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Analyzing the effectiveness of containment measures during the cholera epidemic and COVID-19 pandemic in the Philippines reveals different challenges and important lessons. During the cholera outbreak, it was clear that cultural sensitivity and community engagement were crucial, highlighting the significance of trust and understanding for successful health interventions. On the other hand, the global response to the COVID-19 pandemic faced obstacles such as misinformation, varying levels of public compliance, and the need to balance economic concerns with public health priorities.

Both outbreaks demonstrate the ever-evolving nature of public health crises, emphasizing the importance of adapting strategies to specific circumstances, utilizing technology, and involving communities in crisis responses. Transparency, collaboration, and cultural awareness are key factors in addressing public health challenges. Additionally, investing in healthcare infrastructure, promoting global cooperation, and enhancing public health education are essential for a more proactive and resilient approach to future health crises.

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Both the cholera epidemic and the COVID-19 pandemic in the Philippines shared some strategies, like quarantine and movement restrictions, but had differences. The cholera epidemic faced challenges like a lack of doctors and poor sanitation, with suspicions of poisoning. Overcrowded camps increased disease risk. Responses included education, water distribution, food bans, and quarantine. In contrast, the COVID-19 response had specific measures like quarantine levels, curfews, and travel restrictions. Face mask mandates, social distancing, testing, and a 2021 nationwide vaccination campaign were unique. Despite variations, both crises highlight the need for comprehensive approaches blending public awareness and medical interventions for effective pandemic management.

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The Philippines began its national vaccine drive against COVID-19 on March 1, 2021, with the goal of vaccinating seventy million of its citizens by the end of the calendar year (Inter-Agency Task Force for the Management of Emerging Infectious Disease, 2021).

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Mass testing efforts were conducted, and contact tracing initiatives were implemented to identify and isolate individuals exposed to the virus.

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Face mask and Social Distancing (October 2020)

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Face mask and Social Distancing (October 2020)

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Wearing face masks in public places was mandated to reduce the transmission of respiratory droplets. Physical distancing measures were enforced, and businesses and establishments were required to implement social distancing protocols.

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The Philippines imposed travel restrictions, including bans on international and domestic travel during specific periods. Quarantine protocols were implemented for arriving passengers.

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Local governments implemented curfews to restrict movement during certain hours to help control the spread of the virus.

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Community Quarantine Levels (March 2020)

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Community Quarantine Levels (March 2020)

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The government imposed different levels of community quarantine based on the severity of COVID-19 cases in specific areas. These levels ranged from Enhanced Community Quarantine (ECQ), Modified Enhanced Community Quarantine (MECQ), General Community Quarantine (GCQ), and Modified General Community Quarantine (MGCQ).

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Enhanced personal hygiene practices were observed during pandemic on due to a heightened awareness of the importance of cleanliness. This includes more frequent handwashing, the use of hand sanitizers, and overall efforts to maintain cleanliness in public places, homes, and workplaces. Hand sanitizing stations are often provided in public areas to encourage proper hygiene practices.

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New technology also helps families cope with the pandemic, providing access to education for students, including e-commerce, work-from-home arrangements for workers, virtual conferences and meetings in real-time, masses and similar church activities, online services, food delivery services, and digital payments. People increasingly rely on digital platforms for shopping, banking, and accessing essential services (Modern Technology Cited as Big Help for Families Amid Pandemic, n.d.).

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In the absence of adequate government support, average citizens — from farmers to health care workers — came together to fight hunger and embody bayanihan, or "collecting community effort," by setting up community pantries in the Philippines. (Project & Project, 2022)

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Job losses escalate, especially in the construction and public transportation sectors. Informal workers, small businesses, and the farming sector are severely affected, with cumulative job losses reported. Construction workers and public transport drivers continue to face the brunt of job cuts. Peace and order issues increase, mainly attributed to employment loss, while COVID-related discrimination rises during strict COVID lockdowns (Fallesen, 2023).

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School Closures caused Remote Learning (March 2020)

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School Closures caused Remote Learning (March 2020)

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The nationwide closure of schools from March 9 to March 15 due to the COVID-19 pandemic has negative impacts on society. Students face disruptions in their learning, and families, especially working parents, grapple with managing remote education while juggling work responsibilities. The economic consequences affect sectors tied to education, leading to downturns in transportation, school supplies, and related services. The closure widens educational inequalities, as students with fewer resources may struggle with online learning.

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Mandatory Mask Wearing caused inefficient supplies of Masks (April 2020)

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Mandatory Mask Wearing caused inefficient supplies of Masks (April 2020)

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The Philippines witnessed a surge in demand for face masks as fears over the coronavirus infection increased. Making mask-wearing mandatory became a crucial measure in response to the heightened demand and the understanding that masks could significantly reduce virus transmission.

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Enhanced Community Quarantine changed daily normal lives (March 2020)

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Enhanced Community Quarantine changed daily normal lives (March 2020)

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The implementation of community and enhanced community quarantine measures aimed to curb the spread of the virus, protect public health, and prevent overwhelming the healthcare system. These measures had profound effects on daily life, the economy, and social interactions.

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Global Emergency Declaration caused panic (January 2020)

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Global Emergency Declaration caused panic (January 2020)

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The WHO's declaration of a global emergency signaled the severity of the pandemic, prompting heightened awareness, international cooperation, and the mobilization of resources to combat the virus (Baclig, 2021). It caused panic in the whole society.

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Both the historic cholera epidemic and the recent COVID-19 pandemic in the Philippines affected society in similar and different ways. Both led to poor health conditions and food shortages. People relied on traditional beliefs and religious practices for protection, such as wearing crosses during cholera and using face masks during COVID-19. However, there are differences too. The cholera epidemic involved cultural practices and alternative treatments, while the COVID-19 response included global emergency declarations, government interventions like quarantine measures, and technological advancements like online education and remote work. The community-driven response of setting up community pantries during COVID-19 showed a sense of collective effort when government support was lacking.

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Both the cholera epidemic and the current COVID-19 pandemic share the commonality of being experienced as pandemics in the Philippines. They both spread globally and had a significant impact on Manila, particularly at San Lazaro Hospital. These health crises led to severe issues requiring medical attention, but they differ in their causes and symptoms. The cholera epidemic, caused by El-Tor-type cholera, resulted in severe diarrhea and dehydration. On the other hand, the ongoing COVID-19 pandemic, caused by the SARS-CoV-2 virus, manifests with respiratory symptoms like fever and difficulty breathing. While the cholera epidemic occurred over a specific period from 1961 to 1904, the COVID-19 pandemic has persisted since 2019, prompting continuous responses. Additionally, diagnostic methods vary, with the cholera epidemic relying on patient observations and COVID-19 using advanced techniques like PCR testing. These distinctions highlight the diverse nature of these health challenges and the evolving ways in which they are addressed.

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Anti-American propaganda sparked a wave of resistance from Spanish residents and natives, who denied the presence of cholera, rumors of cholera detention or murder, and accusations of poisonous powders being dropped into wells for villagers' deaths.

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Cholera was believed to be cured by alcohol and opiate, but these remedies did not significantly improve the conditions of the victims. Filipinos continued to use alternative treatments, such as folk healers in Capiz, who provided poultices and plasters, which were considered infallible by a Spanish doctor but did not completely eradicate the disease.

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The people of Capiz and Panay believed in three evil spirits that poisoned them, while the Sulud people of Panay believed in spirits called ibabawon. In Sibalom, Antique province, cholera was believed to be caused by black magic, a priest and servant visiting the community, and a man on the loose touching people. Rumors spread that powders were spread on the streets, leading to fearful locals abandoning the pueblo, burning their houses, and fleeing to the mountains, spreading the disease.

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The saint's novena, read for nine days or longer, began on the 16th of every month, followed by eight days of indulgence for cholera patients. However, health officials during the American Period disapproved, viewing these gatherings as disease spreaders.

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Both the COVID-19 pandemic and the historic cholera epidemic in the Philippines showed similarities and differences in terms of government response. Both faced issues like poor planning, food shortages, and challenges in testing. Both governments enforced strict measures, but the methods differed - the cholera epidemic had more authoritarian tactics, while COVID-19 used a militaristic approach and faced criticism for human rights abuses. The COVID-19 response involved geopolitical concerns with China, unlike the localized approach during the cholera epidemic. However, there were key differences. The cholera response included forceful actions like burning houses, while COVID-19 dealt with financial aid challenges and corruption issues. The neglect of frontliners and dismissal of appeals during COVID-19 contrasted with efforts in the cholera epidemic to promote health and education. Both situations highlighted the need for better planning, community involvement, and respect for human rights during health crises.

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Natives in colonial times relied on folk beliefs and religion for relief and salvation from diseases. Catholic priests played a central role in the public health crisis, allaying fears of outbreaks, seeking healing, and retribution amidst longsuffering, blessing, and burying the dead.

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The general state of health among Batangueños after their release from the concentration camps would have been poor, particularly in the face of a raging pandemic. This state of poor health would have continued even after the end of concentration because farms upon which families depended for subsistence had been neglected while people were in the camps. There would have been food shortages.

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CONCLUSION AND PUBLIC SENTIMENTS (2021-2023)

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CONCLUSION AND PUBLIC SENTIMENTS (2021-2023)

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As the crisis unfolds, it becomes increasingly clear that the government's response is more focused on control than public health. Filipinos, grappling with the aftermath of mismanagement, begin to question the leadership's effectiveness. Panao and Rye's (2023) observation on persistent challenges in COVID-19 testing further underscores the enduring impact of the government's shortcomings on the nation's fight against the pandemic.

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The government dismisses urgent appeals from medical associations, choosing to treat Metro Manila as a "living experiment" despite the critical situation faced by frontliners. This disregard for expert advice and pleas accentuates the disconnect between the government's actions and the pressing needs of the healthcare system.

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The focus on health campaigns centered on education, including the introduction of vaccines and the inclusion of health and hygiene in the curriculum by the 1910s, has significantly reduced cholera cases by the second and third decades of the 20th century.

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Frontline workers, particularly healthcare professionals, find themselves neglected as their appeals for additional facilities and supplies go unanswered. Biana and Joaquin (2020) shed light on the urgent calls for a stricter lockdown to address the overwhelmed healthcare system, revealing a stark lack of responsiveness.

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The Health Literacy Campaign involved the Bureau of Health and Bureau of Education hiring a medical inspector for city schools and regular visits by local health officers.

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In time, the Board of Health implemented measures to reduce the spread of the disease, including an educational campaign, free distilled water distribution, a ban on food items carrying the disease, and quarantine of infected localities to prevent further spread.

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The first cholera case in Batangas occurred just a month after Batangueños were allowed to return to their homes from concentration camps, where they had been forced to live since December of the previous year, as a tactical move to prevent civilian support for General Miguel Malvar's guerrilla efforts.

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Overcrowded and food-scarce concentration camps increased locals' susceptibility to diseases like malaria and dysentery, weakening their immunity and increasing their risk of cholera.

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The province faced a shortage of doctors, making cholera diagnosis and treatment difficult. Sanitary conditions were poor, with water for drinking and personal hygiene often coming from open wells or rivers. When Americans tried to control the disease in Manila, many uneducated people suspected they were poisoned.

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CHINA RELATIONS AND GAMBLING BUSINESSES (2021) 

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CHINA RELATIONS AND GAMBLING BUSINESSES (2021) 

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Amid the crisis, the government maintains close ties with China, raising eyebrows as large gambling businesses with Chinese connections are allowed to operate during the lockdown. Rabena's (2021) observations underscore concerns about the government's priorities during a critical public health emergency.

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Quarantine guards were stationed on all roads, paths, and streams leading out of Manila to prevent the spread of the disease to the provinces. However, it spread, likely due to people who slipped into quarantine by riding bancas or crossing fields.

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Rather than adopting a collaborative and community-focused approach, the government resorts to a militaristic strategy in enforcing lockdown measures. Paras (2022) highlights not only the stringent nature of the lockdown but also the reported human rights abuses carried out by security forces during this period.

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The government's financial aid rollout faced significant delays, exacerbating economic hardships for the population. Paras (2022) exposes instances of corruption in the distribution of aid, further undermining public trust in the government's response to the crisis.

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In the initial stages of the pandemic, the Philippine government swiftly imposed a strict lockdown, but criticism arose as it became evident that the measure was poorly planned. Beltran (2020) highlights the consequences, including food shortages and financial hardships for many Filipinos. Additionally, reports indicate a lack of adequate COVID-19 testing during this period.

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With the iron-hand clutch proving ineffective in cholera cases, the government aimed to combat cholera by promoting health and education, using health circulars and bulletins to provide simple guidelines for avoiding the disease. Filipino health officers were trained in controlling epidemics and implementing hygiene and sanitary work in the community. The Board of Health issued resolutions and bulletins to guide the community in preventing disease spread.

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The Board of Health in Batangas banned funeral services for the dead due to the disease's spread, resulting in church services being held without the deceased's bodies, which were often sent to the cemetery for burial.

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Colonial officials in the cholera combat zone banned gatherings in cholera-prone areas like churches and cockpits, burned victims' houses, and destroyed gathering places like the town market. They also cremated cholera casualties, causing resistance among Filipinos who demanded proper burial.

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The Americans' intentions to suppress disease spread were met with shock and fear from natives, leading to forcible administration of medicines in detention camps, bordering on abuse.

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The cholera epidemic led to 'germ warfare', a stage of the Philippine-American War where military surgeons became 'pacifiers'. Searches and surveillance were conducted to identify and quarantine sick Filipinos. The Filipino response was concealment and evasion, as they refused to leave their sick family members.

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The governor-general refused to believe cholera existed in Manila, leading doctors to handle cases themselves. The outbreak was announced when cases burst, and the chief health officer was blamed for not containing it.

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American health officials in the Philippines discovered a strain of Asiatic cholera in Guangzhou, China, and Hong Kong. The chief quarantine officer ordered the importation of vegetables and directed health officials to be on the lookout for suspicious bowel trouble cases.

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According to Edrada et al. (2020), the polymerase chain reaction (PCR) testing of initial nasopharyngeal/ oropharyngeal swabs detected Influenza B, human coronavirus 229E, Staphylococcus aureus, and Klebsiella pneumoniae was detected on the first patient. On January 30, SARS-CoV-2 viral RNA was detected on the initial swabs, confirming the first COVID-19 case in the Philippines.

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The officials noticed that a significant number of patients with cholera were being admitted to San Lazaro Hospital in Manila at the beginning of the epidemic in the Philippines (Wallace et al., 1964).

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In the study of Edrada et al. (2020), Chinese tourists in the Philippines in January 2020 became the first confirmed COVID-19 cases in the country. The 39-year-old female patient initially tested positive for other respiratory pathogens but was later confirmed to have SARS-CoV-2. Her symptoms included cough and sore throat, and a physical examination was unremarkable. She was admitted to San Lazaro Hospital in Manila on January 25.

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In the study of Wallace et al. (1964, para. 2) the disease spread rapidly in Manila and adjacent provinces, eventually infecting most of the Philippines' cities and provinces.

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On 30 January 2020, the Philippine Department of Health reported the first case of COVID-19 in the country with a 38-year-old female Chinese national. On 7 March, the first local transmission of COVID-19 was confirmed. Consequently, on Friday, July 21, President Ferdinand R. Marcos Jr. issued Proclamation No. 297 which lifted the State of Public Health Emergency that was in place throughout the Philippines due to the COVID-19 pandemic (Presidential Communications Office, 2023).

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On 22 September 1961, the Republic of the Philippines, after a quarter of a century of freedom from cholera, identified its first cholera El Tor cases of adult residents of Manila. Consequently, Heiser (1907) states that according to the official records on file at the Bureau of Health for the Philippine Islands, the last case of cholera of the pandemic which commenced on March 20, 1902, was reported to have occurred on March 8, 1904.

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Formerly known to be 2019-nCoV, this new strain named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes the illness coined as the Coronavirus disease 2019 (COVID-19) having mild symptoms of fever, dry cough, and tiredness to many severe symptoms of chest pain, shortness of breath or difficulty of breathing (World Health Organization, 2020b).

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According to Wallace et al. (1964), a pandemic of El-Tor-type cholera began in southeast Asia in 1961.