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Cholera is a sudden-onset gastrointestinal disorder resulting from Vibrio cholerae bacterial infection in the intestines (Dunkin, 2010).

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COVID-19 is an extremely transmissible illness, from SARS-CoV-2 or severe acute respiratory syndrome coronavirus 2 (Cascella et al., 2023).

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COVID-19 spreads among individuals through direct or indirect contact with infected individuals, including exposure to saliva, respiratory fluids, or droplets expelled when coughing, sneezing, or speaking. Close proximity (within 1 meter) to an infected person increases the risk of transmission, as infectious droplets can enter the mouth, nose, or eyes of those nearby (WHO, 2020).

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During the time COVID-19 hit the Philippines, the government responded with various measure:

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Emergency Declaration

President Duterte declared a public health emergency in the Philippines on March 8 (Proclamation No. 922). This led to the suspension of school classes in Metro Manila. Subsequently, from March 15 to April 14, a partial lockdown was implemented in Metro Manila, including travel restrictions. On March 16, the entire Luzon was placed under enhanced community quarantine (ECQ), constituting the strictest lockdown in the country (Atienza, 2021).

Resource Allocation

Congress granted emergency powers to President Duterte through the Bayanihan to Heal as One Act of 2020 (Bayanihan Act) on March 2, 2020, under Article VI, Section 23(2) of the 1987 Constitution. Despite provisions granting fiscal flexibility, it was enacted with minimal opposition (Yusingco & Pizarro, 2020).

Militaristic Response

The government's COVID-19 response involves a notable military presence, with lockdown measures resembling military checkpoints. Retired generals play key roles in leadership, and President Duterte's directive to arrest quarantine violators highlights a militarized enforcement approach (Regino, 2020; Dizon, 2020).

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Cholera is primarily transmitted through contaminated food and water sources, making ingestion of infected substances a common mode of contraction. Direct person-to-person contact can facilitate the spread of the disease with the prevalence of unsanitary conditions and polluted environments. In areas lacking proper sanitation measures, the risk of contamination increases significantly, which gives importance to environmental factors to curb its spread. Some sources include municipal water supplies, Vegetables grown with water containing human wastes, Foods and drinks sold by street vendors, raw or undercooked fish, and seafood caught in waters polluted with sewage (Dunkin, 2010).

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During the period when Cholera was present in the Philippines, the American government implemented diverse measures in response.

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American interventions, aimed at suppressing the disease, included draconian measures such as forcible administration of medicines:

1. Burning of the Farola district, and detaining residents in concentration camps. These harsh policies led to resistance, further spread of cholera, and susceptibility to other diseases.

2. Cultural insensitivity, including burning victims' bodies, created distrust and hindered health campaigns (Worcester, 1909 as cited by Acevedo 2021).

Though after seeing the results, they then turned to more humane measures of informing and educating the population of the proper and effective medical implications that should be considered when facing a cholera outbreak. The government’s efforts changed direction with the idea of needing fact-based and empathetic initiatives that consider community experiences, histories, and cultures to build infection-free communities.

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During the time when Cholera afflicted the Philippines, the American government enacted a variety of health measures in response.

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Superstition-based Measures

Both Religion and Folk-beliefs are two things that contributed to the emergence influenced the measures taken during the cholera epidemic. Various alleged cures for cholera existed:

1. Including alcohol and opiates, but their effectiveness was limited.

2. Folk healers provided poultices and plasters, and traditional remedies like burning lemongrass were practiced (Boncan, 2016 as cited in Acevedo, 2021).

Thus, the spread of cholera still persisted, with the aforementioned cases highlighting the clash between traditional beliefs and emerging medical approaches during the colonial era.

Health Literacy

With how ineffective putting up strict guidelines and mandates during the time of the Cholera epidemic, the Philippine government pursued health promotion and education as a course against disease Filipino health officers were trained in epidemic control and community hygiene. The Board of Health issued resolutions and bulletins guiding the community on proper hygiene (Acevedo, 2021).

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The Cholera outbreak has resulted in various effects on Philippine society.

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Effect on Agriculture

Cholera had gravely affected multiple parts of the world, wherein countries like Turkey, Russia, South America and Africa, especially so in the case of the latter mentioned. With water, whether fresh or sea water, being what carries the V.cholerae bacteria, its transmission and ways of spreading is a widely used commodity for everyday life. For food, bathing, cleansing of objects, or even being the source of livelihood for people. The state of agriculture of a country during a cholera pandemic is sure to be greatly affected. This was underscored with the case of the Philippines, while also being in a war against America, it had faced a situation where their places of living had to be burned down or sanitized regularly and their food supplies had become scarce.

Loss of Lives

While easy to prevent, with measures like keeping food and water supply clean and other sanitation methods, the deaths Cholera has caused all throughout the world has left a mark as a disease. It has a 25–50% mortality rate in untreated cases, its threat was felt especially in the case of having 50-70 deaths every day during the 1902 Philippine cholera epidemic (The British Medical Journal, 1902).

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Both cholera and COVID-19, while caused by different pathogens, share similarities in their potential to trigger widespread outbreaks and pose significant public health challenges (Yetman, 2020). Additionally, both diseases have the potential to lead to severe illness and mortality, particularly in areas with limited access to healthcare and sanitation services.

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In both cases, the initial government response to the outbreaks involved strict measures, including forcible administration of medicines and lockdowns for cholera, and military-enforced quarantine for COVID-19. However, these measures faced resistance and heightened distrust among affected populations. The lesson from this is that relying solely on such measures is insufficient in effectively combating infectious diseases. Instead, a more balanced and compassionate approach is necessary to address public health challenges (Aldrich & Lotito, 2020).

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During the cholera epidemic, traditional superstitions prevailed but were ineffective, despite modern medical approaches being available.

In contrast, the COVID-19 pandemic saw the use of modern health literacy efforts, focusing on evidence-based practices and education to combat the spread of the disease. Both situations emphasize the vital role of education in controlling diseases, highlighting the importance of evidence-based public health measures. When the public is well-informed, they can make informed decisions, follow guidelines, and contribute to disease control efforts effectively (Brownson et al., 2002)

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Both cholera and COVID-19 disrupt agriculture, livelihoods, and healthcare systems, causing loss of life and economic fallout, especially in vulnerable communities. These outbreaks highlight the complex challenges of infectious diseases. Lessons learned stress the importance of sanitation, a strong healthcare system, and early detection for effective response (Dikid et al., 2020) Addressing socio-economic disparities and promoting equity in healthcare are crucial for resilience against future pandemics.

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During the time COVID-19 hit the Philippines, the government implemented various health measures:

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Community Quarantines:

When COVID-19 hit the Philippines in 2020, the government imposed an "enhanced community quarantine" (ECQ) which included strict measures such as home quarantine, physical distancing, class suspensions, work-from-home arrangements, closure of non-essential businesses and public transport, prohibition of mass gatherings, regulation of essential services, curfews, alcohol sales bans, and increased deployment of uniformed personnel for enforcement (Amit et al., 2021).

Mandatory Masks, Face Masks, and Social Distancing

Malacañang mandated the public to follow strict home quarantine and social distancing measures, including wearing face masks and face shields at all times when outside their homes (Da Silva, 2020).

Vaccination Program

In January 2021, the Department of Health of the Philippines unveiled an interim plan for COVID-19 vaccine deployment. The government led a whole-of-society approach to vaccine deployment, aiming to secure 148 million doses and inoculate 50 to 70 million Filipinos by 2021 to achieve herd immunity against COVID-19 (Tomacruz, 2021; Tejero et al., 2022).

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The COVID-19 pandemic has brought about a range of impacts on Philippine society.

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Loss of Lives

The toll of COVID-19 on Philippine society highlights existing inequalities in access to healthcare and resources, impacting marginalized communities more severely. Approximately 4.1 million people have been infected, with over four million recoveries and around 66.4 thousand deaths (Statista Research Department, 2023).

Healthcare System Strain

The COVID-19 pandemic exposed vulnerabilities in the Philippine healthcare system, straining medical resources, hospital capacities, and healthcare staff. Hospitals were overwhelmed, and managing the surge of COVID-19 cases posed significant challenges for healthcare professionals (Lim, 2020).

Economic Fallout

COVID-19 severely impacted rural livelihoods in the Philippines, particularly in poor communities, with loss of income and job opportunities worsened by pandemic restrictions. Disaster-prone areas faced even greater challenges, with existing issues like lack of income opportunities and reduced pay further intensified by the pandemic (Fallesen, 2023).

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COVID-19 and cholera share common modes of transmission through contaminated surfaces and close contact, leading to rapid community outbreaks, especially in regions with poor sanitation and healthcare resources (WHO, 2020; New York State Department of Health, 2017). Hygiene and sanitation play crucial roles in controlling their spread, underscoring the need for effective preventive measures to mitigate their impact on public health.