Latest / The SHEA Podcast / COVID-19 International Perspectives: Philippines, 10/23

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COVID-19 International Perspectives: Philippines, 10/23 · The SHEA Podcast

• 0:09
  SPEAKER_01: Welcome to the Rapid Response Podcast brought to you by the Society for Healthcare Epidemiology of America, Shay, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:26
  SPEAKER_01: I'm Dr.
• 0:26
  SPEAKER_01: Cindy Prince, Clinical Associate Professor of Epidemiology at the University of Florida, and I'll serve as your moderator.
• 0:33
  SPEAKER_01: Discussion on the podcast does not reflect Shay's perspective, but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
• 0:44
  SPEAKER_01: Shay is excited to launch this episode of the podcast, COVID-19 updates what we know now.
• 0:51
  SPEAKER_01: Today's discussion will focus on international perspectives from the Philippines.
• 0:55
  SPEAKER_01: Our speaker today is Romnik Aguilar, Assistant Chief Nurse and Infection Prevention and Control Officer from City Health Department of San Pedro Jose Amande Emergency Hospital in the Philippines.
• 1:08
  SPEAKER_01: Thank you for joining us today.
• 1:10
  SPEAKER_01: Before we start a discussion, I'd like to turn it over to Dr.
• 1:13
  SPEAKER_01: Hanran to get us started with a brief news and guidance update of the week.
• 1:18
  SPEAKER_02: Thank you.
• 1:19
  SPEAKER_02: As of October 21st, there have been 40,455,651 confirmed cases of COVID-19, including 1,119,431 deaths reported to the World Health Organization.
• 1:35
  SPEAKER_02: The New York Times is reporting that researchers at Imperial College London are planning a study involving deliberate infection of healthy volunteers with coronavirus early next year to determine how people immunized with different vaccines respond to controlled exposure to the virus.
• 1:50
  SPEAKER_02: The study is scheduled to begin in January at a quarantine facility in London.
• 1:54
  SPEAKER_02: The goal of the study is to reduce the time to find a vaccine.
• 1:57
  SPEAKER_02: Rather than testing vaccines by waiting for vaccinated people to encounter the virus naturally, researchers would expose them to the virus in a controlled setting.
• 2:05
  SPEAKER_02: In the first stage of the study, scientists will perform a dose escalation study to determine the dose of virus that will reliably infect up to 90 healthy volunteers ages 18 to 30 years old.
• 2:16
  SPEAKER_02: Subsequently, researchers will begin to compare coronavirus vaccine candidates by immunizing people and then deliberately infecting them.
• 2:23
  SPEAKER_02: The government will decide which vaccines to test.
• 2:26
  SPEAKER_02: Experts in medical ethics are divided over whether such a study is acceptable, largely because there's no highly effective treatment for COVID-19.
• 2:34
  SPEAKER_02: Another concern is that the illness caused by the coronavirus is unpredictable, and although young people in general do not become gravely ill, there have been unexpected and unexplained cases of severe illness in young patients.
• 2:46
  SPEAKER_02: On October 20th, CDC issued guidance on wearing face masks on public transportation conveyances and at transportation hubs.
• 2:53
  SPEAKER_02: CDC states that traveling on public transportation increases a person's risk of getting and spreading COVID-19 by bringing persons in close contact with others, often for prolonged periods and exposing them to frequently touched surfaces.
• 3:06
  SPEAKER_02: Air travel often requires spending time in security lines and busy airport terminals.
• 3:11
  SPEAKER_02: Travel by bus, train, and other conveyances used for international, interstate, or interest aid transportation poses similar challenges.
• 3:18
  SPEAKER_02: Social distancing is often difficult on public transportation.
• 3:22
  SPEAKER_02: People may not be able to distance themselves by the recommended at least six feet from individuals seated nearby or those standing in or passing through the aisles on airplanes, trains, or buses.
• 3:32
  SPEAKER_02: Transmission of the virus through travelers has led to and continues to lead to interstate and international spread of the virus, which causes COVID-19.
• 3:40
  SPEAKER_02: Appropriately worn masks reduce the spread of COVID-19.
• 3:44
  SPEAKER_02: CDC strongly recommends appropriate masks be worn by all passengers and all personnel operating the conveyance while on public transportation and at transportation hubs and other locations where people board such conveyances.
• 3:57
  SPEAKER_02: A study published in MMWR evaluated risk for in-hospital complications associated with COVID-19 and influenza at the Veterans Health Administration in the United States October 1st, 2018 through May 31st, 2020.
• 4:11
  SPEAKER_02: Patients with COVID-19 were slightly older than those with influenza, but patients with influenza had higher prevalences of most underlying medical conditions than did those with COVID-19.
• 4:22
  SPEAKER_02: Black patients accounted for 48.3% of COVID-19 patients and 24.7% of influenza patients, the proportion of Hispanic patients with similar in both groups.
• 4:32
  SPEAKER_02: The percentage of COVID-19 patients admitted to an ICU was more than twice that of influenza patients, and the percentage of COVID-19 patients who died while hospitalized was more than five times that of the influenza patients.
• 4:43
  SPEAKER_02: And the duration of hospitalization was almost three times longer for COVID-19 patients.
• 4:48
  SPEAKER_02: Among patients with COVID-19, 77% had respiratory complications.
• 4:53
  SPEAKER_02: Non-respiratory complications were frequent, including renal, cardiovascular, hematologic, and neurologic complications, as well as sepsis and bacteremia.
• 5:01
  SPEAKER_02: 24.1% of COVID-19 patients had complications involving three or more organ systems.
• 5:06
  SPEAKER_02: Among COVID-19 patients, nine complications were more prevalent among racial and ethnic minority patients, including respiratory, neurologic, and renal complications, even after adjustment for age and underlying medical conditions.
• 5:19
  SPEAKER_02: The Solidary Therapeutics trial is listed on the World Health Organization website as producing conclusive evidence on the ineffectiveness of repurposed drugs for COVID-19 in record time.
• 5:30
  SPEAKER_02: Interim results from the Solidarity Therapeutics trial coordinated by the World Health Organization indicate that remdesivir, hydroxychloroquine, low-pinivir retonivir, and interferon regimens appear to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.
• 5:49
  SPEAKER_02: The study, which spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized patients.
• 5:59
  SPEAKER_02: Other uses of the drugs, for example, in treatment of patients in the community or for prevention, would have to be examined using different trials.
• 6:06
  SPEAKER_02: Newer antiviral drugs, immunomodulators, and anti-SARS-CoV-2 monoclonal antibodies are now being considered for evaluation.
• 6:14
  SPEAKER_02: And that's the news this week.
• 6:16
  SPEAKER_01: I now want to move into the discussion.
• 6:19
  SPEAKER_01: Raman, thank you so much for joining today.
• 6:21
  SPEAKER_01: What's the current state of COVID-19 in the Philippines?
• 6:25
  SPEAKER_00: Thank you, Dr.
• 6:26
  SPEAKER_00: Cindy.
• 6:26
  SPEAKER_00: Hi, everyone.
• 6:28
  SPEAKER_00: First, I would like to thank the Society for Health Epidemiology of America for inviting me for this rapid response podcast.
• 6:35
  SPEAKER_00: The cases of coronavirus infection in the Philippines are on a downtrend, but 17 areas are still considered high risk because of increasing daily attack rates of having more than 100 new cases per day.
• 6:47
  SPEAKER_00: As of October 20, the Philippines had a total of 360,775 cases.
• 6:57
  SPEAKER_00: 11.6% are asymptomatic, 2% severe, and 3.4% are critical.
• 7:04
  SPEAKER_00: We had a total of 310,642 recoveries, 43,443 active cases, and around 6,690 deaths.
• 7:16
  SPEAKER_00: When it comes to testing, we have a total of 4,163,064 tested individuals.
• 7:25
  SPEAKER_00: Early in January, samples were needed to be sent to Australia for testing.
• 7:31
  SPEAKER_00: But now we have a total of 112 licensed RTPCR laboratories and 35 licensed gene expert laboratories.
• 7:40
  SPEAKER_00: For hospital beds and mechanical ventilators, we have a total of 1,900 ICU beds stationwide, with 48% are presently occupied, 13,500 isolation beds with 43% occupancy, and we have 5,500 wards beds with 35% occupancy, and we have 2,100 ventilators, which about 23% are currently occupied.
• 8:08
  SPEAKER_01: During the pandemic, has your country gone into lockdown at all?
• 8:12
  SPEAKER_01: And if you did, what did that look like and how early in the pandemic was that implemented?
• 8:18
  SPEAKER_00: I believe the Philippines is one of the countries that has the longest lockdown.
• 8:22
  SPEAKER_00: It was almost 220 days past when the lockdown was implemented in the Philippines.
• 8:28
  SPEAKER_00: That was around March 16 or 17.
• 8:32
  SPEAKER_00: But as early as January 13, the Department of Health reported the first case of COVID-19 in the country with a 38-year-old female Chinese national.
• 8:42
  SPEAKER_00: And on March 7, the first local transmission of COVID-19 was confirmed.
• 8:47
  SPEAKER_00: With this, the president declared a state of national emergency due to the threat of COVID-19.
• 8:53
  SPEAKER_00: On March 12, the president issued a partial lockdown on Metro Manila, where the capital cities are located, to prevent a nationwide spread of COVID-19.
• 9:04
  SPEAKER_00: The lockdowns were expanded on March 16, placing the entire island of Luzon under an enhanced community quarantine.
• 9:13
  SPEAKER_00: Other local governments outside Luzon follow in implementing similar lockdowns.
• 9:18
  SPEAKER_00: So during the enhanced community quarantine, the general population are advised to 100% stay at home.
• 9:26
  SPEAKER_00: Only medical frontline services are allowed, and those who will purchase basic necessities will be allowed to leave their houses.
• 9:34
  SPEAKER_00: In addition, exercise are not allowed outside.
• 9:39
  SPEAKER_00: Gatherings are not allowed during the enhanced community quarantine.
• 9:44
  SPEAKER_00: No public transport, no domestic flights, limited international flights will be allowed.
• 9:49
  SPEAKER_00: All schools are closed.
• 9:51
  SPEAKER_00: Government offices will be requiring skeleton workforce and work-from-home arrangement.
• 9:57
  SPEAKER_00: At present, we are currently in a general community quarantine.
• 10:01
  SPEAKER_00: So in the general community quarantine, there are also restrictions, but lighter.
• 10:07
  SPEAKER_00: So we have senior citizens and youth below 21 are not allowed to go out.
• 10:12
  SPEAKER_00: And we allowed sports with limited physical contacts.
• 10:17
  SPEAKER_00: And we restricted a maximum of 10 people for the gatherings.
• 10:23
  SPEAKER_00: So we have limited public transport and we implemented strict implementation of the physical distancing.
• 10:30
  SPEAKER_00: For the schools, all will be online and modular.
• 10:35
  SPEAKER_00: So for the staff of the schools, we have skeleton workforce.
• 10:39
  SPEAKER_00: For the government offices, we have alternative work arrangements like a skeleton workforce and then work from home and then staggered working hours.
• 10:50
  SPEAKER_00: At present, we have a mix.
• 10:52
  SPEAKER_00: So we have general community quarantine in one particular area, and other is enhanced community quarantine because the Philippines is composed of more than 7,100 islands.
• 11:03
  SPEAKER_00: So different lockdowns are imposed in different cities and regions.
• 11:08
  SPEAKER_00: Depends on the number of cases at present.
• 11:12
  SPEAKER_01: And how are people doing in the general public?
• 11:15
  SPEAKER_01: Are you finding that they're wearing masks and they're complying with the measures that are put in place to prevent the spread of COVID-19?
• 11:23
  SPEAKER_00: Yes, actually the government is have a mandatory wearing of face masks that implements our, I think, in last April or May.
• 11:32
  SPEAKER_00: So the government mandated and then penalties are imposed for the violators not wearing face masks.
• 11:39
  SPEAKER_00: In addition to that, infection control measures are also implemented and instructed to strictly adhere to hygiene, respiratory etiquette, and physical distancing.
• 11:50
  SPEAKER_00: So right now, actually, in addition to that measures, the government also implements wearing a face shield in all commuters and employees as additional protection against COVID-19.
• 12:04
  SPEAKER_00: So they are required to have face shields and face masks and other protective equipment as needed in the public places.
• 12:14
  SPEAKER_01: And I know a lot of places experienced a shortage of personal protective equipment during the pandemic.
• 12:20
  SPEAKER_01: We were just talking about face masks and face shields.
• 12:22
  SPEAKER_01: And what's been the state of the PPE supplies in the Philippines?
• 12:27
  SPEAKER_00: Early this year, there has been an extraordinary demand of personal protective equipment, leaving some resource challenge areas in the Philippines without adequate PPE.
• 12:37
  SPEAKER_00: I have encountered and actually report to me here in our province that some hospitals improvise by using plastic bags as PPE.
• 12:47
  SPEAKER_00: That's the lowest point where there's no PPE available.
• 12:50
  SPEAKER_00: The price also should up, and we need to look for supplier in the neighboring countries in Southeast Asia to have supplies of PPE.
• 12:59
  SPEAKER_00: That's between the early, I think it's March to April of this year.
• 13:04
  SPEAKER_00: That's the lowest point that we have no available PPE.
• 13:08
  SPEAKER_00: So I personally received a message from a national nursing association here in the Philippines requesting to help them investigate actually one hospital within my vicinity that has been reported regarding the lack of face masks and PPE supplies for healthcare workers.
• 13:23
  SPEAKER_00: Although, based on my verification, the PPE supplies has been delivered because of the lockdown.
• 13:29
  SPEAKER_00: At present, we have an adequate supply by PPE, and the prices are going down, unlike in the previous months.
• 13:36
  SPEAKER_00: So the Department of Health distribute PPE in healthcare facilities, and private organizations and non-government organizations have been donating PPE.
• 13:45
  SPEAKER_00: So many help have been received from the different NGOs and private organizations.
• 13:50
  SPEAKER_00: So PPEs, face masks, face shield, even vitamins they're providing.
• 13:56
  SPEAKER_00: So as of the moment, we have adequate supplies of PPE.
• 14:00
  SPEAKER_01: Well, it's it's hard to imagine someone you know resorting to a plastic bag as per some product of equipment.
• 14:07
  SPEAKER_00: I'm surprised to hear that report.
• 14:09
  SPEAKER_00: Actually, I have a picture of that report that hospital paste a picture on social media regarding the plastic bags as PPE because they have the money, but the suppliers have no available PPE.
• 14:21
  SPEAKER_00: That's the worst case scenario in the Philippines when it comes to PPE, I guess.
• 14:25
  SPEAKER_01: Absolutely.
• 14:26
  SPEAKER_01: But how are you mitigated healthcare worker concerns then about lack of PPE and just other concerns as well with the pandemic?
• 14:34
  SPEAKER_00: In aspect of PPE, so in our hospital, when I become the infection control officer of the hospital, I propose an annual budget when it comes to personal protective equipment.
• 14:46
  SPEAKER_00: So for the past years, I have a stockpile of PPEs in my hospital.
• 14:51
  SPEAKER_00: So that's why when the pandemic happened, the hospital has ample supplies of PPE that lasted almost one to two months.
• 14:58
  SPEAKER_00: Another thing is we observed the increased stress and burnout of our healthcare workers.
• 15:03
  SPEAKER_00: We have initiated different programs for our medical frontliners.
• 15:07
  SPEAKER_00: We have scheduled sessions for talking and opening up their concerns and about how they feel with their colleagues, their patients, their family.
• 15:16
  SPEAKER_00: So, and then we are also asking their recommendation on what they want and what they recommend in improving the work activities in their units.
• 15:25
  SPEAKER_00: So for those healthcare workers who are currently in quarantine, so we've provided wireless forms of communication for their families.
• 15:34
  SPEAKER_00: We have recommended psychologists to talk to them when it comes to the coping strategies.
• 15:39
  SPEAKER_00: So we implement rest and break during work or between the ships.
• 15:44
  SPEAKER_00: And then we arrange the working schedule that best fits for them, considering that some of my personnel are in the other cities.
• 15:52
  SPEAKER_00: So because of the limited public transport, we need to arrange also the service for them.
• 15:58
  SPEAKER_00: I think one of the things that we do is to acknowledge that their role to save lives.
• 16:03
  SPEAKER_00: So they need to also to boost the feeling of that they are saving lives and actually serving the community.
• 16:12
  SPEAKER_00: It's an aerobic, aerobic part for the healthcare workers, I guess.
• 16:19
  SPEAKER_01: That was a lot to have to think about then, thinking about communication and other challenges with families and transportation.
• 16:26
  SPEAKER_01: But what's been the most challenging part from the infection prevention standpoint of responding to COVID-19 in the Philippines?
• 16:34
  SPEAKER_00: Well, actually, in the Philippines, we are not prepared for this coronavirus pandemic.
• 16:39
  SPEAKER_00: I believe that the most challenging part comes from the shortage of personal protective equipment.
• 16:45
  SPEAKER_00: It is a challenge across the countries in Southeast Asia from the beginning of this pandemic that we foresee that it will endanger our healthcare workers.
• 16:55
  SPEAKER_00: In my experience during the early days of this lockdown, most of the hospitals in our city have no stockpile of PPE.
• 17:02
  SPEAKER_00: They have the money to buy the PPEs because there is a need right now because of the pandemic.
• 17:09
  SPEAKER_00: So, but there are no supplies.
• 17:11
  SPEAKER_00: That's the main challenge right now.
• 17:13
  SPEAKER_00: I on the past actually, when it comes to the infection prevention standpoint.
• 17:18
  SPEAKER_00: But actually, one webinar that I have attended gives me the opportunity to ask one of the panelists who is the president of the Taiwan Nurses Association.
• 17:27
  SPEAKER_00: It is regarding on how they manage the scarcity of PPE.
• 17:31
  SPEAKER_00: So she answered me during that webinar because it's a good opportunity since Taiwan is doing a good fight against COVID-19.
• 17:39
  SPEAKER_00: So I asked her regarding the scarcity of PPE, then she uh answered me that Taiwan actually learned the lessons from the SARS outbreak in 2003, I guess, when uh wherein they had been surprised and no available stockpile of PPE during that time.
• 17:55
  SPEAKER_00: So uh they initiated to have a national stockpile of PPE and using an established monitoring system for this.
• 18:02
  SPEAKER_00: So prior to the COVID-19 outbreak, PPE database were subsequently linked to managed resource allocation and logistics.
• 18:14
  SPEAKER_01: And what have you learned from COVID-19 that's changed practice for you?
• 18:21
  SPEAKER_00: Well, the COVID-19 pandemic has shown the importance of establishing a more resilient healthcare system with effective ITC as key to mitigate the impact of the outbreak.
• 18:35
  SPEAKER_00: So we have now appreciated the importance of strengthening the infection prevention and control.
• 18:41
  SPEAKER_00: And we now realize that we need to create a network of healthcare organizations in our city and of the province that can jointly collaborate into evaluating the available evidence and develop a uniform policy, such as on the appropriate PPE to be used, for example.
• 19:01
  SPEAKER_00: So we also now have increased the annual budget of the infection prevention and control.
• 19:08
  SPEAKER_00: So we actually double the budget for infection prevention and control because the senior leaders in my organizations we have talked about because this will not be the last pandemic, I believe.
• 19:21
  SPEAKER_00: So more and more will come.
• 19:22
  SPEAKER_00: And so we have the need to increase the budget.
• 19:26
  SPEAKER_00: And to we have to do a wide uh citywide stockpile of PPE in collaboration with all uh hospitals in in the city.
• 19:36
  SPEAKER_00: So and then the implementation of the IPC measure is now more focused on long-term preparedness and readiness for future pandemics.
• 19:47
  SPEAKER_01: Yeah, I think we we have similar lessons in the US, and it's just my hope that we don't forget that all too quickly when this is done.
• 19:54
  SPEAKER_01: But I know that Philippines is in the midst of influenza season, I guess maybe coming to the close of influenza season, and we're just heading into it now.
• 20:04
  SPEAKER_01: So, how did you prepare for the influenza season and then what has that been like in the Philippines?
• 20:10
  SPEAKER_00: Right now, the City Health Department has implemented the annual flu vaccination in the community.
• 20:18
  SPEAKER_00: So, because early this year, while we are uh communicating uh with different stakeholders, we anticipate that it will be jointly the pandemic and then the implement the season.
• 20:30
  SPEAKER_00: So it will be hard for us for the community, especially those who are high risk population that can contact COVID-19.
• 20:39
  SPEAKER_00: So we have implemented as early mid of this year uh annual flow vaccination in the community.
• 20:45
  SPEAKER_00: We started with the senior citizens and then uh more vulnerable population, the children, and uh, and then now we are almost 80% of the population now have their annual flow vaccination.
• 21:00
  SPEAKER_00: But if we actually prioritize the healthcare workers because they need to have a complete vaccination when it comes to the flu, and then for those who have uh pneumonia vaccination, so we also catered it here in uh for the influenza season.
• 21:20
  SPEAKER_01: How about COVID-19 and the next wave?
• 21:23
  SPEAKER_01: Are you concerned about you know I know you've you've had some lockdowns and you've eased restrictions, and you know, are you worried that you're going to get a next wave like we're seeing in so many countries?
• 21:34
  SPEAKER_01: And how are you preparing for that?
• 21:36
  SPEAKER_00: Actually, in the Philippines, we are anticipating the next wave, although we can never tell when it will happen.
• 21:43
  SPEAKER_00: But what we're doing right now with right now is establishing isolation facilities across across the city.
• 21:51
  SPEAKER_00: So we transform land health facilities, those facilities that there's no uh or for example, there's uh gymnasium.
• 22:01
  SPEAKER_00: Old school.
• 22:02
  SPEAKER_00: So we transform it to an isolation facility.
• 22:05
  SPEAKER_00: So those public facilities, temporary isolation facilities for managing uh mild COVID-19 patients.
• 22:12
  SPEAKER_00: So we're not, we do not require hospitalization.
• 22:14
  SPEAKER_00: So it is distributed along the community, those isolation facilities.
• 22:19
  SPEAKER_00: So every community has established their own isolation facilities because when the second wave hit, most probably there will be a pike on cases.
• 22:30
  SPEAKER_00: That's what we plan in establishing these isolation facilities.
• 22:35
  SPEAKER_00: It will be designed to make sure that potential COVID-19 carriers are kept separate from the public until they complete the mandatory 14-day home quarantine or 14-day quarantine period and be cleared before return to home.
• 22:50
  SPEAKER_00: Right now, we will continue happening right now, the establishment of those isolation facilities for the preparation for the next week.
• 22:59
  SPEAKER_01: That sounds like a great idea.
• 23:01
  SPEAKER_01: It's also interesting to get to hear sort of what you're doing versus what we're doing in the US and the different approaches.
• 23:08
  SPEAKER_01: And do you have any advice based on what the Philippines has either done well or maybe not done as well that you'd like to share broadly with our listener?
• 23:19
  SPEAKER_00: Well, the government has to do more in improving and intensifying the testing, the tracing, and isolation efforts in the high-risk areas.
• 23:30
  SPEAKER_00: Although we have a localized lockdown and strike border controls, so we need to consider also the possibility of early lockdowns because as of January, we have already reported cases.
• 23:44
  SPEAKER_00: But we only uh it takes us March for the lockdown.
• 23:49
  SPEAKER_00: So we need early implementation of those uh restrictions in our border or border control to reduce the impact of an outbreak.
• 23:59
  SPEAKER_00: Actually, we learn now that if we only started the lockdown early, so maybe there is a reduction in the spike of cases.
• 24:11
  SPEAKER_00: And then uh I just remember seven years ago regarding uh the late Senator Miriam Defensor Sanchiago.
• 24:18
  SPEAKER_00: So she filed a Senate deal or the Pandemic and Hostile Preparedness Act.
• 24:24
  SPEAKER_00: This could be a big help for the Philippine government in preparation against this pandemic.
• 24:32
  SPEAKER_00: So I believe that the government should prioritize to pass this law in order to be ready for future pandemic, and this can be an umbrella when it comes to infection control, personal protective equipment, purchase, surveillance system, contact racing.
• 24:52
  SPEAKER_00: So this can be an umbrella, and this can be a source of budget when it comes to the pandemic.
• 24:59
  SPEAKER_01: Yeah, I think that that sounds like that would be a really great thing to have in place, especially given this concern that, you know, this is not going to be the last pandemic that we experience.
• 25:09
  SPEAKER_01: Ramnik, thank you so much for joining us today.
• 25:12
  SPEAKER_01: It's really wonderful to get to hear how you're handling this in the Philippines.
• 25:16
  SPEAKER_00: Thank you.
• 25:17
  SPEAKER_00: Thank you so much for inviting me.
• 25:19
  SPEAKER_00: Hopefully, this pandemic will end, and then we will be, I think we'll not we will not come back in the old ways, but we need to ready for the new normal.
• 25:30
  SPEAKER_01: Yes, absolutely.
• 25:32
  SPEAKER_01: Thank you very much to our speaker for sharing your perspectives and experiences.
• 25:37
  SPEAKER_01: A sincere thank you from Shay to all healthcare personnel for all that you're doing to respond to COVID-19.
• 25:43
  SPEAKER_01: This podcast can be accessed on Shay's online education center, learning CE, under the Rapid Response Program.
• 25:50
  SPEAKER_01: You'll also find resources such as the Recorded Webinars, Healthcare Facility Outbreak Preparedness, and the SHAY COVID-19 Town Hall.
• 26:00
  SPEAKER_01: You can now receive 75% off SHAY membership for the remainder of 2020 using the coupon code podcast during checkout.
• 26:09
  SPEAKER_01: This concludes this episode of the Rapid Response Podcast.
• 26:12
  SPEAKER_01: Thank you for tuning in.