MANILA HEALTH

DEPARTMENT
DISASTER RISK REDUCTION AND
MANAGEMENT FOR HEALTH PLAN

Submitted by:

ARNOLD M. PANGAN, MD, RSW

City Health Officer

Prepared by:

VIRGILIO B. MARTIN, MD, MPA HEDM JONATHAN P. LAYA, RMT, MD, MHA
Medical Officer V Medical Officer IV
Chief, DRRM-H
Message from the Mayor Assistant

Approved by:
 Hon. Francisco “Isko Moreno” Domagoso
Mayor, City of Manila

Message from the Vice Mayor

The year 2021 is a year Filipinos will always remember, especially for Manileños. It is a year where the country,
especially our City of Manila, has experienced excruciating impacts of health and climate-related hazards resulting to
disasters occurring with increasing frequency and intensity. Aside from the several typhoons, flooding, earthquake, the
devastating and deadly coronavirus disease 2019 (COVID-19) still persists, now with different variants. However,
despite all these challenges encountered, the all-hazard Disaster Risk Reduction and Management for Health Plan of
the National Capital Regional Office was developed through a series of consultative workshops, where the Manila
Health Department (MHD) and its Health Emergency Management Systems (HEMS), have shown their roles in
handling disaster response. The workshops were participated by representatives from the Local Health Offices,
Disaster Risk Reduction and Management Offices, and health sector partners, particularly in our city by the Manila
Health Department representatives.
I would like to extend my congratulations to the Manila Health Department, especially to Acting City Health Officer
(ACHO) Dr. Arnold Pangan, RSW, and all the MHD frontline health workers and other personnel involved in disaster
and health response, for successfully doing their roles in handling these disasters and pandemic that struck the city.
The MHD remains steadfast in its commitment to save as many lives as possible in times of disasters and pandemic. It
keeps building back its capacities better, aiming to attain higher and higher level of preparedness and resilience to be
able to cope with the demands and risks of disasters in the city. At present, our healthcare workers from MHD are on
the frontlines of battling COVID-19. We are also ramping up on our vaccination campaign in order to curtail the
severe and critical forms of the infection and most specially death due to Covid 19. Our doctors, nurses, technicians,
transporters, EMTs, pharmacists and everyone involved in healthcare services are doing their best to help save lives
of our most vulnerable populations. They are putting themselves at risk in this pandemic. Thank you for all the
sacrifices that you make, the dedication, commitment and courage that you show deserve our deepest gratitude,
utmost respect and admiration. The services you do is saving countless lives and making millions of our residents and
visitors alike, safe and healthy.

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 Hon. Maria Sheilah H. Lacuna–Pangan, MD, FPDS
Vice Mayor, City of Manila

Hazards affect the country recurrently, and particularly in Manila, every year. This year is no doubt probably that worst
year that hit the country and the city. Aside from the recurring calamities of typhoons, floods and earthquakes, another
pandemic hit the city —the coronavirus disease 2019 (COVID-19). The pandemic has brought about impacts and risks
to the communities with increasing intensity and magnitude causing health risks and loss of lives in the city. It is
probably one of the deadliest diseases that hit the country, causing loss of lives by the thousands. Just recently, the
country embarked on a Disaster Risk Reduction and Management for Health Plan of the National Capital Regional
Office, and was developed through a series of consultative workshops, where the Manila Health Department (MHD)
and Health Emergency Management Systems (HEMS), have participated in their roles in handling disaster response. It
serves as a tool and guide in building the capacities of the country’s hospitals, the regional hospitals, local government
hospitals and communities to prevent or reduce hazards, mitigate disaster risks, to respond effectively and recover
better from the impacts of disasters. It is of utmost significance to optimize the use of this plan on building capacities
and institutionalizing the disaster risk management program of Manila, and executing the recommended response
actions to attain the goal of saving lives. On the other hand, I would like to extend my congratulations to the leadership
and members of the Manila Health Department (MHD) for successfully participating in the recent series of workshops
where the Manila Health Department (MHD) and its Health Emergency Management Systems (HEMS) have shown
their roles in handling disaster response. But most especially, I would like to express my deepest gratitude to our
MHD’s frontline workers and other members for a successful handling of Manila’s COVID-19 response, where millions
of our residents and visitors have been saved from probably the deadliest disease that struck the country and the
world.

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 Foreword

Arnold M. Pangan, MD, RSW

City Health Officer

Acknowledgements

Emergencies and disasters including epidemics and pandemics, and the measures taken to manage their consequences,
have wide-ranging and often severe impacts across societies; they affect health and wellbeing, livelihoods, businesses
and economies, and the continuity of essential services. It is vital that the City of Mania, Civil Society Organizations and
the private sector discharge their respective roles and responsibilities and complement each other in achieving shared
goals of disaster management. Therefore, coordination and integration of all activities necessary to build, sustain and
improve the capability to prepare for, protect against, respond to and recover from threatening or actual natural or human-
induced disasters. It enables a multi-jurisdictional, multi-sectoral, multi-disciplinary and multi-resource initiative. Taking all
these in consideration, The City of Manila has joined the country’s effort in developing and enhancing its Disaster Risk
Reduction and Management for Health (DRRM-H) Plan. Sound risk management is essential to safeguard development
and implementation of the Sustainable Development Goals (SDGs), including the pathway to Universal Health Coverage
(UHC). In order to address current and emerging risks to public health and the need for effective utilization and
management of resources, this paradigm of health emergency and disaster risk management has been developed to
consolidate contemporary approaches and practice. This plan provides a common language and a comprehensive
Virgilio B. Martin III, MD
approach that can be adapted and applied by all actors in health and other sectors who are working to reduce health risks
and consequences of emergencies and disasters, Chief- HEMS strengthen the health security of our City and sustain the
and thereby
resilience of our health system and the communities.

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 TABLE OF CONTENTS

List of Acronyms 8
Definition of Terms 9
Vision, Mission Statement 14

The all-hazard Disaster Risk Reduction and Management for Health Plan of the National Capital Regional Office was
developed through a series of consultative workshops, where the Manila Health Department and its Health Emergency
Management Bureau (HEMB) was part of. The workshops were participated by representatives from the Local Health
Offices, Disaster Risk Reduction and Management Offices, and health sector partners spearheaded by Dr. Amelia C.
Medina, Chief of Local Health Division and Dr. Philip Patrick C. Co, the Head of the National Capital Regional Office
Health Emergency Management Unit supported by his staffs: Ms. Rosela Astudillo and Mr. Bran Darius Niño Nasayao. I
would like to extend my deep appreciation to all the efforts, expertise, good practices, and robust inputs contributed by all
our local partners in the revision and updating of the Initial MMCHD-Health Emergency Preparedness, Response and
Recovery Plan, into its new version of comprehensive all-hazard Disaster Risk Reduction and Management for Health
Plan with practical and acceptable actions to be undertaken. Our sincerest thanks also to all the partners from the
seventeen (17) NCR Local Health Offices. Grateful appreciation is given to Dr. Arnold M Pangan our City Health Officer
for generously sharing his experiences and insights in “Field Management during Disaster” to include “Incident Command
System and Victims Management”. Furthermore, special thanks to Dr. Jesse Bermejo and Rodel Alegre DOH-
Representative for initiating the first step of this plan development as well as to OIC- Director Corazon Flores for her
continuing support and guidance to make this initiative a success. They are putting themselves in the path of this virus —
in Manila and around the country — in this unprecedented crisis. Our doctors, nurses, technicians, encoders,
transporters, EMTs, pharmacists and everyone who supports patient care are rising to the occasion and caring for our
most vulnerable populations. Thank you for the sacrifices you make, every day and especially during this pandemic. Your
dedication, commitment and courage deserve our deepest gratitude and admiration. Your service to patients is saving
countless lives and making thousands of differences.
I. A. Introduction 15
B. Background 16
C. Demographic Profile 16

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 D. Geo-Hazard Mapping 19
E. Manila Health Department Resources 29
F. Vital Health Indices 30
II. Planning
A. Preparing to Plan 33
B. Role and Responsibilities of the Planning Committee 33
C. Data Gathering and Analysis 37
D. Risk Assessment 38
1. Hazard Identification, Matrix and Prioritization 39
2. Hazard Analysis 41
3. Hazard Plan 43
E. Vulnerability Assessment 50
1. Concept of Vulnerability Assessment 50
2. Objectives of Vulnerabilities Assessment 50
3. Process of vulnerability Assessment 50
4. Vulnerabilities and Gaps 50
5. Vulnerability Rating and Criteria 55
6. Vulnerability Assessment Results 56
7. Vulnerability Assessment Plan 57
F. Capacity Assessment 62
1. Concept of Capacity Assessment 62
2. Objectives of Capacity Assessment 63
3. Capacity Assessment
4. Capacity Rating Criteria 67
5. Result and Analysis of Capacity Assessment 69

III UPDATING THE PLAN

A. Prevention and Mitigation Plan 71
1. Objectives 71
2. Key Result Areas 71
3. Activities/Strategies 72
B. Preparedness Plan 72
1. Objectives 73
2. Key Result Areas 74
3. Activities/Strategies 75
C. MHD Response Plan 84
1. Plan Description 84
2. Goal and Objectives 84
3. Concept of Response Operation 84
a. Pre-Impact Response 85
b. During Impact Response 91
i. Covid 19 Response Plan 110
c. Post Impact Response 128
i. Technical Assistance in Establishment of

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 Evacuation Center 129
ii. Provision of Health Services
129 iii. WASH services
130 iv. Nutrition in Emergencies
130 v. MHPSS Services
130 vi. Prioritization for In-
Hospital Care 135

D. Recovery and Rehabilitation Plan 133

IV.IMPLEMENTING THE PLAN 135

A. Priority Areas of Concern and Immediate Action 137

B. HERT Mobilization Process 137
C. Protection of HERTs 140

V.MONITORING AND EVALUATION 141

VI. APPENDICES 142
1. ICS Organizational Chart 142
2. Response to External and Internal Emergencies 147
3. Coordination and Networking for referral Cases 152
4. Activation of Contingency Measures 153
5. Provision of Public Health Services 155
6. Job Action Sheets of ICS organization 158
7. National Policies in Disaster Managements 179
8. MHD Executive Committee 180
9. Logistical requirements of the LHERTs

List of Tables and Figures

Figure 1 Map of 6 Congressional Districts of Manila 18

Figure 2 Ground Shaking Hazard Map 19
Figure 3 Liquefaction Potential Map 20
Figure 4 Tsunami Map 21
Figure 5 District 1 Hazard Map 22
Figure 6 District 2 Hazard Map 23
Figure 7 District 3 Hazard Map 24
Figure 8 District 4 Hazard Map 25
Figure 9 District 5-a Hazard Map 26
Figure 10 District 5-b Hazard Map 27
Figure 11 District 6 Hazard Map 28
Figure 12 Preparing to Plan 35
Figure 13 Planning Committee and Partners 35
Figure 14 Data Gathering Framework 37
Figure 15 Risk Assessment Workshop Network 38
Figure 16. Building on COVID-19 for longer-term preparedness 68
Figure 17 Planning Framework 70
Figure.18 Incident Command Structure 124

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Table 1 Estimated Population per District 2022 18
Table 2 Age/ Sex Distribution, 2022 19
Table 3 Vital Health Indices 30
Table 4 Ten Leading Causes of Mortality, 2020 vs 2021 32
Table 5 Ten Leading Causes of Morbidity, 2020 vs 2021 32
Table 6 Ten Leading Causes of Infant Mortality 2021 33
Table 7 Ten Leading Causes of Maternal Mortality 2021 33
Table 8 Hospital Bed Capacity 34
Table 9 6 LGU Hospital Bed Capacity 35
Table 10 Hazard Assessment Matrix 39
Table 11 Kaisler Permanente Analysis Tool 41
Table 12 Hazard Analysis Result 42
Table 13 Most Common Areas Affected by Hazards 42
Table 14 Pandemic Prevention Plan 45
Table 15 Substance Abuse Prevention Plan 46
Table 16 Fire Hazard Prevention Plan 47
Table 17 Typhoon Hazard Prevention Plan 48
Table 18 flood Prevention Plan 49
Table 19 Earthquake Prevention Plan 50
Table 20 Dengue Prevention Plan 51
Table 21 Vulnerabilities of the Community and Gaps 52
Table 22. Vulnerability Assessment Result of the
Five Elements of the Community 58
Table 23 Result of capacity assessment 69
Table 24 Campolas Kit Plus 78
Table 25 First Aid Kit 79
Table 26 Trauma Kit 80
Table 27 Hygiene Kit 81
Table 28 Pre-Disaster Checklist 86
Table 29 Response Teams 94
Table 30 EWARS 105
Table 31 Updated testing 114
Table 32 Updated Quarantine and Isolation Protocols 115
Table 33 Hospital Classification 128
Table 34 Recovery and Rehabilitation Plan 132
Table 35 Job Action Sheets 153

ACRONYMS
AOP Annual Operational Plan
BHS Barangay Health Station
CHO City Health Office
DRRM Disaster Risk Reduction and Management
DRRM-H Disaster Risk Reduction and Management in Health
EOC Emergency Operations Center
EWARS Early Warning Alert Response System
HEMB Health Emergency Management Bureau
HEPRRP Health Emergency Preparedness, Response and Recovery Plan
HERTs Health Emergency Response Teams
HSFD Hospitals Safe from Disaster

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HUC Highly Urbanized City
ICC Independent Component City
ICS Incident Command System
LCE Local Chief Executive
LDRRMP Local Disaster Risk Reduction and Management Plan
LGU Local Government Unit
LIPH Local Investment Plan for Health
MHPSS Mental Health and Psychosocial Support
MISP-SRH Minimum Initial Service Package for Sexual and Reproductive
Health
STAR Strategic Tool for Analyzing Risk
WASH Water, Sanitation and Hygiene

DEFINITION OF TERMS

Case - a person with a particular problem requiring or receiving medical or welfare

attention. A case is often used to label individuals further as suspect, probable, or
confirmed (AO 2020-0013
Close Contact - a person who has experienced any one of the following exposures
during the 2 days before and the 14 days after the onset of symptoms of a probable or
confirmed case: (WHO Public health surveillance for COVID-19, 7 Aug 2020)
1. Face-to face contact with a probably or confirmed case within 1 meter and for at least
15 minutes
2. Direct physical contact with a probable or confirmed case
3. Direct care for a patient with probable or confirmed COVID-19 disease without using
recommended personal protective equipment OR
4. Other situations as indicated by local risk assessments

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Close contacts can be classified further into first-, second-, and third-generation close
contacts:
1. First-generation close contacts - close contacts of a probable, or confirmed case
2. Second-generation close contacts - close contact of a first-generation close contact.
3. Third-generation close contacts - close contact of a second generation close contact.
Comorbidity - presence of one or more additional conditions co-occurring with
(that is, concomitant or concurrent with) a primary condition that may increase an
individual’s risk for complications or mortality if afflicted by COVID-19.
Confirmed COVID-19 case:
A person with laboratory confirmation of COVID-19 infection, irrespective of clinical
signs and symptoms.
Contact Tracing - the identification, listing, assessment, and monitoring of
persons who may have come into close contact with a confirmed COVID-19 case.
Contact tracing is an important component in containing outbreaks of infectious
diseases. (DM 2020-0189)
COVID-19 - the Coronavirus Disease 2019 which is caused by the virus known
as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (DC 2020-0286)
COVID-19 Alert Level System - refers to the new Community Quarantine
Classifications for dealing with COVID-19 covering entire cities, municipalities
and/or regions; aimed to manage and minimize the risk of the disease through
System Indicators, Triggers and Thresholds determined by the IATF to specify the
public health and social measures to be taken in relation to the COVID-19 response,
as may be updated based on new scientific knowledge, information about the
effectiveness of control measures in the country and overseas, and its application.
a. Alert Level 1 - refers to areas wherein case transmission is low and decreasing, total
bed utilization rate, and intensive care unit utilization rate is low.
b. Alert Level 2 - refers to areas wherein case transmission is low and decreasing,
healthcare utilization is low, or case counts are low but increasing, or case counts are
low and decreasing but total bed utilization rate and intensive care unit utilization rate is
increasing.
c. Alert Level 3 - refers to areas wherein case counts are high and/or increasing, with
total bed utilization rate and intensive care unit utilization rate at increasing utilization.
d. Alert Level 4 - refers to areas wherein case counts are high and/or increasing, with
total bed utilization rate and intensive care unit utilization rate at high utilization.
e. Alert Level 5 - refers to areas wherein case counts are alarming, with total bed
utilization rate and intensive care unit utilization rate at critical utilization.
Cluster - an unusual aggregation, real or perceived, of health events that are
grouped together as to time and space and that is reported to a public health
department.
For the purposes of this document, it is further defined as two or more confirmed cases
from the same area over a period of 14 days.

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 Damage Assessment and Needs Analysis (DANA) – is an assessment to
rapidly diagnose remaining functions and operational capacity of the systems, the
damage suffered, its causes and required repairs and rehabilitation; and quantify the
needs that must be met and estimate the time needed in order to establish key
services. Disaster Risk Reduction and Management in Health (DRRM-H)
Institutionalization – is the establishment of a functional DRRM-H system which
includes the following components: DRRM-H plan, health emergency response teams,
health emergency commodities and operations center.
Disaster Risk Reduction and Management in Health (DRRM-H) Plan – is a
three-year strategic health plan containing disaster risk reduction and management
measures in the four thematic areas: Prevention and Mitigation, Preparedness,
Response, and Recovery and Rehabilitation.
Disease - an illness due to a specific toxic substance, occupational exposure or
infectious agent, which affects a susceptible individual, either directly or indirectly as
from an infected animal or person, or indirectly through an intermediate host, vector, or
the environment (IRR RA 11332) | |
Disinfection - the process of reducing the number of viable microorganisms on a
surface to a less harmful level. It involves use of chemicals including but not limited to a
bleach solution, and is more effective if done after cleaning (which is the physical
removal of contaminants such as dirt, and organic material such as blood and
secretions from surfaces, using cleaning agents such as soap and water, among others,
as a first step in preparation for disinfection and sterilization) (MC No. 2020-0020).
Epidemiologic investigation - an inquiry to the incidence, prevalence, extent,
source, mode of transmission, causation of, and other information pertinent to a disease
occurrence; (IRR RA 11332)
Essential goods and services - covers health and social services to secure the
safety and wellbeing of persons, such as but not limited to, food, water, medicine,
medical devices, public utilities, energy and others as may be determined by the IATF
(MC 2020-0025)
Essential Health Service Package – a package that includes services that aim
to provide a focused approach for all affected individuals especially the vulnerable and
marginalized populations during emergencies and disasters. The package consists of
the four sub-clusters in the DOH-led Health Cluster namely Medical and Public Health
with the Minimum Initial Service Package for Sexual and Reproductive Health (MISP-
SRH); Nutrition; Water, Sanitation and Hygiene (WASH); and Mental Health and
Psychosocial Support (MHPSS)2 services.
Home Quarantine - an intervention where a person is prohibited from leaving
his/her room until allowed by the local health official or his/her designated physician to
do so, following the guidelines set forth in DOH Department Memorandum No. 2020-
0090 as well as the requirements set forth in MC No. 2020-0020,

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 Hazard Mapping – is a process of establishing geographically where and to what
extent a particular hazard and/or phenomenon are likely to pose a threat to the
community.
Hospital Safety Index Tool – is a rapid and low-cost diagnostic tool for assessing
the probability that a hospital will remain operational in emergencies and disasters.
Incident Command System – is the establishment of an organizational structure
that clearly defines the key offices and officials responsible for the overall management
of the event, with specific roles and functions to perform during pre-mpact, impact, and
post-impact phases.
Preparedness – is the strengthening of capacities of communities to anticipate,
cope, and ensure early recovery from the negative health impacts of emergencies and
disasters.
Prevention and mitigation – is avoiding hazards and limiting their potential health
impacts by reducing exposure to the hazards and the existing vulnerabilities of the
community.
Probable COVID-19 case:
A. A patient who meets clinical criteria above AND is a contact of a probable or
confirmed case, or epidemiologically linked to a cluster of cases which has had at least
one confirmed case identified within that cluster.
B. A suspect case (described above) with chest imaging showing findings suggestive of
COVID-19 disease*
* Typical chest imaging findings suggestive of COVID-19 include the following -
chest radiography: hazy opacities, often rounded in morphology, with peripheral and
lower lung distribution
-chest CT: multiple bilateral ground glass opacities, often rounded in morphology, with
peripheral and lower lung distribution
-lung ultrasound: thickened pleural lines, B lines (multifocal, discrete, or confluent),
consolidative patterns with or without air bronchograms.
C. A person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the
absence of any other identified cause.
D. Death, not otherwise explained, in an adult with respiratory distress preceding death
AND who was a contact of a probable or confirmed case or epidemiologically
linked to a cluster which has had at least one confirmed case identified within that
cluster.
Recovery and rehabilitation – is restoring and improving health facilities, health
conditions, and organizational capacity of affected communities, aligning with the
principles of sustainable development and “build back better”, to avoid or reduce future
disaster risk.
Response – are actions taken directly before, during or immediately after a
disaster in order to save lives, reduce health impacts, ensure public safety and
meet the basic subsistence needs of the people affected.

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 Suspect Case
i. A person who meets the clinical AND epidemiologic criteria:
(a) Clinical criteria:
(i) Acute onset of fever AND cough OR
(ii) Acute onset of any three or more of the following signs or symptoms: fever, cough,
general weakness, fatigue, headache, myalgia, sore throat, coryza, dyspnea,
anorexia/nausea/vomiting, diarrhea, altered mental status
(b) Epidemiologic criteria
(i) Residing or working in an area with high risk of transmission of the virus: for example,
closed residential settings and humanitarian settings, such as camp and camp-like
settings for displaced persons, any time within the 14 days prior to symptom
onset OR
(ii) Residing in or travel to an area with community transmission anytime within the 14
days prior to symptom onset; OR
3. Working in health setting, including within health facilities and within households,
anytime within the 14 days prior to symptom onset.
B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with
history of fever or measured fever of 2 38 C°; and cough; with onset within the last 10
days; and who requires hospitalization).

Temporary Treatment and Monitoring Facility (TTMF) -(also known as Mega

LIGTAS COVID Center) -larger scale versions of the LIGTAS COVID Center, managed
by the national government, operating at the provincial/regional level to supplement
LIGTAS COVID Centers and properly refer patients to appropriate facilities in
accordance with separate guidelines for the purpose to be issued by the DOH. (MC No.
2020-0020)
Telemedicine -the practice of medicine by means of electronic and
telecommunications technologies such as phone call, chat or short messaging service
(SMS), audio- and video-conferencing to deliver healthcare at a distance between
apatient at an originating site, and a physician at a distant site (MC 2020-0016)
(MC2020-0024) (MC 2020-0034)
Severe Acute Respiratory Infection (SARI) -an acute respiratory illness with onset during
the previous 7 days requiring overnight hospitalization. A SARI case should meet the ILI case
definition AND any one of the following: a). shortness of breath or difficulty breathing, b). severe
pneumonia of unknown etiology, acute respiratory distress, or severe respiratory disease
possibly due to novel respiratory pathogens (such as COVID-19) (AO 2020-0013)

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 VISION, MISSION STATEMENT

Vision Statement: A disaster resilient health system and community towards Universal Health
Care by 2025

Mission:

To enhance DRRM-H capacity in developing inclusive health polices, uninterrupted and

integrated health services and commitment to excellence in Health Emergency and Disaster
Management towards a resilient health system.

Goals:

1. To ensure institutionalization of DRRM_H, further strengthen the MHD HEMS capacity to

competently manage Emergencies and enhance multi sector coordination, collaboration
partnership
2. To guarantee uninterrupted health service delivery during emergencies and disasters,
avert morbidities and mortalities, and no outbreaks occur secondary to disasters and
emergencies

Specific Objectives:

1. To develop the Manila Health Department Prevention and Mitigation,

Preparedness, Response, Recovery and Rehabilitation Plans.

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 2. To provide and update policies, guidelines, procedures & protocols for an
effective Health Emergency Management Systems.

3. To develop competent, committed, compassionate human resources equipped

with modern and state of the art facilities at par with global standards for
emergency response.

4. To coordinate, enhance linkages with the 6 District Hospitals for better health
emergency management.

5. To ensure availability of logistics, funds, and other resources, in times of

emergency or disaster.

6. To establish new and strengthen existing partnerships and networking activities

both in government and non-government sectors.

7. To establish an organized method of documentation and data banking.

I. BACKGROUND

A. INTRODUCTION

Public health preparedness and response is a complex task involving expertise and
resources across public health sectors, encompassing public and private enterprises, and
extending across international, regional, national, and local stakeholders

The effects of covid 19 pandemic changes the health care delivery landscape,
some are be borne out of sheer necessity rather than innovation. Perhaps most
importantly, we have learned that pre-COVID emergency management and disaster
preparedness plans were insufficient to handle the scale, intensity, and duration of a
health disaster like COVID-19. The present situation requires that providers, including
hospitals, develop emergency preparedness protocols, including policies, procedures,
and communication plans and develop an “all-hazards integrated approach to planning
that focuses on capacities and capabilities that are critical to preparedness for a full
spectrum of emergencies or disasters.

The Disaster Risk Reduction and Management for Health (DRRM-H)is a

comprehensive program of the Department of Health purposely for managing all types of
emergencies and disasters caused by all types of hazards, be it natural or human
generated. This program was established through Executive Order102 s. 1999:
“Redirecting the Functions and Operations of the DOH” to be managed by the Health
Emergency Management Bureau (formerly HEMS), to be operationalized by the DOH
Regional Offices and hospitals, as well as to be implemented by the Local Government
Units.

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 The DRRM-H Program mainstreams the activities of the Four Thematic areas in
the Disaster Risk Reduction Framework namely: Disaster Prevention and Mitigation,
Disaster Preparedness, Disaster Response, and Disaster Recovery and Rehabilitation
aiming to build a safer adaptive and disaster resilient Filipino communities towards
sustainable development. Embedded in the program are plans, strategies, and activities
addressing the risk factors which are the hazards, community exposure and
vulnerabilities as well as capacities to manage risks before disaster strikes;
spearheading an organized response during disaster and recovering for better after the
disaster.

The challenges of the Disaster Management for Health include further

capacitation and trainings and other activities that will arm the response team
and support workforce. Political leadership not political will with legislative
support from the national and local government and multi-stakeholder
collaboration and partnership making DRR an integral part in planning and
programming of the local authorities.

B. HISTORICAL BACKGROUND

Manila, capital of the Philippines, is the oldest city in Metro Manila. It is

the “seat of political power” where the Malacañang Palace, the Supreme
Court, Department of Justice, Manila City Hall and United States Embassy
are located. This makes the city vulnerable to demonstrations, protest rallies and
mass casualty incidents. Major national government offices located here are the
Department of Health, Dept. of Labor & Employment, Dept. of Public Works and
Highways etc. Many renowned universities and colleges like the 400 years old
University of Santo Tomas, University of thePhilippines Manila, the Philippine
Normal University, Centro Escolar University, the University of the East, 100
years old De LaSalle University, San Sebastian College, San Beda College,
and College of the Holy Spirit are also found in Manila. The famous Minor
Basilica of the Black Nazarene in Quiapo, Our Lady of Mount Carmel in San
Sebastian Church, Manila Cathedral and San Agustin Church in Intramuros,
and many high rise buildings and Shoe Mart malls dot the City of Manila. These
are all possible targets of terrorist attacks that can bring about mass casualties.
Its diverse characteristics make it prone to various hazards.

Fire, on top of natural disasters such as earthquakes, can also bring about
untold losses of lives and properties. Being a city with numerous commercial
establishments such as Manila Chinatown, it is prone to untoward incidents like
robbery – hold up, kidnapping, hostage taking. Other potential sources of critical
incidents are the chemical plants like the Pandacan oil depot and mercury spill
The Manila bay area can be wrecked by tsunamis / storm surge and the slum
areas in the city’s 896 barangays are prone to typhoon, flood, fire, destructive

15
earthquake and disease outbreaks. In addition, Manila has two big seaports --
North and South harbors -- probable entry-points of domestic and international
visitors with disease potential for epidemics such as SARS (Severe Acute
Respiratory Syndrome), Avian Flu H5N1 and pandemics like Influenza A H1N1
virus, MERSCOV , EBOLA virus and the most recent COVID-19 virus.

C. DEMOGRAPHY

Based on the 2021 Census, Department of Health – Center for Health

Development (DOH-CHD), the population of Manila was estimated to be
1,951,758.
Total Population 1,951,758
Day time Population 3.8 M+
No. of Households 476,545
Population Density 46,654 / square kilometer
Land Area 38.52 square kilometers
Congressional Districts 6
Barangays 897
Depressed Brgy 229 Non Depressed Brgy 668
Public Elementary Schools 69
Public High schools 31
One City University Pamantasan ng Lungsod ng Maynila
One City College City College of Manila
6 District Hospitals Gat. Andres Bonifacio Memorial
Medical Center
Ospital ng Tondo
Justice Jose Abad Santos Medical Center
Ospital ng Sampaloc
Ospital ng Maynila
Ospital ng Sta Ana

Private Hospitals 25 ( UST Hospital, Manila Doctors etc.)

DOH Hospitals 4 (Jose Reyes Medical Center, San Lazaro

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Hospital ) 1 UP – Philippine General Hospital
Office of the President
2 Cemeteries North and South cemetery

Number of Barangays

Thee CITY
Th CITY OF
OF
OF
MANILA D II

DI
D IV

D III
Land
38. 28 Km2
Area D VI
6 congressi onal
di stricts
strict s D V

Fig. 11. 6 Districts, City of Manila

The City is divided into six (6) congressional districts with 100 zones and 897barangays.

Fig. 1 Map of the 6 Manila Congressional Districts

TABLE 1. ESTIMATED POPULATION PER DISTRICT 2022

BARANGAY N O N DEPRESSED DEPRESSED TOTAL POPULATION HEALTH

17
 CENTERS

DISTRICT NO. POPULATION NO. POPULATION

I 97 237,591 40 218,143 No. of 455,734 10
II 86 141,922 36 94,310 Health 236,232 5
Centers
III 96 156,536 27 86,619 10 243,155 5
IV 162 220,270 30 70,327 5 290,597 9
V 127 171,165 57 231,165 5 402,330 9
VI 100 191,743 39 131,967 9 323,710 7
TOTAL 668 1,119,227 229 832,531 9 1,951,758 45

TABLE 2. AGE AND SEX DISTRIBUTION 2022

Both
Age Group Sexes % Male Male % Female Female %
Under 1 32,743 16,918 15,825
12-23 mos. 32,384 16,633 15,754
12-59 mos. 131,544 67,745 63,802
5-9 yrs 170,711 87,794 82,914
10-14 yrs 175,367 89,934 85,435
15-19 yrs 161,967 81,272 80,693
20-59 yrs 1,091,700 538,210 553,490
60 yr & above 187,722 81,301 106,422
Total 1,951,758

D. GEO-HAZARD MAPPING

18
Legend
PEIS Intensity Low VII

PEIS Intensity Low VIII

PEIS Intensity High VIII

Fig 2 Ground Shaking hazard map, City of Manil

19
 2013 READY
GMMA

Yellow- Low

Violet- Moderate

Red – High

White- Safe

Fig 3 Liquefaction Potential Map, City of

Manila

TSUNAMI MAP CITY OF MANILA

20
 Fig 4 Tsunami map, City of Manila

District Hazard Maps

21
Fig 5 District 1 Hazard Map

22
Fig 6 District 2 Hazard Map

23
Fig 7 District 3 Hazard Map

Fig. 8 District 4 Hazard Map

24
Fig 9 District 5-A Hazard Map

25
Fig. 10 District 5-B Hazard Map

26
 Fig. 11 District 6 Hazard Map

E. MANILA HEALTH DEPARTMENT RESOURCES

27
 a. Manpower
 Physician 143
CHO 1
ACHO 1
Medical Officer V 18
Medical Officer IV 78
Medical Officer III 45
 Dentist 145
Dentist V 1
Dentist IV 19
Dentist III 67
Dentist II 57

 Nurses 185
Nurse VI 1
Nurse V 17
Nurse IV 34
Nurse III 63
Nurse II 70
 Midwife 189
 Sanitation Inspector 72
 Medical Technologist 52
 Pharmacist 7
 Rad Tech 4
 Physical Therapist 2
 Nutritionist 7
 Optometrist 1
 Psychologist 2
 Pest Control 29
 Nursing Attendant 55
 Dental Aide 18
 Laboratory Aide 23
 HEPO 8
 Security Guard 11
 Administration 298

TOTAL 1164

The Department has an actual manpower of 1,205; eighty three percent

(83%) of which are plantilla personnel; maximally utilized to render basic health
services
b. Health Facilities
 45 Health Centers

28
  2 Lying-In-Clinics
 1 City Government Employees Clinic
 1 Geriatric Clinic
 1 Insect and Vermin Control Office
 1 Public Health Laboratory
 2 Cemeteries (North and South)
 2 STI/HIV/AIDS Prevention Clinic
 1 Drug Rehabilitation/Treatment Clinic
 6 Animal Bite Clinics

F.HEALTH INDICES

 TABLE 3 VITAL HEALTH INDICES ( 2021 )

POPULATION
1,951,758

CRUDE BIRTH RATE

31.54 %

CRUDE DEATH RATE

9.84 %

INFANT MORTALITY RATE

26.68 / 1000 LB

MATERNAL MORTALITY RATE

0.81 / 100,000 LB

29
 UNDER 5 MORTALITY RATE
40.74 / 1000 LB

NUTRITIONAL STATUS OF
0-59 MOS. CHILDREN
2020 2021
Classification Number % Number %
Severely UW 831 0.56 693 0.51
Underweight 1982 2.04 1797 1.33
Overweight 821 0.85 751 0.55
Normal 93,369 96.25 132,219 97.61

Natality
 A total of 17,236 live births were registered for the year 2021. Of
the total babies born, 48.71 % (8,936 are males and 51.29%
(8,300) are females.
 Facility based deliveries was noted at 99.8 % (17, 201) and 0.20%
(35) were delivered at non health facility.
 Mortality and Morbidity Data
 Total deaths were registered for 2021 was 18,508 (9.84%) showing
a slight decrease as compared to the figure in 2018 , 10.84%
( 20,096). 10,119 OR 5.38% were Manila residents and 45.33%
( 8,389) were residents of other cities/municipalities. Crude death
rate is 9.84/1,000 population in 2019, which showed an decrease
of 0.2% % as compared to 10.04/1,000 CDR of 2018.
 Under Five Mortality Rate of 40.74/1,000 live births. Maternal
deaths were 48 giving a Maternal Mortality rate of 0. 81/1,000 live
births.

TABLE 4. TEN LEADING CAUSES OF MORTALITY , 2020 vs 2021

DISEASES 2020 DISEASES 2021

1. Heart Disease 3,160 Heart Diseases 3,798
2. Cancer 1,050 Covid 19 2,174
3. HCVD 831 Hypertensive CVD 1,429

30
4. Pneumonia 816 Cancer 1,059
5. Diabetes Mellitus 637 Pneumonia 999
6. Chronic Kidney Disease 350 Diabetes 693
7. Tuberculosis 297 Chronic Kidney Disease 443
8. CVA 222 Cerebro Vascular Accident 351
9. COPD 137 TB 287
10. Wound -Stab, GSW 86 COPD 198

TABLE 5. TEN LEADING CAUSES OF MORBIDITY 2020 vs 2021

Hypertension dominates the causes of morbidity, probably stress related to the pandemic

DISEASES 2020 DISEASES 2021

1. Acute Respiratory Infection 55,023 1.Hypertension 12,762
2. Hypertension 14,871 2.Acute Respiratory Infection 12,754
3. Pneumonia 5,928 3.Animal Bite 7,928
4. TB Respiratory 4,217 4.Diabetes Mellitus 2,991
5. Diabetes Mellitus 4,032 5. TB Respiratory 2,530
6. U T I 3,422 6. U T I 1,873
7. RABIES 3,284 7. Bronchitis 1,321
8. Bronchitis 3,005 8.Pneumonia 850
9. Diarrhea 2,135 9. Diarrhea 823
10. Bronchial Asthma 1,524 10. Dengue 381

TABLE 6 LEADING CAUSES OF INFANT MORTALITY 2020 vs. 2021

DISEASES 2020 DISEASES 2021

1. Pneumonia 94
2. Prematurity 94
3. Intrauterine Fetal Death 74
4. Congenital Heart Disease 19
5. Multiple Congenital Anomalies 19
6. Acute Gastroenteritis 14
7. Anencephaly 7
8. Birth Asphyxia 7
9. Bacterial Meningitis 6

31
10. Congenital Hydrocephalus 5

The top 5 leading causes of Infant Mortality (Table 6) are Prematurity,

Pneumonia, Congenital Heart Disease, Pneumothorax and neonatal pneumonia.
The top 5 leading causes of Maternal Mortality (Table 7) were Pre-
Eclampsia, Eclampsia, HELLP Syndrome, Uterine Atony and induced abortion.

TABLE 7. TEN LEADING CAUSES OF MATERNAL MORTALITY 2019

2020 DISEASES NUMBER 2021 NUMBER

PRE ECLAMPSIA 5 PRE ECLAMPSIA 8

ECLAMPSIA 1 ECLAMPSIA 5

HELLP SYNDROME 1 POSTPARTUM 4

UTERINE ATONY 2 COVID 19 3

INDUCED ABORTION 1 UTERINE ATONY 2

ABRUPTIO PLACENTA 1 SEPSIS 1

PULMONARY EMBOLISM 1 RUPTURED ECTOPIC PREG 1

PERI / POSRTPARTUM
1 POSTPARTUM HEMORRHAGE 1
CARDIOMYOPATHY
MYOCARDIAL INFARCTION 2 POSTPARTUM ECLAMPSIA 1
THYROTOXIC HEART FAILURE 1 PLACENTA INCRETA 1

TABLE 8. HOSPITAL BED CAPACITY

MANILA NUMBER OF AUTHORIZED BEDS

(GOV'T
TOTAL

RATIO
BEDS

POP.

(DISTRIC POPULATIO GOVERNMENT

BED
VAT
PRI

T) N 2019 Other Local & Gov't

Retained
Owned
Gat Andres Bonifacio
I 451,077 Tondo Medical Center
Medical Center 350
II 233,677 OspitalngTondo 50
Jose Reyes Medical
Jose Abad Santos
III 240,537 Center San Lazaro
Medical Center 150
Hospital
IV 287,462 Ospital ng Sampaloc 50
V 397,722 Phil General Hospital Ospital ng Maynila 300
VI 320,221 Sta Ana Hospital 300

TOTAL 1,930,696 1200

32
TABLE 9. 6 LGU HOSPITAL BED CAPACITY

Equip
surge
No. of

Capa
Servi

Resp
onse
Neur
oSur

AMB
Gen.

EMT
beds

Bed

ped

# of
ICU

city
OR
Hospital

ce

#
GAT ANDRES
BONIFACIO 3 4 350 2 6 2
MEDICAL CENTER

OSPITAL NG 3 8 9 50 2 8 31 BN
TONDO
JOSE ABAD
SANTOS MEDICAL 3 6 5 6 150 2 6 2
CENTER
2
OSPITAL NG 3 - 2 5 50 2 5 1 BN
SAMPALOC

OSPITAL NG 5
3 7 7 8 300 2 10
MAYNILA 4 BN

2
STA ANA 3 - 4 6 300 2 3 2 BN
HOSPITAL

II. PLANNING

A. PREPARING TO PLAN
DRRM-H planning is a participative process, carefully studying the hazards, risks,
vulnerabilities and capacities of an area. Additionally, it is a systematic, systemic, strategic,
evidence-based, and consultative process to come up with a national, regional, provincial, city,
municipal, barangay, and hospital DRRM-H Plan and properly implement it to ensure resilient
health systems in these levels of governance

Fig.12 preparing to plan

33
 Fig.13 Planning Committee and partners

Taking into consideration, the DRRM-H Goals and Objectives, the planning and steering
committee in collaboration with the partner agencies ( Hospitals, Barangay LGUs, etc) convene
to discuss, develop and update the DRMM-H plan. This should be adaptable to the stresses
brought about by disasters and emergencies in order to cope up with an inclusive response and
management leading to a resilient community and health system, as summarized in the figure
12

B.ROLES AND RESPONSIBILITIES OF THE DRRM-H PLANNING COMMITTEE

• Develop, review, and update the previous plan

• Gather required information and secure commitment of key people and organizations
• Initiate testing of the plan for its functionality and adaptability to current situation
• Develop annual operational plan and other plans relevant to health emergencies and disasters
• Monitor and evaluate the plan

Specific Roles & Responsibilities

a. City Health Officer

1. Directs and supervises communications and activities during emergency
situations
2. Oversee the emergency medical services in the city.
3. Receives and transmit messages from the Office of the Mayor / Manila Disaster
Risk Reduction Management Office to the District I - VI Emergency Management Office.

34
 4. Coordinates with the Manila Disaster Risk Reduction Management Office for
availability of heavy equipment’s like trucks, rubber boats – transport of personnel and
medical supplies in flooded areas.
5. Provide medical supplies needed by the District I – VI Emergency Management
Office.

b. Assistant City Health Officer

1. Directs and supervises coordination among District Emergency Management
Office and District Emergency Station.
2. Assists the City Health officer and assume its function in his / her absence.

c. Chief Emergency Management

1. Develops plans, guidelines, protocols, for the prevention and response to health
emergencies.
2. Organize and coordinates health sector efforts for health emergency
preparedness.
3. Facilitate capability building of MHD employees on emergency management
4. Initiate advocacy activities.
5. Maintain, set up and update information center for emergencie
6. Conducts monitoring and evaluation activities
7. Receives and transmit messages from the CHO to the District Emergency
Management Office / Station.
8. Consolidates disaster reports and recommends immediate solutions.
9. Acts as Official spokesperson when designated by the CHO

d. District I - VI Emergency Management Officer

1. Serves as emergency management office in their respective districts
2. Direct and supervises Emergency Management Stations / Teams during disaster.
3. Coordinates with the CHO and Emergency Management Coordinator their
immediate needs.
4. Provide medicines and emergency supplies needed by their Emergency
Management Stations / Teams.
5. Provide the MDRRMO and Emergency Management Coordinator with updated
reports and situationers in their respective districts

C. DATA GATHERING
AND ANALYSIS

35
 Fig. 14 Data Gathering Framework

The figure above was followed during data gathering on Hazards, Risks, vulnerability
and capacity to respond to disasters. History from previous incidences, are collected and
analyzed.

A workshop, mapping and brainstorming was done in order to come up with a

comprehensive data to be used for development and updating the DRRM-H plan.(fig 14)

Fig. 15 Risk Assessment workshop framework

D. RISK ASSESSMENTS
Risk Management is a comprehensive strategy for reducing threats and
consequences to public health and safety of the community by:
a. preventing exposure to hazards (target = hazards)
b. reducing vulnerabilities (target group = community)
c. developing response and recovery capacities(target group = response
agencies)

36
 Risk management includes the process of selecting a hazard, identifying the
communities exposed to that hazard, predicting the consequences of that hazard
interacting with that community, analysing each of the 5 elements of community in
relation to the hazard to identify the factors which will lead to each consequence (i.e.
determines the vulnerabilities of each element), and identifying the capacities within the
community to respond to that hazard. (Fig 15)
The formula observed in Risk Management is as follows:
Risk = Hazard X Exposure X Vulnerability
Capacity
This means that even if there is high possibility of hazard and there is high
vulnerability of the community, if the community capacity to manage is also high, then
the probability or risk to occur is low. Therefore, it takes a high capacity or preparedness
of the community to prevent hazard and reduce vulnerability so that risk can be
managed. We equate the capacity with preparedness of the community in risk
management.
Risk Assessment Process done include the following :
 Preparation of the hazard profiles and previous experiences and
history
 Mapping the distribution of hazards
 Identification of the elements of the community exposed to
the hazards
 Prediction of the consequences of a hazard interacting with
the community at a certain time
 Analysis of the five elements of community in the context of the
hazards to identify the factors that lead to each consequence i.e.
determines the vulnerabilities of each element
 Assessment of the response and recovery capacities within
communities (level of readiness)

1. Hazard Identification and Prioritization.

a. Hazard Assessment Matrix

TABLE10 . PRIMARY / SECONDARY HAZARD ASSESSMENT MATRIX

PRIMARY SECONDARY Severity Frequen Extent Duratio Manage total rank

HAZARD HAZARD (A) cy (C) n Ability
(B) (D) (E)

37
 A. Natural
FLOOD 4 2 1 1 5 3
Leptospirosis

Skin diseases

Water born
diseases
TYPHOON 4 4 3 4 4 11 4
Fallen debris

Flood

Loss of life
line
EARTHQUAK
E 4 1 4 4 4 9 5
Collapse
structure
liquefaction

Fire

Loss of life
line
Inc. trauma
patients
TSUNAMI 4 1 2 2 4 5
Collapse
structure
Mud slide

Flood

1. TORNADO 2 1 1 1 4 1
Fallen debris

Collapse
structure
2. EL NIñO 4 1 3 3 5 6
3. LIGHTNING
4. LANDSLIDE
Collapse
structure
Flood

Mud slide

5. LIQUEFACTI
ON 4 1 4 3 3 9
Collapse
structure
Fire

Loss of life
lines
Inc. trauma

38
 patients
B. Biological
1. DISEASE
OUTBREAK/PAN
DEMIC 5 5 5 5 2 18 1
Increase
death
Inc. in
infectious dse.
2. RED TIDE 1 1 1 1 3 1
3. FOOD
POISONING 1 1 1 1 3 1
Inc . patient w/
DHN
C. Technological
1. FIRE Loss of life 5 5 3 3 4 12 3
Displaced
families
Disrupted
living
conditions
2. VEHICULAR
ACCIDENTS 3 3 3 3 4 7
3. Increased
death
Increase in
trauma cases
D. Societal
1. SUBSTANCE
ABUSE 4 5 5 5 4 15 2
2. Criminality
Loss of
livelihood
3. TERRORISM
(Bombing
Incidents,
hostage
taking) 3 1 3 2 3 6
4. Inc. death

Civil
disturbance
Interaction of
livelihood and
source of
income
5. RALLIES 3 1 3 3 4 6
6. Civil
disturbance
Violent
dispersal
Traffic
Road rage
7. MASS 3 2 3 3 3 8
GATHERING
S
8. Civil
disturbance
Traffic

Road rage

39
 b. Kaisler Permanente Analysis and Prioritization tool is also used.
Table 11 KP Analysis Tool

Relative
Type of Hazard Rank
Risk(KP)

PANDEMIC 1 82%
SUBSTANCE ABUSE 2 73%
FIRE 3 68%
TYPHOON 4 60%
FLOOD 5 55%

2. Hazard Analysis Result

From the Data gathered from the matrix above, and the Kaiser Permanente tool, the
following Prioritization are obtained:

HAZARD AREAS COMMONLY AFFECTED

Maceda, Espaňa, Dimasalang Table 12

FLOOD R. Magsaysay Boulevard. V. Mapa Hazard
Quiapo Area, Pier
Analysis
FIRE Result
TYPHOON Parola, Isla Putingbato, Baseco, Smokey Mountain

DISEASE
OUTBREAK Parola, Isla Putingbato, Baseco, Smokey Mountain

SUBSTANCE
ABUSE Parola, Isla Putingbato, Baseco, Smokey Mountain

DENGUE/Leptospirosis Parola, Isla Putingbato, Baseco, Smokey Mountain

Malacañang Palace, Chino Roces Bridge, Lawton, Dept. of Justice,

Prayer / Protest Rallies
Freedom Parks

Storm Surge Roxas Blvd, Baseco, Isla Putting Bato

Waterspout Roxas Blvd, Baseco, Isla Putting Bato

Tsunami Parola, Isla Putingbato, Baseco, Smokey Mountain

Earthquake Manila

Terrorism Malacañang, Universities & Colleges, Malls

40

Pandemic/ (Covid-19) Manila

The table below shows the most common areas affected by the above Hazards

Table 13 Most Commonly Affected Areas

RESOURCE
TIME REQUIREMENT PERSON INDI
HAZA
STRATEGY ACTIVITY FRA RESPON CAT
RD Req’d Avai
ME Source SIBLE ORS
. l
Grow

P th
rate

A MPHS,
Surveillance, ON Antige
yes
LGU,
DOH,
MHD,
Case
s

N PDITR antigen testing for GOING n kits Barangay teste

Donations
prompt isolation d

D and
isolat

E Vacci MHD,
ed

M Ramp up ON
nes
and LGU,
Barangay No.
Fully
I vaccination
Booster GOING relate
d
yes DOH,
Donations
vaxx
ed
C logisti
cs
Health Education, ON MHD, Bgy
GOING
Risk promotion HEPO with
Communicati Barangay Healt
on h
statio
ns
no.
BHE
RTS
train
ed

41
 Granular Intensified DILG No.
ON
Lockdown Police GOING MPD of
operations/visibility Mayor EOs

3. Hazard Prevention Plan

Table 14 Pandemic Prevention Plan

Table 15 Substance Abuse Prevention Plan

RESOURCE
TIME REQUIREMENT PERSON
HAZAR
STRATEGY ACTIVITY FRAM RESPONSIB INDICATORS
D Req’ Ava Sourc LE
E
d. il e

Rehabilitat
City
Rehabilitati Intensified ed
Engine
S on of Drug Drug
2022 er
reformed
dependents rehabilitation drug
U & users programs
DPWH
dependent
Mayor
B s & users
City
S New Build new Engine
T rehabilitatio rehabilitation 2022 er same
n centers centers DPWH
A Mayor
N
Psycho Counseling
C social Reformation of DOH
2022 same
E Mental Drug MHD
Health Dependents
Advocacy

42
 Apprehensi
DILG
on
Intensified PNP
& detention Jailed
Police NCRP
of Drug 2022 Drug lords
A operations/visibi O
lords / Pushers
lity MPD
B pushers
Mayor
U
S

Table 16 Fire Hazard Prevention Plan

TIME RESOURCE PERSON

HAZAR FRAME REQUIREMENT RESPONSIBLE INDICATO
STRATEGY ACTIVITY
D RS
FRAME Req’d. Avail Source RESPONSIBLE

Spea MDDRRMO
F Fire
Safety
Training
/ Fire 2022
ker NO
BFP
, BFP /
Number
of Fire
I Seminars drills
Train
ers
NE MHD / City
Ad
drills
R
E Advocacy Lectures
IEC No of
Fire , IEC FE
2022 mater DOH MHD / BFP advocac
Preventio material W
ials y done
n s
Elderly,
Identify MHD /
MHD bedridd
Master elderly NO Health
2022 perso MHD en PWD
listing bedridde NE Center
nnel identifie
n PWD personnel
d

43
 Evacuat
MHD MDRRMO
Identify ion
Evacuatio / MHD,
evacuati 2022 Done areas
n Areas MDS MDSW
on areas identifie
W Brgy
d
Fire
Coordinate
Identify prone
Hazard Reco FE with Bureau
fire prone 2022 BFP areas
mapping rds W of Fire
areas identifie
Protection
d
Strict Coordinate Decreas
Regular
implement Inspe FE with BFP, e fire
inspectio 2022 BFP
ation of ctors W Bureau of incidenc
n
Fire Code Permits e

More
Fire trucks Coordinate
Acquire fire
& with BFP,
more fire FE trucks &
personnel 2022 DILG BFP Office of the
trucks W PPE
protective Mayor
and PPE acquire
equipment MDRRMO
d

RESOURCE
REQUIREMENT
8HAZAR TIME PERSON INDICATO
STRATEGY ACTIVITY
D FRAME RESPONSIBLE RS
Req’d. Avail Source

Better
T evaluati
Y Updated, PAGASA
on/
Cancell
P PAGASA frequent
2022
TV ation
H Alert
system
PAGASA
monitoring
NETWOR
KS
ofclasse
s
O Suspen
O sion of
work

44
 Installation City Better
Rain /
of more Engineer monitori
wind 2022
rain - wind DPWH ng
gauges
gauges Mayor system
N

City
Installation Better
Engineer
Doppler of more estimati
2022 DPWH
System Doppler on of
Mayor
System rainfall

Table 17 Typhoon Hazard Prevention Plan

Table 18 Flood Prevention Plan

RESOURCE
REQUIREMENT
TIME PERSON INDICATOR
HAZARD STRATEGY ACTIVITY
FRAME RESPONSIBLE S

Req’d. Avail Source

F Waste
De
clogging /
Minimal
clogged Increased City
flooding
L drainage
systems,
size of
concrete
2022
Engineer
DPWH
in low
lying
canals, pipes Mayor
areas
O esteros layed

Proper 2022 DPS Good /

O Poor waste
disposal
waste
segregati
Mayor
City Ad
minimal
waste

45
 system on
disposal
advocacy

Instalation
oif Height
City Height
Height meter
Engineer meter
meter signages 2022
DPWH signages
signages in
Mayor installed
underpas
s, bridges

D Removal of
informal Relocatio City
Informal
settlers n of Engineer
2022 settlers
near informal DPWH
relocated
canals. settlers Mayor
esteros

Table 19 Earthquake Prevention Plan

TIME RESOURCE REQUIREMENT

PERSON INDICATOR
HAZARD STRATEGY ACTIVITY FRAM RESPONSIBLE S
E Req’d. Avail Source

F Pre / Post
Pre / Post IEC MHD Health
On- Consultatio
Advocacy Consultatio Material E DOH Center
going n Lectures
n Lectures s w Personnel
E done

A
R Ea
Earthquak Speake
N
O PHIVOLC
MHD
Coordinate EQ Drills
rthquake 2022
T seminars
e drills r
Trainers N S w/ done
PHIVOLCS
H E

Q
U N
O MMDA Coordinate MHD
Capacity Speake
A Earthquake
trainings
building, 2022 r N
BFP
MDRRM
w/ MMDA
BFP
Personnel
underwent
ELSAROC
K Trainers E O MDRRMO trainings

E Master Identify 2022 HC MHD MHD Health Elderly,

listing elderly Center bedridden
bedridden Personnel PWD
PWD identified

46
 Identification
F Coordinate Condemne
of high risk Hazard Inspect
& map 2022 ors
E City Engr w/ City d buildings
w Engineer identified
condemned
buildings
Strict
implementati F Coordinate Non-
Regular On
on of same E same w/ City issuance of
building
inspection going w Engineer permits
code

F Coordinate
Structural Buildings
assessment
Retrofit 2022 same E same w/ City
retrofitted
w Engineer

Table 20 Dengue Prevention Plan

RESOURC
ACTIVIT TIME E
Y FRAME REQUIRE PERSON
HAZARD STRATEGY MENT RESPONSIBLE
FRAM Req’d. Avail
Sourc RESPO
E e NSIBLE
Active
Search &
Surveillance MHD
destroy Breeding
Larval On
Mosquitoes None MHD places
D Interruption
breeding
going Sanitatio destroyed
Management
E (ASLIM)
places n
Division
N
G Knowledge
Training /
F
Increase
IEC
U Skills
seminars on
2022 Materi E DOH MHD
number of
vector seminars
E surveillance
als
trainings
Attitude w
MHD Pre / Post
Pre / Post IEC F Health Consultati
On
Advocacy Consultation Materi E DOH Center on
going
Lectures als Personn Lectures
w el Done

47
 MHD
Identification Health Dengue
Master listing of Dengue 2022 None MHD Center cases
cases Personn identified
el
MHD
DEP
Formation of Clean
Environmenta ED
dengue 2022 None MHD environme
l sanitation Baranga
brigades nt
y
Bureau

4 O ‘Clock On
None MHD Same Same
habit going

E. VULNERABILITY ASSESSMENT

1. Concept of Vulnerability Assessment

UNISDR defines vulnerability as the “conditions determined by physical, social,

economic and environmental factors or processes which increase the susceptibility
of an individual, a community, assets or systems to the impacts of hazards.”
Simply put, vulnerabilities are the weaknesses of the five elements of the
community – people, properties, services, livelihood and environment.

2. Objectives of Vulnerability Assessment

 To identify the vulnerabilities in City of Manila as to the five elements of

the community toward the priority hazards identified and predict the potential risks
 To identify the gaps why these vulnerabilities exist

3. Process of Vulnerability Assessment

 Assessing the vulnerable elements of the community by relating the

priority hazards identified to the vulnerabilities of the five elements of the
community.
 Identifying the community vulnerabilities and gaps by listing down the
various vulnerabilities of the five elements of the community.
 Identifying the gaps of the vulnerabilities

4. Vulnerabilities of the Community and Gaps

48
 As a result of the overall vulnerability assessment, the properties in MANILA are
highly vulnerable while the rest of the elements, including the City Health Office as
represented by the health facility, are moderately vulnerable.

Table 21 Vulnerabilities of the Community and Gaps

Elements Vulnerabilities Gaps
People
  No/low awareness on DRRM-H      Low awareness of DRRM-H

      Lack of trained staff for

lifesaving skills [basic life support
      Loss of trained staff for
(BLS), standard first aid (SFA),
lifesaving skills
emergency medical technician
(EMT)

      Lack of trained staff for

Nutrition in Emergencies (NiE);
      Lack of access to lifesaving
Water, Sanitation & Hygiene
supplies, equipment & first aid kits
(WASH); and Mental Health &
Psychosocial Support (MHPSS)

      Poor compliance to       Inadequate trained

evacuation plan responders

      Lack of awareness in

      Inadequate evacuation
accessing lifesaving supplies,
centers resulting to overcrowding
equipment and first aid kits

      Inadequate trained       Poor sanitation & waste

responders management

      Poor sanitation & hygiene

practices, poor health education &
      Insufficient vaccinators and
lack of information education
low FIC
campaign (IEC) materials

      Responders are victims of

      Insufficient vaccinators
disasters

49
       Low fully immunized child       Many astray animals, poor
(FIC) rodent and vector control

      Responders are victims of       Poor implementation of NiE,

disasters WASH and MHPSS

      No isolation place in

evacuation centers for sick victims &
pregnant women about to deliver
      No friendly spaces for
vulnerable population in evacuation
centers

      High rate of lost-to-follow-up

patients

      No back-up for patient’s

records

      High rate of animal bites

      Poor access to nutritious

foods / micronutrients

      Lack of support groups

Property       Facilities do not follow the       Disaster risk reduction is not
building code therefore are not considered in the facility
disaster resistant development

      Health centers have no

DRRM-H plan, contingency &       Lack of plans
continuity plans

      Lack of back-ups (weak

      Surge capacity not available
resource management system)
      No back-up system for
critical resources       Poor logistics management,
storage and warehousing

      DRRM-H has competing

      No funds for a bigger and
priority with other health programs
safer health warehouse
even during disaster
      Inadequate evacuation       Many critical facilities not

50
 covered by the new building code
centers with overcrowding
standards

      Lack of local support in

      Lack of transportation for
building warehouses safe from
victims
disaster

      Lack of logistics: medicines       Health facilities have poor

and medical supplies, vaccines, surge capacity to manage the influx
laboratory reagents of victims

      Inadequate evacuation

      Lack of sanitary toilets
centers

Services
      Poor delivery of health care       Surge capacity is not a
services due to victimized providers priority

      Program and health care

      Lack of reagents, laboratory
delivery systems are not adapted to
supplies and equipment
disaster situation

      Lack of field health facilities

      Lack of contingency plan
for temporary victim management
      Poor delivery of services of
      Lack of hygiene promotion
health facilities
      Lack of sanitary toilets       Service providers are victims

      Inadequate Nutrition       Difficult replenishment of

logistics damaged logistics
      Unclear mechanism on how
      Lack of trained staff in
to request for assistance in times of
MHPSS
disaster

      Lack of waste management

      Lack of MHPSS logistics
system in times of disaster

      Lack of vulnerable groups’

      Poor NiE, WASH and
friendly spaces
MHPSS services

      No continuity of long-term       Lack of health programs

treatments implementation during disasters

51
       Lack of back-up for patient’s
records
      Lack of treatment protocols
of the different health programs in
emergencies

      Lack of networking of health

facilities

      Weak surveillance services

and poor reporting
      Poor delivery of hospital
services due to: lack of medical
specialists, blood & blood services,
special cases and lack of field
hospital

      Non-compliance to SPEED

      DRRM plan does not

      No alternative employment consider preparing for alternative
(work for cash or food) employment package in times of
disaster
      Lack of consideration for risk
      Lack of insurance package
financing
      Lack of price regulation       Weak price monitoring &
policy regulation during disasters
Livelihood
      Lack of business continuity
      Hoarding practices
plan
      No monitoring of basic life
supplies

      Poor planning / budgeting

      Lack of mainstreaming
disaster risk reduction in the
community

      Environment is vulnerable to

      No funds for procurement of
Environment fire due to lack of fire suppression
water filtration equipment
system

52
       Presence of informal settlers
      Poor zoning & land use
leaving the alleys inaccessible to fire
program
trucks

      Illegal connection of water       Poor implementation of Fire

and electrical supplies Prevention & Control Program

      Poor environmental

      Poor practices of informal
condition due to houses located in
settlers
dumping sites, bridges, etc.
      Non-adaptation of the Waste
      Poor sanitation, hygiene and
Management System in evacuation
health care practices
centers
      Clogged canals with
      Poor community discipline
stagnant water due to improper
and participation
waste disposal
      Poor land development       Poor drainage system

      Waste Management System

during disasters is not a primary
consideration with no back-up
system for collection of voluminous
wastes

      Lack of sanitary toilets

5. Vulnerability Rating Criteria

 Green LOW vulnerability; weaknesses that can result to risks that

are manageable by the community.
 Yellow MODERATE vulnerability; weaknesses that can result to
risks necessitating citywide response.
 Red HIGH vulnerability; severe weakness that can result to very
severe impacts or risks that are too difficult to manage or non-manageable at
all by the city needing regional or national aid or beyond.

6. Vulnerability Assessment Results

TABLE 22. Vulnerabilities of the Five Elements of the Community

53
Type of *Health Livelihoo
People Property Services Environment
Hazard Facility d

PANDEMIC

SUBSTANCE
ABUSE

FIRE

TYPHOON

FLOOD

DENGUE

EARTHQUAKE

TERRORISM

7. Vulnerability Assessment Plan

54
 Vulnerable Vulnerabilities
Hazard
Areas People Properties Services Environment Livelihood

NO
HEALTH POOR
SOURCE
CARE COMMUN
OF
WORKERS ITIES
INCOME
P
A HEALTH
N CENTER
AND OR CLUSTER NO
D HOSPITA HOUSES CONTINI
SENIORS
E MANILA and WITH
L OUS
SERVICE POOR SOURCE
M COMORBIDS
/IMMUNOCO S SANITATI OF
I MPROMISED ON NOT LIVELI
PRACTICI HOOD
C NG MPHS

NO
The rest of STREET
DWELERS
WORK
population
NO PAY

Vulnerable Vulnerabilities
Hazard
Areas People Properties Services Environment Livelihood

55
 INFORM HEALTH
S AL CENTER POOR
NO
SOURCE
U MANILA POOR SETTLE IN COMMUN
OF
RS POOR ITIES
B AREAS
INCOME
S
T PAROLA
A INFORMAL HEALTH
N ISLA
PUTTING
SETTLERS POOR
COMMU
CENTER
WITH
CLUSTER
NO
CONTINI
C BATO NITIES MANY
RED
HOUSES
OUS
E ADOLESC
[NFOR
MAL
SOURCE
OF
POOR
BASECO ENTS / LOW SETT LIVELI
SANITATI
A SMOKEY
YOUNG
INDIVIDUA
INCOME
FAMILY
LERS
ON
HOOD

B MOUNTAIN LS
U
S
E VITAS
FROM STREET STREET NO
BROKEN DWELE NONE DWELER WORK
RESETTLE
HOMES RS S NO PAY
MENT

Vulnerabilities
Vulnerable
Hazard
Areas People
Propertie
Services Environment Livelihood
s

56
 Manila Informal Low lying
settlers areas, river Old
Espana Health banks, Fragile
Very young Center esteros Dilapidated
F Maceda & very old Shantie
s
built on
low Informal
Fishing
boats
Dimasalang People with lying settlers
L Ramon
Disability areas Areas
Microenter
Magsaysay Pregnant Houses Poor waste preneurs
O Parola
women made of
light
management
Small
Informal Material Clogged businessm
O Isla
Putingbato
settlers s Old &
Dilapida
drainage
system
en

Poor ted
D Baseco
Homeless Houses
HealthC
enter Poor Flood
Smokey built control
Mountain near program
river
P. Burgos banks
&estero
Taft avenue s

Vulnerable Vulnerabilities
Hazard
Areas People Properties Services Environment Livelihood

57
 T Manila
Very
young &
Shanties
Old &
Average of
22
Jobless

Y very old Houses dilapidated typhoons No

P Parola
People
made of
light
, poorly
constructe
per year permanent
source of
H Isla with Materials d Health 10 – 12 income
O Putingbato Disability
Houses
Centers. Strong
Typhoons Hand to
O Baseco Pregnant built near Lying In per year mouth
N Smokey
women river
banks
clinics in
low lying Strom
existence

Mountain Informal &esteros areas signal No Self

settlers 2-4 employed

Poor &
homeless

Vulnerable Vulnerabilities
Hazard
Areas People Properties Services Environment Livelihood

Low lying areas Poor

Children & Poor basic
with stagnant Shanties environmental Junk shop
Young adults services
water sanitation
Far fetched
Densely Poor waste
communitie Vulcanizing shop
populated areas management
D s
Houses
E PAROLA
made of
Increased
vector
Shops selling old
tires, drums,
light
N materials
presence containers

G SMOKEY
Immuno
compromis
U MOUNTAIN ed
Individuals
E TENEMENT Many informal
HOUSES settlers
Malnourish
Dilapidated
BASECO ed poor
houses
children
ISLA PUTING
BATO

Hazar Vulnerable Vulnerabilities

d Areas People Properties Services Environment Livelihood

Houses Hazard Vulnerable Vulnerabilities

Manila Very built of Areas

58
 young & light
Parola very old materials
F
Isla People Shanties
Putingbato with old
I Disabilit houses
Baseco y condemne
d buildings
R Smokey Pregna
Mountain nt Non
women observanc
E e of
Informal Building
settlers Code

Illegal
Poor electric
connectio
ns /
jumper
cables

Non
usage of
Circuit
breakers

Haza Vulnerable Vulnerabilities

rd Areas People Properties Services Environment Livelihood

59
T MANILA Very High rise HEALTH Financial Macro / Micro
E young & buildings & CENTER Districts enterpreneures
R MALACA-
ÑANG
very old residential
houses
that are
crowded
Commerci
al areas Saelf employed
R People & no / lax
O US
EMBASSY
with
Disability
Foreign
Embassies
security Foreign
embassies
Commercial
establishments
R
I BINONDO Pregnant
women
Malls Exclusive
subdivision
S SM MALLS Commerci
M CHURCH
Overcro
wded
al
establishm
Accessible
air / sea
areas ents ports

Mallgoer
s

F. CAPACITY ASSESSMENT

1. Concept of Capacity Assessment

UNISDR defines capacity as “the combination of all strengths, attributes and

resources available within an organization, community or society to manage and reduce
disaster risks and strengthen resilience. It may include infrastructure, institutions,
human knowledge and skills, and collective attributes such as social relationships,
leadership and management.”

The institutionalized DRRM-H is the first and foremost capacity required to

determine the readiness of M H D in effectively managing disasters in the areas of:
policy, DRRM program, response teams, functional operation center for health and
emergency commodities. HEMS Manager and Disaster Risk Reduction Management
Office (DRRMO) representatives underwent the Capacity Assessment Workshop to
evaluate the existing capacity of the different cities in terms of their readiness to
manage the risks of anticipated mega-disasters in the context of the four thematic areas
of Disaster Risk Reduction and Management namely: hazard prevention, risk mitigation,
preparedness, and recovery

2. Objectives of Capacity Assessment

 To assess the capacity of Manila Health Department in managing disasters

60
 To identify the existing capacities of M H D in managing disaster

3. Capacity Assessment

 The capacity assessment intends to assess the capacities of City Health Office in
managing disasters on the following aspects:
 Capacity to prepare for disaster response through presence of institutionalized
DRRM-H
 Capacity to respond effectively through capabilities to manage incident, victims,
public health services and service providers, resources, and information
 Capacity to bounce back timely to respond when affected by disaster in the
presence of DRRM-H Systems in place

DRRM-
Policy to DRRM-H Organiz
H Function Available
Institutiona Plan ed
Progra al Emergency
lize Develop Respons
m OPCEN Commodities
DRRM-H ed e Teams
Created
G G G G G G

a. Institutionalization of DRRM-H

A formally developed DRRM-H Policy (DRRM-H Plan signed by the LCE,

Operation Center for Health, dedicated and trained response teams and availability of
emergency commodities) is paramount in the institutionalization of DRRM-H for the
establishment and support of the program. Although the M H D has a partially
functioning DRRM-H with formally designated program managers, there is a need to
formally institutionalize the DRRM-H as part of the Monitoring and Evaluation for Equity
and Effectiveness.

Organized Contingency and

DRRM-H
Policy to Plan Planning Business
Guidelines
Committee Continuity Plans

G G G Y

b. Capacity to Manage Incident During Response

Almost all LGUs have low to moderate capacities to manage disaster incident.
Although the Incident Command System (ICS) is being practiced already in Manila

61
together with the DRRMO, formal ICS guidelines are not available. Manuals for ICS
Levels I to IV are available but only one health personnel were trained.

Repository
OPCEN Trained Equipped OPCEN
of
24/7 Staff OPCEN Activation
Information
G G Y G Y

c. Capacity to Manage Operation Center

The Operation Center serves as the seat of command, control and coordination.
It provides the communication hub to link the incident command staffs with the key
players and partners in the disaster field.

M H D has a newly acquired dedicated OPCEN facility, which is activated by the

City Health Officer only upon notification of the Local Chief Executive, mostly during
weather disturbances and mass gatherings or activities.

Intra- Coordinatio Coordinatio

Coordinatio Coordinatio
agency n of n of Human
n with n of
coordinatio Logistics Resource
partners Information
n Mobilized Mobilized
Y Y Y Y Y

d. City of MANILA Coordination

Coordination is the mechanism of getting together all stakeholders to be

presented with issues and concerns on disaster management so that together they can
create actions to address such.

The assessment shows that there is a moderate capacity in general when it

comes to coordination in the context of ability to immediately organize and mobilize
response teams in times of organizational shift during disaster response including
coordination with partners in the areas of information management, logistics and human
resource mobilization.

Code Alert SPEED Organized SPEED Organized START

62
System in Place Implementation Teams Teams
Y Y Y G

e.Code Alert System and Surveillance

M H D follows the Code Alert System of the Department of Health. SPEED is

being implemented with one-point person per health center, although an update of the
latest guidelines is needed.

f.Victim / Field Management

Disasters are local affairs. In the first 72 hours post-disaster, the community is
expected to manage on its own in the absence of external help. In disaster response
operation, the goal is to save as much lives as possible focusing much effort in saving
live victims.

M H D has a moderate capacity in field management as tested in the annual

simulation drills (under the DRRMOs Unified Command) and actual disaster response
management in the past.
Managemen
t of Identification Initial Rapid Referral &
Alerting
Advanced of Field Health Transport
System
Medical Areas Assessment System
Post (3Ts)
Y Y Y Y Y

g.Service Packages
The service packages to be delivered during disasters are emphasized on the
initial quad cluster services namely health or medical, MHPSS, Nutrition and WASH.
The Essential Health Service Packages (EHSP) is available in M H D but there is
no organized team for WASH, Nutrition and MHPSS with poor logistical support, and so
with the hospitals. There is also moderate capacity for the Child Protection Program with
the conduct of regular awareness campaigns on violence against women and children.

Establish Available Available Child

Organized
EHSP EHSP EHSP of Protection
EHSP Team
Services Logistics Hospital
Y G G G Y

63
 h.Management of the Dead and Bereaved Families
Although the goal in disaster response operation is to save as much lives as
possible, it should not be forgotten that even dead victims have the right to be found,
managed and brought to their loved ones for proper disposition while their bereaved
family members deserve also support to allay their grief.

All LGUs have low capacity in managing dead victims and their bereaved
families. The main role of the City Health Office is to issue death certificates. Provision
of MHPSS to the bereaved is not available due to lack of trained staff.

Standard & Support to Sanitation Support to the

Proper Reporting
Specifications Morticians Protocols Bereaved
G G G G G

i. Information Management
Information is the backbone of a timely effective and efficient response because
it tells the true picture of what is actually happening in the ground. Timely and accurate
information helps the managers and partners in decision-making, planning, appropriate
resource mobilization and good risk communication.

Majority of the LGUs have low capacity in information management due to the
following: lack of training on information management and risk communication; no
standard reporting forms from the regional office; and the DRRMO Council manages the
information at the LGU level including the reports of the City Health Office.

Reporting &
Data Risk Final Post-Incident
Information
Management Communication Reporting Evaluation
Sharing
G G G G G

j.Logistics Management

Logistics here is referred to the resources that support disaster management

operations. This assessment was limited to the system, lifelines and funds that are
crucial needs for response operations.

Again, majority of the LGUs have low capacity in Logistics Management

hampering the capacity to manage disaster operations and may possibly lead to
increased disaster risks.
Contingency Fund and
Establish Logistics
Lifeline Management Fund from the City Health
Management System
Office
G G G

64
4.Capacity Rating Criteria
 Red LOW capacity; not institutionalized DRRM-H; has inadequate or no
capacity at all to manage incident, victims, public health services and
service providers, and information; DRRM-H Systems not totally developed
or not in place or not practiced.
 Yellow MODERATE capacity; partly institutionalized DRRM-H; has
some but inadequate capacity to manage incident, victims, public health
services and service providers, and information; has DRRM-H Systems but
not totally in place or practiced.
 Green HIGH capacity; presence of institutionalized DRRM-H; has full
capacity to manage incident, victims, public health services and service
providers, and information; has DRRM-H Systems in place.

5. Result and Analysis of Capacity Assessment

Capacities Low cap. Mod cap. High GAPS
cap.

1. Institutionalized DRRM-H Approval from LCE

2. Dev. And implement
plan
3. Manage incident

ICS
OPCEN Enhancement of
Op Cen
Coordination Tap NGOs and
private agencies
EWARS On going

65
 procurement
4. Manage living
victims
Field Management

Hospital care
Evacuation Center
Service packages
Manage the dead
Manage bereaved fam.
5. Manage service
providers
Team organization Increase the
capacitation
Team deployment Increase the
capacitation
Support team Strengthen
mobilization
6.Monitoring & NeedsSemi-
Evaluation Annual M&E
7. Manage Information
Data management
Information Strengthen DIMS
management
Risk Communication Formulate IEC
Documentation
PIE management
Conduct PIE
6. Document and
conduct Post-
Incident Evaluation
Logistics management
Lifelines management
Intra- and inter- agency
sharing of resources
management
Management of
donations
Financial Management

66
 III. UPDATING THE PLAN

Fig 16. Building on COVID-19 for longer-term preparedness

67
Thematic Plan

MHD DISASTER RISK REDUCTION MANAGEMENT for HEALTH PLAN

The MHD DRRM – H plan has 4 Thematic Areas:

Prevention and Mitigation Plan - The Prevention and Mitigation Plan is a

combined hazard exposure prevention and vulnerability reduction plan
 Preparedness Plan- contains strategies and activities that the MHD will carry out to
build and enhance its capacity to respond to emergency or disaster
 Response Plan includes strategies and activities for effective and efficient response
during emergency or disaster. Likewise, this Response Plan includes policies,
protocols, guidelines and procedures pertaining to various emergency management
systems for more efficient response.
 Recovery or Rehabilitation Plan has strategies and activities aimed in the return
of the DOH-NCRO to its normal operation the earliest possible time. This involves
restoration of the lifelines and support services.

A. PREVENTION AND MITIGATION PLAN

Goal: Avoid hazards and mitigate and prevent their potential health impacts by reducing
the exposure to the hazards and the existing vulnerabilities of the community.

OBJECTIVE 1: TO IMPROVE CAPACITY TO MITIGATE THE EFFECTS OF THE DISASTER

RISKS
Key Results 1.1: Improve Blood Collecting system
Percent Completion Timeline
ACTIVITIES 2023 2024 2025
1.1 .1 Develop policy on enhancing blood collection Policy review,
Policy
collation & Review &
dissemination
dissemination update policies
conducted
conducted
1.1.2 Explore MOA with companies and establishment 1st Q
1.1.3 Create a council on safe blood 1st Q

68
Key Results 2: Enhance Disease surveillance and reporting
Percent Completion Timeline
Activities 2022 2023 2024
4.2.1 Review and collate policies and guidelines on disease Policy review,
Policy
surveillance collation & Review & update
dissemination
dissemination policies
conducted
conducted
4.2.2 Develop a tool to enhance disease surveillance and Develop GL for
reporting Surveillance and
GL
reporting review, Review & update
dissemination
collation & policies
conducted
dissemination
conducted
4.2.3 Develop SOP and Protocol on Disease surveillance and Protocol review,
Protocol
reporting collation & Review & update
dissemination
dissemination policies
conducted
conducted
4.2.4 Develop tool for monitoring and evaluation M&E Policy
Policy
Review & update
dissemination
developed policies
conducted
4.2.5 Collate all data on disease surveillance and forward to Database of Database of
GIS Office Documented documented documented
health-related health-related health-related
emergencies & emergencies & emergencies &
disasters collected disasters disasters
developed updated

B PREPAREDNESS PLAN

Objective: Strengthen governance and drive better execution through leadership

and management capacities, coordination, and support mechanisms necessary to
enhance functionality

OBJECTIVE 1: DEVELOPING AND UPDATING OF DRRM-H PLAN

KEY RESULTS 1: Develop and updated DRRMH-plan

In
Time Resources charge Indicator
frame Required Source
Number of
1.1.1 Engage in multi- DRR
2022-2024 112,000.00 LGU Meetings
stakeholder dialogue M-H
conducted
1.1.2 Policy Development & 2022-2024 112,000.00 LGU DRR Number of

69
 workshops
Consultative Planning work
M-H conducted,
shop.
policy dev
Number of
1.1.3 Assess and develop
DRR Meetings
the institutional basis for 2022-2024 112,000.00 LGU
M-H conducted,
DRRM-H
SOP created
1.1.4 Create or strengthen
Number of
mechanisms for systematic DRR
2022-2024 112,000.00 LGU Meetings
coordination for disaster risk M-H
conducted
reduction
1.1.5 Undertaking of MOU
Number of
among private and DRR
2022-2024 112,000.00 LGU Meetings
Government Agencies on M-H
conducted
Provision of service

KEY RESULTS 2: Develop Guidelines, Advocate and Operationalize DRRM-H

Percent Completion Timeline
ACTIVITIES: 2022 2023 2024
1.2.1. Review and Develop treatment guides and
1st Q
protocols
1.2.2 Develop DRRM IEC materials 1st Q
1.2.3 Enhance DRRM-H awareness raising
1st Q
activities
KEY RESULTS 3: Develop inclusive policies and guidelines in all health programs
Percent Completion Timeline
ACTIVITIES 2019 2020 2021
1.3.1 Regular Coordination meeting with PDAO 1 Q
st

1.3.2 Review and adapt DOH inclusive policies

1st Q
and guidelines and other relevant laws
1.3.3 Training on Basic Sign language for Health
1st Q
Personnel’s
1.3.4 Strengthen GAD responsiveness in health
1st Q
programs

KEY RESULTS 4: Develop a M&E tool for testing and evaluating the Plan
Percent Completion Timeline
ACTIVITIES 2022 2023 2024
1.4.1 Checklist of M&E tool 1st Q
1.4.2 List all variables for monitoring 1st Q
1.4.3 Develop drills and exercise to test the plan 1st Q
1.4.3 Conduct of SDN/PIR 1st Q
70
 OBJECTIVE 2: TO ORGANIZE AND TRAIN AND COMPETENT WORKFORCE

Key Result 1: Update life-saving skills and emergency response capability

Strategies and Time Resources
In charge Indicator
Activities frame Required Source*
2.1.1.To create the
Manila Health
Department DRRM-H office
2022 28,000.00 LGU DRRM-H
Emergency created
Management Office
(MHDEMO)
2.1.2.To establish
the Organizational
2022 28,000.00 LGU DRRM-H OSSP stablished
Structure of the
MHDEMO
2.1.3.To create the No of Teams
2022 28,000.00 LGU DRRM-H
MHDEM team organized
2.1.4.Capability
Number of person
building of MHDEM 2022 LGU DRRM-H trained
team
2.1.4a. Training on 250,000.0 Number of person
2022 DOH/CHD DRRM-H
PHEMAP 0 trained
2.1.4b. Basic and
Number of person
Advance ICS 2022 41,600.00 DOH/CHD DRRM-H trained
Training
2.1.4c. Mass
260,000.0 Number of person
Casualty Incident 2022 DOH/CHD DRRM-H
0 trained
Training
2.1.4d. EOC Number of person
2022 41,600.00 DOH/CHD DRRM-H
Training trained
2.1.4e. Exercise Number of person
2022 41,600.00 DOH/CHD DRRM-H
Design Training trained
2.1.4f. Coordination
and Risk Number of person
2022 41,600.00 DOH/CHD DRRM-H
Communication trained
training
2.1.4g. Leadership Number of person
2022 DOH/CHD DRRM-H
training 50,000.00 trained
2.1.4hTraining on
Basic Life support, Number of person
2022 240000 DRRM-H trained
CPR and Standard
First Aid
2.1.4iTraining on
Number of person
WASH in 2022 41,600.00 DOH/CHD DRRM-H trained
Emergencies
2.1.4jTraining on 2022 41,600.00 DOH/CHD DRRM-H Number of person

71
 HERO trained
2.1.4jTraining on Number of person
2022 41,600.00 DOH/CHD DRRM-H trained
SPEED
2.1.4kTraining on Number of person
Nutrition in Training on 2022 41,600.00 DOH/CHD DRRM-H trained
Emergencies
2.1.4lTraining on Number of person
2022 41,600.00 DOH/CHD DRRM-H trained
MHSPSS
2.1.4Training on MISP
for Sexual and Number of person
2022 41,600.00 DOH/CHD DRRM-H trained
Reproductive
Health/GAD

Key Result 2: Develop a Disaster Information and Management system capability

Time Resources
Strategies and
fram In charge Indicator
Activities Required Source*
e
2.2.1. Gathering
baseline, historical and
BASELINE data
attribute data on
encoded
exposure
2022 3200 LGU
vulnerability and DRRM-H
adaptive capacity
as basis for Health
emergency assessment
and response
2.2.2. Resource
mapping to
avoid overlapping roles logistics system
and responsibilities 4,000 LGU DRRM-H in place
2022
and guide for
inventories of
non-human resources
2.2.3. Formulate a
means to communicate 4,800.00
2022 LGU DRRM-H No of IEC done
all Data to the
level of the community
Type and
2.2.4. Printing of IEC 2022 5000 LGU DRRM-H
copies printed
2.2.5. Orientation on Number of
2022 41,600 DOH/CHD DRRM-H
EWARS people trained
2.2.6. Develop a DIMS number of lay
integrated assessment
2022 4800 LGU DRRM-H
BLGU Risk tools
Assessment tool developed
2.2.7. Orientation on
Information 2022 Number of
6400 DOH/CHD DRRM-H
Management and people trained
Surveillance

72
Information generation,
storage
and dissemination

Key Result 3: Ensure adequate availability disaster commodities

Percent Completion
Timeline
ACTIVITIES 2022 2023 2024
2.3.1 Conduct regular inventory of Disaster commodities Q2
2.3.2 Collate, Review and adapt DOH Policies on Disaster Q2
commodities
2.3.3 Develop policies and guidelines on procurement of disaster Q2
commodities
2.3.4 Procure CAMPOLAS + KIT Q2
2.3.5 Procure PPE and VEST for ERT Q2
2.3.6 Procure First Aid Kit for ERT Q2
2.3.7 Procure MISP kits Q2
2.3.8 Procure Tetanus Q2
2.3.10 Preposition Emergency Commodities based on the areas Q2
identified as frequently affected
2.3.11 Provide equipment supplies for saving lives (AED, Spine Q2
Boards, EMT, BLS/SFA equipment and supplies
2.3.12 Procure tents for Advance Medical Post Q2

Procurement of Disaster Commodities

73
CAMPOLAS KIT
Items Specifications Qty Unit
Cotrimoxazole 800 mg tablet 100 tabs/box 45 Treatment pack
Cotrimoxazole syrup 200 mg 60 ml 20 Bottles
Amoxicillin 500 mg capsule, 100 tabs/box 45 Treatment pack
Amoxicillin 250 mg, 5 ml powder susp. 60 ml 20 Bottles
Metformin 500 mg tablet, 100 tabs/box 2 Boxes
Paracetamol 250 mg, 5 ml powder susp. 60 ml 20 Bottles
ORS, 10 sachet/box 30 Sachets
Lagundi 300 mg, 5 ml syrup, 120 ml 20 Bottles
Lagundi 300 mg tablet, 100 tabs/box 600 Tablets
Skin ointments

Plus
Sulfur ointment, 30 grams tube 10 Tubes
Fusidate/fucidic acid tube 20 Tubes
Imidazole 10 Tubes
Losartan 500 mg tablet/100 tablet/box 3 Boxes
Vitamin A (Retinol) 200,000 IU/ 100 caps/bottle 1 Bottle
Vitamin B complex, 100 tabs/box 6 Boxes
Doxycycline 100mg, 100tabs/box 3 Boxes
Amlodipine 10 mg, 100 tabs/box 3 Boxes
Sambong 300 mg tabs, 100 tabs/box 2 Boxes
Gauze pad 4 x 4, 100 pads/box 1 Box
Gauze pad 2 x 2, 100 pads/box 1 Box
Plaster strip, 100 pcs/box 1 Box
Surgical tape 1/2 inch, 24 rolls/box 1 Box
Cotton 100 grams 1 Roll
Povidone Iodine 5 Bottles

First Aid Kit are intended to be brought by the team of responders on site.

74
 Items Specifications Qty Unit
Surgical gloves, latex, disposable, sterile 5 Pairs
Elastic bandage, 10 cm. x 1.6 (unstretched) approx. 4.5 m. stretched,
permanent strong compression bandage with high stretch for controllable
2 Rolls
compression, with selvedges and fixed ends, made of cotton, compression
bandage with high stretch, individually packed
Cotton, absorbent, 25 grams, individually packed 1 Packs
Bandage scissors, standard, stainless steel, length 5 ½” (14 cm)
1 Pair
approximately
Triangular bandage, 100% cotton, white, non -sterile, 40 "x 40" x 56", with 2
1 Pieces
safety pins, individually packed
Gauze pads, 2 x 2 inches, 8-ply, 24 x 20 mesh, sterile, individually packed,
10 Packs
100 packs per box
Gauze pads, 4 x 4 inches, 8-ply, 24 x 20 mesh, sterile, individually packed,
10 Packs
100 packs per box
Surgical paper tape, hypoallergenic, 1 inch x 10 yards, roll 1 Rolls
Gauze bandage, 2 " x 6 yards, 24 x 20 mesh, individually packed in box 1 Rolls
Gauze bandage, 4 " x 6 yards, 24 x 20 mesh, individually packed in box 1 Rolls
Plaster strips, soft absorbent layer, perforated strips, strong adhesive,
10 Piece
nonstick film
Plastic
Hydrogen peroxide 3% solution, 60 ml plastic bottle 1
Bottle
Plastic
Povidone iodine 10% solution, 60 ml plastic bottle 1
Bottle
Oral rehydration salts (ORS 75 replacement), 20.5 grams per sachet 5 Packet
Paracetamol 500 mg tablet 30 Tablet
Lagundi 300 mg. tablet 30 Tablet
Mefenamic acid 500 mg capsule 30 Capsule
Silver sulfadiazine 1% cream, 25 grams tube 1 Tube
Fucidate sodium/ fucidic acid , 5 grams tube 1 Tube
Amoxicillin 500 mg capsule 30 capsule
Bayabas herbal soap, 65 grams 1 Bar
First Aid Kit bag 1 Piece
Instruction Guide for First Aid Kit , laminated 1 Piece

Trauma Kit

Items Specifications Qty Unit

Personal safety
Surgical gloves, sterile , size 7, 50 pairs per box 10 Pairs

75
Safety goggles individually packed with plastic 1 Pair
Minor cuts and scrapes
Elastic bandage, 4 inches width, 2 metal locked, length unstretched 60 " or 5 ft, permanent
strong compression bandage with high stretch for controllable compression with selvedges 10 Rolls
and fixed ends, made of poly cotton, individually packed
Gauze pad/swab 2 inches x 2 inches , 12-ply, 24 x 20 mesh, sterile, individually
25 Pack
packed, 100 packs per box
Tongue depressor , wooden , individually packed , sterile 2 Piece
Surgical paper tape, hypoallergenic, 1/2 inch x 10 yards, 24's box 1 Roll
Larger trauma/injuries
Gauze pad/swab 4 inches x 4 inches , 12-ply , 24 x 20 mesh, sterile, individually
25 Packs
packed, 100 packs per box
Gauze bandage , 4" x 6 yards, 24 x 20 mesh , individually boxed 4 Rolls
Triangular bandage, muslin cloth, cream, non – sterile, approximately 90 cm x 90
2 Pieces
cm x 127 cm, individually packed
Elastic bandage, 4 inches width, 2 metal locked, length unstretched 60 " or 5
ft, permanent strong compression bandage with high stretch for controllable
10 Rolls
compression with selvedges and fixed ends, made of polycotton, individually
packed
Survival blanket 1 Piece
5 Oral airways 1 Set
Stethoscope 1 Set
Sphygmomanometer, aneroid with case 1 Set
Cold packs, large 2 Pack
Wound Dressing
Sodium chloride irrigation solution, 250ml 2 Bottle
Antiseptic wipes 20 Pack
Alcohol hand sanitizer 4oz 1 Bottle
Antibiotic ointment 5 Tube
Splinter forceps 1 Pairs
Alcohol prep pads 12 Pack
Resealable plastic bag 1 Piece
Biohazard trash bag 2 Piece
Ballpen 1 Piece
Bag/container for the contents 1 Piece
Minor suturing set: needle holder, tissue scissor, tissue forcep, eye towel, cotton
3 Sets
swab, betadine swab
PNSS 1 liter 1 Bottle
Asepto syringe 50 cc (plastic) 2 Piece
Suture set 2.0 12 Piece

Hygiene Kit are intended for families primarily in the evacuation center to ensure personal
cleanliness and minimize infection. One kit is good for a family of five members

Items Specifications Qty Unit

Detergent bar, 420 grams 2 Bar

76
Toothbrush 5 Pieces
Toothpaste, 145 grams 1 Tube
Shampoo 10 ml 5 Sachet
Sanitary napkin/pads, 8 pads 3 Pack
Water dipper (tabo) 1 Piece
Towel, rectangular, white, cotton 5 Pieces
Utility pail w/ cover, plastics, 12 L, lock-zip tie 1 Piece
Bath soap, 135 grams 2 Bar
Panty (4 small, 4 medium, 4 large) 12 Pieces
Malong 1 Piece

Key Result 4: Create and Develop guidelines Health Emergency Response Team
Percent Completion
Timeline
ACTIVITIES 2022 2023 2024
2.4.1 Create and Develop guidelines in WASH Team Q2
2.4.2 Create and Develop guidelines in Emergency Medical Team Q2
2.4.3 Create and Develop guidelines in Emergency Team Q2
2.4.4 Create and Develop guidelines in MHPSS Team Q2
2.4.5 Create and Develop guidelines in Facility ICS structure Q2

OBJECTIVE 3: TO STRENGTHEN NETWORKING WITH PARTNERS

Key Results 1: Develop guidelines in networking of partners

Percent Completion
Timeline
ACTIVITIES 2022 2023 2024
3.1.1 Review and Collate City and DOH Guidelines in networking of Q2
partners
3.1.2 Collect list of Health Professional Organization Q2
3.1.3 Collect list of Pharmacy and drugstore Q2
3.1.4 Collect list of Medical Supplies establishment Q2

77
3.1.5 Collect list of Volunteer organization/NGO Q2
3.1.6 Explore possibility of MOA/MOU with potential partners Q2
3.1.7 Integrated Health service delivery network Q2

Key Results 2: Enhanced coordination mechanism

Percent Completion
Timeline
ACTIVITIES 2022 2023 2024
3.2.1 Formulate policies in coordination Q2
3.2.2 Develop guidelines and SOP on coordination Q2
3.2.3 Collect relevant information of all stakeholders in the city Q2

Key Results 3: Support BLGU in mainstreaming DRRM-H into the Barangay

Development Plan
Percent Completion
Timeline
ACTIVITIES 2022 2023 2024
3.3.1 Develop template for DRRM-H Plan for barangay Q2
3.3.2 Conduct DRRM-H planning orientation Q2
3.3.3 Technical Support for BLGU in managing WASH related risks Q2
3.3.4 Technical Support on managing Nutrition in Emergencies Q2
related risk
3.3.5 Technical support on community IEC development Q2
3.3.6 Provide Technical Assistance on development of Community Q2
Quad Cluster Team

OBJECTIVE 4:
STRENGTHEN THE CAPACITY TO RESPOND TO HEALTH EMERGENCIES AND
DISASTERS THRU OPCEN UPGRADING

Key Result 1: Enhanced Health OPCEN Operational capabilities

Percent Completion
Timeline
ACTIVITIES 2022 2023 2024
4.1.1 Review and Update memo on OPCEN operation
4.1.2 List OPCEN supplies/equipment’s needed for operational
sustainability
4.1.3 Procure OPCEN office supplies (Bond paper, pencils, pen,
makers, paper clips, folders, storage box)
4.1.4 Procure OPCEN back-up communication and Internet
Connection and subscription

78
4.1.5 Procure IT equipment (Desktop, Laptop, Projector, 4 in 1
Printer)
4.1.6 Procure Monitoring Equipment (50” LED TV, FM/AM
Transistor Radio, ABS-CBN Black box)
4.1.7 Provision of food for 24-hour OPCEN duty
4.1.8 Train dedicated OPCEN staff for Operation
4.1.9 Provision of recording and reporting forms
4.1.10 Develop directory of Partners and Stakeholders

C. MANILA HEALTH DEPARTMENT RESPONSE PLAN

As stated by the United Nations International Strategy for Disaster Reduction

(UNISDR), a disaster can be defined as “a serious disruption of the functioning of a
community or society involving widespread human, material, economic or environmental
losses and impacts, which exceeds the ability of the affected community or society to
cope with using its own resources.”

1. Plan Description

The plan comes in the form of a Checklist along with the standard operating procedures
for further guidance of the actions to be taken. It can also serve as a reporting form
submitted to the regional office (MMCHD) and can also serve as a monitoring tool for
the HEMS Managers and key health officials.

2. Plan Goal and Objectives

The Disaster Response Plan supports the overall goal of response which is to “minimize
damages and losses of lives and properties in times of disaster” as measured by:

79
 a. Guaranteed uninterrupted health service delivery during emergencies
and disasters
b. Averted preventable morbidities, mortalities and other health effects of
emergencies and disasters
c. No outbreaks that occur secondary to emergencies and disaster. In
order to achieve the goal, the plan aims to address the necessary
steps in mounting effective and organized response actions in the
context of:

1. Managing the incident

2. Managing the victims
3. Managing the services and service providers
4. Managing the non-human resources
5. Managing the information.

d. Concept of Disaster Response Operation

The Disaster Response Plan lays down the concept of operation in the three phases of
disaster:
1. Pre-impact response is the time to manage disaster risks a day or days
before the onset of event. There are identified hazards in the city that
will be preceded by a warning (i.e. flood, typhoon and tsunami),
allowing enough time for preparation. But there also identified hazards
that will come without warning (i.e. earthquake, fire, etc.) which will put
the city at higher risks. Major activities that must be done for a timely
and organized response include: activation of all response plans,
activation of the Operation Center for Health, prepositioning of
logistics, organizing stand-by teams, coordination with concerned
agencies and gathering data about the event and its possible impact
on the city.

2. During impact response is the time to manage the actual disaster risks
from the time the hazard occurred up to two days (0-48 hours). All
efforts are directed towards saving lives and minimizing the health
impacts to the affected community. The key actions in this phase
include: establishment of command and control, activation of the
appropriate plans and systems, gathering of data and sharing of
information to devise appropriate interventions, deployment of medical
assets and mobilization of logistics, delivery of appropriate health
services and continuous coordination with concerned agencies.

3. Post-impact response varies according to the type of disaster that

occurred, usually after 48 hours and beyond, since this phase of
response continues the operations started from the time the hazard
struck until it leads to the demobilization of resources as the affected

80
 community is returning to its normal level of functioning. Essential
health activities include: continuous provision of QUAD Cluster
services (Medical/Health, MHPSS, Nutrition and WASH), gathering of
data and sharing of information for disaster recovery planning for
building back better after the disaster, inventory of all human and non-
human resources, deactivation of response teams and debriefing and
post-incident evaluation for enhancement and improvement of disaster
management for future disasters.

a. PRE-IMPACT DISASTER RESPONSE

i.Background

The Pre-Impact Disaster Response in this plan conveys the actions to be undertaken by
the Manila CHO in a day or days before the hazard or disaster may possibly occur in
preparation to manage and mitigate the anticipated disaster risks.
Triggers:
a. Report of re-emerging diseases or disease outbreak
b. Forecast typhoon
c. Tsunami alert
d. National or local elections
e. Mass action or demonstration
f. Any event or emergency with potential for Mass Casualty Incident
(MCI)
g. Any hazard that may result in an emergency or disaster

ii. Objectives:

a.To know the nature, time and place/s that will be affected by the
hazard
b.To be able to anticipate the risks of the community
To be able to plan for appropriate response interventions and
resource mobilization
To prepare for an organized, efficient and effective disaster
response

iii.Checklist

Establish prescence of Validate and Confirm report

emergency/disaster Notify CHO

CHO declares CODE ALERT

Elevate CODE ALERT according to situation
Declare CODE ALERT Disseminate CODE ALERT
Deactivate ALERT

Equip OPCEN with back ups

24/7 HEALTH OPCEN Monitor the evolution of hazard

Organize Response Prepare and Activate ERT base on CODE ALERT scenario
Team DRRM-H submit list of ERT Teams on stand-by
81
Preposition Disaster DRRM-H Manager prepares list of needed emergency logistics
Nofity supply section to update resouce inventory on preposition
a. Establish the presence of an emergency or disaster
 1) Operation Center for Health (Health OpCen) validates and confirms report of
forthcoming hazard
Nature, place, date and time of incident (NOI, POI, DOI and TOI)
 2) Notify City Health Officer (CHO), Assistant CHO, sections heads and DRRM-H
Program Managers regarding the confirmed report

b. Declare and disseminate the appropriate code alert

 3) LGU and/or CHO declares Code Alert: ___ Code White ___ Code Blue
___ Code Red
 4) Escalate Code Alert White as to ___ Blue or ___Red while nearing to the
actual incident
 5) Deactivate the Code Alert if it did not happen
 6) Disseminate Code Alert or any change of the alert to all health personnel

c. Activate and run the Emergency Operation Center for Health (Health EOC)
 7) Equip the Health EOC with backups
Communication equipment with backups (handheld radio, telephone, cellular
phone, internet, fax machine, satellite phone, computer, etc.)
Lights, generators and emergency lights with backup
Transistor radio and television with backup
Displays (maps, boards, IECs, etc.)
Sound system with backup
Tables and chairs
 8) Start monitoring the progression of the hazard
 9) Put the Command Center activation on standby

d. Organize stand-by response teams for possible deployment

 10) Organize health personnel to go on duty in the Health OPCEN
 11) Prepare schedule of standby teams
 12) Inform standby teams of their duties thru a signed office order
 13) DRRM-H Program Managers to submit list of response teams with schedule
of duties
Emergency medical teams
MHPSS team
Nutrition team

82
 WASH team
Rapid Health Assessment (RHA) team
Support teams (e.g. administrative, risk communication, etc.)

e. Preposition needed emergency commodities
 14) DRRM-H Program Managers prepare the list of needed emergency
commodities and submit it to the Logistics Section
 15) Notify Logistics Section to submit an updated inventory of available
commodities in the office and the warehouse
List of CAMPOLAS Plus
List of medical supplies and equipment
List of MHPSS medicines and supplies
List of Nutrition supplies and equipment
List of WASH supplies and equipment
 16) Notify Transport Officer (thru the Administrative Section) to submit report on
the following:
Functional transport vehicles
Stock of fuel
Designated drivers to go on duty
Schedule of duty of drivers
 17) Notify Engineering Department to submit inventory of lifelines:
Generator and backup
Communication and backup
Water supply and backup
 18) Notify Finance Officer (thru Administrative Section) to submit report on the
following:
Cash advances
Funds for response operations
Funds for emergency procurement

f. Reporting and monitoring

 19) Submit report within 24 hours
Collect all reports stated above and submit to the CHO
Submit filled-up Pre-Impact Response Checklist signed by the CHO to
MMCHD and/or local DRRMO if needed
 20) Continuously monitor the event from all possible sources
 21) Notify CHO and other key health officials for any significant changes

g.Intermediate Actions

 22) Intra-agency coordination meeting (QUAD Cluster meetings)

Health Cluster meeting
MHPSS Cluster meeting
Nutrition Cluster meeting
WASH Cluster meeting

83
  21) Inter-agency coordination meeting
Meeting with local DRRMO
Meeting with LGU departments
Meeting with private sector and non-government agencies (NGOs)
 22) Memorandum of Agreement (MOA) with partners
Pharmaceuticals, medical supplies and forwarders
Hospitals, health facilities and medical associations

iv.Standard Operating Procedures

The Manila Health Department has to act immediately once a report of impending
hazard with disaster potential has been validated and confirmed by the proper
agency (MMCHD, local DRRMO or CESU).

1. The M H D OpCen shall establish the strong possibility of an emergency or

disaster:

a. Validate and confirm warning report received from all reliable

sources regarding:
 NOI, POI, DOI, TOI (Nature, Place, Date and Time of Incident)
 Anticipated risks (health-related risks to people, properties,
services, environment and livelihood)
 Magnitude of risks
b. Analyze the implications of the report of hazard with disaster
potential
 Will it be of local, regional, national or international concern

c. Notify the health authorities regarding the validated warning report

 DRRM-H Manager notify CHO regarding the confirmed report
and recommend appropriate Code Alert to be declared
 CHO, Assistant CHO and key health officials
d. Disseminate the validated report regarding the hazard with disaster
potential to all health personnel
e. Do continuous monitoring of the event from all possible sources
f. Notify the CHO or the immediate supervisors for any significant
changes.

v.Declare, disseminate and lift the Code Alert

g. The DRRM-H Manager recommend to the CHO the declaration of

the appropriate Code Alert
h. CHO declares the appropriate Code Alert (Code White)
i. Escalate the alert upon nearing to the actual occurrence (Code Blue
or Red)

84
 j. CHO deactivates the alert if the incident did not happen on the
anticipated day or time
k. Disseminate Code Alert to all health personnel including significant
changes thru office orders, memo, text messages, etc.

vi.Activates the Health Emergency Operation Center (Health EOC)

l. Organize health personnel to go on duty in the Health EOC

m. Prepare schedule of standby teams
n. Inform health personnel of their duties thru a signed office order
o. Equip the Health EOC with backups
 Communication equipment with backups (handheld radio,
telephone, cellular phone, internet, fax machine, satellite
phone, computer, etc.)
 Lights, generators and emergency lights with backup
 Transistor radio and television with backup
 Displays (maps, boards, IECs, etc.)
 Sound system with backup
 Tables and chairs
p. Start monitoring the progression of the hazard
q. Put the Command Center activation on standby

vii.Organize standby response teams for possible mobilization

r. Organize health personnel to go on duty in the office and to be

deployed in the field for response
s. Prepare schedule of standby teams
t. Inform standby teams of their duties thru a signed office order
u. DRRM-H Program Managers to submit list of response teams with
schedule of duties
 Emergency medical teams
MHPSS team
Nutrition team
WASH team
Rapid Health Assessment (RHA) team
 Support teams (e.g. administrative, risk communication, etc.)

viii.Prepare needed emergency commodities

v. DRRM-H Program Managers prepare the list of needed emergency

commodities and submit it to the Logistics Section
w. Notify Logistics Section to submit an updated inventory of available
commodities in the office and the warehouse
 List of CAMPOLAS Plus
 List of medical supplies and equipment

85
  List of MHPSS medicines and supplies
 List of Nutrition supplies and equipment
 List of WASH supplies and equipment
x. Notify Transport Officer (thru the Administrative Section) to submit
report on the following:
 Functional transport vehicles
 Stock of fuel
 Designated drivers to go on duty
 Schedule of duty of drivers
y. Notify Engineering Department to submit inventory of lifelines:
 Generator and backup
 Communication and backup
 Water supply and backup
z. Notify Finance Officer (thru Administrative Section) to submit report
on the following:
 Cash advances
 Funds for response operations
 Funds for emergency procurement

ix Reporting and monitoring

aa. Submit report within 24 hours

 Collect all reports stated above and submit to the CHO for his
reference and guidance
 Submit filled-up Pre-Impact Response Checklist signed by the
CHO to MMCHD and/or local DRRMO if needed

If time permits, the following activities can be conducted by the CHO:

bb. Intra-agency coordination meeting (QUAD Cluster meetings)

 Health Cluster meeting
 MHPSS Cluster meeting
 Nutrition Cluster meeting
 WASH Cluster meeting
cc. Inter-agency coordination meeting
 Meeting with local DRRMO
 Meeting with LGU departments
 Meeting with private sector and non-government agencies
(NGOs)
dd. Review the formal agreements (MOA) with partners who could be of
help when needs arise during the disaster
 Pharmaceuticals, medical supplies and forwarders
 Hospitals, health facilities and medical associations

86
b.DURING IMPACT RESPONSE

i.Background

The During Impact Disaster Response in this plan conveys the actions to be
undertaken by the Manila CHO from the time the hazard occurred up to two days
(0-48 hours) or more depending on the magnitude of the disaster. The Manila
CHO has to exercise its responsibility to manage, harmonize and synchronize the
health response operations being undertaken in the city i.e. advanced medical
post, evacuation centers and hospitals, in order to have an organized, effective
and efficient disaster response management.
Disasters commonly result in an increased number of injuries, morbidities and
mortalities, creating very high demands for health services that exceed beyond the
existing health capacities and infrastructures. During disaster impact, the Manila
CHO manages the incident inside the Health EOC and outside in the advanced
medical post and evacuation centers to facilitate disaster victim management. The
health sector follows the Incident Command System (ICS) of the city, a command
and control system where the Local Chief Executive (LCE) or the Mayor serves as
the Responsible Official.

1. Incident Recognition – a system of validating, confirming reports of incidents or

warnings of impending disaster and prompting dissemination and notification of
proper authorities for appropriate actions.
2. Early Warning Alert and Response System (EWARS) – a system that describes
the gravity of the incident according to the level and magnitude of disaster risks,
that serves as basis for appropriate resource mobilization to support the response
actions.
3. Incident Command System (ICS) – a system of establishing an organizational
structure with a Responsible Official (RO) that designates an Incident Commander
(IC) with his/her roles and functions in order to facilitate the response operations.
4. Emergency Operation Center (EOC) – serves as gatherer and repository of
reports ,data, and information; the monitor of the incident and the response
operation; as well as the seat of communication and coordination.
5. Coordination Mechanism – system to link with stakeholders inside the
department, between agencies, and among health sectoral partners to collectively
support and manage the response operations.

ii.Triggers:

1..Presence of hazard affecting the city resulting to disaster

87
 Hazard caused major impacts to the city in terms of deaths and injuries to people,
population displacement, damages to properties especially health facilities, disruption of
health service delivery, and damages or disruptions of the environment and livelihood
2. Disaster with warning or continuation of an anticipated disaster preceded by a
warning (with pre-impact phase)
3. Disaster without warning
4. The period of 0-48 hours from the time disaster happened

iii. Objectives:

 To manage the incident

 To manage the victims in the advanced medical post and evacuation centers
 To manage the health services and service providers during and post-impact
phases
 To manage the non-human resources
 To manage data and information gathered from the event

iv. Management of Incident in the Health OPCEN: Checklist

a. Incident Recognition

 1) Confirm the reported incident from the MDRRMO

 2) Collect initial RHA report from MDRRMO OpCen or RHA Team within 2 hours
post-disaster
i. NOI, POI, DOI, TOI
 Number of injuries
 Number of deaths
 Number of displaced population
 Health services needed
 Capacity of the LGU or CHO to manage the risks (HR and non-HR)
ii. Magnitude of risks
iii. Immediate needs
 Response teams
 Emergency commodities

b. .Early Warning Alert and Response System Activation

 3) Health OpCen notifies the CHO, Assistant CHO, section heads and DRRM-H
Program Managers and recommend declaration of Code Alert
 4) CHO (or duly designated representative in his/her absence) to declare Code
Alert

88
 _____ Code White _____ Code Blue _____ Code Red
 5) Health OpCen to disseminate Code Alert and comply with all resource
requirements based on declared Code Alert

c. Activation of Incident Command System

 6) LDRRMO (for events of national concern) or CHO (for health-related events)

to establish command and control
i. Suspend normal office transactions and shift to disaster mode
 7) Establish chain of command
i. Designate Responsible Person (RO), Incident Commander (IC) and
Spokesperson (depending on the type of event if of national or health
concern)
ii. Fill up positions in the ICS Structure
iii. Provide Job Action Sheets
iv. Provide IDs and uniforms to the Incident Management Team (IMT)

 8) Activate and manage the Health EOC

i. Maintain continuous operation, monitoring and gathering of reports 24/7
ii. Ensure it is properly equipped with backups
iii. Located near the Command Center
iv. Provide reports to the Command Center for action
v. Provide reports to be used for Recovery Plan development
 9) Activate and manage the Command Center
i. RO/IC preside the coordination meetings
ii. IMT attends the meeting
iii. Conduct coordination meetings in the morning and afternoon
 10) RO/IC initiate Incident Action Plan development

d. Response Teams Mobilization

 11) Organize Response teams for deployment

Type of Team Composition Functions

EMT Type 1 — Primary and emergency care team .

Mobile composed of general doctors, Initial triage/medical triage
nurses and logistics staff . Basic first aid
. Basic stabilization and prompt
referral of
trauma and non-trauma
emergencies
Initial (basic) wound care to

89
 include
tetanus toxoid prophylaxis
Definitive care for minor trauma
and
non-trauma emergencies for all
ages
(Including provision of drugs
and
medicines)
Medical consultations and
definitive
treatment of primary level acute
cases/conditions and continuity
care of chronic conditions
Basic outpatient (primary) care
for all
ages
Pharmacy and drug supply to
care to
cases seen
Minimum Initial Service
Package for
Sexual and Reproductive
Health
Basic public health services
related to
nutrition, and water, sanitation
and
hygiene
.PsychologicalFirst Aid
EMT Type 1 — Team leader Clinical/ Medical Lead
Fixed and staff Logistics Lead and staff Capacity to provide EMT Type
(Outpatient) Nursing Lead and staff Public 1 Mobile
Health Point Person Logistic Lead Emergency pediatric care for
and staff Primary and Emergency injuries and
Care team endemic diseases
Basic obstetrics and
gynecology
services, including
Reproductive Health services
Basic stabilization (with
provision of
BLS, ACLS)
and prompt referral of severe
trauma and non-trauma (acute)
emergencies to

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 include emergency care of
exacerbations of chronic
diseases
Basic fracture management
Emergency care of chronic
diseases
Outpatient management of
acute
malnutrition
Out patient management of
psychiatric cases
Public Health
Services/Assessment
Basic laboratory services
And drug supply to cases seen
Ambulance Medical doctor (as necessary) Manage cases especially in
Team c. Nurse relation to trauma or in mass
d. EMT-B casualty incidents (MCI)
e. Ambulance driver Work with the Incident
Commander in MCI and handle
the Advanced Medical Post in
providing triage, treatment and
proper transport of patients to
the nearest
appropriate facilities
Lead in the setting up of
temporary
health facilities or field hospital
For events and immediate
response
however, expertise of the team
may vary depending on the
nature of the incident, the
severity and the scope or
magnitude of areas
and population that are affected
RHA Team 1. DOH Representative . 1. Validate and monitor
2.SurveillanceOfficer 3.Disaster situation in the first 24 hours
Risk Reduction Management in 2. Assess magnitude of the
Health (DRRMH) Manager and event and health situation
Assistant DRRM-H Manager . 3. Determine health capability
Nurse Midwife Or any personnel to cope with the situation
with training or orientation on how to 4. Prepare report, including
do RHA observations,
recommendations and support
needed using RHA template

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Surveillance in SPEED point person . 1. Provide technical assistance
Post Extreme RESU point person . Epidemiologist to the LGUs in activating and
Emergencies Assistant/Nurse . Driver deactivating SPEED in
and Disasters evacuation centers, RHU, and
(SPEED) Team hospitals
2. Orient/train other field
reporters in the event that local
health people are
themselves Victims
3. Provide all necessary
logistical
Requirements to ensure
implementation
of SPEED
4. Monitor and evaluate
SPEED reports and make
necessary recommendations to
Superiors for the appropriate
interventions
WASH Team Sanitary engineer Sanitary inspector . Lead in WASH Rapid
Environmental point person Other Assessment
WASH Cluster members . Recommend priority areas for
WASH
3. Provide technical guidance
and
Assistance related to WASH
4. Ensure the following in
coordination
with the LGU concerned:
a. Collection and disposal of
wastes
b. Acquisition and distribution
of
potable water supply
0. Construction of additional
toilet
Facilities (1. Supervision of
sanitary conditions of the
community
6. Hygiene promotion, vector
control,
etc.
Nutrition Team Nutritionist (national/region/LGU) 1. Lead in the conduct of a
Staff from the regional NNC and Rapid Nutrition Assessment
DOH . Barangay Nutrition Scholars . 2. Prioritize services to
Other Nutrition Cluster members vulnerable population

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 3. Identify appropriate
nutritional intervention in the
area
4. Monitor milk code violations
5. Ensure availability of
breastfeeding areas
6. Coordinate with higher level
facilities for referral of severely
malnourished children
7. Lead in advocacy and IEC in
nutrition
Mental Health a. Doctors 1. Lead in the conduct of rapid
and b. Nurses MHPSS assessment
Psychosocial c. Psychologist 2. Prioritize services to
Services d. Other members of the MHPSS vulnerable population based on
(MHPSS) Cluster the assessment including
Team relatives of the dead
3. Identify appropriate
psychosocial support care to
victims and responders, military
and leaders
4. Implement preventive
measures with proper
coordination to higher level
facilities
5. Provide necessary
psychotropic drugs at various
levels
Public Health A team composed of experts to Provide the following services
Team (or to provide public health services, at evacuation centers and the
Composite include at least 5 members as community as a team such as:
Team) follows: 1. Vaccination
A . Surveillance Officer 2. Reproductive health services
b.Program managers(doctors)
3. Child care services
especially for communicable 4. Assessment and provision of
diseases , RH services, child care WASH and nutrition needs,
services 5. Establishment of surveillance
c. Sanitary engineer nutritionist- system
Dietitian 6. Health promotion services
e. logistics person
f. Driver
g. MHPSS
h. Health Promotion and Advocacy
Personnel
OpCen Team At least 3 members with experience 1. Assist in the activation, and
in Operations Center especially in management of OpCen

93
 monitoring the events and preparing 2. Provide technical guidance
reports in the timely collection of data,
validation, evaluation, and
translation into reports that
serves as inputs to decision-
making and appropriate
intervention
3. Assist in the preparation of
presentations and reports for
presentation
4. Lead in the Emergency
Medical Team Coordination
Cell
Support Team This includes Financial Teams . 1.Assist in the financial support
(group of personnel coming from the service’
financial section) and Administrative 2. Depending on the need due
Team (may compose of drivers, to the impact of the disaster
janitors, packers, logistic aides, provide support to meet
utility workers, carpenters, cooks administrative needs of
and others). responders and victims (e.g.
cooking meals, packing of
commodities,
cleaning/washing,
mobility/transport, etc.) that are
lacking in the affected areas
Other Expert Depending on the situation and 1.Evaluate damages in
Teams need, other special teams can be hospitals including estimated
requested to support in the following cost and works needed for
fields: a. Health infrastructure: repair and rehabilitation .
architects, engineer experts b. 2.Determine damage to
Technology experts or equipment equipment such as x-rays, CT
experts c. Experts on Chemical, scan, MRI, etc. .
Biological, Radiological, Nuclear 3.Assess/diagnose CBRNE
and Explosive incidents and provide
appropriate interventions

 12) Prepare schedule of duties

 13) Recall out-of-the-office staffs to be mobilized
 14) Conduct pre-deployment orientation/briefing to all teams
 15) Provide the necessary logistics to the teams to make them self-sufficient for 2
weeks
i. Personal needs
ii. Transportation
iii. Communication equipment
iv. Food

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 v. Medicines, medical supplies and equipment
vi. Financial support (cash advances, allowances, etc.)
vii. Office order
 16) Monitor deployed teams
 17) Provide team augmentation
i. Request team augmentation from nearby non-affected LGUs
ii. Request team augmentation from the QUAD clusters
iii. Request team augmentation from the Regional Office
 18) Manage service providers and volunteers
i. Identify priority areas where to deploy teams
ii. Make arrangements with the Barangay Captain of the affected community
iii. Arrange team composition based on LGU needs
iv. Conduct pre-deployment orientation/briefing
v. Ensure self-sufficiency of the teams
vi. Ensure proper and timely submission of reports

e. Logistics Mobilization

 19) Operation Section Chief submits the list of needed logistics in the field to the
IC
 20) IC requests report of Logistics Section Chief regarding emergency
commodities
i. List of available logistics in the CHO, warehouse and health centers
ii. List of QUAD cluster supplies and equipment
i. Inventory of CAMPOLAS Plus, medical supplies and equipment
ii. Inventory of Nutrition supplies and equipment
iii. Inventory of MHPSS medicines and supplies
iv. Inventory of WASH supplies and equipment
iii. MOAs with pharmaceuticals, forwarders, etc.
iv. Coordination with logistics forwarders
v. Provision of necessary forms for documentation
vi. Funds for cash advances of responders
vii. Funds for response operation in the office
viii. Funds for emergency procurement if needed

 21) Monitor and document logistics mobilization coming from the national
and/or regional offices

f. Management of lifelines

 22) Ensure the availability of functional lifelines

i. Functional transport vehicles with fuel
ii. Inventory of communication facilities/equipment
iii. Generator with backups
iv. Water supply with backups

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  23) Provide forms for documentation

g. Coordination Meetings

 24) Health / Medical cluster meeting

 25) MHPSS cluster meeting
 26) Nutrition cluster meeting
 27) WASH cluster meeting
 28) Inter-agency coordination meeting

h. Management of information and media affairs

 29) Disseminate approved risk communication messages through media

 30) Post IEC materials in strategic locations
 31) Document all teams’ activities (photo and video)
 32) Media monitoring
 33) Provide reports being requested by the media upon approval of the
LCE/RO/IC/CHO thru the official spokesperson only
 34) Prepare and submit reports to MMCHD

iv.Managing the Incident: Standard Operating Procedures

a.Incident Recognition

Daily, the Health OpCen gathers data and information regarding any emergency or
disaster in the city. Once the Health EOC is activated, it will be dedicated to gather
data and information pertaining to the particular emergency or disaster to support
the response operations, separate from the Health OpCen.

2.Confirm the reported incident from the LDRRMO if there is really an emergency or
disaster within 2 hours after impact.

3.OPCEN collects initial RHA Report from the DRRMO OPCEN or RHA team within
two hours post-disaster to establish emergency or disaster.

4. OPCEN analyzes the initial RHA Report:

i. Can the affected area cope?
ii. Is resource augmentation needed?
iii. What resources (HR and Non-HR) are needed onsite?

5. OPCEN notifies the following authorities regarding the confirmed disaster incident
and recommends declaration of appropriate Code Alert.

96
 i. City Health Officer
ii. Assistant City Health Officer
iii. Section Heads
iv. DRRM-H Program Managers

6.Disseminate report to all health personnel (thru meeting, SMS, social media, office
order, etc.)

The Manila Health Department through the Health Emergency

Management Staff (HEMS) develops, tests, implements and updates the DRRM-
H Plan. This plan serves as a guide in preparation for, during and after
emergencies and disasters. It delineates the roles, functions and responsibilities
of key players in the four thematic areas of disaster management: Disaster
Prevention and Mitigation, Preparedness, Response and Recovery.

b. Roles of Manila Health Department and Its Offices

City Health Officer

 Oversees the efficient and effective operations of the CHO and ensures
faster decision-making for the management of emergencies and disasters.
 Communicates information about the plans and measures to the local
government officials, relevant agencies within the health sector and
external partner organizations to ensure cooperation and coordination.

HEMS Manager
 Provide strategic direction for HEMS and assist the City Health
Officer in the implementation of established protocols and procedures for
emergencies and disasters.
 Develop plans, policies, programs, standards and guidelines for the
prevention and mitigation of health emergencies and disasters.
 Prepare a series of training programs and simulation activities to all
personnel who may be involved in emergency and/or disaster activities.
 Gather information on all identified and potential hazards, risks and
vulnerabilities.
 Determine the probability of occurrence of identified and potential
hazards, risks and vulnerabilities, possible consequences and how to
address them.

City Epidemiology and Surveillance Unit (CESU)

 Assists in the development of plans, policies, programs, standards
and guidelines for the prevention and mitigation of health emergencies and
disasters.
 Surveillance and analysis of health hazards, risks and vulnerability.

97
  Ensures the establishment of Surveillance in Post-Extreme
Emergencies and Disasters (SPEED) in evacuation centers following set
criteria.
 Early detection of outbreaks, rare cases or unusual increases of
disease entities that permits the prompt implementation of control measures.
 Coordinates local disease outbreak investigation and response to
RESU.
 Maintains a documentation of all reported diseases that have the
potential to become an epidemic in the city.

Administrative Office
 Analyzes, determines and makes available all resource requirements
for emergencies and/or disasters including personnel, equipment, supplies
(medical, administrative, food, etc.), sources of energy (electrical, fuel and
emergency power production or generators), and volunteer groups (Red
Cross, charitable agencies, utility workers, private contractors, etc.)
 Creates a plan for obtaining additional emergency resources and
distributing them on short notice.
 Ensures that existing equipment and supplies are operational,
updated and upgraded.
 Plans for the availability of priority equipment, supplies and services
needed, as well as alternatives, for recovery and reconstruction.
 Develops mutual aid agreements with other government agencies and
the private sector.

Logistics Office
 Manages the schematics of the task at hand to directly meet the
demands of the emergency and/or disaster and gathers information to
determine the nature and extent of emergency and/or disaster conditions.
 Coordinates and requests funds and additional emergency assistance,
upon evaluation and approval of the City Health Officer, for equipment,
supplies and associated materials needed during an emergency and/or
disaster.
 Provides financial and cost analysis information as requested and
maintains a record of all emergency and/or disaster-related expenses.
 Maintains an updated inventory of all emergency resources, including
equipment, transportation, medicines, personnel and associated
materials.
 Keeps a record of all resources used, requested or depleted in the
course of the emergency and/or disaster.

Sanitation Office

98
 Addresses environmental health concerns that can potentially affect the
health of the people – sanitation, water, air, toxic chemicals and
hazardous waste, occupational health, food safety, solid waste and
climate change.
 Prevents illness through management of the environment and/or
changing the behavior of the people through interventions involving
prevention of generation of agents, vectors or risk factors; interruption of
disease transmission; and minimizing contact between man and these
agents.

Roles of Disaster Management Teams and Members

Operation Center Team

 Monitors all health and health-related events on a 24/7 basis.
 Coordinates all health emergencies and disasters in the different
evacuation centers and ensures timely and efficient health cluster
response.
 Mobilizes technical experts and all types of medical and response
teams needed.
 Mobilizes all logistical requirements needed and requests for
augmentation from the DOH-MMCHD if necessary.
 Coordinates with all agencies and other partners in health to
respond to emergencies and disasters, as well as facilitates the
movement of all resources.
 Prepares all needed reports, have it approved and disseminates to
all concerned.
 Ensures timely and complete documentation.

Advanced Medical Post (AMP) Team

 Triages all cases brought to the AMP as to green, yellow, red and
black.
 Provides basic first aid, life support, fracture management and
wound care to include tetanus toxoid prophylaxis.
 Provides basic outpatient (primary health care) services for all
ages.
 Performs basic stabilization and prompt transport of patients to the
nearest appropriate facilities.
 Provides appropriate medicines, if available, to all cases seen.

Evacuation Center Medical Team

 Provides the following services: medical consultations and
treatment; reproductive health services; childcare services;
immunization/chemoprophylaxis; monitoring and provision of continuous
treatment for communicable (TB) and non-communicable diseases

99
(diabetes mellitus, hypertension, etc.); and treatment and care of wounds
and injuries.

Rapid Health Assessment (RHA) Team

 Validates and monitors situation in the affected areas in the first 24
hours.
 Assesses the magnitude of the disaster using the following:
 Population affected
 Evacuation centers
 Lifelines destroyed
 Assesses the health situation using the following:
 Number of casualties
 Number of health facilities damaged
 Number of health personnel who reported for work
 Availability of drugs/medicines/ supplies
 Response capacity of the community
 Determines the health capacity to cope with the disaster.
 Prepares the report and submits to the Operation Center.

Surveillance in Post-Extreme Emergencies and Disasters (SPEED)

Team
 Provides leadership in SPEED implementation (technical skills and
logistics).
 Ensures proper coordination and networking.
 Provides crash courses to identified SPEED data managers and
reporters.
 Ensures proper transition before disengagement.

Nutrition Team
 Leads in Rapid Nutrition Assessment.
 Prioritizes services to vulnerable population.
 Identifies appropriate nutritional intervention.
 Monitors milk code violations.
 Ensures availability of breastfeeding areas.
 Coordinates with higher-level facilities for referral of severely
malnourished children.
 Leads in advocacy and information, education and communication
(IEC) in Nutrition.

Mental Health and Psychosocial Support (MHPSS) Team

 Leads in Rapid MHPSS Assessment.
 Prioritizes services to vulnerable population based on the rapid
Assessment including relatives of the dead.

100
  Identifies appropriate psychosocial support care to survivors and
responders.
 Implements preventive measures with proper coordination to
higher-level facilities.
 Provides necessary psychotropic drugs, if available.
 Water, Sanitation and Hygiene (WASH) Team
 Leads in Rapid WASH Assessment.
 Recommends priority areas for WASH.
 Provides technical guidance and assistance related to WASH.
 Ensures the following in coordination with other clusters concerned:
 Collection and disposal of wastes
 Acquisition and distribution of potable water supply
 Construction of additional toilet facilities
 Supervision of sanitary conditions of the community
 Hygiene promotion and vector control

EARLY WARNING ALERT AND RESPONSE SYSTEM ACTIVATION (EWARS)

The presence of a confirmed emergency or disaster calls for immediate management

of the incident. The Early Warning Alert and Response System (EWARS) describes
the gravity of the incident according to the level and magnitude of disaster risks that
serves as basis for appropriate resource mobilization to support or carry out the
response operations.

a) Process of Declaring Code Alert

i. Health EOC monitors the event and provides data regarding the
severity or magnitude based on the initial health assessment report of
the RHA team.
ii. DRRM-H Program Managers validate the assessment results
according to the following criteria

Code WHITE Code BLUE Code RED Code ORANGE

1. Strong possibility of Any condition in Any condition Any condition
military operation Code White plus with all present: where all or
(e.g., coup attempt, two below: 1. Declared any three
armed conflict) 1. Mobilizing of disaster in the present:
2. Mass DOH resources area 1. All lifelines
action/demonstratio 2. 30-50% health 2. >100 down
n facilities casualties in (communicati
3. Forecast affected one area ons,
typhoons (signal2 (incapability of 3. MMCHD transportation
up) LGU to personnel , power,
4. National or local respond) incapable of water, food

101
 elections 3. Geographic handling entire supply)
5. National coverage and operation 2. >5000
event/holidays affected 4. Mobilization of deaths/injured
with potential for population>3 health sector 3. >50% of staff
MCI 0% needed unable to
6. Emergency w/ 4. MCI with 50-100 5. Uncontrolled report for
potential10- 50 casualties human-to- work,
casualties 5. High case human especially
7. Terrorist attack fatality transmission of those
8. Unconfirmed ratefor Avian flu/ delivering
report of re- epidemics SARS critical
emerging 6. Confirmed 6. Event resulting functions
diseases(SARS/ human-to- in mass dead 4. >50% of
bird flu) human and missing health
9. Any hazard that transmission 7. Disaster facilities are
may result in of Avian declared in damaged &
emergency flu/SARS >two provinces non-functional
10. To prepare for 7. Presence of or 30% of or main
possible timely, evacuation Metro Manila hospital
effective, efficient centers > one cities compromised
and well-organized week with 8. Uncontrolled & unable to
response public health epidemic or render health
implications outbreak services
8. Conditions that 9. To provide 5. No
require continuous information
mobilization of service delivery within 24
entire region to prevent and hours post
9. To provide control new disaster
adequate risks, like 6. Breakdown in
timely, morbidities and chain of
appropriate epidemics command
and well- 7. Isolation of
organized the affected
response areas
action 8. Uncontrolled
human-to-
human
transmission
of
SARS/avian
flu

iii. DRRM-H Program Managers determine the type of emergency or disaster and
recommends Code Alert level to the CHO/Assistant CHO
iv. CHO/Assistant CHO declares the Code Alert level through a memorandum

102
b.Disseminating the Code Alert
i. Disseminate the alert to all health perso
ii. nnel thru office order, SMS, meeting,
etc.
iii. Alert health personnel for recall and mobilization
iv. Maintain, raise or lift the Code Alert pending evolution of the disaster
incident
v. Disseminate any alert changes to all health personnel

c. Human Resource Requirements as per Code Alert Level

Code WHITE Code BLUE Code RED Code ORANGE

1. Two Emergency 1. EOD 1 & 2 1. Mobilize ALL 1. Mobilize ALL
Officers On-Duty 2. DRRM-H health personnel health personnel
(EOD) at the Program & make & make
Health OpCen Manager to be schedule on a schedule on a
that should be physically rotation basis, rotation basis,
functioning 24/7 present at the ensuring all ensuring all
2. DRRM-H Health OpCen areas will be areas will be
Program 3. All DOH covered from the covered from the
Manager (on- representative OpCen to the OpCen to the
call) s in the field field
3. DOH affected area 2. All DOH 2. All DOH
representative to should be representatives representatives
be physically available in the in unaffected in unaffected
present at their area of areas should areas should
assigned cities assignment report to the report to the
4. Driver 4. RHA team & regional office & regional office &
5. One Rapid other provide support provide support
Health appropriate to the affected to the affected
Assessment teams LGU LGU
(RHA)Team 5. Three teams 3. Provide staff at 3. Provide staff at
ready for on standby the Command the Command
dispatch (medical, Center Center
 HEMS surveillance, (LDRRMC) to (LDRRMO) to
personnel environmental) serve as serve as
 Nurse 6. Logistics representative representative
 Driver Officer 4. Suspend all 4. Suspend all
6. All other health 7. Finance Officer activities activities
personnel as necessary (training, (training,
should be placed 8. Health workshops, workshops,
on standby for promotions conferences, conferences,
immediate Officer as monitoring, etc.) monitoring, etc.)
deployment if necessary to ensure that to ensure that
warranted & in 9. Driver there will be there will be

103
 the event of 10. All other health enough staff to enough staff to
elevation of the personnel on support the support the
code standby for operation operation
immediate 5. Request for
mobilization augmentation
from the regional
office should be
addressed right
away

d. Other Requirements per Code Alert Level

Code WHITE Code BLUE Code RED Code ORANGE

1. Health EOC All those All those mentioned All those mentioned
activated24/7 mentioned in in Code Blue plus: in Code Red plus:
with adequate Code White plus: 1. ICS activation 1. Ensure RHA
staff & 1. Activation of mandatory done right away
communication the Incident 2. The CHO can for prioritization
2. Monitor event Command cancel all types of services
development System (ICS) of leaves & can 2. IC/CHO should
3. Report to 2. Health Op Cen order all health decide right
MMCHD OpCen on 24/7 with personnel to away to ask for
daily adequate report to the support
4. Get field update personnel & office. (manpower&
as necessary logistical 3. The CHO should logistics) after
5. Finance support to stop all rapid
Section to receive, operations not assessment.
ensure evaluate & related to the This should
available funds analyze all disaster. include not only
for operation reports 4. The CHO should technical but
6. Logistics 3. Mobilize RHA anticipate administrative
Section to team to request for support.
be aware affected areas additional 3. Continuous
of all 4. CHO or his/her manpower& networking with
logistics designate to specialists not LDRRMC & all
available & make proper available in the clusters
to coordination office. He should assigned
coordinate with LDRRMC request help for 4. Do active &
with for networking support from massive public
possible & other neighboring information
suppliers requirements LGUs & to campaign
for 5. Incident accept especially in
additional Commander volunteers & evacuation
requireme (IC)/CHO other medical & centers
nts should assign allied health 5. Ensure regular
7. Transport needed staff in professionals to briefing of media

104
 section to Operations, augment its & anticipate
ensure Logistics, manpower. issues/concerns
availability of Planning & 5. Continuous 6. Provide regular
vehicles & Administrative networking with updated report
drivers Sections LDRRMC & all to the MMCHD
8. Organize 6. Public clusters
standby teams Information assigned
for immediate Officer to 6. Do active &
mobilization prepare & massive public
9. Intense IEC have regular information
campaign media campaign
through conference or especially in
health press release evacuation
advisories 7. Continuous centers
10. Coordinate IEC campaign 7. Ensure regular
with local through health briefing of media
hospitals for advisories & anticipate
their especially in issues/concerns
preparedness evacuation 8. Provide regular
& availability centers updated report
of back- to the MMCHD
upteams

d.Lifting of the Code Alert, through Memorandum, if any of the following

conditions are met:

i. Hazards and impacts subside and no more new risks

ii. If all rescue/relief operations have ended and rehabilitation/ development
started
iii. MMCHD no longer needed in the operation and the city assumes overall
control of situation
iv. For Coup d’état, bombings and similar incidents, declaration of situation under
control

COVID 19 RESPONSE

Implementation of the Prevention, Detection, Isolation, Treatment, Reintegration and

Ramped up Vaccinations Strategies against Covid 19 shall be the cornerstone of response to
prevent further transmission, and shall be a shared responsibility of the national government,
local government units, private sector, and the public.

1. Prevention,

Minimum public health standards, which include physical distancing, hand hygiene,
cough etiquette, and wearing of masks among others, shall be strictly implemented across all

105
settings, regardless of severity of risk. Policies, ordinances (preferably penalizing the offenders)
and protocols should be developed and implemented to support most of these activities
Contact tracing shall be initiated after case investigation of every reported probable and
confirmed COVID-19 case. It will l also commence for contacts of suspect cases upon detection,
while waiting for specimen collection for SARS-CoV-2 diagnostic testing for the suspect case, or
while waiting for rRT-PCR results. Contacts of suspect cases shall also be listed, traced, and
assessed based on the same criteria used to identify close contacts. Second and third-
generation close contacts may also be traced as part of active contact tracing, most especially
those with variants of concern
Proper clinical assessment shall be the basis for quarantine or isolation, and testing
algorithms anchored on two main factors: symptoms and exposure, and shall reflect the most
cost-effective intervention. All close contacts of probable and confirmed cases, and travelers
shall be placed under quarantine. In the event that they develop symptoms or test positive for
COVID-19, they shall be isolated and shall be admitted and treated in the appropriate facility.
(pls see latest IATF protocol on Domestic and foreign travels) All suspect, probable, and
confirmed cases shall be isolated in the proper facility depending on the severity of symptoms.

Asymptomatic confirmed, mild and moderate cases shall be admitted and isolated in
Temporary Treatment and Monitoring Facilities (TTMFs). Severe and critical cases shall be
isolated and managed in Level 2 or Level 3 hospitals. Step-down care and proper inter-health
facility referral system shall be applied to all cases whenever applicable. Second-generation and
third-generation close contacts, and general contacts shall be advised to self monitor, strictly
adhere to the minimum health standards, and report for appearance of signs or symptoms.
Contacts of suspect cases shall be notified and advised to self-monitor, and adhere to stringent
minimum public health standards. Should the suspect case turn out to be probable or confirmed,
contacts will be asked to undergo quarantine or isolation whichever is appropriate.

2. Detection

A. Surveillance General Process

Disease surveillance and response systems of the Department of Health (DOH) along with
its local counterparts shall be the first line of defense to epidemics and health events that pose
risk to public and security, following the provisions specified in the 2020 Revised Implementing
Rules and Regulations (IRR) of Republic Act No. 11332, or the Mandatory Reporting of
Notifiable Diseases and Health Events of Public Health Concern Act. Establishment of
Epidemiology and Surveillance Units in every province, city, and municipality nationwide that will
conduct disease surveillance and epidemiologic response activities including contact tracing,
recommended needed response, and facilitation of capacity building in applied field
epidemiology, disease surveillance and response as organized and provided by EB; Disease
surveillance by the Bureau of Quarantine in ports and airports of entry and sub-ports as well as

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the airports and ports of origin of international flights and vessels; and Facilitation of CHDs/
Regional Offices and Regional Epidemiology Unit (RESU) of submission of weekly notifiable
disease surveillance reports from public and private hospitals.
A. Surveillance, contact tracing, quarantine, isolation, and testing activities shall
endeavor to meet the following targets:
1. Surveillance staff of 1:100,000 population ratio;
2. >80% of investigations done within 48 hours of getting rRT-PCR test results in areas
with new cases as sources of infection;
3. Contact tracing staff of 1:800 population ratio;
4. 70% of close contacts are traced within 24 hours of getting rRT-PCRtest results; and
5. 100% are traced within 48 hours of getting rRT-PCR test results;
6. 100% of asymptomatic confirmed cases and symptomatic are isolated in an isolation
facility within 24 hours;
7. 100% of those requiring quarantine or isolation who opt to use their homes are in
households that meet the criteria for home quarantine or isolation

B. Contact Tracing General Processes

Contact identification All Disease Reporting Units (DRUs), including health facilities,
local government units (LGUs), and laboratories, shall complete the Case Identification
Forms (CIFs) of all suspect, probable, and confirmed cases they encounter, and
simultaneously submit such information to DOH information systems and the respective
LGU. Patients who self-report symptoms personally or through DOH information systems,
and patients reported by occupational safety and health (OSH) officers shall be included in
LGUs’ list of contacts and cases that shall be for case investigation. All Local Epidemiology
and Surveillance Units (LESUs) shall initiate case investigation for daily new contacts from
submissions of DRUs and extracts from DOH information systems.
2. Case investigation or contact listing. The LESUs shall develop a contact tracing
ecosystem that are composed of community support teams such as Barangay Health
Emergency Response Teams (BHERTs), interviewers, encoders, analysts, and technical
support staff. All LESUs shall assign a contact tracer for each suspect, probable, and
confirmed case manually or through DOH information systems. Laboratory confirmation
shall not delay the initiation of contact tracing. Case and contact interviews shall be
conducted in safe and conducive environments to establish trust and rapport. Cognitive
interviewing techniques shall be used to elicit the following information, as applicable: All
people with direct physical contact, all people who lived with the case in the same
household; all places, establishments, and workplaces visited; all healthcare facilities
visited; and anyone else who might have exposed. Other methods, including records and

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 CCTV review, shall be conducted to obtain the following information mentioned above. All
disease reporting units and other entities, such as workplaces, flight, sea vessel and land
transport services, hotels, malls, etc, shall ensure that LESUs are provided access to
pertinent records and help facilitate the interview of the confirmed COVID-19 cases, and
their relatives, caregivers, and/or guardians.

Patients shall provide information to communicate with the contacts such as contact number
and address. Each contact tracer shall identify all close contacts and exposure histories of
the case and input the information in CIF forms, which shall be submitted by contact tracer
or LESU to DOH information systems. All identified close contacts that belong to a different
LGU shall be forwarded by the originating LESU to the LESU of the next LGU for
appropriate action, either manually or through DOH information systems.

C. COVID-19 Expanded Testing is defined as testing all individuals who are at-risk of
contracting COVID-19 infection. This includes testing the following groups:
(1) suspect cases or
(2) individuals with relevant history of travel and exposure (or contact), whether
symptomatic or asymptomatic, and
(3) health care workers with possible exposure, whether symptomatic or asymptomatic.
Sub-groups of at-risk individuals arranged in order of greatest to lowest need for rRT-PCR
testing are identified). Due to global shortage of testing kits and other supplies, and limitation in
local capacity for testing, there is a need to rationalize available tests and prioritize subgroups A
and B. Indiscriminate rRT-PCR testing beyond close contacts of a confirmed COVID-19 case is
not recommended. Reasons for testing the identified priority groups are also emphasized -
testing for diagnosis, screening, or surveillance. Pls see table 23 for updated testing protocol

Diagnostic testing / Testing for diagnosis looks for presence of COVID-19 at the
individual level and is performed when there is a particular reason to suspect that an individual
may be infected (i.e. manifestation of symptoms or known history of exposure). Diagnostic
testing intends to diagnose an infection in patients suspected of COVID-19 by their healthcare
provider, such as in symptomatic individuals, individuals who have had recent exposure, and
individuals who are in a high-risk group such as healthcare providers with known exposure. In
these guidelines, this shall be applied to close contacts and suspect cases identified after
symptoms-based screening.
Availability of test; Best time to use the test; Turn-around-time of test results; and
Test specificity and sensitivity which shall be independently validated. Use and limitations on
the reliability and validity of the current available test kits shall be recognized. Interpretation of
results of any tests for COVID-19 shall be done by a licensed physician and shall always be
correlated with the clinical picture of the patient.
The currently recommended test to confirm COVID-19 infection is the Real-time reverse
transcription polymerase chain reaction (rRT-PCR) assay, which detects the viral RNA rRT-PCR

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testing shall prioritize diagnostic testing of exposed symptomatic individuals and close contacts,
as well as screening testing of travelers. The use of the rapid antigen test (AgT) as a substitute
for rRT-PCR shall be allowed for diagnostic testing of suspect, including symptomatic and
asymptomatic close contacts who fit the suspect case definition, and probable cases
(a) in the community or hospital setting when rRT-PCR capacity is insufficient,
(b) in the hospital setting where the turnaround timeis critical to guide patient cohort
management, or (c) in the community during outbreaks for quicker case finding
Provided that in any setting, only FDA-certified antigen tests with sensitivity and specificity in
conformity with HTAC specifications are used. For symptomatic close contacts, a positive AgT
result shall be treated as the final diagnostic test result. Symptomatic close contacts who tested
negative for AgT, as well as asymptomatic close contacts regardless of AgT result, shall
undergo confirmatory rRT-PCR test.

Table 23 Updated testing protocol

Reporting of the full line list of all (RT-PCR specimen tests, regardless of results, from the start
of the operations of DOH licensed COVID-19 laboratories shall use the COVID-19 Repository
Document System (CDRS). Linelist of antigen tests results shall be reported by the local
government units through their municipal or city epidemiology and surveillance units to DOH
using CDRS as well. The COVID-19 Case Investigation Form (CIF) and any information
technology system registered to DOH and/or validated by the Department of Information and
Communications Technology shall be used for case investigation and testing.

3. Isolation

After Testing positive with Covid 19, prompt isolation is the key to limit the spread of the
virus. Symptomatic, tested or not are encouraged to isolated with the same purpose of averting
transfer of the diseases. Discharge criteria for suspect, probable, and confirmed COVID-19
cases shall no longer entail repeat testing. Repeat testing should not be a prerequisite for the
issuance of a clearance or certification to be issued by medical doctors. The latest protocol for

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General Public, Health care workers and immunocompromised in Quarantine and Isolation is
presented in table 24. Vaccination status is also considered in the said protocol
Patients with mild symptoms who have completed at least 7 days isolation if fully
vaccinated and 10 days for unvaccinated or partially vaccinated days of from the onset of illness
either at home or a temporary treatment and monitoring facility inclusive of 3 days of being
clinically recovered and asymptomatic can be discharged and reintegrated to the community
without the need for further testing, provided that a licensed medical doctor clears the patient.
Confirmed cases with mild symptoms can be tagged as recovered once discharge criteria are
met. Patients with moderate, severe or critical symptoms who have completed at least 21 days
of isolation in a hospital from the onset of illness, inclusive of 3 days of being clinically recovered
and asymptomatic can be discharged and reintegrated to the community without the need for
further testing, provided that a licensed medical doctor clears the patient. Confirmed cases with
moderate, severe or critical symptoms can be tagged as recovered once discharge criteria are
met. Close contacts who remain asymptomatic for at least 14days if unvaccinated or partially
vaccinated, and 7 days for fully vaccinated from date of exposure can discontinue their
quarantine without the need of any test.

Table 24 Updated Quarantine and Isolation Protocols

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 4. Case Management

a. All contact tracers shall ensure that all close contacts identified shall be:
i. Informed of the protocols for communicating with, managing, and secure reporting of
identified close contacts;
ii. Informed of protocols for daily symptom monitoring;
ii. Referred by the BHERTsto appropriate quarantine, isolation, or tertiary care facilities as
applicable based on risk screening;
iv. Requested to personally notify their close contacts for preemptive quarantine and isolation
even prior to communication by designated contact tracer;
v. Referred for testing following protocols and prioritization for testing described below, and
follow up and update information systems with test results as necessary;
vi. Monitored by the BHERTs to complete the required quarantine days depending on
vaccination status of the close contacts
b. Contact tracers shall be deputized to provide test results to confirmed cases using
information available from DOH information systems, while waiting for official laboratory results
from laboratories, provided processes for such are followed as developed by the MEOC.
c. Contact tracers or the LESU shall notify establishments or workplaces that suspect, probable,
and confirmed cases have visited, based on guideline developed by the LGU.
d. Contact Tracing Teams shall be composed of physicians, nurses, midwives, sanitary
inspectors, population officers, staff from local disaster risk reduction and management offices,
Bureau of Fire Protection, local police officers, members of the Armed Forces of the Philippines
(AFP) and volunteers for contact tracing, navigation, and monitoring of cases. In areas with
limited numbers of healthcare workers, allied healthcare workers shall serve as lead of CTTs
and other key community members shall be included, such as parent leaders of the Pantawid
Pamilyang Pilipino Program and members of civil society organizations.

d.Protocol for Contact Tracing in the workplace:

1.Asymptomatic Close Contacts of Probable and Confirmed Cases in the Workplace
Listed close - contacts shall undergo immediate quarantine. The Occupational Safety and
Health (OSH) Officer shall also inform concerned LESUs.
LESUs shall generate the list of close contacts outside the workplace and shall be referred to
LGU Contact Tracing Teams. While in quarantine, close contacts shall be monitored whether or
not symptoms will manifest Clearance for returning to work shall be symptoms-based and upon
the assessment of the OSH Officer.
2.Suspects (Symptomatic Close Contacts) in the Workplace – When a suspect, or
symptomatic close contact who fit the suspect case definition, has been identified at work, the
OSH Officer of the workplace shall determine and trace all close contacts of the case. The OSH

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Officer shall also inform concerned LESU. LESUs shall generate the list of close contacts
outside the workplace and shall be referred to LGU Contact Tracing Teams. Suspects shall be
referred to an appropriate health facility for isolation, testing, and clinical management.
Clearance for returning to work shall be symptoms-based and upon the assessment of the OSH
Officer.
For Self-reporting Close Contacts - when a patient knows s/he is a close contact, is
asymptomatic and wants to self-report, they shall contact their respective BHERTs for
assessment and proper referral to the appropriate facility. They shall be monitored whether or
not symptoms will manifest during the 14-day quarantine. Self-reporting Suspects (Symptomatic
Close Contacts) shall contact their respective BHERTs for assessment, proper referral to a
TTMF, and testing

e. Points of Entry
1. Returning Residents (RRs) - All RRs may only be allowed to travel if they are
asymptomatic. They shall be screened for symptoms prior to boarding and with negative rtpcr
72 hours pre boarding and is fully vaccinated. Screening testing shall be required depending on
the prevalence of COVID-19 in the places where they came from. The Classification of the level
of risk of a country and management for foreign travelers is based on IATF resolution no 154-c
series of 2021.

“Green” List countries/jurisdictions/territories are those classified by the IATF as “Low Risk”
countries/jurisdictions/territories. The protocols for “Green” List countries/jurisdictions/territories
in all ports of entry in the Philippines shall be as follows:
A. Fully vaccinated international arriving passengers shall be required to present a negative
Reverse Transcription - Polymerase Chain Reaction (RT-PCR) test taken within seventy-two
hours (72hrs) prior to departure from the country of origin. Additionally, they shall be required to
undergo facility-based quarantine until the release of their negative RT-PCR test taken on the
third (3rd) day. After which, they shall be required to undergo home quarantine until their tenth
(10th) day, with the date of arrival being the first day.
B. For unvaccinated, partially vaccinated, or individuals whose vaccination status cannot be
independently validated, they shall be required to present a negative RT-PCR test taken within
seventy-two hours (72hrs) prior to departure from the country of origin. Additionally, they shall
be required to undergo facility-based quarantine until the release of their negative RT-PCR test
taken on the seventh (7th) day. After which, they shall be required to undergo home quarantine
until their fourteenth (14th) day, with the date of arrival being the first day.
C. All passengers, whether Filipinos or foreigners, merely transiting through a non-Green List
country/jurisdiction/territory shall not be deemed as having come from or having been to said
country/jurisdiction/territory if they stayed in the airport the whole 3 time and were not cleared
for entry into such country/jurisdiction/territory by its immigration authorities.

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D. The Bureau of Quarantine shall ensure strict symptom monitoring while in the facility
quarantine. If found positive, he/she shall follow the prescribed isolation protocols. Upon
completion of such quarantine, the BOQ shall issue a Quarantine Certificate indicating therein
the individual’s vaccination status.
E. The Department of Transportation shall ensure that airlines board only passengers who
comply with the negative RT-PCR test-before-travel requirement. This notwithstanding, children
three (3) years old and below, regardless of country of origin, shall be exempt from the
requirement of presenting a negative RT-PCR test result before boarding the flight, unless
symptomatic.
F. The testing and quarantine protocols of minors shall follow the testing and quarantine
protocol of the parent/guardian traveling with them, regardless of the minor’s vaccination status
and country of origin.
“Yellow List” countries/jurisdictions/territories are those classified by the IATF as “Moderate
Risk” countries/jurisdictions/territories upon recommendation of the sub-Technical Working
Group on Data Analytics, the protocols for “Yellow” List countries/jurisdictions/territories in all
ports of entry in the Philippines shall be as follows:
A. For fully vaccinated individuals: a negative RT-PCR test taken within seventy-two hours (72
hrs) prior to departure from the country of origin will be required. Upon arrival, they shall
undergo facility-based quarantine with an RT-PCR test taken on the fifth (5th) day, with the date
of arrival being the first day. Regardless of a negative result, they shall be required to undergo
home quarantine up to the fourteenth (14th) day from the date of arrival.
B. Individuals who are unvaccinated, partially vaccinated, or whose vaccination status cannot be
independently validated: a negative RTPCR test taken within seventy-two hours (72 hrs) prior to
departure from the country of origin will be required. Upon arrival, they shall undergo facility-
based quarantine with an RT-PCR test done on the seventh (7th) day, with the date of arrival
being the first day. Regardless of a negative result, they shall be required to undergo home
quarantine up to the fourteenth (14th) day from the date of arrival.
“Red” List countries/jurisdictions/territories are those classified by the IATF as “High Risk”
countries/jurisdictions/territories, upon recommendation of the sub Technical Working Group on
Data Analytics. The inbound international travel of all persons, regardless of vaccination status,
coming from or who have been to “Red List” countries/jurisdictions/territories within the last
fourteen (14) days prior to arrival to any port of the Philippines shall not be allowed. Only
Filipinos returning to the country via government-initiated repatriation, non-government initiated
repatriation, and Bayanihan Flights may be allowed entry subject to the following entry, testing,
and quarantine protocols:
A. For fully vaccinated individuals: International arriving passengers shall be required to present
a negative RT-PCR test taken within seventy-two hours (72hrs) prior to departure from the
country of origin. Additionally, they shall be required to undergo facility-based quarantine with an
RT-PCR test taken on the seventh (7th) day. They may be discharged from the facility upon the
release of a negative RTPCR result but shall observe home quarantine until the fourteenth
(14th) day of arrival with the day of arrival being the first day.
B. For individuals who are unvaccinated, partially vaccinated, or whose vaccination status
cannot be independently validated: International arriving passengers shall be required to
present a negative RT-PCR test taken within seventy-two hours (72hrs) prior to departure from

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the country of origin. Additionally, they shall be required to undergo a mandatory ten (10) day
facility-based quarantine with RT-PCR testing on the seventh (7th) day. They may be
discharged only upon the completion of a 10-day facility-based quarantine, regardless of a
negative RT-PCR result, and shall observe home quarantine until the fourteenth (14th) day of
arrival with the date of arrival being the first day.
D. Passengers merely transiting through Red List countries/territories/jurisdictions shall not be
deemed as having come from or having been to said country/territory/jurisdiction if they stayed
in the airport the whole time and were not cleared for entry into such country/territory/jurisdiction
by its immigration authorities. Upon arrival in the Philippines, passengers who merely transited
through a Red List country/territory/jurisdiction shall comply with existing testing and quarantine
protocols.

5. Treatment of COVID-19 Cases

1. For patients with mild COVID-19 disease, supportive care is recommended. These include
antipyretics for fever, oral fluids for hydration, isolation in temporary treatment and monitoring
facilities or, if applicable, at home. Routine empiric antibiotics and routine anti-influenza drugs
are not recommended for mild COVID-19 disease.
2. Patients with moderate, severe and critical symptoms shall be admitted to the hospital and
shall be managed accordingly, following the latest Interim Management Guidelines for COVID-
19 of the Philippine Society for Microbiology and Infectious Diseases, Inc

6.Manila COVID-19 Vaccination Plan

The Philippines is one of the top five (5) that has COVID-19 confirmed cases and
fatality rate in the South East Asia.; The Philippine government has a prioritization
framework for COVID-19 vaccination based on the World Health Organization (WHO)
Strategic Advisory Group of Experts (SAGE) to preserve the health system capacity of
the country and reduce the mortality rate. Through the implementation of the Philippine
National Deployment and Vaccination Plan for COVID-19, the National government
wants the Local Government Unit (LGU) to prepare and take the lead for the
implementation of the COVID-19 vaccination program.
The government of the City of Manila, prepared the COVID-19 Vaccination Plan.
During the pre-phase of vaccination, comes the creation of Manila COVID-19 Vaccine
Action Center (MCVAC). The MCVAC are responsible for the advisories, developing
and the release of bulleting relevant to the vaccination campaign; assists in registration;
conduct orientation and capacity building to program managers, implementers, and
monitors; monitor the implementation of the campaign; review preparedness plans of
the health centers and provide guidance or recommendations to implementers; analyze
and report data to the City Health Officer (CHO) and Local Chief Executive; and to send
reports and referral of Adverse Event Following Immunization (AEFI).
In determining the priority vaccine recipients, the city consolidate the master list
of the following priority group; Frontline Health workers has a total of thirteen thousand
and five hundred fifty two (13,552), composed of health workers from Manila Health
Department (MHD), six (6) Local Government Unit (LGU) Hospitals, private hospitals
and private clinics; Senior Citizens from the eight hundred ninety six (896) barangays
has a total of one hundred fifty seven thousand and six hundred seventy nine (157,679);

114
Indigents with five hundred two thousand and six hundred twenty seven (502,627); and
Uniformed Personnel with four thousand eight hundred seventy nine (4,879). With the
total of six hundred seventy eight thousand and seven hundred thirty seven (678,737)
population from the priority group.
Last December 31, 2020, the City of Manila launch its Manila Vaccination and
Immunization application or website. Where the residence of Manila can register in just
four (4) easy steps for the Manila COVID-19 Vaccine. The launching of the website of
www.manilacovid19vaccine.com is powered by the TAP IT Solution and STAR Prestige
Import and Export Enterprise.
The city has eighteen (18) school and six (6) hospital for vaccination site. For
District 1 vaccination sites, Isabelo Delos Reyes Elementary School, Vicente Lim
Elementary School, Emilio Jacinto Elementary School and Gat Andres Bonifacio
Memorial Medical Center; District 2 vaccination sites, Plaridel Elementary School,
Osmeña High School, Francisco Benitez Elementary School and Ospital ng Tondo;
District 3 vaccinations sites, P. Guevarra Elementary School, Mabini Elementary
School, Bonifacio Elementary School and Justice Jose Abad Santos General Hospital;
District 4 vaccination sites, Alejandro Elementary School, Ramon Magsaysay High
School, Legarda Elementary School and Ospital ng Sampaloc; District 5 vaccination
sites, Benigno Aquino Elementary School, Justo Lukban Elementary School, Rafael
Palma Elementary School and Ospital ng Maynila; and for the District 6 vaccination
sites, Eulogio “Amang” Rodriguez Institute of Science and Technology (EARIST),
Zamora Elementary School, Sta. Ana Elementary School and Sta. Ana Hospital.In
Addition, 4 malls and other private schools and pharmacies are also engaged in
vaccination activity
Vaccination teams are composed of one (1) supervisor; five (5) physicians for
screening and emergency doctor; six (6) Nurses for the five (5) vaccinators and one (1)
surveillance; six (6) dentist as counsellors and encoders; one (1) midwife for monitoring;
one (1) Health Education Promotion Officer (HEPO); five (5) barangay health workers
for taking of vital signs and encoders; one (1) logistics officer for vaccine delivery and
retrieval; and six (6) support staff for security, crowd control, driver, sanitation and
maintenance.

There are three (3) vaccination teams per school site with a target client of one
thousand (1,000) per site; daily city target of eighteen thousand (18,000), which has a
total of weekly city target of one hundred twenty six thousand (126,000) clients.
For the preparation of vaccination site, there are designated group in each task.
The City Government Services Office are responsible for equipment like chairs, fans,
tables, etc.; Electronic Data Processing for internet connection; Sanitation Office for
disinfecting the site; City Engineering Office for the sound system; Manila Police District
for the safety and security; Manila Barangay Bureau and Liga ng mga Barangay for the
information dissemination; Manila Health Department and MDRRMO for the logistics
like the material for the personal protective equipment (PPE), medical supplies,
emergency kits and twelve (12) ambulances; and Sanitary Division of Manila Health
Department for the Biohazard or waste disposal.
There are designated vaccination site for the Manila Health Department (MHD)
personnel. Central Office Employees at City Government Employees Clinic (CGEC);

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 District 1 employees at T. Paez Integrated School; District 2 employees at Tondo Health
Center; District 3, PHL, Motorpool, North Cemetery and Rehabilitation Clinic employees
at Lanuza Health Center; District 4 and Social Hygiene Clinic employees at Belmonte
Health Center; District 5 and South Cemetery employees at Rosario Reyes Health
Center; District 6, Training Office and Wellness Clinic employees at Esperanza Health
Center.
Last January 21-28, 2021, there’s an eight (8) days training of the health
personnel for COVID-19 vaccination program. The barangay officials has an orientation
on COVID-19 vaccination to prepare the officials on what will be the flow of the
vaccination. There is a simulation exercises together with the City Mayor Francisco
“Isko Moreno” Domagoso at Unibesidad de Manila (UDM) last January 19, 2021; and
Isabelo delos Reyes Elementary School last January 28, 2021.
The City of Manila has a COVID-19 vaccine storage facility at Sta. Ana Hospital.
The storage facility have twelve (12) refrigerators; maintained its temperature of positive
two degrees Celsius to positive eight degrees Celsius (+2 to +8 °C), negative ten
degrees Celsius to negative thirteen degrees Celsius (-10 to -13°C) and negative sixty
degrees Celsius to negative eighty degrees Celsius (-60 to -80°C).

The vaccine distribution strategy, from the Department of Health (DOH) storage facility
or Vaccine Suppliers to Sta. Ana Hospital Manila COVID-19 Vaccine Storage Facility,
then will be distributed to the eighteen (18) vaccination location of school sites.

INCIDENT COMMAND SYSTEM ACTIVATION

The Manila City Health Office follows the Incident Command System (ICS) of the city, a
command and control system where the Local Chief Executive (LCE) or the Mayor
serves as the Responsible Official. ICS is an on-scene disaster response and
management mechanism under the Philippine DRRM System and its aim is to support
the well-organized and well-coordinated response actions in the field.

a.) The functions of the ICS are:

To plan and direct appropriate interventions to support the overall response
operations
To organize and mobilize resources
To conduct coordination to gain support to the operation
To monitor the whole operation
To resolve operational issues in the field
To provide health reports to all concerned

4. Establish command and control

 Once incident is confirmed and Code Alert is declared to be BLUE or RED, the
LCE/LDRRMO/CHO activates ICS.
 Initiate organizational shift, suspend normal office transactions and shift to
disaster mode.
5. Establish the chain of command

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  LCE/Mayor takes the role of Responsible Official (RO).
 RO designates the Incident Commander (IC).
 Activate Incident Management Team (IMT).
 Establish the ICS structure and fill up all the positions of the ICS members.
 Provide Job Action Sheets to the IMT to make them aware of their roles and
responsibilities.
 Provide IDs and/or uniforms for easy identification of the IMT members.

6. Fill up the ICS structure positions

 Command staffs: Safety Officer, Liaison Officer, Public Information Officer.
 General staffs: Operations ,Planning ,Logistics and Administrative Sections to
support the IC.
 These staffs are governed by their Job Action Sheets that they need to be
oriented onto facilitate response operations.
 Organize response assets into five functional areas:
i. Develops the specific tactics and executes activities to accomplish the
goals and objectives in the management of victims.
ii. Oversee the entire operation including field and hospital operations,
public health concerns, health promotion, logistics, and team
mobilization.
iii. Do a lot of coordination and directing and ensure that plans are put into
action

 PLANNING SECTION
i. Organizes and directs all aspects of planning, from an Initial Action Plan
to Continuing Plan as the incident develops.

 LOGISTICS SECTION
i. Organizes and directs the provision of the right logistics at the right time,
right place, and right cost, maintenance of the physical environment, and
provision of adequate levels of food, shelter, and supplies to support the
response teams.

 ADMINISTRATIVE (FINANCE) SECTION

i. Oversees and facilitates acquisition of supplies and services needed for
response.
ii. Ensures available funds to support operations.
iii. Monitors the utilization of financial assets and provides administrative
support.
iv. Supervises the documentation of expenditures relevant to the
emergency incident

7. Fill up the ICS structure positions and provide job action sheets

RESPONSIBLE OFFICIAL (RO)

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 The official responsible for administering policy for an agency or jurisdiction,
having full authority for making decisions, and providing direction to the
management organization foran incident. The Responsible Official is the LCE, Mayor or
his/her authorized representative.

Roles and Responsibilities:

-Typically makes the decision to activate ICS and order an IMT.
-Delegates authority to the IC for incident operations.
-Conducts an initial meeting (preferably face-to-face) with IC.
-Conducts briefing to the incoming IMT for the delegation of authority,
current situation, incident goals and performance expectations.
-Interacts with the IMT during response operations to validate objectives and
ensure that the IMT is progressing toward meeting those objectives.
-Conducts closeout meeting with the IMT and evaluates team performance.
-Ensures resource coordination and support to the IMT from the Emergency
Operation Center (EOC).
-Incident Management Team (IMT) is an incident command organization
comprised of Command and General Staff members and other
appropriate personnel that can be activated or deployed as needed.
-IMT is formed to manage an incident or a planned event.
-IMT should have formal training, certification, qualification, notification,
deployment, and should have developed its operational procedures.

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Basic ICS Structure

119
 Responsible
Official

Liaison Officer Safety Officer

Public Information
Officer

Planning Section Operation Section Logistics Section Administrative

Chief Chief Chief Section Chief
(DRRM-H Program (DRRM-H Program
(Logistics Officer) (Administrative Officer)
Manager) Manager)

Medical/Health
Data/Information Supply Unit
team Finance Officer
Officer Leader
representative

MHPSS team Communications

Field Officer Transport Officer
representative Unit Leader

Nutrition team Facilities Unit

Program Managers
representative Leader

QUAD Cluster WASH team

Representatives representative

RHA team
representative

Management of the
Dead & Missing
(MDM)
representative
Figure. Incident Command Structure

c.POST IMPACT RESPONSE

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In the Evacuation Center

Priority for Evacuation (On-Scene)

So as to have a common standard in color tagging of victims, we follow the same color
tagging as the in-hospital.
RED TAG
 Priority for evacuation
 Needs immediate care
YELLOW TAG
 Second priority for evacuation
 Patient needs care
 Injuries are not life threatening
GREEN TAG
 Third priority for evacuation
 Minor injuries
 Walking wounded

BLACK TAG
 Last priority
 Patient is dead.
 Victims who are clinically dead.
 Those who die while awaiting treatment, and those in cardiac arrest
following trauma.

i.Technical Assistance in establishing Evacuation Center

Create gender sensitive spaces to separate the males from

Create safe spaces for the vulnerable population
Create friendly spaces for the vulnerable population
Establishing the Medical Clinic/Station
Provide Technical assistance in the repair/restoration/quick fixing of WASH and
Nutrition facilities c/o LGU, water providers and partners to sustain health services
delivery

ii. Provision of basic or essential health services

Medical/Health Services
a. Establishing Medial station/clinic manned by EMT to:
• Provide medical consultation and treatment
• Provide drugs and medicines
• Provide transport to other/higher level health care facility
• Provide BLS and Standard First Aid services, if needed

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b. Observe the GREEN tagged victims or the walking wounded for other injuries like
those with head injury or fractured upper limbs who can walk but need more
definitive treatment. They might be YELLOW tagged victims who need treatment

iii.WASH Services
a. Provide safe water for drinking. In the initial response phase, consider providing
bottled water due to lack of safe water source
b. Provision of safe water for hygienic purposes
c. Provision of safe water for food preparation
d. Provision of gender sensitive toilets and bathing areas

iv.Nutrition Services
a. Establish breastfeeding areas with privacy, security and supportive care
b. Promote breastfeeding
c. Refer severely acute malnourished children with complication
d. Provision of supplementary feeding

v..MHPSS Services
a. Provision of Psychosocial First Aid
b. Provision of basic needs
c. Screening of victims for those having potential to become mentally pathologic
d. Referral of pathologic cases to hospitals

vi.Implement SPEED to intensify disease surveillance for early detection of diseases

especially those with
epidemic potential, to facilitate early diagnosis and treatment to prevent disease
outbreak

Evaluation, care (first aid, medical care etc) and stabilization of casualties at impact site,
Advance Medical Post and during Evacuation/ Transport Continuing Coordination/
Monitoring with Regional / DOH Central Operations Center and Receiving Hospital

 The Hospital .maintains continuous coordination with the community

This is especially important regarding disaster notification and
communication, transportation of casualties and provisions for dispatch
of hospital medical teams to a disaster site.
 Strong coordination with community agencies (e.g. fire department, the
local EMS, local emergency management or the civil defense agency)
are important to ensure a orchestrated disaster response.
 Hospital coordinates with the military, local chapters of Philippine
National Red Cross and other volunteer agencies, along with other
national agencies.

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  Hospital coordinates with other agencies not readily available may be
needed in a particular disaster situation. Plans should consider how to
rapidly access these resources. Plans for obtaining additional shelter,
food and water should also be considered.
 The hospital network is a sharing arrangement between several
hospitals of different levels and specialties in a given area to work
together for the purpose of managing medical emergencies more
efficiently.
 The hospital network shall be mobilized during disaster operations.
There should be prearranged referral to tertiary medical centers and
special units whether private or government institutions (e.g. burn,
spinal, pediatric trauma centers unit).

The following hospital capability ratings are recommended:

RATED 1 means that the hospital is capable of accepting all cases of this specialty. A
hospital Rated 1 is an end-hospital that will not refuse patients unless the situation
makes admission extremely difficult or impossible.
RATED 2 means that the hospital is capable of handling sub-specialty cases buthas
some limitations such as bed capacity, equipment,etc .and cannot be expected to offer
definitive care. It may also mean there are not enough full-time consultants or residents
available on a 24 hour basis or that there is no training program and therefore no front-
line personnel in this specialty.
RATED 3 means the hospital is incapable of handling cases of this sub-specialtybeyond
giving primary care and resuscitation’

HOSPITAL CLASSIFICATION (DOH AO 2012 – 002)

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 A lead hospitalist assigned for each sub-specialty to coordinate the compilation of
treatment protocols.

 All lead hospitals are Rated 1 for their respective sub-specialties.

 A two-way referral system between the lead hospital and other hospitals in
the network shall be established.
 A team leader for each lead hospital shall also be designated.
 Hospitals both private and government should work together to form the
network irrespective of specialty and capability.
 There should be a clear system of referral so as to prevent patients
referred to the wrong hospital.

vii.Prioritization for In-Hospital Care

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R E D – Priority One: Life threatening / immediate. The patient requires
immediate attention. The following factors should be used to determine when a
mass casualty incident ( MCI ) victim is a Priority One.
a. Obstruction or damage to airway
b. Disturbance of breathing – respiration above 30/min
c. Disturbance in circulation – capillary refill greater than 2 seconds or
carotid pulse weak , irregular or absent, radial pulse absent
d. Does not follow commands or altered level of consciousness
e. Need for life-saving measures ( BLS and ATLS) and urgent hospital
admission
f. Victims whose injuries demand definitive treatment in the hospital but
which treatment may be delayed without prejudices to ultimate recovery.
YELLOW – Priority Two: Urgent. Patient has passed primary survey, but
major system injury limits delay of transport to one hour. Any one of
the following factors could take place a victim into a Priority Two category:
a. Needs to be treated within 4-6 hours otherwise they will become unstable.
b. Severe burns; burns involving hands, feet or face ( not including the
respiratory tract); burns complicated by major soft tissue trauma;
c. Hospital admission is required.
d. Moderate blood loss; Back injuries; Heat injuries with a normal level of
consciousness.

GREEN– Priority Three: Delayed. An injury exists but treatment can be

delayed for up to six hours. Generally ( but not always ), anyone who can walk to
a designated area for treatment will be a Priority Three. The following injuries
are example:

a. Minor injuries not threatened by ABC instability

b. Minor fractures, minor soft tissue injuries, minor burns
c. Victims whose injuries are so severe that survival cannot be expected
even under the most ideal conditions; obviously mortal wounds where
death is certain ( such as head injuries or massive burns ).

BLACK – Priority Four

a. Patient is dead.
b. Victims who are clinically dead.
c. Those who die while awaiting treatment, and those in cardiac arrest
following trauma.
Legend:
A = Airway B = Breathing C = Circulation

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 BLS = Basic Life Support
ACLS = Advance Cardiac Life support
ATLS = Advanced Trauma Life support

The following information shall be hand printed on the Patient’s color Tag:
 Patient’s sequence number
 Name of patient
 Tentative diagnosis or suspected injury
 Previous treatment as stated on the tag which was placed on the patient at the
scene of the disaster
 Blood type ( cross matching/signature)
 X-ray number

D.RECOVERY AND REHABILITATION PLAN

This is the stage after the impact of a disaster or an emergency, where the situation
has stabilized or returned back to normal.
Recovery is a multi-dimensional process that spans restoration of basic
services, livelihoods, shelter, governance, security and rule of law, environment and
social dimensions, including the reintegration of displaced populations. It also

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establishes the foundations for longer term development, by supporting and generating
self-sustaining and locally owned processes for post-crisis recovery (adapted from
UNDP 2011

1. ACTIVITIES DURING THE RECOVERY / RECONSTRUCTION PHASE AFTER AN EMERGENCY /

DISASTER
1. Upon lifting the Code Alert after an emergency the Disaster Recovery Plan is
activated. (Resumption to normal)
2. Organizational structure shift back to the normal.
3. Implementation of the Recovery SOPs/Protocols.
a. Follow- up of Damaged Assessment and Needs Analysis (DANA)
b. Provision of Public Health Services:
- Continuing surveillance, water and sanitation, endemic diseases,
nutritional status monitoring;
- Immunization
- Micronutrient Supplementation and Breast feeding
- Environmental Sanitation
- Health Promotion and Advocacy : Risk Communication
4. Capability building: Refresher/Updates on HEPRRP, MCI, BLS, EMT,etc.
5. Provision of Mental Health and Psychosocia Support(MHPSS) for casualties, staff,
and other responders.
6. Clean up/repair of damages of buildings, provision of assistance for the repair of
health facilities/equipment.
7. Human Resource Management:
a. Payment of overtime pay and recognition rites for responders
b. Provision of assistance to affected staff
c. Retraining/refresher course.
8. Information/data management for future research activities.
9. Conduct post evaluation activities, review systems, and proposed improvement
10. Review and update HEMS manual, policies, guidelines, SOPs based on the lessons
learned.
11. Networking, strengthening of partnership with other stakeholders: GOs and NGOs.

1. Recovery and Rehabilitation Objective

a. To restore disrupted basic health services

b. To restore damaged health infrastructures

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 c. To guide in restoring the well-being of the people who suffered
from the effects of disaster
d. To restore the functionality of systems and facility installations

2. Process of Activities of Recovery and Rehabilitation

I. SITUATIONAL ANALYSIS

a. .Analyze the reports gathered inorder to identify what are needed to be restored
i. Field report is the daily report that reflects what is happening in the field,
the evolution of the incident, the field response operation, the expressed
needs as well as the operational issues.
ii. Health Situation Report is a report specific to health-related concerns that
describes the health-related risks, existing health capacity and needs
versus the services being delivered by the humanitarian actors.
iii. SPEED reports provide data/information regarding the existence of
diseases especially those with epidemic potential that triggers
investigation and assessment of capacity in the field to manage the
brewing new risk/disease.
iv. Health Assessment Reports of:
a. Evacuation Center
b. Health Cluster
c. MHPSS Cluster
d. Nutrition Cluster
e. WASH Cluster

II. To restore the Health Services

a. Conduct a Post-Disaster Risk Assessment (PDRA) for Health

i. Review and analyze the Rapid Health Assessment (RHA) reports of the
evacuation center
ii. Identify secondary hazards posing threats to the community together with
their vulnerabilities to these hazards
iii. Know the risks to people, health facilities, services, and environment and
what service and systems need to be restored
iv. Know the existing and non-existing or disrupted health services

b. Quad Core Assessments

i. Identify the specific disrupted health services to be restored
ii. Identify the causes of services disruptions in terms of:
a. Systems – non-functioning communication system, logistics
management system, etc.
b. Manpower – lack of manpower or need for technical experts, etc.
c. Machines – lack of medical equipment, etc.
d. Materials – inadequate or lack of drugs, medicines, supplies, etc.
e. Facilities – health facilities, health offices, warehouses, etc.
iii. Identify operational issues to be resolved

III. To restore Damaged Facilities

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 a. Conduct Post-Disaster Damage and Needs Analysis
PDNA is a multi-sectoral and multi-disciplinary structured approach for assessing
disaster impacts and prioritizing recovery and reconstruction needs. It is undertaken by
government agencies in collaboration with international development partners and the
private sector. This serves as one of the bases for developing the Recovery and
Rehabilitation Plan for Health
i. Inventory and assess the structurally damaged health facilities
ii. Assess the functionality of damaged health facilities. Describe if they are
totally or partially damaged, functional or non-functional (e.g. totally
damaged but partially functional). Name the non-functional parts or
services.
iii. Assess, identify, quantify and estimate the cost of the non-structural
damages of health facilities
iv. Assess, identify, quantify and estimate the losses (direct) incurred in the
disaster
v. Assess, identify, quantify and estimate the resources utilized that need to
be replaced/recovered
vi. Identify and cost all recovery and construction needs. Develop initial
recovery program/plan of activities
a. Resources to be mobilized for recovery and reconstruction
b. Evaluate the adverse consequences of the disaster in the context
of health on Assets, Processes, Service delivery and access to
goods and services
vii. Estimate damages caused by disaster
viii. Identify all recovery and construction needs

b. Damage and Loss Analysis

i. Assess physical and psychosocial status of responders and those affected
by the disaster
ii. Quantify the losses (direct) incurred in the disaster
iii. Identify the resources utilized that need to be replaced/recovered
a. Manpower (human resources)
b. Money (budget, funds, finance)
c. Machines (equipment, other technologies)
d. Materials (medical and office supplies, medicines, drugs,
reagents)

IV. To Restore systems functionality

a. Conduct Post-Incident Evaluation

i. Make a comprehensive assessment of the organizational capacity to
manage risks, functionality of DRRM-H Plan, functionality of DRRM-H
systems and the organized and effective response covering the following:
a. Status of DRRM-H plans and preparedness prior to the
emergency or disaster
b. Communications in place
c. Early Warning and Alert Response System including origins,
transmission and receipt, processing, dissemination, actions
taken (by sender and recipient), and functioning of warning
systems

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 d. Emergency Operations Center, acquisition, receipt and handling
of information, display and assessment of disaster situation,
decision-making, and dissemination of decisions and information
e. Mobilization of response facilities/units
f. Assignment of tasks to units/departments involved in the
response operation
ii. Identify the strengths and weaknesses encountered and process the
learning using the following questions:
a. What worked well? Why did this work well?
b. What did not work well? Why not?
c. What are the insights from these experiences in the context of
the present event, as well as past events?
d. What are the recommendations for future response work?
iii. Consider other documented sources of insights from actual experiences
(e.g. post-mission, final reports) of the deployed teams in your review.
iv. Where appropriate, include the briefing from technical experts on future
trends and developments to help achieve optimum utilization of post-
incident experiences into the Post-Incident Evaluation.
v. Come up with a set of lessons learned (either as new lessons or validated
ones) based on previous experiences to further enhance the response
management.
vi. Undertake a critical review of the results of the assessment and based on
this, come up with recommendations to further enhance the response
management
vii. Use the results of the PIE as basis for the finalization of the Final Report.

V. To rehabilitate Affected By the Disaster

a. Human Recovery Needs Assessment (HRNA)

i. Assess people’s capacity to cope with and recover from the impacts of
disaster
a. Knowledge & skills on DRRM-H
b. Post-disaster capacity building needs
ii. Assess the needed enabling environment for human resource recovery in
terms of the following:
a. Basic health service needs (e.g. medical and MHPSS)
b. Policies
c. Monetary compensations
d. Rest and respite

VI. Develop the Plan for Recovery and Rehabilitation

a. Utilize all the results of the post-disaster assessment initiatives

b. Identify possible sources of the Disaster Recovery and Rehabilitation Plan logistical
requirements and incorporate in the plan
c. Implement, monitor and evaluate the Disaster Recovery and Rehabilitation Plan

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 TIME RESOURCE PERSON
STRATE INDICAT
DAMAGES ACTIVITY FRA REQUIREM RESPONS
GY ORS
ME ENT IBLE
DAMAGE
DANA
TO
MHD DOH REPORT
INFRASTRUC
S DONE
TURE
LIVELIHO
LOSS OF D OD
MDSW
PROPERTY DANA PROJEC
DAMAGE
A FORMS & TS GIVEN
ASSESS TEAMS
N MENT
JOB A NEEDS 2020
DISPLACEM GAWAD ANALYSI CONSTRUC
KALING S TION
ENT RELOCA
A TEAMS MATERIAL MDSW
S TION &
PROGR NEW
AMS GAWAD
LOSS OF HOUSES
KALINGA
INCOME BUILT

RELOCATIO
N

IV. IMPLEMENTING THE PLAN

Implementation of the DRRM-H Operational Plan shall commence upon approval of the
plan. Since the activities are integrated in different plans, the DRRM-H Manager/Health Officer
shall ensure smooth execution of the targeted activities and proper utilization of funds. This
shall be done through close monitoring and management of implementation gaps and guided by
the indicators set in each of the matrices that were accomplished.
1. Identify the implementers of the plan and other key stakeholders.
2. Ensure that resources (e.g. technical assistance, budget augmentation) are focused,
allocated, and available upon implementation.
3. Orient the Heads of the institutions/ Local Chief Executives and other stakeholders on the
final and approved plans.
4. Communicate to the stakeholders and decision-makers the results of the implementation.

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The accomplishment reports are submitted to the DRRM-H Planning Committee in order to
monitor the progress of the plan. Utilization reports shall also be regularly provided to Planning
and Development Office, DRRM Council, government, non-government, and partner agencies,
and community organizations that pledge budgetary support to the DRRM-H Operational Plan
A. Priority Areas of Concern and immediate action:
1. Enhancement of the Operational Capability of the Health sub-OPCEN
2. Procurement of Disaster Commodities
3. Capacity Building of Health Emergency Response Team

To further strengthen the Health OPCEN Operational capabilities the following are
recommended course of actions:
A. Procurement of OPCEN office Equipments
B. Procurement of Office Supplies
C. Regular rotation of Health personnel on duty at OPCEN
D. Printing of OPCEN Reporting forms

B.HERT mobilization process

The response mobilization processes are integrated into two (2) phases such as:
1. Preparedness phase
a. All mobilizing agencies/organization shall develop mechanisms to obtain,
review, analyze, and use the information gathered to determine the best possible
actions and interventions at any given time, during disaster risk reduction
management.
b. Regular monitoring of events/incidents from all sources shall be
verified/validated and/or coordinated with the affected area/s.
2. Response phase
a. Pre-mobilization phase
1) The decision for mobilization shall be based on the set of triggers
2) The types and number of HERTs to be mobilized shall be dependent on the nature of
the event, category of the mobilization process (whether emergency deployment,
sudden onset disaster, and others), magnitude of the impact, and identified needs.
3) Members of the HERTs shall be notified/informed on the schedules and plans for the
mobilization, to include notification of subsequent batches to go on standby.
4) For IHERTS, an offer of assistance declaring their capacity shall be prepared and
submitted to DOH, copy furnish the Department of Foreign Affairs, Philippine Embassy
or Consulate in their area. DOH shall examine whether the offer will be accepted. No
IHERTs shall engage in humanitarian mission without the approval of DOH. For EMTs
from foreign countries, those that are verified by the WHO Will be the priority to be
mobilized in the Philippines. However, those not verified yet but are complying with the
global minimum standards may be mobilized upon local verification.

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5) An orientation/final briefing of the HERTs shall be done prior to mobilization of teams.
It shall include discussion of the mission objective, schedule, mobilization plan, logistic
requirements, role of each member of the HERTs, and preparation of necessary
documents.
b. Mobilization phase
1) All HERTs shall register/check—in at the Incident Command Post of the affected
area/country upon arrival following the level of response as provided under Republic Act
10121.
2) In terms of monitoring, all mobilizing agencies/organizations shall:
a) Monitor the movement of the HERTs from the time of activation, enroute, and
engagement in the field until their demobilization and return to base.
b) Ensure the security, and address the relevant concerns of the mobilized HERTs.
c) Monitor the progress of the attainment of the mission objectives using a standard
monitoring tool.
d) Inform sending agencies/organizations on the progress of the mobilization.
3) In terms of reporting: '
a) The Operation Center (OpCen) of the mobilizing agency/organization shall monitor
the activities/movement of the team throughout the entire duration of the mission.
b) All mobilized HERTs shall submit reports on a regular basis, using standard forms, to
the area recipient of assistance/operations head, mobilizing and sending
agency/organization, through existing and
available lines of communication. A preliminary assessment(RHA)/activity report shall
be provided to concerned agencies using a standard reporting form.
4) The decision for the demobilization of the HERTs shall be based on set of triggers
listed
Post-mobilization phase
1) Post-Mission Report (including all records) shall be submitted within 24 hours after
termination of operations for locally deployed teams and five days after arrival for
internationally-deployed teams upon return to normal duty. IHERTs ,on the other hand,
shall submit post-mission report before leaving the Philippines.
2) Mental Health and Psychosocial Support Services (MHPSS) shall be provided to the
teams mobilized by trained MHPSS personnel, as deemed necessary and immediately
after mobilization, if feasible.
3) Post Incident Evaluation (PIE) shall immediately follow the conduct of the debriefing
of the teams mobilized, usually within five days’ post mobilization. A report shall be
generated for improvement of existing standard operating procedures, policies, plans,
and systems on team mobilization.
4) For international teams, debriefing and PIE shall be done following their
country/agency/organization’s protocol.
5) Liquidation of expenditures
a) HERTs shall liquidate expenditures within 30 days for local mobilization and 60 days
for international mobilization upon return to normal duty.
b) It shall be the responsibility of the team leader and the deputy team leader to
facilitate the processing of liquidation of expenditures.
c) All receipts and related documents shall be submitted by the team to the
administrative officer/responsible official for liquidation purposes and clearance.

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6) Return to normal duty. All team members shall report back to duty on the following
days, after Completion of the all the necessary requirements:
a) Local emergency/disaster/events less than one week: one working day upon arrival
of the HERTs to their base
b) Local emergency/disaster/events lasting more than one week: two working days
upon arrival of the HERTs to their base
c) International emergency/disaster/events: three working days upon arrival of the
HERTs to their base. The said number of days and the number of days the team
member was
quarantined, if necessary, shall not be deducted from their leave credits, and shall be
considered as compensatory day off

C.Protection of the HERTs

1. All mobilized members of the HERTs shall be on temporary added duty status.
2. All mobilized members shall be entitled to all remunerations/benefits on top of the
regular benefit package provided during normal working conditions.
3.The remunerations/benefits shall include but not limited to per diem, lodging, meals,
communication allowance, incidental expenses, overtime pay, compensatory leave,
recognition and reward, mobilization insurance (travel, accident and death), death and
burial allowance, vaccination (as required/necessary),mobilization/operational fund, and
other allowable benefits due them from the sending agencies/organization.
4.In case of illness, injuries, disability, and hospitalization due to mobilization, the
personnel shall be entitled to financial assistance for hospitalization, recovery and
rehabilitation care (including orthopedic appliances) and other entitlements whereby
necessary. Likewise, they shall be entitled to emergency extraction (as needed).
5.No deduction of leave credits during the time of hospitalization, recovery and
rehabilitation care of the affected members of the HERTS.

Local Government Units shall

1.Formulate their DRRM—H plans to adopt and implement the policy on mobilization
of HERTs;
2.Establish a mechanism on mobilization of teams that is appropriate for their
respective area of jurisdiction;
3.Develop, implement and monitor a mechanism of coordination and collaboration
with DOH Regional Office, DOH Hospitals, DRRMCs, health sector partners, and
other stakeholder, to ensure efficient and effective mobilization of HERTs;
4.Provide logistical support requirements of the HERTs; and
5.Prepare and submit all the necessary reports based on the prescribed templates and
Timelines

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 V.MONITORING AND EVALUATION

The DRRM-H Plan shall be reviewed annually and updated as necessary, especially when
a major event/disaster affects the area. Likewise, the DRRM-H Plan should be tested through
drills and exercises to ensure functionality and determine possible implementation challenges.
Monitoring results and plan evaluation shall guide the updating of the plan. Indicators formulated
for the prevention and mitigation plan and preparedness plan shall be used to monitor the
progress in implementing the strategies formulated for each. Additionally, the response and
recovery and rehabilitation plans shall be regularly tested using drills and exercises.
Progress shall be reported to the uplines and the DRRM-H Planning Committee members
annually during the review of the plan. This shall be complemented by the accomplishment
reports generated in monitoring the DRRM-H Operational Plan for specific activities of each
strategy. Evaluation shall be done every three years, prior to the review and updating of the
DRRM-H Plan.
The DRRM-H Planning Committee shall conduct post implementation evaluation for every
incident/event to ensure the appropriateness of the existing plans. The results of these
evaluations shall be documented and presented for consideration to guide the updating of the

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plan. All accomplishment reports, health cluster meeting documentation, PIE results as well as
documentation of lessons learned from an incident shall be compiled, reviewed, and processed,
to assess the success of the plan relative to the accomplishment of its objectives.
In doing the monitoring and evaluation of the DRRM-H Plan, whether in the form of a
consultative workshop/ PIR or doing field visits, the intentions are the following:
1. recognize good practices and lessons;
2. identify implementation gaps and provide recommendations for improvement;
3. generate insights to support policies, programs on DRRM-H and capability-building

VI.APPENDICES

Appendix 1

Organizational Chart of MHD Incident Command System

The MHD Incident Command System is an example of an emergency

management system which employs a logical management structure, defined
responsibilities, clear reporting channels, and a common nomenclature to help unify the
MHD with other emergency responders. ICS is an emergency management system
made up of positions on an organizational chart. Each position has a specific mission to
address an emergency situation.
However, it is important to keep in mind the four basic components of ICS, which
are Operations, Logistic, Planning and Finance which must be retained at all cost.

MHD INCIDENT COMMAND SYSTEM

1. Command and Control Establishment

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 Incident Commander

Safety Officer Public Info. Officer

Liaison Officer

Operations Logistics Planning Administrative/

Finance

An on site ADVANCE COMMAND POST within the incident area should be

established, preferably in a pre-designated area. This Operation Center should be able
to communicate with the patient receiving area (triage site), patient care areas, and with
local EMS, police, fire, and government authorities. Provision for multiple modes of
communication (mobile phone, two-way radio, runners, etc.) should be made. The
command personnel should include at least a physician, a nurse and an administrator.

The internal command and control of an incident at Health Services would

include ultimate control as incident commander with the Health Services Director or
designee. The Span of Control should be kept within manageable means by dividing the
incident into pieces. Under normal situations this division would be into a Medical
Commander and a Logistical Commander under the overall Incident Commander.

It is recognized that the overall Incident Commander be stationary in the

Advance Command Post to make timely decisions as information and requests reach
him or her. In the command structure, the two operational commanders (Medical and
Logistical) will have the role to evaluate the entire Health Services’ conditions. These

137
commanders need not be completely stationary to be effective in directing their specific
areas. These individual commanders should have hand held 2 way radio mobile
communications in the command post at all times.

The area commanders are the eyes and ears for the Incident Commander. It is
only through proper evaluation of the on-going incident and constant feedback to the
command post that the incident can be best managed. A telephone call-tree shall be
maintained and kept up-to-date with current staffing needs and information. This
telephone tree shall be utilized by those designated to initiate the recall of personnel
when directed by the Incident Commander.

As part of disaster planning, it is essential that certain areas of the FIELD

Hospital be designated for specific functions such as reception of casualties, treatment,
and discharge of patients. The plan should be quite specific as to the function of these
areas, staffing requirements and basic supplies to be utilized.
Once the Code Blue has been declared, the MHD Incident Command System
shall be established for proper command and control over the situation. The Incident
Commander ( CHO, ACHO, Chief, E MX, Hospital / Medical Director or Chief of Clinics
shall initiate the following:
Step 1. Assume command
The Incident Commander will organize his/her command force by designating the
Public Information Officer, Liaison Officer, Security Officer who are directly under his
command; then will create the Operation; Planning; Logistics; and Administrative
Committees.
Step 2. Assess the situation
Step 3. Identify and set perimeters
Step 4. Establish/Activate the pre-designated or alternative command post
Step 5. Identify safety officer
Step 6. Identify staging area and staging office

2. Job Action Sheets

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 Job Action Sheets are distributed to designated officers. These sheets contain
the functions, responsibilities, and activities to be carried out for emergency response.
(Refer to Appendix 6 below)
3. Incident Management Process
The incident commander initiates the incident management process which describes an
ordered sequence of actions that:
 Establishes incident goals (where the system wants to be at the end of response)
 Defines incident objectives (how to get there) and strategies to meet the defined
goals
 Adequately disseminates information, including the following, to achieve
coordination throughout IMS:
– Response goals, objectives, and strategies
– Situation status reports
– Resource status updates
– Safety issues for responders
– Communication methods for responders
 Evaluates strategies and tactics for effectiveness in achieving objectives and
monitors ongoing circumstance
 Revises the objectives, strategies, and tactics as dictated by incident circumstances

Outputs: - Incident Action Plan

- Establishment of Gold (Strategic), Silver (Tactical) and Bronze (Operational)
commands

ACTIVATION OF THE MHD OPERATION CENTER

The MHD Operation Center, is activated once Code White has been declared.
This serves as the Command Post when Code BLUE is raised. It keeps an open
communication for reporting and coordination with the HEMS OPCEN, with the
Regional Operation Center, as well as with Regional/ Provincial Disaster Coordinating
Councils. There must be back-up communication system to be utilized or mobilized in

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case where the system fails. It mobilizes necessary logistics and response teams for the
response operation.
An Emergency Operation Center (EOC) must be established to provide overall
command and coordination of the hospital’s disaster response activities. These
activities include activation of the plan, coordination of hospital activities with those at
the disaster site and adjusting the plan as necessary. Good communication is
absolutely essential for these coordination activities and must be immediately available
via telephone, radio and messengers. EOC responsibilities include opening up
additional hospital wards or clinics, obtaining assistance, evacuation of endangered
patients, and assignment of staff to treatment areas and revision of original job
assignments.

STANDARD OPERATING PROCEDURES FOR EOC’S

Activation Operations Closing-down
Open EOC Message Flow File messages & other
Documents
Mobilize staff Information display
Activate communications Information processing Releasestaff Systems
Prepare/post up maps & Control resource mobilization Closedown
Display boards & deployment communications
Draw up support staff Drafting of situation reports Close down EOC
Roster Decision-making Organize operational
Debrief Briefings
Reporting to higher authority

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Appendix 2

RESPONSE TO INTERNAL AND EXTERNAL EMERGENCIES

1. Management of Field / On- site Activities
As a First Responder Team to an External Emergency
a. Deployment of On-scene response team
i. SOP: Standard Operating Procedure on Information and Dispatch
ii. Composition of Response Team (Refer above.. Organization of
Response Team)
 All hospitals and Operation Centers shall dispatch teams within their
catchments area upon monitoring or receiving a call confirming a Mass
Casualty Incident
 Any hospital can also be dispatched even outside their catchments area upon
a request of help from neighboring facilities or upon instruction of the HEMS
Central OPCEN

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  HEMS Central OPCEN, upon instruction of the HEMS Director can dispatch
teams from any hospital upon monitoring events that necessitates response
form the Department of Health or upon request from agencies of government
with authority over certain events (ex. NDCC)
 While the initial team is dispatched, the OPCEN anticipates the scenario and
alerts additional teams that might be needed, nearby hospitals especially the
receiving hospitals, and starts reviewing its logistics (A.O. 155)
b. Predetermination of Field Areas
SOP on Site Selection, Signage’s and Logistics
c. Assessment of Scene using Rapid Health Assessment
i. Initial Assessment:
 Identify immediate extent and potential risk of the problem
 Mobilize adequate resources to correctly organize field management
 Conduct immediate assessment of the initial incident
ii. Data Requirements for Initial Assessment and Reporting
 Precise location of the event
 Time of the event
 Type of incident
 Estimated number of casualties
 Added potential risk
 Exposed population
 Right resources needed

iii. Reporting to Operation Center

 Submission of initial assessment

 Submit immediately initial assessment
 Refrain from starting haphazard or unplanned work to avoid
delay in the mobilization of resources
 Processing of initial assessment by OPCEN
 Dispatch the necessary teams required and immediate
resources needed

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  Alert and put on stand-by additional responders that might
be required
 Coordinate with the receiving hospitals to prepare for the
deluge of patients
 Prepare other hospitals in the event that the volume of
patients is beyond the capacity of the receiving hospital
 Review logistical requirements
 Report to superiors
 Report to HEMS Central OPCEN
 Report to Disaster Coordinating Council
o Establishment of Command Post or Linkage with Incident Command Post
through Field Medical Commander as Incident Medical Commander
(Unified Medical Command)
i. Identification of Field Areas
Identification of field areas for various purposes prior to dispatch and operation will
allow various incoming resources to reach their places rapidly and efficiently. This is the
first part of deployment. This consider the topographical area, wind direction and access
roads. Maps could be used initially and will help in the management of restricted areas,
and potential risks to victims and the population are graphically determined including
boundaries. The following should be mapped out and identified:
 Impact Zone
 Command Post Area
 Advance Medical Post Area
 Evacuation Area
 Staging Area
 VIP and Press Area
 Access Roads

e. Assignment of a Field Medical Commander in cases of multiple On- scene

response teams
f. Conduct of measures for site safety

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Safety measures are implemented to protect victims, responders and exposed
population from immediate and/or potential risk (extension of the accident, responding
to traffic accident, hazardous materials, etc)
i. Direct Action includes risk reduction by fire fighting, confinement of
hazardous materials, use of protective clothing, and evacuation of
exposed population
ii. Preventive Actions (WMD) include the establishment of the following
restricted areas:
 Impact Zone/Hot Zone – strictly restricted to professional
rescuers who are adequately equipped such as HAZMAT
Teams, WMD Teams, etc.
 Secondary Area/Warm Zone – restricted to authorized staff
working in rescue operation, care delivery, command and
control, communications, ambulance services, and
security/safety. The Command Post, Advance Medical Post,
Evacuation Center, and Parking for the various emergency and
technical vehicles will be set up in this area. This is
approximately 100 meters from the impact zone and depends
on the wind direction.
 Tertiary Area or Cold Zone – is to be accessed by press
officials and serves as “buffer” zone to keep onlookers out of
danger. This is approximately 50 – 100 meters away from the
Warm Zone, also depending on wind direction
iii. Minimum Personal Protective Equipment (PPE) of any medical
responder who is in contact with the patient are the following:
 Gloves
 Goggles
 Masks
For suspicious Weapons of Mass Destruction incidents medical responders are allowed
only at the Cold Zone with proper protective clothing. Only those with protective clothing
Only those with protective clothing and with proper training will be allowed entry into the
Hot and Warm Zone.

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g. Establishment of Advance Medical Post
SOP 2: Site Selection, Signage and Logistics
h. Evacuation and Transport Establishment of Field Hospital/ Evacuation
 Site or Temporary Shelter
This will be established to provide effective field stabilization for victims of MCI.
This is established right away and managed by the Field Medical Commander who is
the first knowledgeable medical personnel to arrive at the scene. Upon the arrival of
more experienced person or a team, he should transfer the command. This is the place
where all the incoming medical teams will be referred and given specific responsibilities.
Right away the following area and people should be designated:
 Triage Area with Triage Officer
 Treatment Area with Treatment Officer
 Transport Area with Transport Officer
 Staging Area with Staging Officer
 Mortuary Area with Mortuary Office

Appendix 3

COORDINATION AND NETWORKING FOR REFERRAL OF CASES

 From the very start of response operation, initial and regular coordination
must be done by the receiving/affected hospital with the HEMS-OPCEN for
them to alert the neighboring hospitals and for assistance
 The hospital must have a directory at hand of all the members of their hospital
network with contact numbers of focal persons
 The Hospital Chief/Director or his designate coordinates with their hospital
networks informing them their status and possible plan of actions.
 Proper communication and coordination with the referral hospital must be
done prior to transport of patient for diagnostic purposes or for admission
 Two-way referral system must be employed (with feedback mechanism)
 Two-way referral form must be properly and completely filled up by the
referring physician signed by the senior resident

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  Request for medical assistance like medical teams, ambulance service,
logistics, etc., to be used for emergency or disaster operations and which are
available within the DOH hospital Network shall be coursed directly to the
hospital concerned. Requests not within the capacity of the network to
accommodate shall be relayed to the Operation Center for Central
Coordination, response and reporting.

Appendix 4

ACTIVATION OF CONTINGENCY MEASURES

a. In the event of electrical power disruption

 Emergency lights must be activated in all critical areas of the hospital while awaiting
for the functionality of the power generator
 Power generator must be activated to provide 100% of hospital electrical demand
b. In the event of water supply disruption
 Provision of safe water for drinking to all hospital patients, personnel and others
 Activation of water tanks to provide 100% hospital demand for water
 Coordination to appropriate water authority for possible water rationing
c. In the event of hospital isolation with shortage of food supply
 Coordination with DOH-HEMS for networking assistance
 Coordination with DSWD for assistance
 Coordination with other GOs and NGOs for assistance

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d. In the event of lack of source of drugs, medicines, medical supplies
 Coordination with pharmaceutical companies for assistance
 Coordination with DOH-HEMS, PLS, etc. for assistance
e. In the event of disrupted waste management system
 Coordination with appropriate agencies for assistance (ex. MMDA, etc.)
 Activation of pre-designated temporary collection and storage areas for wastes
pending functionality of the system
f. In the event that hospital personnel are getting overburdened, over fatigued,
and could difficulty function
 Coordination with DOH-HEMS for personnel augmentation assistance
 Coordination with other DOH hospital network members for assistance

Example of Contingency Plan

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Appendix 5.

PROVISION OF PUBLIC HEALTH SERVICES

a. Blood Services during Emergency

 The blood and blood product stocks at the blood bank shall be mobilized to address
the needs of the victims
 Elective surgeries shall be postponed and the blood and blood products intended for
these cases can be utilized for the disaster victims if deemed necessary
 Victims who are in dire need of blood transfusion shall be given even in the absence
of blood donors from the end of the victim
 Blood transfusion protocol shall be observed even in emergencies
 Coordination with the Blood Center for assistance must be done in the event of
unavailability of blood
 Coordination with the hospital network for can be done in cases of blood and blood
product assistance
b. Laboratory and other ancillary services
 Provide water analysis services;

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 Diagnostic tests and examinations;
 Blood banking services;
 Radiological examinations;
c. Disease and injury surveillance
 Provide records and reports of injuries secondary to the disaster
 Conduct hospital disease surveillance services
 Provide report/database of injuries and reportable diseases
d. Nutrition in emergency
 Provide therapeutic nutrition to malnourished patients affected.
e. Health information and education
 Provide necessary IEC materials
 Conduct information and education activities in times of emergency or disaster
 Establish IEC corner accessible to the public

e. Management of Casualties

- Ensure availability of Emergency Unit/ Department at short notice to

receive multiple casualties who are identified, registered, triaged, and
treated in designated treatment areas; and admitted or transferred
- Ensure availability of competent personnel to manage surge of patients
- Ensure availability of diagnostic tools
- Ensure availability of definitive care services and logistics
- Proper handling of patients with attached equipment

SOP 3: Handling of Equipment Attached to Patient

- Clearance of all non-emergency patients and visitors from the emergency
department;
- Cancellation of all elective admissions and elective surgery to
accommodate surge of multiple casualties
- Determination and preparation of rapidly available beds;

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 - Determination of the number of patients who can be transferred or
discharged

f. Management of Information

Reporting to the Operation Center and Submission of initial

rapid assessment
i. Submit immediately initial assessment
ii. Refrain from starting any haphazard or any unplanned work to avoid delay in
resource mobilization
-Record all required information and submit report regularly to HEMS
Operation Center
-Post significant information on the bulletin board at the OPCEN and at a
strategic place accessible to the media and the general public

-Maintain information that can be readily shared with proper authorities

approved by the Hospital Chief/Director
-All final reports on the incident shall be stored in the hospital OPCEN or
“Administrative Records” with a copy furnished to the HEMS OPCEN.

Management of the dead during disaster

a. Dead victims from the disaster site shall not be brought to the hospital
b. Hospital shall manage the victims who died in the hospital
c. All possessions of the dead and all evidences possessed by the dead
victims shall be preserved or shall be subject to proper safe keeping
d. List of hospital dead victims shall be submitted to the proper authorities
such as DOH-HEMS, PNP, etc.
e. Dead victims shall be released only to the legitimate claimants after proper
identification being established

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 Appendix 6.

JOB ACTION SHEETS

INCIDENT COMMAND SYSTEM ORGANIZATION
A - INCIDENT COMMANDER
(Field or Facility)
Mission: Performs overall direction for the field and/or facility operations and if needed,
authorize evacuation
Qualificat Must be an Emergency Manager for Field; CHD Director, Hospital Director for
ions Facilities or his designate
Preferably has experience in handling “on-scene” Mass Casualty Incident for
Field; experience in management situations for facilities
Must possess good communication skills
Must have leadership qualities.
Must be a good coordinator, good command and control abilities
Function Initiate the Incident Command System (ICS) by assuming the role of the
s & Incident Commander and put any identification mark.
Responsi Designate a Command Post to include required logistical needs.
bilities Carefully assess the situation and the magnitude of the casualties
Secure the area, preventing entry of unauthorized people and designate
staging and transport area for Field Operations
Depending on the number of responders and the magnitude of the
emergency, fill up the organization assignment list, the needed positions
relevant to the situation.
In major MCI the following should be filled up: Safety Officer, Liaison Officer,
Public Information Officer, Operations Manager, Triage Officer, Treatment

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 Officer, Staging Officer, Transport Officer and Morgue Officer.
The Planning Officer, Logistic Officer and Administrative Officer complements
and completes the positions in severe MCI necessitating the support of major
agencies and requiring long period of operations.
Announce an action plan meeting and identifies the general objective of the
operations including alternatives, and the incident communication plan.
Assign someone as Documentation, Recorder/Aide.
Authorize resources as needed or requested by managers
Designate routine briefings with managers to receive status reports and
update the action plan regarding the continuance and termination of the action
plan.
Communicate status to higher authority
Approve media releases

Identifica Proper signages (hard hat with mark of Incident Commander or a vest)
tion

B - SAFETY AND SECURITY OFFICER

Position assigned to:
You report to: _________________________________ (Incident Commander)
Command Post: ______________________________ Telephone: _______________

Missio Monitor and have authority over the safety of rescue operations and
n: hazardous conditions. Organize and enforce scene/facility protection and
traffic security.
Qualif Knowledgeable on safety precautions, procedures.
icatio Preferably with various training in emergencies relating to bombing, fire,
ns hazardous materials, structural assessment, security procedures and safety
of responding personnel
Had experiences in emergencies and disasters
Good decision making abilities.
Have sound knowledge in evacuation procedures.
Functi Obtain appointment and briefing from the Incident Commander
ons & Implement the emergency lockdown policy and personnel identification
Resp policy.
onsibi Establish Security Command Post
lities Remove unauthorized persons from restricted areas.
Establish ambulance entry and exit route in cooperation with Transportation
and Staging Officers.
Secure the Command Post, Advance Medical Post, Triage and Treatment
Areas including the Morgue Area and all other sensitive or strategic areas
from unauthorized access.
Fully understand the importance of his roles especially in the safety of the
responders
Secure and post non-entry signs around unsafe areas.

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 Always alert to identify and report all hazards and unsafe conditions to the
Incident Commander
Secure areas evacuated to and from, to limit unauthorized personnel access.
Initiate contact with fire, police agencies through the Liaison Officer, when
necessary.
Advise the Incident Commander and others immediately of any unsafe,
hazardous or security related conditions.
Confer with Public Information Officer to establish areas for media
personnel.
Establish routine briefings with Incident Commander.
Provide vehicular and pedestrian traffic control.
Secure food, water, medical, and blood resources.
Document all actions and observations.
Can order stoppage of operation if unsafe
Identif Use of any identification hat or vest
icatio
n

C - PUBLIC INFORMATION OFFICER (P.I.O)

Position assigned to:
You report to: _________________________________ (Incident Commander)
Mission Provide information to the public and the media.
Command Post: ______________________________ Telephone: ______________
:
Qualification Knowledgeable on communication aspects especially in collating relevant
s information needed
Knowledgeable in media handling
Preferably with experience in emergencies and disasters
Preferably with understanding of Mass Casualty Management
Good communication skills and interpersonal relationships
Sensitive on restrictions in contents of news and patient care activities.

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Functions &
Responsibilit
ies Obtain appointment and briefing from the Incident Commander
Ensure that all news releases have the approval of the Incident
Commander.
Responsible for collating relevant information needed to inform the public
and for media releases; obtain progress reports from respective areas as
appropriate
Issue an initial incident information report to the news media especially on
the casualty status and the actions being done
Schedule press conferences on a regular basis
Inform on-site media of the physical areas, which they have access to, and
those which are restricted. Coordinate with Safety and Security Officer.
Contact other scene agencies to coordinate released information
Direct calls from those who wish to volunteer to Liaison Officer. Contact
Operations to determine requests to be made to the public via the media

Identification Proper signages (hard hat with a mark of Public Information Officer or a
vest)

D - LIAISON OFFICER
Position assigned to:
You report to: _________________________________ (Incident Commander
Command Post: ______________________________ Telephone: _______________

Mission: Function as incident contact person for representatives from other

agencies (government or private).
Qualification Preferably with experience in liaison procedures and coordination
s Good or excellent public relations skills
Preferably with understanding of Mass Casualty Management
Understands the bureaucracy and working relationships of the different
government as well as private agencies responding to emergencies.
Good grasp of patient care and management in mass casualty
situations; informed on inter-hospital emergency communication
network, municipal operation centers and/or province, region or national
as appropriate.
Knowledge on the inventory of resources available in the area/country
Understands municipal (provincial, regional, national) organizational
charts to determine appropriate contacts and message routing.

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Functions & Obtain appointment and briefing from the Incident Commander.
Responsibilit In coordination with the Public Information Officer should always be
ies knowledgeable on the following:
The number of “Immediate” and “Delayed” patients that can be received
and treated immediately (Patient Care Capacity); also the status of all
other victims especially in mass dead situations
Number of patients transferred to hospitals.
Any resources, which are requested by each area (i.e., staff, equipment,
supplies).
Establish contact with liaison counterparts of each assisting and
cooperating agency.
Keeping appropriate agency Liaison Officers updated on changes and
development of response to incident
Request assistance and information as needed through the different
network of government and private organizations responding to
emergencies and disasters.
Respond to requests and complaints from incident personnel regarding
inter-organization problems.
Prepare to assist Labor Pool with problems encountered in the
volunteer credentialing process.

Identification Proper signage (hat or vest)

E - LOGISTIC SECTION CHIEF

Position Assigned To:
You report to: _______________________________________ (Incident Commander)
Logistics Command
Mission: Organize Post:
and direct_____________________________ Telephone:
those associated with maintenance of the physical
____________________
environment, and adequate levels of food, shelter, supplies and other
resources needed to support the objectives of the incident

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 Qualifications Preferably with experience in logistics management
Preferably with experience in emergencies and disasters
Understands the bureaucracy and working relationships of the different
units in government especially in procurement and emergency
purchases.
Good grasp of procurement procedures; knowledgeable in accessing
supplies, medicines and equipment needed during emergencies
Good coordination with pharmaceuticals, companies and suppliers and
knowledgeable on database of available resources in the market.

Functions & Obtain appointment and briefing from the Incident Commander.
Responsibiliti Establish Logistics Section Center in proximity to the Command Post
es Brief all his staff on current situation; outline action plan and designate
time for next briefing.
Attend damage assessment meeting with Incident Commander
Coordinate with companies regarding stock level, available supply and
equipment
Anticipate needed logistical requirement.
Obtain information and updates regularly; maintain current status of all
areas;
Communicate frequently with Emergency Incident Commander.
Obtain needed supplies with assistance of the Finance Section Chief,
and Liaison Unit Leader.

Identification Proper signage (hat or vest)

F - PLANNING SECTION CHIEF

Position Assigned To:

You report to: _______________________________________ (Incident Commander)
Planning Command Post: _____________________________ Telephone:
____________________

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Mission: Organize and direct all aspects of Planning Section operations. Ensure
the distribution of critical information/data. Compile scenario/ resource
projections from all areas and effect long range planning. Document all
activities.
Qualificatio Preferably a senior official with adequate knowledge in planning and
ns decision making
Had experiences in emergencies and disaster situation in addition to
crises management
Adequate knowledge on the government bureaucracy and the role of the
different government entities responding to emergencies and disasters
Good coordination and networking skills
Functions Obtain appointment and briefing from the Incident Commander; have
& regular updates as appropriate.
Responsibil Brief members of the staff after meeting with Incident Commander.
ities Provide for a Planning/Information Center
Recruit a documentation aide from the labor Pool. Appoint Planning Unit
Leaders; Situation Status Leader, Labor Pool and other appropriate
positions as needed. Ensure that all appropriate agencies are represented
in this section.
Ensure the formulation and documentation of an incident-specific action
plan. Distribute copies to Incident Commander and all areas.
Call for projection reports (Action Plan) from the Planning Unit Leaders for
scenarios 4, 8, 24 and 48 hours from time of incident onset. Adjust time
for receiving projection reports as necessary.
Instruct staff to document/ update status reports from all areas for use in
decision-making and for reference in post-disaster evaluation and recovery
assistance applications.
Schedule planning meetings to include Planning Section Unit Leaders,
Section Chiefs and the Incident Commander for continued update of the
Action Plan.
Coordinate with the Liaison Officer and Labor especially with regards
manpower requirements
Identificatio Proper signage (hat or vest)
n

G - FINANCE SECTION CHIEF

Position Assigned To:

You report to: _______________________________________ (Incident Commander)
Finance Command Post: _____________________________ Telephone:
____________________

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Mission: Monitor the utilization of financial assets. Oversee the acquisition of
supplies and services necessary to carry out the objective of the incident.
Supervise the documentation of expenditures relevant to the emergency
incident.

Qualifications Preferably a senior official with adequate knowledge in financial

management.
Had experiences in emergencies and disaster situation
Adequate knowledge on the government bureaucracy and the role of the
different government entities responding to emergencies and disasters.
Good resource manager; knowledgeable on tapping other resources

Functions & Obtain appointment and briefing from the Incident Commander.
Responsibiliti Appoint members of his staff preferably the following: Time Unit Leader,
es Procurement Unit Leader, Claims Unit Leader, Cost Unit Leader and
other appropriate positions as he desires.
Establish a Financial Section Operations Center. Ensure adequate
documentation/recording personnel. His station need not be within the
area of incident.
Confer with Unit Leaders after meeting with Incident Commander and
develop an action plan.
Approve a “cost-to-date” incident financial status report eight hours
summarizing financial data relative to personnel, supplies and
miscellaneous expenses.
Obtain briefings and updates from Incident Commander as appropriate.
Relate pertinent financial status reports to appropriate chiefs and unit
leaders.
Schedule planning meetings to include Finance Section unit leaders to
discuss updating the section’s incident action plan and termination
procedures.

Identification Proper signage (hat or vest)

H - OPERATIONS SECTION CHIEF

Position Assigned To:

You report to: _______________________________________ (Incident Commander)
Command Post:__________________________ Telephone: ____________________

Mission: Organize and direct aspects relating to the Operations. Carry out directives
of the Incident Commander.

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 Qualifications Knowledgeable on Operation Procedures; understands well the
organizational chart in MCI
Preferably has experience in handling “on-scene” Mass Casualty Incident
with varied knowledge of all types of operations (Search and Rescue, Fire,
Medical etc.)
Must be a crisis manager and with leadership skills
Good communicator and can stand pressures
Must know capabilities of people for proper assignments

Functions & Obtain appointment and briefing from the Incident Commander.
Responsibiliti Responsible for all specific sections of the operations: ex. Medical, Search
es and Rescue, Fire Suppression and others depending on the incident
Establish Operations Section in the Command Post preferably with the
Incident Commander.
Brief all Operations Officers on current situation and develop the section’s
initial plan.
Designate times for briefings and updates with all Operations Officers to
develop/ update section’s action plan.
Ensure that all areas are adequately staffed and supplied.
Brief the Emergency Incident Commander routinely on the status of the
Operations Section especially on the status of all patients, problems
encountered, resources needed etc.
Ensure that all actions and decisions are documented.
Observe all staff and personnel for signs of stress and inappropriate
behavior and report concerns to Psychosocial supervisor. Ensure rotation of
all personnel to prevent burnt out among personnel.

Identification Proper signage (hat or vest)

I - TREATMENT TEAM LEADER

Position Assigned To:
You report to: _______________________________ (Field Medical Commander/Operations Chief)
Treatment Area: ____________________________ Telephone: _________________

Mission: Responsible for the management of the Treatment Area and assigning of
responsible supervisor for specific areas (Red, Yellow and Green
subsections). Assure treatment of casualties according to triage categories.
Provide for a controlled patient discharge and transfer to appropriate
hospitals.

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 Qualifi Preferably a general surgeon/Trauma/Emergency
cation Physician/Anesthesia/Family Medicine
s Knowledgeable on Mass Casualty Management and the organization chart
Should have “on- scene” experience in MCI; Knowledgeable on triaging and
skilled in field care and field operation.
Skilled in emergency procedures especially life sustaining and stabilization of
patients
Good in personnel management especially in stress situations
Functi Receive appointment and briefing from Incident Commander/Operations
ons & Chief/ Field Medical Commander
Respo Organizes the treatment area assigning all members of their specific
nsibili assignments and responsibilities. In cases of WMD, treatment area should
ties be at the cold zone.
Appoint unit leaders for the following treatment areas in pre-established
locations: Second Triage; Immediate Treatment (Red); Delayed Treatment
(Yellow); Minor Treatment (Green); Discharge.
Supervise the receiving of patient from the Initial Triage from the site, re-
triage the victims and institute measures to stabilize the victims; ensure that
all victims are continuously monitored.
Assess problems, treatment needs and customize the staffing and supplies
in each area.
Receive, coordinate and forward requests for personnel and supplies to the
Field Medical Commander and/or Staging officer.
Contact the Safety and Security Officer for any security needs in the Area.
Establish 2-way communication (radio or runner) with Field Medical
Commander, Triage, Transport and Staging Officers
Coordinate with Transport Officer, decides on the order of transfer of victims,
the mode of transport, escort and place of transfer
Document everything with regards every individual patient brought to the
area using the individual treatment form.
Regularly report to the Field Medical Commander
Observe and assist any staff that exhibits signs of stress and fatigue. Report
any concerns to Psycho Supervisor. Provide for staff rest periods and relief.
Identifi Proper signage (hat or vest
cation
J - TRIAGE (INITIAL) TEAM LEADER
Position Assigned To:
Mission:
You Sort casualties at the site according
report to: ________________________________ to Medical
(Field priority Commander/Operations)
of injuries, and transfer
(according to tagging priorities)
Triage Area: ____________________________ to the treatment
Telephone: area.
_________________
Qualifi Any of the following:
cation  Doctor of Medicine preferably trained in emergency medical
s care and triaging
 Nurse, paramedic with appropriate training in emergency,
medical care and basic triaging.
Knowledgeable on mass casualty management and had experience in
“on-site” mass casualty incident; skilled in field care and field

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 operations
Duties Receive appointment and briefing from the Field Medical Commander
& or as previously designated by the Incident commander.
Respo Assess first the safety in entering the incident area; note abnormalities
nsibilit in the surrounding, any untoward manifestations of the victims and
ies approximate number of casualties and the type of injuries.
Protect self by using the appropriate Personal Protective Equipment
(PPE)
In cases of WMD, ensure that Decontamination is present before
entering the incident site.
Report first to authority and request for additional help before
proceeding to actual triaging.
Quickly brief members of the Triage Team and assign areas for
triaging
Tag the appropriate color to every patient as follows:
 RED – immediate stabilization necessary
 YELLOW – close monitoring, care can be delayed
 GREEN – minor; delayed treatment or no treatment
 BLUE – Near or almost dead
 BLACK – dead
Document important things to consider in the site for purposes of
evidence by use of camera, by mapping or sketching etc. especially in
WMD.
Ask first all walking wounded to an identified place.
Provides and administers life sustaining support to the patient in
extreme cases (only for bleeding and respiratory problems)
Bring patients to the Treatment Area according to priority
Assess problem, triage-treatment needs relative to specific incident.
Identify a Morgue Manager and a Morgue Area for black patients.
Coordinate with Field Medical Commander and Treatment Team
Leader to report number and types of casualties, equipment needs
Contact the Safety and Security Officer of security and traffic flow
needs in the Triage Area.
Ends his services once all patients are out of his area and receives
another assignment from the Feld Medical Commander
Identifi Proper signage (hat or vest)
cation

K - TRANSPORT GROUP SUPERVISOR

Position Assigned To:
Mission:
You Coordinate the transfer of(Field
report to: ________________________________ patient received
Medical from the Treatment
Commander/Operations)
Area to the appropriate
Triage Area: ____________________________ hospitals_________________
Telephone:

Qualifications Preferably a paramedic, nurse or doctor with basic training in

Basic Life support
Experienced and knowledgeable in Mass Casualty

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 Management
Skilled in ambulance traffic control; skilled in radio
communications
Sound knowledge of country’s transportation resources
Sound knowledge of access routes to Health Care facilities
Familiar with terrain, road maps, alternate routes
Has sufficient knowledge in the return time of the ambulance
Duties & Receives appointment and briefing from the Incident
Responsibilities Commander/ Field Medical Commander
Establish immediately an ambulance loading zone observing
principles on way traffic flow; identifies access routes and
communicates traffic flow to drivers;
Coordinates and supervises transport of victims from the
Treatment Area
Ascertain all information relating to receiving hospital (as to type
of facility, bed availability, hospital capability, contact ER
medical officer etc…)
Supervises all available ambulance drivers; assigns appropriate
vehicle in accordance with status of patients
Receives requests for transportation; Maintains a log of the
whereabouts of all vehicles under his control
Ensure all patients transferred are tagged and with their
treatment form
Brief ambulance crew as to the condition of the patient, care
required, access routes, traffic flow, location of the receiving
hospital and the procedures in the endorsement of the patient
Coordinate regularly with the Treatment Team Leader/Staging
Officer and report all patient transferred and when the last
person is transported.
Document all activities in his area including a complete record
of all patients
Identification Proper signage (hat or vest)
L - STAGING OFFICER
Position Assigned To:
You report to: ___________________________________________ (Operations Section
Chief)

Advance Medical Post (AMP)__________________________ Telephone:

_________________

Coordinate all resources arriving at the scene. For manpower

resources, referring them to appropriate area of assignment. For
transportation resources organizing them and dispatching them as
required.

162
Qualifications At least a paramedic or an EMT
Preferably with knowledge in Mass Casualty Management and
understands the organizational chart

Duties & Receives appointment and briefing from the Incident Commander/
Responsibilitie Operations Section Chief
s Identify suitable place for the Staging Area usually away from the
incident
Organize, classify all transportation resources
Coordinates with Transport Supervisor
Dispatch appropriate vehicle as requested by Transport Supervisor
Coordinate with appropriate agencies with regards traffic flow and
access routes within the site.
Direct all incoming responding teams to the Field Medical
Commander
Document all resources

Identification Any identification mark (hats or vests)

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M - FIELD MEDICAL COMMANDER
Position Assigned To:
You report to: _____________________________________ (Operations Section Chief)
Advance Medical Post (AMP)__________________________ Telephone: _________________

Mission: Organize, prioritize and assign officers under it’s jurisdiction to areas
where medical care is being delivered. Advice the Operations
Section Chief/Incident Commander on issues related to handling of
the victims.
Qualifications Must be a Doctor of Medicine
Must possess managerial skills in disaster
Preferably with training and experience in MCI management
situations
Knowledgeable in the hospital capability and networking; sound
knowledge of country’s health resources
Skilled in pre-hospital care; skilled in radio communications
Skilled in staff management; skilled in logistical operations
In the absence of the above the first who arrives at the scene
preferably coming from the following:
a. Municipal Health Officer, City Health Officer, any Emergency
Health Physician
b. Emergency Critical Nurse (in the absence of an MD)
c. Private MD with experience in emergency care
Can first assume the position and later endorse (face to face)
providing an orderly transfer of command to the next incoming
qualified medical personnel
Duties & Receives appointment from the Incident Commander/Operations
Responsibilitie Section Chief
s Identifies the suitable site for the Advance Medical Post and inform
everybody
Responsible for the different members of his team (if not yet
identified): Triage Officer, Treatment Officer, Transport Officer,
Mortuary Officer
Responsible that all the needed medical resources be mobilized and
available
Reports and coordinates with the Operations/Incident Commander;
likewise attend meetings and press conferences
Ensures the welfare and safety of the medical team including relief
and sustenance (decking, scheduling, pullback etc.)
Conducts regular meeting with his designated officers in the area.
Anticipates other concerns and regularly confer with the Operations
Officer/Incident Commander
Responsible that all the necessary recording of the events be done
and all required reports to all the authorities be submitted on time

164
 Evaluate the whole activity and make the necessary
recommendations to improve future responses
Coordinates and regularly reports to the Medical Controller of the
DOH Operations Center/Regional Operation Center
Identification Proper signages (hat or vest)

N - MORGUE MANAGER
Position Assigned To:
You report to: __________________________________ (Triage Officer/Treatment Officer)
Morgue Area:___________________________________ Telephone: _________________

Mission: Collect, protect and identify deceased patients

Qualifications Doctor of Medicine aided with a social worker, a psychosocial support
officer
For medico-legal cases forensic experts from the PNP Crime
Laboratory or the National bureau of Investigation will be part of the
team

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 Duties & Receives appointment and briefing from the Triage Officer/Field
Responsibilities Medical Commander
Identifies and establish the Morgue Area; coordinate with the Triage
Officer and Treatment Officer
Maintain master list of deceased patients with time of arrival
Assure all personal belongings are kept with deceased patients and
are secured.
Assure all deceased patients in Morgue Areas are covered, tagged
and identified where possible.
Provide a system or procedures for identifying and endorsing the
body of the deceased to authorized members of the family
In medico-legal cases consult with PNP and NBI with regards
procedures necessary for proper identification and for evidence
collection and preservation
Keep Triage/Treatment officers appraised of number of deceased.
Contact the Safety and Security Officer for any morgue security
needs.
Arrange for frequent rest and recovery periods as well as relief for
staff.
Schedule meetings with the Psychological Support Unit Leader to
allow for staff debriefing.
Observe and assist any staff that exhibits signs of stress or fatigue.
Report any concerns to the Treatment Areas Supervisor.
Review and approve the area documenter’s recording of
action/decisions in the Morgue Area.

Identification Proper signage (hat or vest)

MEDICAL CONTROLLER
Position Assigned To:
You report to: ______________________________________ (DirectorHEMS/CHD/Hospital)
DOHCentral/Regional/HospitalOperationCenter:________________ Telephone:
______________

Mission: Coordinate all activities of the Department of Health/Health Sector in

response to the Mass Casualty Situation

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 Qualifications Doctor of Medicine/Nurse familiar with the Operation Center (Central,
Regional and Hospital)
Good knowledge of the DOH organization as well as members of the
Health Sector responding to emergencies and disasters
Good resource mobilizer
Knowledgeable on the manpower resources, hospital capabilities,
dispatching and radio communications
Articulate and good spokesperson
Excellent coordinator
Duties & Designated by the office and assume the position in case of Mass
Responsibilitie Casualty Situations
s Supervises the Operation Center and make all decisions in relation to
the dispatch and subsequent fielding of additional teams
Assists in the scheduling of rotation of the medical teams at the site in
the event of prolonged operations in coordination with the Field
Medical Commander
Coordinates with the different receiving hospitals to prepare their
facilities
Coordinates with other agencies, DCC agencies, response units etc.
Review resources not only within the DOH OPCEN but of the other
facilities of the DOH; likewise mobilize resources if need be
May respond to queries by officials, media in relation to DOH
response
Update superiors especially the Secretary of Health
Document and record the event
Evaluate the proceedings and make some necessary input for policy
amendments or recommendations
Schedule and lead postmortem evaluation within one week of the
event for the Health Sector

Identification Proper signage (hat or vest)

Mission: Represents the Department of Health in the Field Command Post

and coordinates all health activities/requirements in cases of
Regional Emergencies/Disasters
Qualifications Highest official designated by the Regional Health Office
Good knowledge of the DOH organization as well as members of
the Health Sector responding to emergencies and disasters; sound
knowledge of the region’s health resources
Knowledgeable on Mass Casualty Management and it’s organization
Skilled in logistical operation and staff management
Knowledgeable in both public health and pre- hospital care
Duties & Designated by the CHD and assume the position in case of Mass
Responsibilities Casualty Situations

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 Reports to the Incident commander in the Command Post. Usually
will be part of the Planning Committee
In constant coordination with the Field Medical Commander and the
Medical Controller
Anticipates other concerns such as public health concerns
(sanitation, nutritional needs, needs of evacuees) or Psychosocial
concern especially in situations of Mass Dead
Leads in public health information and the needed IEC materials
Organizes all reports coming from the Field Medical Commander
and attend all press briefings and conferences
Document and make his/her own evaluation of the incident
Identification Proper signage (hat or vest)

P - INCIDENT MEDICAL COMMANDER

Position Assigned To:
You report to: __________________________________________ (Incident Commander)
Command Post :____________________________ Telephone: _____________________

Annex 7

A. National Policies in Disaster Management

1. Philippine Disaster risk Reduction Management Act of 20109 -

RA 10121

2. Philippine Climate Change Act of 2009 – RA 9729

168
3. Policy and Implementing guidelines in reporting and
documentation in Emergencies and Disasters DOH AO# 2012-
0014

4. Policies and Guidelines on logistics Management in

Emergencies and Disasters- DOH AO#2012-0013

5. Framework on Health sector Response to Terrorism DOH

AO#2011-0006

6. National policies for the Ambulance and Services DOH

AO#2010-0003

7. Adoption and Institutionalization of an Integrated Code Allert

System within the Health Sector DOH AO#2007-0024

8. National Policy on the Management of the Dead and Missing

Persons during Emergencies and Disasters DOH AO# 2007-0018

9. Guidelines on the Acceptance and Processing of Foreign and

local Donations during Emergencies and Disasters DOH
AO#2007-0017

10. National Policy on Health Emergencies and Disasters DOH

AO#168

11. Implementing Guidelines for managing Mass Casualty

Incidents during Emergencies and Disasters DOH AO#155

Appendix 8

Manila Health Department Executive Committee

169
 NAME DESIGNATION
DR. ARNOLD M. PANGAN City Health Officer
DR. GINA F. PARDILLA Assistant (ACTING) City Health Officer
DR. PAZ FRANCO District Health Officer I
DR. RENATO SOLIVEN District Health Officer II
DR. ROMEO CANDO District Health Officer II
DR. BERNADETTE FUGGAN District Health Officer IV
DR. DOLORES MANESE District Health Officer V
DR. DAVID PINTO District Health Officer VI
DR. EMMA SANTIAGO Office of Public Cemeteries
DR. ROSALINA R. TAN Division of Maternal and Child Health
DR. VIRGILIO B. MARTIN III Emergency Management
MR. ERNESTO ALCAPARAZ Division of Administration
DR. GINA PARDILLA Division of Planning and Coordination
DR. EDUARDO SERRANO, JR. Division of Preventable Diseases
DR. MA. JULIETA RECIDORO Division of TB Control
MS. NELIA RAFAEL Division of Nursing Services
DR. SUSAN SAN DIEGO Division of Dental Services
MS. JULIE BARLAAN Office of Midwifery
DR. ROSALINA R. TAN Office of Reproductive Health and Safe Motherhood
MS. CRISTY CAWAS Office of Nutrition
DR. REGINA BARTOLOME City Government Employees Clinic / Geriatrics Clinic
DR. MA. LOURDES P. SANTOS Division of Public Health Laboratory
DR. MA. LYNETTE GEMPERLE Non Communicable Diseases Control

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Appendix 10

COVID 19 EMERGENCY OPERATION CENTER MANUAL OF PROCEDURES

EOC’S OPERATIONAL PRINCIPLES

•Centralized command. All activities should emanate from the EOC under the
leadership of the Local Chief Executive (LCE). The LCE is in charge of the planning
and decision-making in all the activities of the EOC. The decision-making powers are
retained by the head of the EOC. The different clusters receive commands from the
EOC.
•Real time Data. Data are collected straight from molecular laboratories, hospitals,
clinics, and communities.
•Data-driven. Come up with decisions, program designs and implementations that
are based on the real-time analysis and interpretation of data.
•Evidence-based. Formulate appropriate health interventions that are derived from
the analysis and assessment of empirical data.
•Coordinated. Bring together the different elements of a complex activity or
organization into a cohesive relationship that will ensure greater efficiency in the
workflow.
•Collaborated. Work jointly and willingly with others.
•Synchronized. Move, operate and work at the same time or rate.
•Harmonized. Minimize redundancy or conflicting processes that may be carried out
independently or separately.
•Swift Actions. Provide a quick response at any given time

EOC FRAMEWORK OF ANALYSIS

The EOC framework of analysis considers three primary factors namely People,
Process and Place.
1. People factors
a. work ethics
b. dedication
c. behaviors
d. habits
e. perceptions of the situation
2. Process related factors
a. national guidelines and protocols
b. local executive orders, ordinances and resolutions
c. EOC’s established systems and processes
d. operationability and execution of the established systems and processes
e. degree of compliance and organizational structure leading to the desired
outcome
3. Place related factors
a. EOC’s area capacity and crowd volume
b. workplace health standards

171
These primary factors come to interplay in the everyday activities at the EOC.
Considering one or two will not result to the desired outcome. It is imperative that all
should be considered to have an effective and efficient EOC. In organizing the EOC,
one important aspect under people factors is having an open mind among the cluster
heads and members. Everyone should be encouraged to contribute ideas in the
discussions.

REFERRAL SYSTEM
This chapter outlines the entire process on how a suspected COVID-19 case is
handled --from the time the individual seeks consultation due to Influenza-like Illness
(ILI) and Severe Acute Respiratory Illness (SARI) to initial medical interventions
including testing/ swabbing, and proper referral to either isolation facility or hospital
depending on his/her current health condition. This referral system aims to provide a
complete health care intervention program to suspected patients. This system will
also help decongest or avoid congestions in hospitals.
Illustrated below is the referral flow for symptomatic individuals.

STEP 1: A suspected COVID-19 individual recognizes the symptoms of ILI and SARI
such as:
1. fever
2. cough
3. sore throat
4. body malaise
5. loss of taste
6. loss of smell
7. Diarrhea

STEP 2: A suspected COVID-19 individual considers the different health facilities that
are available for treatment.
1. Barangay Health Center (BHC)
a. Open during office hours (8am to 5pm) – Duty Health Care Worker will

172
b. conduct an assessment.
c. The individual will be immediately referred to COVID-19 clinics.

1. Barangay Hall
a. During office hours - Refer the individual to the BHC. The BHC process stated
above will be followed.
b. During Non-office hours – Refer the individual to the EOC’s Telemedicine
Center.

2. EOC’s Tele Medicine (TeleMed)

a. EOC’s TeleMed operates by assigning a Doctor on call 24/7 to respond and
conduct assessment to individuals who are experiencing symptoms.
b. A TeleMed agent will receive a call, get the initial patient information, and
pass on the call to the Doctor on duty.
c. The Doctor, through TeleMed, will assesses the individual.
i. For those showing mild symptoms, they will be advised to proceed to the
COVID 19 Clinic.
ii. For moderate to severe cases, they will be referred to the hospital.

3. COVID 19 Clinic
a. Duty Doctor will assess the patient.
b. If a patient exhibits ILI or SARI symptoms, he/she will be subjected to
c. swabbing. CIF of a patient is filled out by the clinic’s staff.
d. After swabbing, the patient will be sent home for quarantine together with
household members while waiting for the test result.
i. If the result is negative, the household quarantine is lifted.
ii. If the result turns out positive, the usual process of managing a positive
patient is followed.
e. A non-COVID 19 related patient will be referred to other clinics or hospitals for
treatment.

ORGANIZATIONAL CHART

This chapter presents the proposed structure of the EOC,

specifically the roles and functions of each of the identified clusters.
The EOC serves as the hub for all the intervention programs to be
carried out by LGUs. It is the central point for:
1. Overall operations;

2. Information gathering, analysis and assessment, and

dissemination of data; and
3. Coordination with national government agencies,
local government units, private entities and other
relevant stakeholders.

DILG Local Chief Executive

OCD EOC Head
DOH
PNP
AFP Deputy for Administration and
Deputy for Medical Services
Operations

Data Collection, Analysis &

Secretariat 173
Management Section
Contact Swabbing Extraction Supply & Isolation Patient COVID Liga ng
Tracing Cluster Cluster Logistics Facilities Monitoring Clinic mga
Cluster Cluster Cluster & Cluster Barangay
Evaluation Cluster
Cluster

Business Legal Community Information Communica Emergency RR-ROF- Manage-

Monitoring Cluster -
Awareness & tion Medical APOR ment of
Education
& Cluster Cluster (Hotline/ Services Monitoring COVID-19
Inspection TeleMed) (EMS) Cluster Deaths
Cluster Cluster Cluster Cluster

The Local Chief Executive heads the EOC. He/ She oversees and takes appropriate
action on administrative, operational and medical-related concerns brought to the
attention of the EOC.

The EOC has two deputies, a data collection, analysis and management section, and
a secretariat. Their tasks and responsibilities include the following:

1. Deputy for Administration and Operations - Shall oversee the operational

activities and provide for the administrative requirements of the center, such as
personnel, equipment and materials.
2. Deputy for Medical Services – Shall oversee the implementation of medical-
related intervention programs and address other medical concerns that will arise.
3. Secretariat – Shall carry out the administrative work of the EOC, particularly
in organizing and facilitating meetings.
3.1 Roles and Responsibilities
a. In charge in the preparation of the conference room.
b. Organizes the daily huddle meeting and other meetings the EOC will conduct
with relevant stakeholders.
c. Prepares the agenda of the meetings.
d. Maintains proper decorum during the meeting.
e. Documents the meetings and prepares the minutes.
f. Takes note of action items or deliverables to be validated and presented
during the next meeting.
g. Tracks action items and reports on the status of previous meeting’s
compliances.
h. Creates a chat group for the EOC cluster heads and authorized staff.
i. Posts the minutes of the meeting and reminders to the chat group before the
next meeting.

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2. Data Collection, Analysis and Management (DCAM) Section - Serves as the
“brain” of the EOC. It provides accurate data for a more efficient and effective
response

The EOC has sixteen (16) clusters. Each cluster is manned by the Head and
corresponding staff who perform specific tasks. Each cluster functions
interdependently. For a cluster to function effectively, collaboration within and among
other concerned clusters is necessary. The following are the clusters:

1. Contact Tracing Cluster

2. Swabbing Cluster
3. Extraction Cluster
4. Isolation Facilities Cluster
5. Supply and Logistics Cluster
6. Patient Monitoring and Evaluation Cluster
7. COVID-19 Clinic Cluster
8. Liga ng mga Barangay Cluster
9. Business Establishment Awareness, Monitoring and Inspection Cluster
10. Legal Cluster
11. Community Awareness Cluster
12. Information and Education Cluster
13. Communications Hotline and Telemedicine Cluster
14. Emergency Medical Services Cluster
15. RR/ROF/APOR Cluster
16. Management of COVID Death Cluster

Under the operational structure of the EOC, there are national agencies and local
entities that provide technical, administrative and logistics support such as the DILG,
OCD, DOH, PNP, AFP and Liga ng mga Barangay.

DATA COLLECTION, ANALYSIS AND MANAGEMENT SECTION

This serves as the “brain” of the whole EOC which provides accurate
data that will enable the different clusters to carry out more efficient
and effective COVID-19 response efforts.

A. Organizational Structure

A. Roles and Responsibilities

The DCAM Head is responsible for:

175
1. Adopting and implementing the Data Management System (DMS) program
for effective COVID-19 data management and data sharing. DMS is a system that
defines, retrieves, updates, shares and manages data, which shall be used as basis
for appropriate decisions and actions.
2. Setting-up an email address for centralized data gathering from the molecular
laboratories and hospitals. This email shall be handled by a group of data staff where
one attends to the daily data input streaming into the email inbox and another one
does the daily audit or counter-checking. This system ensures that no inputted data
is missed due to human error.
3. Gathering all COVID-19 related data from different sources as the basis for
the EOC’s daily operations, which include the following:
a. Negative and positive line lists from all the molecular laboratories;
b. Suspect and probable patients from the hospital’s emergency room and
outpatient department;
c. Suspect and probable patients from government and private clinics; and,
d. Health Care Capacity Management (HCCM) data from government and
private hospitals. Below is the sample template for the daily Health Care Capacity of
the government and private hospitals within the locality. This template is in excel file,
the updating of which can be done by filling out the (d.ii COVID-19 Beds Capacity
Utilization Rate) specific columns.
Health Care Capacity Management (HCCM) AND Utioization Rate

H EA LT H C A R E C A PA C IT Y M A N A G E M E NT
of Hospitals in the City Local
Government of A s of

74.42% Capacity In P atients A d m ission s

U tilizatio n
R ate
563 F un ctio n 73% R egular C ITY P rovi C ity Provi
al C O VID
CO V ID nce nce
B ed s
B eds
527 R egular 92% ICU COVID 419 0 26 0
C O V ID B Beds
eds
39.79% P rivate 419 A d m itted
36 ICU P atien ts
COVID
Beds
39% R egular 386 R egular
CO V ID P atients
B eds
144 50% ICU COVID 33 ICU Patients
A vailabl Beds
eC O VID P rivate Go v't
B ed s

C om m itted
92.20% 0 H ealthcare
141 Regula 112 29 G overn m e W orkers to
C O V ID Areas
r Beds nt

3 ICU 3 0 92% R egular 0 Quarantine

Beds CO V ID Regular
B eds

100% ICU COVID 0 Q uaratine

Beds IC U

COVID-19 Beds Capacity Utilization Rate

The HCCM helps the EOC monitors the allocation of COVID-19 regular and ICU

176
beds and the patient’s census of both private and public hospitals in a locality. Based
on DOH Administrative Order No. 2020-0016-A dated October 5, 2020, at least 30%
of the authorized bed capacity of the government hospitals are allocated for COVID-
19 beds and 20% for private hospitals. In case of surge, private hospitals should
increase the allocation up to 30%. The EOC having the Patient Monitoring Cluster
(PMC) in charge of monitoring and referring suspects from the community and
patients from the TTMF and other isolation facilities, is guided by the census data
from all the hospitals. Having these data on a daily basis, a patient can be efficiently
referred where he/she can be admitted based on his/her choice without going
through hospital hopping.

The HCCM also helps to determine the locality’s Critical Care Capacity in terms of
allocated COVID-19 beds, equipment and healthcare workers through the Capacity
Utilization Rate (CUR) metric. According to recent standards set by the DOH, the four
(4) levels of CUR are as follows:
 Below (<) 60% is Safe
 60% to below (<) 70% is Moderate
 70% to 85% is High Risk
 Above (>) 85% is Critical

COVID-19 capacity of the community’s Healthcare System must be prepared ahead

of time to ensure its ability to absorb any sudden increases in the number of Active
COVID-19 cases needing hospitalizations/treatment.

1. Validating and verifying the data for accuracy. Collect, consolidate, clean,
prepare data to be used in the analysis by medical doctors, cluster leader and
contact tracers.
2. Sharing of the validated data with the concerned EOC clusters.
3. Gathering available data from contact tracing apps such as Quick Response
Code, and sharing the data to the contact tracing cluster.
4. Monitoring and updating of the DMS, particularly data gathered after the
completion of every activity of each cluster as part of the feedback mechanism.
5. Analyzing the COVID-19 daily situation based on the following: 8.1.“AT A
GLANCE” daily report
This dashboard reflects the daily COVID-19 situation, as well as its relation to
cumulative figures in a locality. At a glance, one can already see the number of fresh
cases, mortalities and recoveries, status of the quarantine and isolation facilities,
testing volumes with local positivity rate, and where fresh cases were admitted after
extraction.

This daily “At a Glance” dashboard data, which emanate from the different clusters
and molecular laboratories, provides the EOC cluster heads and members an
evidence-based and data-driven direction as the basis of their course of actions and
strategic approaches in containing, isolating, and mitigating the COVID-19 virus in
the locality. Epidemiologic trends that can be extracted and summarized from this
dashboard will show the success/improvement or failure of the EOC in managing this
pandemic.
This dashboard is a general template that has been used and applied in various
cities and municipalities in the country. As a template, it can be modified and
customized based on the the current health situation in the area, as well as the
health care capacity of a particular LGU.

177
The numbers below correspond to the identification numbers above. This slide
presents the following.
1. Total number of cases starting from the first recorded case/s
2. Total number of recoveries from the first recorded recovery
3. Total number of deaths starting from the first recorded case/s
4. Total Active Cases for 14 days, broken down into:
4.1 Actual cases within the past 14 days, and;
4.2 Cases beyond the 14-day period that will be subjected for validation, whether
recovered or not.
5. Reflects the daily cases, probables, recoveries and deaths.
5.1 Daily Case/s classified as Close Contacts (CC) - RR/APOR/ROF,
symptomatic (mild, moderate, severe and critical), asymptomatic, positive Antigen
Test in the hospitals, probables and unclassified.
5.2 Daily Probables - Symptomatic individuals (SARI and ILI) who were swabbed
and waiting for test results. These individuals came from either COVID -19 clinics,
hospitals’ emergency rooms and outpatient department, private and government
clinics, and walk-ins in all swabbing facilities.
5.3 Daily recoveries are patients medically declared recovered by a doctor daily.
5.4 Daily deaths are the COVID-19 expired patients in the hospital or community

accounted based on the actual date of death. The deaths that did not occur on the
current day should be added to the monthly total of mortalities with specific dates.
1.1 Monthly total of deaths/mortalities reflects the total COVID - 19 deaths in a
month including the delayed reported deaths while noting the specific dates.
2. Swabbing/testing conducted by the following:
a. CHO testings of CCs, RRs/APORs/ROFs, suspects, pregnant women,
dialysis patients, HCWs and sectors for surveillance
b. Hospitals
c. Government and private molecular laboratories
3. This section includes the following:
a. Total recorded tests from the onset of testing with the positivity rate
b. Total individuals tested daily with the positivity rate
4. This section presents the number of barangays with transmissions within 14
days, with no transmission or zeroed in transmission, and no history of transmission.
5. This section shows the total number of occupied or available COVID-19 beds
in government and private hospitals, Temporary Treatment and Monitoring Facilities
(TTMF), and authorized home isolations.

8.2.Barangay daily trends to determine critical areas

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The Barangay Trend Dashboard presents the specific barangays’ number of
accumulated positive cases and deaths in the past 14 days. At a glance, the level of
affectations of the barangays as arranged from the highest to the lowest of positive
cases, as well as deaths. In addition, it pin-points the whereabouts of COVID-19
transmissions, whether they are in a densely or less populated area.
Addressing COVID-19 is more of a localized effort in the community. The trend of
cases is an indicator of the efforts of the barangay officials -- whether they are
successful or not in mitigating COVID-19 cases in their community. It provides an
assessment whether the health protocols are imposed and practiced by the barangay
folks.
Furthermore, this trend provides analysis on whether symptomatic individuals are
given immediate medical attention. Late detection and medical intervention cause
mortalities which are classified as community deaths, dead on arrival (DOA) and ER
deaths. Also, a barangay that has COVID-19 deaths but with no reported COVID-19
cases indicates undetected transmissions.
With all these analysis and assessment, intervention programs are planned and
designed to address the gaps, and strengthen the efforts of the EOC and the
Barangay officials.
8.3 Harmonization of Data

Since the EOC collects the line list directly from the molecular laboratories daily, this
table assures that all EOC positive indexes matches with that of the DOH. This is to
ensure that all positive indexes are acted upon and nothing is missed out.

179
Regular harmonization of EOC and DOH data is important to address discrepancies.
A regular weekly meeting is held for this purpose.

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 8.3 Data Sharing Process Flow

Collection and Analysis of Data

This section shall collect and analyze the following data:

1. List of Suspects – These are data of symptomatic patients (SARI and ILI) who sought
consultations at the hospitals’ emergency rooms and outpatient department, and private and
government clinics.
2. List of Probables – These are data of symptomatic patients (SARI and ILI) who were
swabbed from the private clinics, COVID-19 clinics, hospitals’ emergency rooms and outpatient
departments and are waiting for their results. The list also includes walk-in symptomatic
individuals swabbed in the molecular laboratories.
3. List of Confirmed positives and negatives – These are the line lists submitted by
molecular laboratories directly to the established email of the EOC.
4. List of Deaths - These are data of suspects, probables and confirmed COVID-19 deaths
coming from the hospitals and communities that are reported on a daily basis.
5. List of recovered patients - This is the line list of medically-declared recovered patients.
6. List of Untagged – These are patients who have gone beyond the 14-day period from
the date of swabbing, but are still tagged as active cases.

Management of Data

The DCAM section maintains the database management system (DMS). It is a system that
defines, retrieves, updates, shares and manages data as basis for appropriate decisions and
actions.
Access to the DMS is limited to the data needs of a specific cluster. Log-in credentials are
provided to each cluster to allow them to either view, edit or both.

The following are the data entries required from each cluster.

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Clusters DMS required data
DCAM  Patients Profile

 Clinical Status and specimen details (from Laboratory)

Patient Monitoring and  Name of Admitting Hospital

Evaluation (PME) Cluster
 Date referred

 Name of Referral facility

 Date Discharged
DILG  Date Died

 Final Diagnosis

 date reported

 claimed (yes, no), If NO, please indicate the reason

 Buried / Cremated

 Burial Site

 Remarks
COVID-19 Clinic Cluster  Reporting clinic/s

 Developed s/sx (Y/N)

 If yes, Date of onset of sx

 Fever (Y/N)

 Cough (Y/N)

 Sore throat (Y/N)

 SOB/DOB (Y/N)

 Other s/sx

 Impression

 Swabbed (Y/N)

 Date Swabbed
Contact Tracing Cluster (CTC)  Index Case

 Contact Traced (Y/N)

 No. of close contacts traced

 Place of exposure

 Date of exposure

182
Extraction Cluster  Extracted (Y/N)

 If no, where?

 Date of Extraction

 Isolation Facility/ Hospital

Isolation Facilities Cluster  Name of TTMF

 Date of admission

 Date of re-swab

 Date Discharge

 Patient Trail
Logistics Cluster  Household Lockdown (Y/N)

 Date of Lockdown

 Provisions given (Y/N)

 Expected date of lifting

 Household Trail

Clusters DMS required data

Others:  VERIFICATION of patient’s status
LnB, PME and CTC
DCAM Section  lab result (TAT)
 patient trail
 patient trail extraction

It should also monitor the completeness and accuracy of the data entered by the clusters.
Finally, it should ensure that each cluster maintains a validated database to aid in the analysis
and assessment of all needed data in the implementation of the intervention programs.

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CONTACT TRACING CLUSTER

This chapter describes the organizational structure of this cluster and the coordination
mechanisms needed to execute fast and reliable contact tracing. As the heart of the EOC, this
cluster shall be the basis of its operations.

A. Organizational Structure

Heads: Doctor
Police Officer

Heads: Doctor
Police Officer

Note:
There can be one of more Area Clusters.
There can be one or more Contact Tracing Teams.

A. Roles and Responsibilities

Cluster Heads
Shall consist of a doctor from the CHD/ CHO and a police officer designated by the local PNP
Office. Their responsibilities include the following:
1. Organize and orient the contact tracing teams (CTTs);
2. Ensure that CTTs are strictly practicing minimum health standards by wearing face
masks and face shield, and observing physical distancing;
3. Sort the daily line list by barangay from the database management system;
4. Distribute the lists to the Area Cluster Heads;
5. Monitor the daily activities of the CTTs;

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6. Supervise the data management team in encoding the information coming from the
contact
tracing activities;
1. Prepare the report for the daily huddle at the EOC; and
2. Create a cluster chat group for faster coordination, exchange of information and
feedback.

Contact Tracing Cluster (CTC) Data Management Team

Contact Tracing
Cluster Data
Management
Team

Encoder Lead Area Cluster

Encoders

Note:
Area Cluster Encoders can be one or more.
The CTC Data Management (DM) Team must have its own database to store necessary data
from the Case Investigation Form. The CTC DM Team has Area Cluster Encoders stationed at
the EOC. A lead is designated to each area cluster of encoders.

CTC Data Management Team Leader

His/her main duties and responsibilities are the following:

1. Review the data in the DMS submitted by the contact tracers;

2. Ensure that the contact tracing data in the DMS is updated daily;
3. Generate the line list of close contacts for swabbing; and
4. Maintain backup file of the DMS by downloading its latest version.
CTC DM Team Leader has encoders with the following tasks:
a. CTC DM Area Cluster Encoder Lead
i. Regular checking of area encoder’s output;
ii. Monitors assigned number of cases vs. actual number of cases encoded;

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iii. Report any major errors or inconsistencies to the CT Cluster Head; and
iv. Distribute the encoders based on the number of cases per cluster, and make sure there
are people assigned even during weekends.

a. CTC DM Encoders
i. Receives and encodes all data from the contact tracer’s daily outputs;
ii. Notify the contact tracers for incomplete details;
iii. Notify the CTT DM head for any inconsistencies or errors in the data;
iv. Confirm that entered data aligns with original documentation;
v. Transcribe, scan or photocopy printed documents and forms as needed; and
vi. Assist the Cluster Doctors in preparation of the daily positive index profile slide
presentation.

Area Cluster Heads

Consist of C/MHO doctor and PNP officer. Their tasks include the following:

1. Plan for the deployment of CTTs within the cluster area based on the number of positive
indexes;
2. Conduct pre-deployment daily briefing among CTTs;
3. Maintain daily reports of ongoing and completed contact tracing activities;
4. Check the completeness of positive index profile slide coming from the Contact Tracing
Area Encoders;
5. Conduct post deployment daily debriefing (usually in the afternoon);
6. Report inconsistencies and other concerns to the Contact Tracing Cluster Head;
7. Supervise the contact tracing activities within their assigned area;
8. As a complementary effort to the Contact Tracers’ face-to-face interviews, Area Cluster
Head Doctors shall also conduct phone interviews with positive indexes in the area.
9. Coordinate with the CTC Head, PNP counterparts, and barangay officials on the daily
operational activities.

Note: Area Cluster can be based on CHO or PNP district delineation depending on the area of
coverage of each LGU. For LGUs with smaller areas of operations, the basic structure without
the cluster heads is recommended.

Contact Tracing Team

Composed of one (1) uniformed personnel and one (1) civilian, both of whom should preferably
have a medical background. They will be supervised by team leaders composed of a doctor
from the City Health Office and a police officer.
On a daily basis, they have to:
1. Receive the list provided by the CTT cluster head.
2. Attend pre-deployment briefings.
3. Coordinate and meet the barangay focal person for the activity.
4. Proceed to the location of the positive index with a guide from the barangay.

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5. Contact trace thru face-to-face outdoor interviews with positive indexes, observe health
protocols such as wearing of masks and face shields and keeping a distance of 3 meters from
others.
6. Subject the positive index to a phone interview, preferably to be done by a cluster doctor
or a trained nurse.
7. Evaluate the positive index’s condition and home status.
8. Identify his/her close contact/s.
9. Inform the close contact/s that they will be subjected to swabbing and home quarantine.
a. For positive results, extraction will be implemented.
b. For negative results, complete the fourteen (14) day home quarantine starting from the
date of swab of the first index.
10. Fill up the contact tracing forms and immediately send a photo to the respective area
cluster encoders’ chat group at the EOC.
11. Attend post deployment debriefings.

A. Process Flow
The contact tracing should be a well-coordinated, timely and reliable process of the EOC.
Making the path of the virus visible is one of the keys for an efficient and effective COVID-19
response. The process is divided into two (2) parts: the actual conduct and the post contact
tracing activities.

1. Extract the line list of positive indexes from the database management system (DMS).
2. Coordinate with the Liga ng Barangay to carry out the following tasks:
a. Give them the positive line lists so that they can inform the barangays of their cases for
the day; and
b. Monitor the actions of the barangays, through teams that will be deployed lockdown
houses with positive patients.
3. The line list shall be forwarded to the CTTs composed of representatives from the PNP,
DILG and BLGU.

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4. Constitute and deploy teams to each house with positive indexes who are scheduled for
interviews.
5. Conduct the actual interview of the positive index following maximum health standards.
All interviews shall be done outside the house, in an open-air area.
6. During the interview, the following shall be done:
a. Case Investigation and Identification of Sources of Infection: Using Form 1 (Confirmed
Case Form – A simplified form of the DOH Case Investigation Form) and Form 2 (History of
Exposure Form)
b. Identify and List Close Contacts: Using Form 3 (Close Contact Line List Form), the
contact tracer shall ask the positive index to enumerate the persons who may have come into
contact with him or her for the past 7 days prior to the onset of illness. If a positive index is
asymptomatic, he or she then identifies close contacts with the past 14 days.
7. After the interview, the CTT shall immediately take a photo of the interview forms, and
send to the data staff stationed at the EOC for encoding.
8. The Contact Tracing Teams shall prepare their daily report and submit the same to the
Cluster Head.

SWABBING CLUSTER

This chapter describes the swabbing cluster’s structure, functions, and processes. It also
presents the different types of testing procedures for cases, namely: close contacts, suspects,
authorized individuals (pregnant women, dialysis patients, persons deprived of liberty) and
individuals for Surveillance Testing.

A. Organizational Structure

The swabbing cluster has a data staff, an encoding team, swabbing teams and, and a packing
team. Ideally, the swabbing cluster is headed by a doctor who also oversees the data staff
functions.

A. Roles and Responsibilities Cluster Head

Oversees the entire flow and operations of the cluster and coordinates with other clusters of the
EOC as needed. Specifically, he or she is tasked to:

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1. Determine and establish swabbing sites in coordination with the Liga ng Barangay. The
sites should be strategically located within the locality;
2. Designate a team leader to oversee the deployment of the swabbing teams. Once the
line list is generated, the team leader distributes the swabbing teams based on the number of
individuals to be swabbed;
3. Instruct the team leader to dispose the teams to the designated swabbing sites assigned
by the Liga ng Barangay;
4. Deploy swabbing teams to COVID-19 Clinics and other swabbing sites established by
the City or Municipal Health Office (C/ MHO);
5. Coordinate with the molecular laboratories on the cut-off time in running the specimens;
6. Check on the compatibility of the formats being used to avoid double encoding by both
the cluster and molecular laboratory encoders.
7. Schedule the collection of specimens from the swabbing sites to packing area,
preferably
every two (2) hours to facilitate early and continuous packing and encoding activities.
1. Ensure that all specimen collected from the swabbing sites are being submitted to the
molecular laboratory;
2. Ensure that all samples submitted will have a corresponding result ideally within 24-48
hours by monitoring the transmittal of results from the molecular laboratories to the EOC; and
3. Do an inventory of swab kits to ensure the continuity of swabbing activities.

Data Staff
1. Receives the line list of close contacts from the data collection, analysis and
management cluster and furnish the list to the team leader;
2. Maintains the swabbing database; and
3. Provides daily updates to the database management system (DMS).

Team Leader
1. Distributes the line list to the swab teams;
2. Prepares swab kits and distributes to swabbing teams;
3. Deploys swabbing teams to designated sites; and
4. Supervises swabbing teams and reports their progress to the cluster head.

Encoding Team
Generates and encodes a line list for the specimens collected from the different swab sites
using the COVID-19 Data Repository System (CDRS) format to be sent to the molecular
laboratory in soft copy.

Swabbing Teams
A swabbing team is composed of one (1) swabber and one (1) recorder. The number of teams
to be deployed will depend on the projected number of daily cases and the area coverage.
Ideally, the swabber has to be a registered medical technologist or a registered nurse. However,
if these personnel are not available, individuals with medical background can be trained.

Packing Teams
1. Receives the specimens from the collector;
2. Checks and packs all the specimen for transport to the laboratory; and
3. Facilitate the transport of the specimens to the molecular laboratory.

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A. Process Flow

EXTRACTION CLUSTER
This chapter describes the organizational structure of the Extraction Cluster, the process flow of
extracting COVID-19 positive indexes, and the status of extraction.
A. Organizational Structure

B. Roles and Responsibilities

The Extraction Cluster handles the extraction of COVID-19 positive indexes from their
residences in the barangays and transports them to Temporary Treatment Medical Facilities
(TTMFs), hospitals and other isolation facilities for admittance. This cluster shall be composed
of a cluster head, a data staff, and extraction and transport teams. Their specific responsibilities
are as follows:

Cluster Head
He or she is in charge of the overall extraction process. He or she is tasked to:
1. Closely coordinate with other clusters such as the Liga ng Barangay, Patient Monitoring,
Contact Tracing, Isolation Facility and Emergency Medical Services Clusters;
2. Validate the line list forwarded by the data staff for appropriate extraction response; and
3. Report to the EOC the status of the extraction.

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Data Staff
1. Gather the line list of positive indexes from the Data Collection, Analysis and
Management Cluster;
2. Update the database based on the status of the extractions; and
3. Prepare the daily status reports.

Transport Team
1. Ensure the transport requirements of the Extraction Team;
2. Assign appropriate vehicles for extraction; and
3. Ensure that vehicles are disinfected after each usage.

Extraction Team

Carries out the extraction of COVID-19 positive indexes from their residences to the appropriate
facility as determined by the Patient Monitoring and Evaluation Cluster.

A. Extraction Process Flow

The process of extraction involves the following steps

1. Generation of the COVID 19 positive line list from the Data Collection, Analysis
and Management Cluster.
2. This line list shall be coordinated by the Extraction Cluster Head with the
following clusters:
a. Contact Tracing cluster for the current location of the positive index.
b. Liga ng mga Barangay for proper coordination with the respective BLGUs on
the exact addresses of the positive indices. The BLGU shall also ensure the
readiness of the patient for extraction.
c. Patient Monitoring Cluster for the proper tagging of the positive index to
determine which facility he/she will be brought to.
d. Isolation Facility for the acceptance of the patients.
3. Extraction Cluster head will then direct the transport team to deploy appropriate
vehicles for the extraction team to pick up the positive index and transport
him/her either to a TTMF, hospital or other isolation facilities, depending on the
tagging by the Patient Monitoring Cluster.
4. After extraction, the data staff shall then update the DMS on the action taken and
status of the extraction. A daily status report shall also be prepared by the data
staff.
5. Below is the suggested template for the daily update with the following data:
a. Date
b. Total Confirmed Positive Indexes - Fresh cases for the day
c. Patient Extracted - Total number positive indexes extracted for the day.
d. Home Quarantine - Positive indexes for extraction.
e. Home Isolation – EOC-approved home isolation.
f. Hospital Admission- Positive indexes admitted in the hospital.
g. Other Isolation Facility - Isolation facility other than the TTMF.
h. Expired Positive Indexes - Total number of dead positive indexes scheduled
for extraction for the day.

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 i. Backlogs - Positive indexes are yet to be extracted. Ideally, all positive
indexes should be extracted within the day.

Total
Other Expired
Confirmed Patient Home Home Hospital Backlog
Date Isolation Positive
Positive Extracted Quarantine Isolation Admission
Facilities Indexes
s
Indexes
30-Dec 4 3 0 0 1 0 0 0
31-Dec 3 3 0 0 0 0 0 0
1-Jan 2 1 0 0 1 0 0 0
2-Jan 1 0 0 0 1 0 0 0
3-Jan 4 1 0 0 0 3 0 0
4-Jan 3 0 0 0 3 0 0 0
5-Jan 2 0 0 0 2 0 0 0
6-Jan 8 6 0 0 0 2 0 0
7-Jan 5 2 0 0 1 2 0 0
8-Jan 8 7 0 0 1 0 0 0
9-Jan 4 2 0 0 2 0 0 0
10-Jan 5 3 0 0 1 1 0 0
11-Jan 2 0 0 0 0 2 0 0
12-Jan 2 2 0 0 0 0 0 0
Total 53 30 0 0 13 10 0 0
Note: The table should
reflect 14-day data and has to be updated on a daily basis.
ISOLATION FACILITY CLUSTER

This chapter discusses how a positive index patient should be managed in a Temporary
Treatment Facility until he or she has fully recovered. Normally, an asymptomatic patient is
declared recovered after the 14-day isolation period from the date of swab. For a symptomatic
patient, the last manifestation of symptoms should be at least 3 days prior to the 14-day period.
If symptoms manifest on the 12th day and beyond, a patient is declared recovered 3 days after
the last manifestation of symptoms.

A. Organizational Structure

A. Roles and Responsibilities Cluster Head

This post should ideally be held by a doctor. He/she is tasked to:

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1. Manage the operations of the isolation facilities;
2. Ensure the availability of adequate facilities (school buildings, hotels and other
established facilities) based on the number of daily cases in the locality;
3. Ensure that the facilities are in good condition;
4. Ensure the preparation of daily reports on bed occupancy and bed availability;
5. Overseethedaily monitoring of the facilities, personnel, patients, food, supplies and
logistics;
6. Coordinate with the EMS Cluster in case a patient needs to be transferred to a level 2 or
3 facility;
7. Ensure the rational distribution of patients to isolation facilities to maximize the utilization
of personnel;
8. Plan and develop a wellness program for patients;
9. Issue medical certificates to recovered patients;
10. Ensure the timely discharges of patients;
11. Administer the duty schedules of the medical staff and HCWs in the facilities; and
Oversee the medical record keeping and reporting of patients.

Data Management Team.

The responsibilities of the team include the following:

1. Collects the list of positive index cases from the DCAM;

2. Prepares a daily report on patient admissions and discharges;
3. Flags discharged patients based on the date of swab or last day of symptoms
experienced; and
4. Updates the DMS daily.
Medical Team

1. Monitors the daily vital signs of patients;

2. Ensures that patients are well-attended;
3. Monitors patients at least once per shift;
4. Conducts an assessment of health care workers based on their level of exposure;
5. Conducts a wellness program and provides psychological support to patients;
6. Refers a patient to a doctor if there are changes in his/her health condition i.e. from mild
to moderate;
7. Refers patients to a cluster head in case there is a need for them to be transferred to a
level 2 or 3 facility;
8. Documents necessary medical information on procedures, treatment and services
provided to patients; and
9. Implements the Criteria for Discharging Patients which include:
a. Complete resolution of symptoms
b. Completion of 14-day quarantine period
c. Clearance given by the attending physician

Administrative Team
1. Ensures delivery of food and COVID-19 related supplies;
2. Ensures that patients eat on time;

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3. Ensures that food preparation, handling and distribution shall follow appropriate health
and safety guidelines, as well as meet the prescribed standards of patient health care;
4. Ensures the strict implementation of protocols and procedures at the facilities;
5. Ensures that medical supplies are clean and sterile;
6. Maintains the cleanliness and orderliness of the facilities;
7. Implements Infection Prevention and Control Standards based on Department
Memorandum No. 2020-0186 on protocols for disinfection; and
8. Implements the criteria for admission of patients which include the following;
a. Exhibiting mild symptoms
b. Aged between 18-59 years old
c. Without comorbidities
d. Establish a station or area for documentation

Supply Team
1. Provides adequate and appropriate personal protective equipment to all staff and
ensures that everyone abides with the recommended risk-based utilization as stated
in DM No. 2020-0123;
2. Ensures the proper storage, dispensing and monitoring of drugs and other medical
supplies;
3. Conducts a regular inventory of medical supplies and follows the strict compliance to
risk- based issuances

B Process Flow

SUPPLY AND LOGISTICS

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This chapter discusses the structure of the Supply and Logistic Cluster and how food provisions
and COVID-19 related supplies are administered from warehousing to delivery. The Supply and
Logistic Cluster is responsible for ensuring the efficient and timely delivery of food provisions
and COVID-19 related supplies. Distribution of food items for close contacts should be made
through the punong barangays.

Organizational Structure

A. Roles and Responsibilities Cluster Head

1. Ensures the availability of food provisions and COVID-19 related supplies;
2. Maintains a proper inventory and recording of food provisions and COVID-19 related
supplies;
3. Ensures the proper storing of food provisions and COVID-19 related supplies in a
warehouse;
4. Ensures sufficient buffer stocks at all times;
5. Coordinates directly with the Contact Tracing Cluster Head on the location of the
households and number of close contacts per household that have been placed on lockdown;
6. Oversees the collection of data from the DCAM and requests for COVID-19 related
supplies from other clusters for distribution;
7. Oversees the distribution of needed food provisions to isolation facilities and households
that are on lockdown, as well as handles other requests for COVID-19 related supplies;
8. Ensures the daily updating of the DMS; and
9. Provides a daily report to the EOC.

Data Collection and Verification Team

1. Collects data of close contacts from the DCAM, which shall be used for the distribution
of food provisions;
2. Verifies the correctness of the data with the Contact Tracing Cluster and Liga ng mga
Barangay Cluster;
3. Receives requests for food provisions from the Isolation Facility Cluster;

4. Receives requests of COVID-19 related supplies from other Clusters; and

5. Forwards the data and requests to the Records and Inventory and Warehousing and
Delivery Teams.
Records and Inventory Team

1. Collects data for food distribution and requests for COVID-19 related supplies from the
Data Collection and Verification Team;

195
2. Maintains records and conducts a regular inventory of foodstuffs and COVID-19 related
supplies;
3. Prepares a daily inventory report for submission to the Cluster Head;
4. Updates the DMS daily; and
5. Recommends the replenishment of food items.

Warehousing and Delivery Team

1. Handles the proper storing of food items and COVID-19 related supplies in a warehouse;
2. Distributes food items and COVID-19 related supplies as requested/needed; and
3. Ensures the availability of vehicles during food/supply distribution.

PATIENT MONITORING AND EVALUATION CLUSTER

A. Organizational Structure

Patient Monitoringand
Evaluation Cluster

Barangay Health
Center Staff

City/Municipal Funded
Barangay Health
Workers
A. Roles and Responsibilities

Patient Monitoring and Evaluation Cluster (PMEC) Head

1. Oversees the implementation of the Patient Referral System (PRS). (Please refer to
Chapter V - Referral System).
2. Conducts an initial assessment of the positive index based on the clinical information of
the CIF.
3. Provides medical advice as needed.
4. Evaluates the severity of a patient’s illness.
5. Tags the positive index line list in the DMS for proper referral and for the Extraction
Cluster’s reference when extracting cases.
a. Asymptomatic and mild cases are referred to Level 1 established quarantine facilities,
which include:
i. School buildings
ii. Temporary Treatment Monitoring Facilities (TTMF)
iii. DOH-accredited Hotels
b. Moderate to severe cases are referred to hospitals.
6. Evaluates an index case with special needs to determine if an isolation facility is
appropriate or if home isolation will be authorized.
7. Facilitates the transfer of a patient:

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a. For step up, from the isolation facility to the hospital.
b. For step down, from the hospital to the isolation facility.
8. Supervises the monitoring of authorized home isolated patients thru the city/ municipal-
funded health workers and barangay health workers.
9. Declares the authorized home isolated patients as clinically recovered upon completion
of the 14-day quarantine period.
10. Supervises the monitoring of home-quarantined individuals (close contact, RR, ROF and
APOR).

Barangay Health Center Staff (BHCS)

1. Supervises the monitoring of positive indexes on authorized home isolation and

individuals on home quarantine thru the city/ municipal-funded health workers and barangay
health workers (BHWs), and in coordination with the barangay captain;
2. Ensures the completeness of monitoring sheets for evaluation by the PMEC head. (See
below template);

DAILY INDIVIDUAL SIGNS AND SYMPTOMS LOG SHEET

Date:
Name: Age:/Sex:
Address: Nationality:
Date of Arrival Date of Last exposure: Date of Mandatory Quarantine Period End:
INSTRUCTIONS: Monitoring shall be done twice a day. Go through each condition for monitoring. Put Check
(✓) if the close contact met the condition being asked under the corresponding time of the day (AM/PM)
monitoring was done. Provide the temperature taken (e.g. 36.1)
Conditi Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day Day 11Day Day 13Day 14
ons for 10 12
Monitor Date: Date: Date: Date: Date: Date: Date: Date: Date: Date: Date: Date: Date: Date:
ing A P A P A P A P A P A P A P A P A P A P A P A P A P A P
M M M M M M M M M M M M M M M M M M M M M M M M M M M M
No
Signs/
Sympt
oms
Fever
(temp.
C)

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Cough
Sore
throat
Difficult
y of
Breathi
ng
Other
Sympto
ms: 1.
2.
3
Took
medicat
ion
(specify
)
Sought
Consult
ation
Nurse
on Duty
(NOD)

Notes: 1. Quarantine Period ends 14 days after date of last exposure

AM SHIFTS 6am-6pm; PM SHIFTS: 6 pm-6am
2.

3. NOD to affix initial signature on every shift

4. This log shall be endorsed to RESU upon completion of the
quarantine period; In return, a Quarantine Completion Certificate
shall be issued.

3. Refers close contacts who develop symptoms to the PMEC Head;

4. Coordinates with city/ municipal-funded health workers and BHWs on the declaration of
recovered positive indexes on authorized home isolation; and
5. Reports recoveries of positive indexes on authorized home isolation to the PMEC Head.

City/ Municipal-funded Health Workers and Barangay Health Workers

1. Monitors the daily health conditions of positive indexes who are on authorized home
isolation;
2. Immediately reports to the BHCS any changes in the health condition of positive
indexes;
3. Monitors the daily the health conditions of close contacts, RRs, ROFs and APORs who
are on home quarantine, and reports those who develop COVID-19 related symptoms to the
BHCS;
4. Recommends the lifting of lockdowns on houses to the PMEC Head;

5. Reports COVID-19 suspects to the BHCS; and

6. Refers COVID-19 suspects to the COVID-19 clinics.

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 B. Process Flow

1. PMEC receives the line list from DCAM.

2. PMEC monitors the patients in the hospitals.
3. PMEC head sends the line list to barangay health center staff.
4. BHCS sends the line list to respective city/municipal funded and barangay health
workers.
5. The BHCS provides feedback to PMEC Head.
6. The city/municipal funded and barangay health workers monitor the health conditions of:
(1) RRs, ROFs and APORs on home quarantine, and (2) positive indexes on authorized home
isolation daily.
7. The city/municipal funded and barangay health workers provide feedback on their
monitoring activities to the barangay health center staff.

COVID-19 CLINIC CLUSTER

This chapter will discuss the organizational structure of a COVID-19 Clinic that will solely cater
to suspects or individuals who are showing Influenza Like Illnesses (ILIs).

There is a need to establish a COVID-19 Clinic in communities to avoid contamination between

patients and health workers. An idea facility is one with good ventilation and enough space, with
separate entrance and exit points for patients. See suggested COVID-19 Clinic patient’s flow
below.

A. Organizational Structure

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 Nurse/ Midwife Swabbers

A. Roles and Responsibilities

The COVID-19 Clinic Cluster is headed by a doctor, and assisted by city/municipal health care
workers and a swab Tteam.

Cluster Head
1. Oversees the implementation of the correct patient flow to avoid transmission;
2. Conducts a physical assessment of a patient;
3. Recommends the testing of a patient with Influenza Like Illness (ILI), and makes a
recommendation on whether she can go home or be transported to the hospital;
4. Refers a non-ILI patient to a local non COVID-19 clinic;
5. Ensures the proper wearing of PPEs among staff; and
6. Manages the rational usage and maintains the required stocks of PPEs.

City/Municipal funded Health Care workers

1. Register patients for consultation;
2. Take vital signs and keep records of patients;
3. Implement the correct patient flow to prevent possible transmissions;
4. Dispense medication as ordered by the doctor; and
5. Prepare a daily report of probable patients to be submitted to the DCAM, through the
DMS.

Swab Team
1. Conducts swabbing of suspects;
2. Ensures the completeness of the CIF; and
3. Submits the CIF to the Packing Team.

LIGA NG MGA BARANGAY CLUSTER

This chapter provides a description of the cluster’s structure, as well as outlines the process
flow of its coordination, data sharing and implementation of activities.

A. Organizational Structure

The Liga ng mga Barangay Cluster serves as direct communicatorsto residents, and being
such, needs to constantly provide regular updates on the activities being carried out by the
EOC. The Cluster can be composed of teams depending on the categorization of the barangays
during the start of engagement with them. These teams are also responsible for downloading
information purposively to inform, generate additional information and verify data for appropriate
action by the barangays.

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The structure of the LnB Cluster is shown below:

Liga ng mga
Barangay (LnB)
Cluster
Data
Management

Team

A. Roles and Responsibilities

The LnB Cluster has three (3) main roles in the EOC, namely:

1. Data sharing
Any related information from the Data Management Cluster of the EOC will pass through the
LnB Cluster for dissemination to the barangays. Likewise, the LnB Cluster shall provide real
time feedback in all matters to the Data Management Cluster of the EOC.

2. Data verification
The Data Management Cluster transmits data on daily fresh cases and unclassified active
cases beyond 14 days to the concerned barangays for verification on their status. Accordingly,
the LnB shall provide feedback and recommendations for appropriate action to the EOC.

3. Coordination and monitoring of activities in the barangays

This Cluster links the EOC with the barangays to ensure that every action taken is well-
coordinated. Below are the major activities of the LnB Cluster:

a. Contact Tracing
Upon receipt of the updated line list of fresh cases within the day, LnB Cluster shall immediately
inform the concerned barangays on the following measures that have to be undertaken the next
day:

i. The BLGU shall initially trace the index case, seal off the household, and subject the
individual and household members to contact tracing. It will also extract the positive index and
subject the household members to COVID-19 testing.
ii. The BLGU shall provide area perimeter security thru its barangay tanods or people
designated by the punong barangay.
iii. The BLGUs shall designate personnel to guide the contact tracers to the residence of
the positive index.

b. Swabbing
Before the swabbing of individuals are conducted, the LnB cluster should conduct prior
coordination with the barangays in establishing pre-determined swabbing sites that are
strategically located within the locality.

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Upon receipt of line list of close contacts, the LnB Cluster shall immediately inform the
concerned barangays on the following actions that have to be undertaken:

i. Ensure preparation of swab sites;

ii. BLGU shall inform the close contacts on the swabbing schedule; and
iii. Facilitate the transport of close contacts to and from the swab sites.

c. Extraction
Upon receipt of the positive line list, the LnB Cluster shall immediately inform the concerned
barangays on the following actions that have to be done:
i. BLGU shall inform the positive index regarding the scheduled time of extraction;
ii. BLGU shall ensure that the positive index is physically and mentally prepared for
extraction; and
iii. BLGU to designate focal person to assist the Extraction Team in going to the residence
of the positive index.

d. Information Drive and Campaign against COVID-19

Upon receipt of instruction from the EOC, the Community Awareness Cluster and the
Information, Education and Campaign Cluster, in close coordination with the LnB Cluster, shall
undertake the following:
i. BLGU to assist in implementing, conducting and facilitating the awareness programs;
and
ii. BLGU to ensure manpower assistance in the implementation of the intervention
programs.

e. Supply and Logistics

Upon receipt of information from the LnB Cluster, the BLGU shall undertake the
following actions:
i. Facilitate the distribution of food items provided by the city or municipal government for
household members who are on quarantine; and
ii. BLGU may provide additional or supplementary assistance to household members who
are on quarantine.

Process Flow

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COMMUNITY AWARENESS CLUSTER

This Cluster is handled by the Barangay Affairs Office. It is responsible for planning and
implementing initiatives that will help create a greater awareness among residents on minimum
health protocols in coordination with the Philippine National Police (PNP) and the Armed Forces
of the Philippines (AFP). With the support of the Liga ng Barangay, the Cluster shall implement
the following recommended programs:

1. Conduct a recorrida using city/municipality/barangay organic vehicles. The utilization of

tricycles is considered to be among the most cost effective vehicles which can be used by an
LGU for this purpose;
2. Post COVID-19 related signages in strategic areas within the communities;
3. Involve barangay officials, tanods, purok leaders and health workers in the awareness
program on minimum health protocols;
4. Strictly implement minimum health protocols in the community through the barangay
officials.

INFORMATION AND EDUCATION CLUSTER

This chapter discusses the role of the Information and Education Cluster in creating a greater
sense of awareness of the programs and activities being carried out by the EOC through the
use of mass and social media, forums, signages and billboards, among others. The Cluster
aims to make people better understand the need to follow minimum health protocols.

In particular, this Cluster will focus on reminding business owners and other sectors to fully
comply with health protocols. The ultimate goal is to shape everyone’s behavior and convince
them that following minimum health standards will redound to the public’s best interests.

A. Organization Structure

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A. Roles and Responsibilities Cluster Head
1. Oversees all activities of the Cluster.
2. Attends the daily huddle to gather relevant information for dissemination to the general
public, such as:
a. Situation update – Awareness of the current health situation.
b. EOC’s activity update – Information that will prevent and mitigate the impact of the virus.
c. Breaches on protocols in the community – Violations in the community that need to be
addressed; emphasize the benefit complying with minimum heath protocols.
d. Breaches in protocols among government institutions and business establishments -
Educate government institutions and business establishments on the general health guidelines
and protocols, especially those with reported transmissions.
3. Provide a daily update to the EOC.
Writer

Prepares materials (press releases, social media posts) with appropriate messaging based on
the daily huddle for dissemination in social, print, and broadcast media.

Photographer

In charge of documenting events and activities to complement write-ups and other information
materials to be produced by the Cluster. He/she must ensure the high quality of these photos,
as they will be used for all official publications of the EOC.

Videographer

Responsible for planning, filming and editing videos based on EOC’s events and activities.
Coordinates with the writer and photographer so that he/she can produce the necessary
content.

Technical and lay out artist

Produces various IEC materials and graphics content such as brochures, posters and signages.
He/she will be in charge in communicating ideas and information through visual media content.

COMMUNICATIONS HOTLINE AND TELEMEDICINECLUSTER

This chapter discusses how a suspect, person with ILI, or those experiencing SARI symptoms
are triaged through the telephone to make sure that they are given immediate healthcare
services. This section will also discuss the process flow of Telemedicine (TeleMed) consultation.
TeleMed refers to the practice of attending to the needs of patients remotely through voice calls
or video teleconference.

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A symptomatic patient who undergoes early consultation will help prevent further complications
and possible death. TeleMed service bridges the gap between patients and medical health
professional during non-office hours.

A. Organizational Structure

Cluster head
1. Oversees the administrative and operational needs of the Cluster;
2. Organizes and manages the distribution of teams to cover the 24/7 schedule;
3. Ensures the availability of adequate telephone lines for emergency and telemedicine
calls;
4. Coordinate with the deputy for medical (please fill in info) to ensure the 24/7
availability of doctors for telemedicine;
5. Ensures that all calls are properly logged; and
6. Reports telemedicine activities daily to the EOC.

Operator
1. Handles all calls received from the hotlines;
2. Ensures that vital information and concerns of a caller are properly documented;
3. Transfers the call to a doctor after taking the vital information; and
4. Logs all calls for documentation purposes.

Telemedicine Doctor
1. Receives referral calls from a hotline operator;
2. Conducts an initial assessment of the patient to determine if he/she is a suspect.
3. Advises a mild suspect to undergo swabbing at the COVID-19 Clinic during office hours;
and
4. Refers a moderate to severe suspect to the Patient Monitoring Cluster for hospital
admission.

B. Process Flow

1. A person calls a Telemedicine hotline.

2. An operator answers the call to get the following details from the patient:
a. Name

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b. Age
c. Sex
d. Complete Address
e. Contact Number/s
f. Attending Physician
g. Test/Swabbing Status
h. Concerns/Complaints
i. Past Medical History
3. The Operator will refer the person to a duty doctor.
4. The doctor will interview and assess whether a patient is due for swabbing or for hospital
admission.
5. The doctor will send a confirmatory SMS to the operator to confirm the final disposition
of the patient.
6. The operator will prepare a report of the calls received during the day and submit to the
Cluster head.

EMERGENCY MEDICAL SERVISES CLUSTER

This chapter discusses the care and transport services provided by the Cluster to symptomatic
and asymptomatic non-ambulatory patients to and from following destinations:

1. From the community to the TTMF or hospital

2. Transfer from a TTMF to another TTMF
3. Step up - From a TTMF to a hospital
4. Step down - From a hospital to a TTMF

The EMS Cluster works closely with the Extraction Cluster, Patient Monitoring Cluster and the
Communications Hotline and Telemedicine Cluster to provide appropriate and timely transport
services to patients who are referred either to a TTMF or a hospital.

A. Organizational Structure

Ambulance Crews can be one or more

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A. Roles and Responsibilities

EMS Cluster Head – Should ideally be a doctor specialized in Emergency Medicine. His/her
responsibilities include the following:
1. Oversees the overall operations of the Cluster;
2. Establishes communications and dispatch protocols;
3. Develops infection prevention and control policies and procedures for the ambulance
crews, which include a recommended sequence for safety donning and doffing;
4. Trains crews on how to prevent COVID-19 transmissions;
5. Ensures availability of PPEs; and
6. Conducts training on the use of PPEs.

Emergency Call Team

1. Receives emergency and non-emergency COVID-19 and suspectscalls and records
significant information such as:
a. Name
b. Age
c. Sex
d. Complete Address
e. Contact Number/s
f. Attending Physician
g. Test/Swabbing Status
h. Concerns/Complaints
2. Provides data to the Cluster Head and Ambulance Dispatch Team Leader.
3. Records all calls and prepares a daily report.

Ambulance Dispatch Team Leader – Should ideally be a registered nurse. His/her

responsibilities include the following:
1. Trains the ambulance crews on initial patient care, safety procedures and the proper use
of PPEs;
2. Organizes and schedules the ambulance crews to respond to calls 24/7;
3. Ensures the availability of supplies and equipment in the ambulance;
4. Receives the patient’s information from the Emergency Call Team;
5. Dispatches the ambulance crews;
6. Ensures the disinfection of equipment and vehicles; and
7. Records all activities and prepares a daily report.
Ambulance crew

1. Receives dispatch orders from the Ambulance Dispatch Team Leader;

2. Receives patient information from the Ambulance Dispatch Team Leader;
3. Practices safety procedures at all times; and
4. Observes the proper wearing and use of PPE.

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RETURNING RESIDENT / AUTHORIZED PERSON OUTSIDE RESIDENCE/ RETURNING
OVERSEAS FILIPINO CLUSTER

A. Returning Resident Process Flow

1. An incoming RR shall only be allowed by an LGU to enter a locality upon presenting the
required documents, which are as follows;
a. Travel Authority from JTF shield (PNP);
b. Medical Certificate issued within seven (7) days preceding travel;
c. Proof Residency or Acceptance from the City Government; and

d. RT-PCR (negative) result from accredited/private hospital or laboratory issued within five
(5) days preceding travel.

2. Upon arrival, the RR will fill out the Registration Form (see Registration Form in letter D)
and present all the needed documents for checking.
3. An RR with a negative RT-PCR result shall undergo a 14-day home quarantine starting
from the date of swab. An RT-PCR test is valid for 120 hours (5 days) from the date of swab.
4. If an RR has an invalid negative RT-PCR result, he/she shall be subjected to RT-PCR
testing.
5. After swabbing and awaiting test results, the RR will be placed in a quarantine facility or
a DOH-accredited quarantine hotel at his/her own expense.
6. A positive case shall be extracted from his/her home and will be brought to the TTMF or
a DOH-accredited isolation hotel. For an RR with negative result, he/she shall continue the
complete the prescribed quarantine period days at home.
B. Authorized Person Outside Residence Process Flow

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B.1. Resident APOR

1. An incoming resident APOR who has been out for 1-7 days shall only be allowed to
enter a locality upon presenting the required documents, which are as follows:

a. Office/Agency Identification Card or Certificate of Employment;

b. Travel Order issued and signed by the head of office/agency; and
c. Medical Certificate issued by the city/municipal health office or government accredited
hospital within seven days from travel.

2. An incoming resident APOR who has been out for more than 7 days shall only be
allowed to enter the locality upon presenting the following documents

a. Office/Agency Identification Card or Certificate of Employment;

b. Travel Order issued and signed by the head of office/agency;
c. Medical Certificate issued by the city/municipal health office or government accredited
hospitals within seven days from travel; and
d. A negative RT-PCR result from an accredited/private hospital or laboratory issued within
five (5) days preceding travel.
3. Upon arrival, a resident APOR will fill out the Registration Form (see Registration Form
in letter D) and present all the needed documents for validation/checking.
4. A resident APOR with complete requirements shall not be subjected to quarantine
protocols.
5. A resident APOR who has been out for more than 7 days and has an invalid RT-PCR
result shall be subjected to RT-PCR testing. While awaiting tests results, he/she will be placed
on home quarantine.
6. If the result is negative, the RR’s home quarantine is lifted. If the result is positive,
he/she will be extracted and brought to a TTMF or a DOH-accredited isolation hotel.

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B.2 Non-Resident APOR
1. An incoming non-resident APOR who will stay for 1-3 days shall be allowed to enter a
locality upon presenting the documents as follows:

a. Office/Agency Identification Card or Certificate of Employment;

b. Travel Order/Mission Order issued and signed by the head of office/agency; and
c. Medical Certificate issued by the city/municipal health office or government accredited
hospitals within seven days from travel.

2. An incoming non-resident APOR who will stay for more than 3 days shall be allowed to
enter a locality upon presenting the following required documents.

a. Office/Agency Identification Card or Certificate of Employment;

b. Travel Order issued and signed by the head of office/agency;
c. Medical Certificate issued by the city/municipal health office or government accredited
hospitals within seven days from travel; and
d. A negative RT-PCR result from an accredited/private hospital or laboratory issued within
five (5) days preceding travel.

1. Upon arrival, a non-resident APOR will fill out the Registration Form (see Registration
Form in letter D) and present all the needed documents for checking.
2. A non-resident APOR with an invalid negative RT-PCR result shall be subjected to RT-
PCR testing. While waiting for the result, he/she may stay in a quarantine facility or a DOH-
accredited quarantine hotel.
3. If the result is negative, the RR’s home quarantine is lifted. If the result is positive,
he/she will be extracted and brought to a TTMF or DOH accredited isolation hotel.
A. Returning Overseas Filipino Process Flow

. Returning Overseas Filipinos

1. A ROF shall be required to coordinate with the Overseas

Workers Welfare Administration (OWWA) and present the
following documents upon entry:

a. Travel Authority issued by the JTF CV SHIELD (PNP);

b. Negative Result of RT-PCR test;
c. Certificate of Acceptance or Proof of Residency issued by the receiving
LGU.

2. Upon arrival, the ROF will fill out the Registration Form (see
Registration Form in letter D) and present all the needed
documents for checking.

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 3. The ROF will be housed in an accredited quarantine facility
and shall undergo RT-PCR test on the 5th day from arrival.

4. A positive case shall be extracted to the TTMF or a DOH

accredited isolation hotel. For those with a negative result,
he/she shall continue the remaining quarantine days at home

D. Registration Form for RR, APOR and ROF

REGISTRATION FORM

PASSENGER’S DATE ( to be filled out by the

PASSENGER)
TRAVEL HISTORY (Countries visited for
DATE OF : the past 4
ARRIVAL Weeks)
AIRLINE : _ □ China □ Singapore
PASSENGER INFORMATION □ Italy □ France

PLACE OF : □ Taiwan □ USA

ORIGIN □ Hong □ Japan
LAST NAME : Kong
□ South Korea
□ Thailand
□ UAE

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 □ Macau Others:
□ Vietnam

FIRST NAME :
MIDDLE NAME : RT-PCR TEST
OCCUPATION : DATE OF :
SWAB
AGE: BIRTHDAY(MM/DD/YYY): DATE OF :
RESULT
SEX: CONTACT NUMBER:
BARANGAY :
CONTACT : CONTACT :
PERSON NO

MANAGEMENT OF COVID-19 DEATH (MCD) CLUSTER

This chapter describes the structure and outlines the process flow of the MCD Cluster.

A. Organizational Structure
Note: MCD Cluster has one or more teams

The Department of the Interior and Local Government (DILG) heads the MCD Cluster. This
cluster will ensure the proper handling and disposal of COVID-19 cadavers within 12 hours to
prevent transmission and contamination.
Other members of this Cluster are the Local Health Office, Philippine National Police (PNP),
Bureau of Fire Protection (BFP), city/municipal legal office and the Local Social Welfare and
Development Office (LSWDO).

B. Roles and Responsibilities of the Cluster

The MCD Cluster shall maintain close coordination with hospitals, clinics and barangays for the
timely monitoring and immediate response of COVID-19 related deaths.
The MCD cluster shall forward the information it gathers to the local MCD teams, and shall
perform the following tasks:

1. Identification and retrieval of the Dead

Upon receipt of information coming from hospitals, clinics and barangays, the MCD Cluster
verifies the location of the cadaver, whether coming from the community or hospital.
If coming from community, the Local MCD Team shall:
a. Coordinate with the barangay and get decision of the bereaved family on the manner of
the body’s disposal – cremation, double-sealed casket burial or double bag burial;
b. Deploy a retrieval team from the MCD Cluster, together with the funerals/mortuary
workers; and
c. Ensure the strict implementation of protocols as stipulated in DILG Memorandum
Circular 2020-063 on “Packaging, Removal and Transportation of Human Remains coming from

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home quarantine for PUIs or symptomatic person” and “Precaution for All Human Remains
Retrieved under Care for Human Remains and Environmental Controls in Mortuary.

If coming from a hospital or clinic, the Local MCD Team shall:

d. Inform and get the decision of the bereaved family on the manner of the body’s disposal:
cremation, double-sealed casket burial or double bag burial;
e. Call for the deployment of a retrieval team from the MCD Cluster, with the assistance of
funeral/mortuary workers; and
f. Ensure strict implementation of protocols as stipulated in DILG Memorandum Circular
2020-063 on “Packaging, Removal and Transportation of Human Remains coming from Referral
Facility/Hospital for COVID-19 positive” and “Precaution for All Human Remains Retrieved
under Care for Human Remains and Environmental Controls in Mortuary.”
2. Final Arrangement for the Dead
The MCD Cluster, thru the local MCD teams, shall coordinate with the legitimate claimants of
the body and concerned LGUs regarding the final arrangements for the diseased.
The MCD cluster, thru the local MCD teams, shall ensure strict implementation of the following
protocols as stipulated in DILG Memorandum Circular 2020-063:
a. Disposition of the Human Remains of a Person (Muslim and non-Muslim) who died of
Dangerous Communicable Disease without Claimants, Refused or unable to Claim by
Immediate Family or Relatives – As a general rule, the order of priority for disposal shall be the
following, to be conducted within 12 hours from the time of death:
i. Cremation;
ii. Double – sealed casket burial;
iii. Double bag burial; and
iv. Freezer (for temporary storage only)

b. Cost of burial of the deceased – As a general rule, the cost of the burial of the diseased
shall be borne by the nearest kin. If the kin are not financially capable of shouldering the
expenses, or if the deceased has no kin, the cost shall be borne by the city or municipal
government where the person expired, subject to reimbursement by the LGUs where the dead
person held permanent residence.
c. Transfer of human remains – As a general rule, the remains of those who died of
dangerous communicable diseases cannot be transferred from one place to another.
3. Management for the Bereaved Families
The MCD Cluster thru the LSWDO shall come up with the list of legitimate claimants who will be
provided with the following assistance packages:

a. Food assistance
b. Financial assistance
c. Livelihood assistance
d. Clothing assistance
e. Shelter assistance
f. Management of orphans
g. Food/cash for work

4. Coordination
MCD Cluster shall undertake immediate action on the following:

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a. In the event that a cadaver has not been claimed or picked within 6 hours from the time
of death, the hospital shall immediately inform the MCD Cluster of the presence of the
unclaimed body.
b. In the event that a cadaver has not been claimed or picked up for the past 12 hours, the
hospital, through the designated point person, shall report the presence of unclaimed bodies to
the city/municipal government thru the MCD Cluster (i.e. place of death).

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