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circa 1902

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year 2019

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Despite a century-long difference, the government responses during the cholera epidemic share resemblances with the timely COVID-19 pandemic. On a superficial level, the government was able to execute concrete plans in an attempt to lessen the damages caused by the aforementioned diseases. However, when analyzing both situations from a deeper perspective, one can suppose how flawed and unjust such plans are for marginalized communities. For instance, Bell instructed the officials to eradicate any traces of cholera by burning down the houses of communities affected by the disease. What was more concerning was how the low-class communities were treated inferiorly to the middle-class and upper-class people, which became evident when the officials solely sprayed their houses with disinfectants because it was "less dangerous." Moving forward, more than a century later, a similar approach to inequality arises with how the government responded to COVID-19 cases in the country. A primary example is former President Rodrigo Duterte's campaign of executing or punishing quarantine violators at a higher degree compared to middle-class and upper-class citizens who can pay their way out of trouble. On a positive note, the occurrence of the COVID-19 pandemic allowed international manufacturers to disperse vaccination globally as soon as possible. Through health devolution, communities got their vaccinations free of charge as distributed by Local Government Units, a significant factor in the disease recovery that the cholera epidemic did not suffice.

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March 14 1902 in Manila: A Hong Kong Vessel arrived carrying cholera.

March 20, 1902: First cases of cholera confirmed at San Juan de Dios Hospital in Manila

April 7, 1902: The official date of the cholera's first appearance in Laguna province.

April 16, 1902: General Miguel Malvar surrendered in Rosario, Batangas due to the scarcity in food supplies and the suffering of his countrymen

April 19, 1902: Three days after Malvar's surrender, all restrictions to trade and travel in the region were to be lifted, but the cholera forced the ports to remain closed in order to give time for local health boards to organize and take the required pre-cautions

April 24, 1902: First cases of cholera at Pagsanjan and Majayjay in Laguna province.

March 08, 1904: Cholera ended with 109,461 deaths (4,386 from Manila)

Cholera victims were from all levels of society

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In March 1902, it was the fourth year of the Philippine-American War. Many towns in Luzon, hamletted by the Americans, suffered from famine. In Isabela, Emilio Aguinaldo would soon be captured. In Batangas, Miguel Malvar felt forced to surrender soon, so that rice could be planted in May. To top it all, cholera arrived. "For the inhabitants of the war-torn areas, it was ultimately a choice between dying of hunger or dying of cholera," wrote historian Reynaldo C. Ileto.

"In March 1902 a vessel from Hongkong arrived in Manila carrying cholera. Soon after, the first cases of cholera surfaced. Cholera was impossible to contain because the Filipinos and even the American troops themselves moved around carrying the bacteria. Cholera was not selective; it claimed as victims people from different strata of society and ethnicity-elite, masses, Filipinos, Americans, Spaniards and Chinese. But the lower classes were the hardest hit, especially in certain districts in Manila, because of the 'overcrowding, poor sanitation, and poor diet.' By the time the epidemic ended, about 109,461 died, 4,386 of which were in Manila...

"[T]he cholera epidemic gave way to what Ileto calls 'germ warfare,' another stage of the Philippine-American War. During this time, military surgeons became the next wave of 'pacifiers' after the cavalrymen and troops. Searches and surveillance were conducted among Filipino homes to ferret out the sick and quarantine them. The Filipino response was concealment and evasion since they refused to part with their sick family members.

"Within the cholera combat zone, colonial officials prohibited gatherings of people in places considered conducive to the spread of cholera like churches and cockpits. Officials also resorted to burning the houses of cholera victims and even gathering places like the town market. By cremating cholera casualties, they elicited further resistance and hatred among Filipinos whose religious practices demanded proper burial.

"Ileto notes that powerful drugs, strict quarantine, and cremation of the dead did not end cholera. Rather, it was the combination of the heavy rains and the increasing immunity of the populace that caused the epidemic to subside [italics mine]." (Quoted from The Philippine History Site, Outbreak of cholera epidemic, https://opmanong.ssc.hawaii.edu/filipino/cholera.html. The basic study is Ileto, "Cholera and the origins of the American sanitary order in the Philippines," 1988.)

My personal connection. It was Rey himself who explained to me, when we became friends circa 1985, how the 1902 cholera probably affected my own father's family of orientation. Heavy rains came in 1903, and washed away the cholera-infected sewage; Rey dates the end of the epidemic as February 1904.

Thus by September 1904, when my father Federico Mangahas was born in Hagonoy, Bulacan, the epidemic had come and was just gone. Federico had elder siblings but never met them, since they all died before he was born, most probably from cholera. He grew up as an only child, with relatively elderly parents, and was orphaned by the time he reached high school.

Might the coming Philippine hot weather slow down COVID-19? It has been reported that the coronavirus does not thrive in high-temperature and high-humidity environments. This suggests that COVID-19 may be more vulnerable in the coming summer months. If the hot season could play a role in combating the present pandemic, just as the rainy season played a role in ending the 1902 cholera epidemic, it would be fitting.

On 4/2/20, the Foundation for Economic Freedom (FEF) recommended ending the hard lockdown on April 12, and doing a calibrated easing of the lockdown, on the general principle that restrictions on the movement of people and commerce are harming the people's livelihoods and also ultimately endangering public health. I am a Founding Fellow of FEF, and fully support this recommendation.

Contact [email protected].

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In March 1902, it was the fourth year of the Philippine-American War. Many towns in Luzon, hamletted by the Americans, suffered from famine. In Isabela, Emilio Aguinaldo would soon be captured. In

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December 2019: An outbreak was identified in Wuhan, China

January 30, 2020: DOH recorded the first case of COVID-19 with a Chinese national

March 07, 2020: DOH reported the first local transmission

March 11, 2020: The government declared the country under the  state of pandemic

March 17, 2020: Former President Rodrigo Duterte declared a state of calamity in the entire country for a period of six months

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Houses pf upper classes were sprayed with disinfectants

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Magic bullets

“Wooden houses of the middle- and upper classes were deemed “less dangerous” and simply sprayed with disinfectants”

Houses of cholera victims were burned to eradicate the virus

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Contact tracing

Travel restrictions

Localized free COVID-19 vaccine from LGUs

Former President Rodrigo Duterte’s order to shoot quarantine violators

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The comparison of the two events share a level of similarity, yet there were notable differences in outbreak containment and challenges worth mentioning. When the Cholera first arrived in Manila in 1902, the American government was not sufficiently prepared to contain the disease causing its immediate spread from town to town. To combat the Cholera, Bell imposed house-to-house inspections by sending out his troops– this resulted in cases of abusive soldiers to Filipinos from the low social class, but in the end, it was a futile attempt as the disease continued to spread resulting in a state of epidemic in the Philippines. Similarly, when COVID-19 arrived in the Philippines, former President Duterte responded in the same manner by deploying military services around the country to ensure the compliance to quarantine protocols that unfolded a series of wrongful arrests particularly to Filipinos belonging to the marginalized population. His method of containing the disease was also an ineffective attempt when the country was declared in a state of calamity two months after the arrival of the disease. Moving forward, the analysis of the events proved the way both governments from respective timelines handled the disease outbreaks poorly by the evidence of methods that varied depending on social classes, reflecting the prevalent inequality among the rich and the poor.

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It is worth noting that both events occurred due to a foreign transmission from Hong Kong and China that led to the spread of cholera and COVID-19, respectively. Since then, the diseases have been able to be transmitted from one person to another in a matter of days, for which a fast-paced death rate is observable in both events. Despite the declaration of a stricter health protocol a couple of days after the first reported cases of cholera and COVID-19, many of the communities in the country were unable to secure themselves from the transmission of the disease. In roughly two years, hundreds and thousands of people died of such diseases.

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The two events despite taking place on a different timeline are somehow identical from the beginning of transmission, how it was initially handled, and how it affected the masses. From this point, the parallelism reflects the Philippines' susceptibility to disease outbreaks mainly rooted in the inadequate healthcare system, overpopulation, poor sanitary levels in communities, and the government's strategy to prioritize a militarized approach rather than scientific and health-centered solutions to outbreaks.

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Quarantine measures (implemented after the aftermath of their mistakes)

House-to-house inspections

Isolating suspected patients in detention camps

Benzozone, a drug used as a ‘germicidal’ antiseptic in an attempt to treat cholera symptoms

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14-day quarantine and mandatory RT PCR testing for travelers arriving in the Philippines

Mandatory wearing of PPE, including face mask

Social distancing and self-isolation

Ivermectin, a pseudo-medicine that people once thought was a treatment for COVID-19

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 Korina Sanchez-Roxas on Instagram: "Am certified vaccinated. But am not totally immune to infection. So I STILL wear a mask and stay away from crowds. I take my Vit C, D and zinc daily. I take ivermectin every two weeks. I still quarantine and take Covid tests before joining groups. The BEST of life is yet to come. Let’s all be around when that happens. 💚 #BestLife #ingatangatbakunalahat @BakunaSikat"

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6,800 likes, 872 comments - korina on July 24, 2021: "Am certified vaccinated. But am not totally immune to infection. So I STILL wear a mask and stay ..."

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View this post on Instagram

A post shared by Korina Sanchez-Roxas (@korina)

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With regard to the public health measures, there are clear similarities that both events underwent amidst the health crisis. First, communities followed strict quarantine measures implemented by the government to ensure less risk of contamination and transmission. Although the people's response during the COVID-19 pandemic was one step advanced, as evidenced by the invention of rapid testing kits and highly advanced techniques to detect a positive result from the disease. Moreover, isolation is highly evident on both sides as such action is an apparent way to reduce human interaction, which is a risk factor for disease transmission. Because cholera and COVID-19 vary in terms of mode of transmission, the latter required communities to wear Personal Protective Equipment or PPE—including face masks—as an additional measure to combat the disease. Additionally, both events did not avoid the amount of false information that many among the communities complied with, as they thought that such drugs contained properties that would increase their disease resistance. For instance, during the cholera endemic, communities once used an experimental drug named benzozone to eradicate the cholera bacteria in the body. However, ingesting the drug came with repercussions, as burning of the mouth and stomach linings occurred. On the other side, COVID-19 had a similar style of fashion where people once thought that the drug ivermectin—a dewormer medication for dogs—was a protection against the disease. A well-known broadcast journalist in the country, Korina Sanchez, was criticized by many people after proudly admitting to taking ivermectin tablets every other week despite no connections to COVID-19 treatment.

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Abusive military troops

People fled from Manila – due to the Americans’ response – and the epidemic quickly spread out to the rest of the country

Eruption of traditional medical practices

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The containment measures during the Cholera outbreak were rudimentary compared to the modern solutions implemented during COVID-19. It was a huge challenge to combat Cholera before since the government then had no background knowledge about the disease. Back in 1902, the extent of understanding of the disease was that it was highly contagious only, hence, the isolation and quarantine measures. There were few discoveries on medications such as the 'benzozone' referred to as the 'magic bullets' that was given to the Cholera patients, but since the government had limited medical knowledge, the drug was purely experimental and lacked scientific evidence to ensure that it is suitable to treat the disease. Unlike today, there is now a major leap in the healthcare system as shown by the disease prevention programs and protocols in place; travel restrictions, mandatory RT-PCR testing, and localized vaccine programs. Medical improvements today made it possible for the government to approach COVID-19 through a scientific perspective. Nonetheless, the country’s current state of healthcare system, or the inadequacy to cater the entire public still contributed to the widespread of COVID-19. All these events upon analysis reflect that the health care system is a major problem in the country; community-centered programs and accessibility to health care is a necessity that needs to be prioritized in events like this.

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While both events encouraged communities to make alterations to their daily lives, one can notice how complicated adjustment is during the cholera epidemic. Fortunately, during the COVID-19 pandemic, the innovation of technologies to connect with people without means of physical contact exists. Hence, students were able to continue their education without much risk by shifting their mode of learning from a face-to-face setup to an online mode. Similarly, people who work with computers had a shift to a work-from-home setting to make a collective effort to alleviate the cases of affected people. On the contrary, no social media or technological advancements existed during the cholera epidemic, and people had to comply with the abusive military troops' strict regulations. Consequently, many of the communities in Manila fled to provinces outside the city, which resulted in the widespread cholera epidemic throughout the country.

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Shift to online classes

Work from home setting

Lifestyle changes

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The main difference between both timelines when it comes to the diseases' impacts on society boils down to one conclusion; during COVID-19 people had a way of coping with the effects of the outbreak, unlike people from 1902 who had no means of coping with the isolation and fear brought by the epidemic. However, it is important to mention the complexities of time periods, wherein during the Cholera epidemic, people had no means of technological advancements to cope with the societal impacts of the epidemic, including the colonial context in the matter.