“Prevention is better than cure.” In the era of the “new normal” spurred by COVID-19, the importance of this motto is appreciated even more by governments and institutions due to the high cost of curative measures to control the spread of the pandemic. The impact of COVID-19 on the economy has reached unprecedented scale and amid dwindling resources, prevention has become not only a strategy but a necessity.
This situation has forced governments and agencies to implement preventive approaches to limiting the spread of COVID-19. Initially relying on recommendations from the World Health Organization and Department of Health, they soon realized the importance of technical expertise in developing strategies applicable to their unique settings, which may not be sufficiently covered by generalized guidelines. These concerns fall within the field of public health, defined as the “art and science of preventing disease, prolonging life and promoting health through organized efforts.”
Health professionals working in clinical fields have resorted to telemedicine to continue seeing patients, without having to interact with them in person. In these cases, a teleconference or a web app-based conversation may suffice. But what about agencies that would need to consult on appropriate prevention strategies to halt the spread of COVID-19?
Enter an approach similar to telemedicine but aims to prevent disease and potentially save millions of lives each time: Tele-Public Health.
Tele-Public Health is the use of telecommunication techniques implemented over a distance for purposes of 1) sharing public health expertise for the benefit of policy makers and service providers and 2) providing health education for the public. This definition significantly differs from a closely similar term, Telehealth, which is defined by the International Organization for Standardization as “the use of telecommunication techniques for the purpose of providing telemedicine, medical education, and health education over a distance” but within the context of a health provider-patient relationship.
Elements of Tele-Public Health have been seen in the past to assist health officials in epidemic-stricken areas to manage contact tracing and mapping of disease clusters, in an area dubbed as tele-epidemiology. Now, as the “new normal” redefines the way essential public health functions are being carried out, there is a need to reimagine how a Tele-Public Health approach can be applied in other fields within public health, and in many jurisdictions at once, thereby transcending borders that are heavily guarded due to still-implemented quarantines or lockdowns.
Furthermore, there will be a need to rethink how agencies implement occupational health policies in workplaces, and how health systems ensure continued implementation of maternal and child health programs and address persistent health challenges such as lack of access to clean water and sanitation, non-communicable diseases, mental health, vector-borne diseases, vaccine preventable diseases, soil-transmitted helminthiasis, and schistosomiasis.
Already, in keeping with its public service mandate, UP Manila has undertaken efforts in implementing Tele-Public Health through its College of Public Health (CPH), also designated as SEAMEO TROPMED Philippines. A collaboration between CPH and the Commission on Higher Education (CHED) commenced with the formation of a Public Health Experts Group (PHEG) that developed guidelines for the establishment of Community Isolation Units (CIUs) in state universities and colleges (SUCs), which were tapped by local government units (LGUs) in a bid to isolate patients with confirmed mild infection and contacts for quarantine. Since each SUC is different, and so is the LGU involved, the PHEG has met with concerned SUC and LGU officials from Luzon, Visayas and Mindanao for further guidance on setting up and managing their CIUs as well as on addressing other major public health concerns.
Another continuing effort is the tie-up between the CPH and the DOH in delivering webinars to the Doctors to the Barrios, who are currently deployed in 160 municipalities and health facilities nationwide and are pursuing their Master of Public Health studies. This activity, coupled with continuing engagement between them and CPH faculty, has shown the importance of capacity building while also fostering a sense of community, a dimension that is less felt in existing telemedicine ventures.
Tele-Public Health, while still new as an approach to doing public health, already demonstrates the importance of merging elements of advocacy, capacity-building and knowledge sharing for the benefit of policy makers, service providers and the public, while also building a sense of community. Amid the need to put up physical boundaries, Tele-Public Health presents a promising way forward on how to prevent disease, prolong life, and promote health in the “new normal.”
Dean Vicente Belizario, Jr. and Jaifred C. F. Lopez
Published in Healthscape Special COVID-19 Issue No. 8
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