito. Kailangan aggresive tayo (We need to act fast. At crunch time, we need to be very aggressive)," said Magalong. Only 30% to 40% of COVID-19 patients' contacts are currently traced, he said.

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Local government were found to trace only up to 5 contacts of each patient, or just their immediate family members. In Baguio, up to 37 were traced per patient. Ideally 30 to 35 contacts must be traced in urban areas and 25 to 30 in rural areas, he said. If one city for example has a positivity rate of 10 percent and 2,500 contacts are untraced, it could mean 250 potentially positive patients are out there spreading the disease, he said.

Contact-tracing as a job should be "incentivized," Magalong said. Tired from long days on the field, contact-tracers should not be burdened with long reimbursement processes. They should have their own vehicles and gas money. "Sa Baguio, hindi madaming papel (In Baguio, we don't require many documents)," he said.

With the Department of Health, Magalong said he was working to ensure that patient data is complete and correctly encoded. In the current data, some patients lack names or addresses. Health Secretary Francisco Duque is addressing this, he said. "Isa yan sa pinakamalaking problema sa COVID system natin (That is one of the biggest problems of our COVID system)."

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"Challenge yun, magkaroon ng comprehensive and accurate information ang kanilang database (That's the challenge, to have comprehenisve and accurate information on their database)," he said. The current system is also designed for clinical analytics, not with contact-tracing in mind, he said.

Magalong said he oversaw the training of contact-tracers for seven regions with the highest number of cases with the rest of the country to follow. It is only now that local executives are realizing the equal importance of contact-tracing. The contact-tracers were given benchmarks and key performance indicators.

"Yung iba, tutok sa testing, quarantine, relief, pero nakakalimutan nila gaano ito kaimportante (Some are focused on testing, quarantine and relief that they forget that this too is important)," he said.

Four days into the Modified Enchanced Community Quarantine, authorities have set up a command center for hospitals, moved to increase bed allocations for COVID-19 patients, and prepared to go house-to-house in search for potential carriers. Once the MECQ is lifted, authorities will shift to localized lockdowns, he said.

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"We are not giving up. Sometimes, we get frustrated but we're not giving up," said.

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