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Study Protocol

Assessing the effect of the COVID-19 pandemic, shift to online learning, and social media use on the mental health of college students in the Philippines: A mixed-method study protocol

Roles Funding acquisition, Writing – original draft

Affiliation College of Medicine, University of the Philippines, Manila, Philippines

Roles Methodology, Supervision, Visualization, Writing – original draft, Writing – review & editing

Affiliations Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines, Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines

ORCID logo

Roles Methodology

Affiliation Department of Psychiatry, College of Medicine, University of the Philippines, Manila, Philippines

Roles Conceptualization, Funding acquisition, Project administration, Supervision, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

  • Leonard Thomas S. Lim, 
  • Zypher Jude G. Regencia, 
  • J. Rem C. Dela Cruz, 
  • Frances Dominique V. Ho, 
  • Marcela S. Rodolfo, 
  • Josefina Ly-Uson, 
  • Emmanuel S. Baja

PLOS

  • Published: May 3, 2022
  • https://doi.org/10.1371/journal.pone.0267555
  • Peer Review
  • Reader Comments

Fig 1

Introduction

The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and teachers. Our study aims to assess Filipino college students’ mental health status and to estimate the effect of the COVID-19 pandemic, the shift to online learning, and social media use on mental health. In addition, facilitators or stressors that modified the mental health status of the college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning will be investigated.

Methods and analysis

Mixed-method study design will be used, which will involve: (1) an online survey to 2,100 college students across the Philippines; and (2) randomly selected 20–40 key informant interviews (KIIs). Online self-administered questionnaire (SAQ) including Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE will be used. Moreover, socio-demographic factors, social media usage, shift to online learning factors, family history of mental health and COVID-19, and other factors that could affect mental health will also be included in the SAQ. KIIs will explore factors affecting the student’s mental health, behaviors, coping mechanism, current stressors, and other emotional reactions to these stressors. Associations between mental health outcomes and possible risk factors will be estimated using generalized linear models, while a thematic approach will be made for the findings from the KIIs. Results of the study will then be triangulated and summarized.

Ethics and dissemination

Our study has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01). The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.

Citation: Lim LTS, Regencia ZJG, Dela Cruz JRC, Ho FDV, Rodolfo MS, Ly-Uson J, et al. (2022) Assessing the effect of the COVID-19 pandemic, shift to online learning, and social media use on the mental health of college students in the Philippines: A mixed-method study protocol. PLoS ONE 17(5): e0267555. https://doi.org/10.1371/journal.pone.0267555

Editor: Elisa Panada, UNITED KINGDOM

Received: June 9, 2021; Accepted: April 11, 2022; Published: May 3, 2022

Copyright: © 2022 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This project is being supported by the American Red Cross through the Philippine Red Cross and Red Cross Youth. The funder will not have a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

The World Health Organization (WHO) declared the Coronavirus 2019 (COVID-19) outbreak as a global pandemic, and the Philippines is one of the 213 countries affected by the disease [ 1 ]. To reduce the virus’s transmission, the President imposed an enhanced community quarantine in Luzon, the country’s northern and most populous island, on March 16, 2020. This lockdown manifested as curfews, checkpoints, travel restrictions, and suspension of business and school activities [ 2 ]. However, as the virus is yet to be curbed, varying quarantine restrictions are implemented across the country. In addition, schools have shifted to online learning, despite financial and psychological concerns [ 3 ].

Previous outbreaks such as the swine flu crisis adversely influenced the well-being of affected populations, causing them to develop emotional problems and raising the importance of integrating mental health into medical preparedness for similar disasters [ 4 ]. In one study conducted on university students during the swine flu pandemic in 2009, 45% were worried about personally or a family member contracting swine flu, while 10.7% were panicking, feeling depressed, or emotionally disturbed. This study suggests that preventive measures to alleviate distress through health education and promotion are warranted [ 5 ].

During the COVID-19 pandemic, researchers worldwide have been churning out studies on its psychological effects on different populations [ 6 – 9 ]. The indirect effects of COVID-19, such as quarantine measures, the infection of family and friends, and the death of loved ones, could worsen the overall mental wellbeing of individuals [ 6 ]. Studies from 2020 to 2021 link the pandemic to emotional disturbances among those in quarantine, even going as far as giving vulnerable populations the inclination to commit suicide [ 7 , 8 ], persistent effect on mood and wellness [ 9 ], and depression and anxiety [ 10 ].

In the Philippines, a survey of 1,879 respondents measuring the psychological effects of COVID-19 during its early phase in 2020 was released. Results showed that one-fourth of respondents reported moderate-to-severe anxiety, while one-sixth reported moderate-to-severe depression [ 11 ]. In addition, other local studies in 2020 examined the mental health of frontline workers such as nurses and physicians—placing emphasis on the importance of psychological support in minimizing anxiety [ 12 , 13 ].

Since the first wave of the pandemic in 2020, risk factors that could affect specific populations’ psychological well-being have been studied [ 14 , 15 ]. A cohort study on 1,773 COVID-19 hospitalized patients in 2021 found that survivors were mainly troubled with fatigue, muscle weakness, sleep difficulties, and depression or anxiety [ 16 ]. Their results usually associate the crisis with fear, anxiety, depression, reduced sleep quality, and distress among the general population.

Moreover, the pandemic also exacerbated the condition of people with pre-existing psychiatric disorders, especially patients that live in high COVID-19 prevalence areas [ 17 ]. People suffering from mood and substance use disorders that have been infected with COVID-19 showed higher suicide risks [ 7 , 18 ]. Furthermore, a study in 2020 cited the following factors contributing to increased suicide risk: social isolation, fear of contagion, anxiety, uncertainty, chronic stress, and economic difficulties [ 19 ].

Globally, multiple studies have shown that mental health disorders among university student populations are prevalent [ 13 , 20 – 22 ]. In a 2007 survey of 2,843 undergraduate and graduate students at a large midwestern public university in the United States, the estimated prevalence of any depressive or anxiety disorder was 15.6% and 13.0% for undergraduate and graduate students, respectively [ 20 ]. Meanwhile, in a 2013 study of 506 students from 4 public universities in Malaysia, 27.5% and 9.7% had moderate and severe or extremely severe depression, respectively; 34% and 29% had moderate and severe or extremely severe anxiety, respectively [ 21 ]. In China, a 2016 meta-analysis aiming to establish the national prevalence of depression among university students analyzed 39 studies from 1995 to 2015; the meta-analysis found that the overall prevalence of depression was 23.8% across all studies that included 32,694 Chinese university students [ 23 ].

A college student’s mental status may be significantly affected by the successful fulfillment of a student’s role. A 2013 study found that acceptable teaching methods can enhance students’ satisfaction and academic performance, both linked to their mental health [ 24 ]. However, online learning poses multiple challenges to these methods [ 3 ]. Furthermore, a 2020 study found that students’ mental status is affected by their social support systems, which, in turn, may be jeopardized by the COVID-19 pandemic and the physical limitations it has imposed. Support accessible to a student through social ties to other individuals, groups, and the greater community is a form of social support; university students may draw social support from family, friends, classmates, teachers, and a significant other [ 25 , 26 ]. Among individuals undergoing social isolation and distancing during the COVID-19 pandemic in 2020, social support has been found to be inversely related to depression, anxiety, irritability, sleep quality, and loneliness, with higher levels of social support reducing the risk of depression and improving sleep quality [ 27 ]. Lastly, it has been shown in a 2020 study that social support builds resilience, a protective factor against depression, anxiety, and stress [ 28 ]. Therefore, given the protective effects of social support on psychological health, a supportive environment should be maintained in the classroom. Online learning must be perceived as an inclusive community and a safe space for peer-to-peer interactions [ 29 ]. This is echoed in another study in 2019 on depressed students who narrated their need to see themselves reflected on others [ 30 ]. Whether or not online learning currently implemented has successfully transitioned remains to be seen.

The effect of social media on students’ mental health has been a topic of interest even before the pandemic [ 31 , 32 ]. A systematic review published in 2020 found that social media use is responsible for aggravating mental health problems and that prominent risk factors for depression and anxiety include time spent, activity, and addiction to social media [ 31 ]. Another systematic review published in 2016 argues that the nature of online social networking use may be more important in influencing the symptoms of depression than the duration or frequency of the engagement—suggesting that social rumination and comparison are likely to be candidate mediators in the relationship between depression and social media [ 33 ]. However, their findings also suggest that the relationship between depression and online social networking is complex and necessitates further research to determine the impact of moderators and mediators that underly the positive and negative impact of online social networking on wellbeing [ 33 ].

Despite existing studies already painting a picture of the psychological effects of COVID-19 in the Philippines, to our knowledge, there are still no local studies contextualized to college students living in different regions of the country. Therefore, it is crucial to elicit the reasons and risk factors for depression, stress, and anxiety and determine the potential impact that online learning and social media use may have on the mental health of the said population. In turn, the findings would allow the creation of more context-specific and regionalized interventions that can promote mental wellness during the COVID-19 pandemic.

Materials and methods

The study’s general objective is to assess the mental health status of college students and determine the different factors that influenced them during the COVID-19 pandemic. Specifically, it aims:

  • To describe the study population’s characteristics, categorized by their mental health status, which includes depression, anxiety, and stress.
  • To determine the prevalence and risk factors of depression, anxiety, and stress among college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning.
  • To estimate the effect of social media use on depression, anxiety, stress, and coping strategies towards stress among college students and examine whether participant characteristics modified these associations.
  • To estimate the effect of online learning shift on depression, anxiety, stress, and coping strategies towards stress among college students and examine whether participant characteristics modified these associations.
  • To determine the facilitators or stressors among college students that modified their mental health status during the COVID-19 pandemic, quarantine, and subsequent shift to online learning.

Study design

A mixed-method study design will be used to address the study’s objectives, which will include Key Informant Interviews (KIIs) and an online survey. During the quarantine period of the COVID-19 pandemic in the Philippines from April to November 2021, the study shall occur with the population amid community quarantine and an abrupt transition to online classes. Since this is the Philippines’ first study that will look at the prevalence of depression, anxiety, and stress among college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning, the online survey will be utilized for the quantitative part of the study design. For the qualitative component of the study design, KIIs will determine facilitators or stressors among college students that modified their mental health status during the quarantine period.

Study population

The Red Cross Youth (RCY), one of the Philippine Red Cross’s significant services, is a network of youth volunteers that spans the entire country, having active members in Luzon, Visayas, and Mindanao. The group is clustered into different age ranges, with the College Red Cross Youth (18–25 years old) being the study’s population of interest. The RCY has over 26,060 students spread across 20 chapters located all over the country’s three major island groups. The RCY is heterogeneously composed, with some members classified as college students and some as out-of-school youth. Given their nationwide scope, disseminating information from the national to the local level is already in place; this is done primarily through email, social media platforms, and text blasts. The research team will leverage these platforms to distribute the online survey questionnaire.

In addition, the online survey will also be open to non-members of the RCY. It will be disseminated through social media and engagements with different university administrators in the country. Stratified random sampling will be done for the KIIs. The KII participants will be equally coming from the country’s four (4) primary areas: 5–10 each from the national capital region (NCR), Luzon, Visayas, and Mindanao, including members and non-members of the RCY.

Inclusion and exclusion criteria

The inclusion criteria for the online survey will include those who are 18–25 years old, currently enrolled in a university, can provide consent for the study, and are proficient in English or Filipino. The exclusion criteria will consist of those enrolled in graduate-level programs (e.g., MD, JD, Master’s, Doctorate), out-of-school youth, and those whose current curricula involve going on duty (e.g., MDs, nursing students, allied medical professions, etc.). The inclusion criteria for the KIIs will include online survey participants who are 18–25 years old, can provide consent for the study, are proficient in English or Filipino, and have access to the internet.

Sample size

A continuity correction method developed by Fleiss et al. (2013) was used to calculate the sample size needed [ 34 ]. For a two-sided confidence level of 95%, with 80% power and the least extreme odds ratio to be detected at 1.4, the computed sample size was 1890. With an adjustment for an estimated response rate of 90%, the total sample size needed for the study was 2,100. To achieve saturation for the qualitative part of the study, 20 to 40 participants will be randomly sampled for the KIIs using the respondents who participated in the online survey [ 35 ].

Study procedure

Self-administered questionnaire..

The study will involve creating, testing, and distributing a self-administered questionnaire (SAQ). All eligible study participants will answer the SAQ on socio-demographic factors such as age, sex, gender, sexual orientation, residence, household income, socioeconomic status, smoking status, family history of mental health, and COVID-19 sickness of immediate family members or friends. The two validated survey tools, Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE, will be used for the mental health outcome assessment [ 36 – 39 ]. The DASS-21 will measure the negative emotional states of depression, anxiety, and stress [ 40 ], while the Brief-COPE will measure the students’ coping strategies [ 41 ].

For the exposure assessment of the students to social media and shift to online learning, the total time spent on social media (TSSM) per day will be ascertained by querying the participants to provide an estimated time spent daily on social media during and after their online classes. In addition, students will be asked to report their use of the eight commonly used social media sites identified at the start of the study. These sites include Facebook, Twitter, Instagram, LinkedIn, Pinterest, TikTok, YouTube, and social messaging sites Viber/WhatsApp and Facebook Messenger with response choices coded as "(1) never," "(2) less often," "(3) every few weeks," "(4) a few times a week," and “(5) daily” [ 42 – 44 ]. Furthermore, a global frequency score will be calculated by adding the response scores from the eight social media sites. The global frequency score will be used as an additional exposure marker of students to social media [ 45 ]. The shift to online learning will be assessed using questions that will determine the participants’ satisfaction with online learning. This assessment is comprised of 8 items in which participants will be asked to respond on a 5-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree.’

The online survey will be virtually distributed in English using the Qualtrics XM™ platform. Informed consent detailing the purpose, risks, benefits, methods, psychological referrals, and other ethical considerations will be included before the participants are allowed to answer the survey. Before administering the online survey, the SAQ shall undergo pilot testing among twenty (20) college students not involved with the study. It aims to measure total test-taking time, respondent satisfaction, and understandability of questions. The survey shall be edited according to the pilot test participant’s responses. Moreover, according to the Philippines’ Data Privacy Act, all the answers will be accessible and used only for research purposes.

Key informant interviews.

The research team shall develop the KII concept note, focusing on the extraneous factors affecting the student’s mental health, behaviors, and coping mechanism. Some salient topics will include current stressors (e.g., personal, academic, social), emotional reactions to these stressors, and how they wish to receive support in response to these stressors. The KII will be facilitated by a certified psychologist/psychiatrist/social scientist and research assistants using various online video conferencing software such as Google Meet, Skype, or Zoom. All the KIIs will be recorded and transcribed for analysis. Furthermore, there will be a debriefing session post-KII to address the psychological needs of the participants. Fig 1 presents the diagrammatic flowchart of the study.

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https://doi.org/10.1371/journal.pone.0267555.g001

Data analyses

Quantitative data..

Descriptive statistics will be calculated, including the prevalence of mental health outcomes such as depression, anxiety, stress, and coping strategies. In addition, correlation coefficients will be estimated to assess the relations among the different mental health outcomes, covariates, and possible risk factors.

thesis title about pandemic in the philippines

Several study characteristics as effect modifiers will also be assessed, including sex, gender, sexual orientation, family income, smoking status, family history of mental health, and Covid-19. We will include interaction terms between the dichotomized modifier variable and markers of social media use (total TSSM and global frequency score) and shift to online learning in the models. The significance of the interaction terms will be evaluated using the likelihood ratio test. All the regression analyses will be done in R ( http://www.r-project.org ). P values ≤ 0.05 will be considered statistically significant.

Qualitative data.

After transcribing the interviews, the data transcripts will be analyzed using NVivo 1.4.1 software [ 50 ] by three research team members independently using the inductive logic approach in thematic analysis: familiarizing with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming the themes, and producing the report [ 51 ]. Data familiarization will consist of reading and re-reading the data while noting initial ideas. Additionally, coding interesting features of the data will follow systematically across the entire dataset while collating data relevant to each code. Moreover, the open coding of the data will be performed to describe the data into concepts and themes, which will be further categorized to identify distinct concepts and themes [ 52 ].

The three researchers will discuss the results of their thematic analyses. They will compare and contrast the three analyses in order to come up with a thematic map. The final thematic map of the analysis will be generated after checking if the identified themes work in relation to the extracts and the entire dataset. In addition, the selection of clear, persuasive extract examples that will connect the analysis to the research question and literature will be reviewed before producing a scholarly report of the analysis. Additionally, the themes and sub-themes generated will be assessed and discussed in relevance to the study’s objectives. Furthermore, the gathering and analyzing of the data will continue until saturation is reached. Finally, pseudonyms will be used to present quotes from qualitative data.

Data triangulation.

Data triangulation using the two different data sources will be conducted to examine the various aspects of the research and will be compared for convergence. This part of the analysis will require listing all the relevant topics or findings from each component of the study and considering where each method’s results converge, offer complementary information on the same issue, or appear to contradict each other. It is crucial to explicitly look for disagreements between findings from different data collection methods because exploration of any apparent inter-method discrepancy may lead to a better understanding of the research question [ 53 , 54 ].

Data management plan.

The Project Leader will be responsible for overall quality assurance, with research associates and assistants undertaking specific activities to ensure quality control. Quality will be assured through routine monitoring by the Project Leader and periodic cross-checks against the protocols by the research assistants. Transcribed KIIs and the online survey questionnaire will be used for recording data for each participant in the study. The project leader will be responsible for ensuring the accuracy, completeness, legibility, and timeliness of the data captured in all the forms. Data captured from the online survey or KIIs should be consistent, clarified, and corrected. Each participant will have complete source documentation of records. Study staff will prepare appropriate source documents and make them available to the Project Leader upon request for review. In addition, study staff will extract all data collected in the KII notes or survey forms. These data will be secured and kept in a place accessible to the Project Leader. Data entry and cleaning will be conducted, and final data cleaning, data freezing, and data analysis will be performed. Key informant interviews will always involve two researchers. Where appropriate, quality control for the qualitative data collection will be assured through refresher KII training during research design workshops. The Project Leader will check through each transcript for consistency with agreed standards. Where translations are undertaken, the quality will be assured by one other researcher fluent in that language checking against the original recording or notes.

Ethics approval.

The study shall abide by the Principles of the Declaration of Helsinki (2013). It will be conducted along with the Guidelines of the International Conference on Harmonization-Good Clinical Practice (ICH-GCP), E6 (R2), and other ICH-GCP 6 (as amended); National Ethical Guidelines for Health and Health-Related Research (NEGHHRR) of 2017. This protocol has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01 dated March 25, 2021).

The main concerns for ethics were consent, data privacy, and subject confidentiality. The risks, benefits, and conflicts of interest are discussed in this section from an ethical standpoint.

Recruitment.

The participants will be recruited to answer the online SAQ voluntarily. The recruitment of participants for the KIIs will be chosen through stratified random sampling using a list of those who answered the online SAQ; this will minimize the risk of sampling bias. In addition, none of the participants in the study will have prior contact or association with the researchers. Moreover, power dynamics will not be contacted to recruit respondents. The research objectives, methods, risks, benefits, voluntary participation, withdrawal, and respondents’ rights will be discussed with the respondents in the consent form before KII.

Informed consent will be signified by the potential respondent ticking a box in the online informed consent form and the voluntary participation of the potential respondent to the study after a thorough discussion of the research details. The participant’s consent is voluntary and may be recanted by the participant any time s/he chooses.

Data privacy.

All digital data will be stored in a cloud drive accessible only to the researchers. Subject confidentiality will be upheld through the assignment of control numbers and not requiring participants to divulge the name, address, and other identifying factors not necessary for analysis.

Compensation.

No monetary compensation will be given to the participants, but several tokens will be raffled to all the participants who answered the online survey and did the KIIs.

This research will pose risks to data privacy, as discussed and addressed above. In addition, there will be a risk of social exclusion should data leaks arise due to the stigma against mental health. This risk will be mitigated by properly executing the data collection and analysis plan, excluding personal details and tight data privacy measures. Moreover, there is a risk of psychological distress among the participants due to the sensitive information. This risk will be addressed by subjecting the SAQ and the KII guidelines to the project team’s psychiatrist’s approval, ensuring proper communication with the participants. The KII will also be facilitated by registered clinical psychologists/psychiatrists/social scientists to ensure the participants’ appropriate handling; there will be a briefing and debriefing of the participants before and after the KII proper.

Participation in this study will entail health education and a voluntary referral to a study-affiliated psychiatrist, discussed in previous sections. Moreover, this would contribute to modifications in targeted mental-health campaigns for the 18–25 age group. Summarized findings and recommendations will be channeled to stakeholders for their perusal.

Dissemination.

The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.

This study protocol rationalizes the examination of the mental health of the college students in the Philippines during the COVID-19 pandemic as the traditional face-to-face classes transitioned to online and modular classes. The pandemic that started in March 2020 is now stretching for more than a year in which prolonged lockdown brings people to experience social isolation and disruption of everyday lifestyle. There is an urgent need to study the psychosocial aspects, particularly those populations that are vulnerable to mental health instability. In the Philippines, where community quarantine is still being imposed across the country, college students face several challenges amidst this pandemic. The pandemic continues to escalate, which may lead to fear and a spectrum of psychological consequences. Universities and colleges play an essential role in supporting college students in their academic, safety, and social needs. The courses of activities implemented by the different universities and colleges may significantly affect their mental well-being status. Our study is particularly interested in the effect of online classes on college students nationwide during the pandemic. The study will estimate this effect on their mental wellbeing since this abrupt transition can lead to depression, stress, or anxiety for some students due to insufficient time to adjust to the new learning environment. The role of social media is also an important exposure to some college students [ 55 , 56 ]. Social media exposure to COVID-19 may be considered a contributing factor to college students’ mental well-being, particularly their stress, depression, and anxiety [ 57 , 58 ]. Despite these known facts, little is known about the effect of transitioning to online learning and social media exposure on the mental health of college students during the COVID-19 pandemic in the Philippines. To our knowledge, this is the first study in the Philippines that will use a mixed-method study design to examine the mental health of college students in the entire country. The online survey is a powerful platform to employ our methods.

Additionally, our study will also utilize a qualitative assessment of the college students, which may give significant insights or findings of the experiences of the college students during these trying times that cannot be captured on our online survey. The thematic findings or narratives from the qualitative part of our study will be triangulated with the quantitative analysis for a more robust synthesis. The results will be used to draw conclusions about the mental health status among college students during the pandemic in the country, which will eventually be used to implement key interventions if deemed necessary. A cross-sectional study design for the online survey is one of our study’s limitations in which contrasts will be mainly between participants at a given point of time. In addition, bias arising from residual or unmeasured confounding factors cannot be ruled out.

The COVID-19 pandemic and its accompanying effects will persistently affect the mental wellbeing of college students. Mental health services must be delivered to combat mental instability. In addition, universities and colleges should create an environment that will foster mental health awareness among Filipino college students. The results of our study will tailor the possible coping strategies to meet the specific needs of college students nationwide, thereby promoting psychological resilience.

Psychological impact of COVID-19 pandemic in the Philippines

Affiliations.

  • 1 Department of Physiology, College of Medicine, University of the Philippines Manila, Taft Avenue, Manila 1000, Philippines; Philippine One Health University Network. Electronic address: [email protected].
  • 2 Department of Pediatrics, College of Medicine, University of the Philippines Manila, Taft Avenue, Manila 1000, Philippines. Electronic address: [email protected].
  • 3 Department of Psychiatry and Behavioral Medicine, College of Medicine, University of the Philippines Manila, Taft Avenue, Manila 1000, Philippines.
  • 4 School of Statistics, University of the Philippines Diliman, Philippines.
  • 5 South East Asia One Health University Network. Electronic address: [email protected].
  • 6 Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge 119228, Singapore. Electronic address: [email protected].
  • PMID: 32861839
  • PMCID: PMC7444468
  • DOI: 10.1016/j.jad.2020.08.043

Background: The 2019 coronavirus disease (COVID-19) pandemic poses a threat to societies' mental health. This study examined the prevalence of psychiatric symptoms and identified the factors contributing to psychological impact in the Philippines.

Methods: A total of 1879 completed online surveys were gathered from March 28-April 12, 2020. Collected data included socio-demographics, health status, contact history, COVID-19 knowledge and concerns, precautionary measures, information needs, the Depression, Anxiety and Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) ratings.

Results: The IES-R mean score was 19.57 (SD=13.12) while the DASS-21 mean score was 25.94 (SD=20.59). In total, 16.3% of respondents rated the psychological impact of the outbreak as moderate-to-severe; 16.9% reported moderate-to-severe depressive symptoms; 28.8% had moderate-to-severe anxiety levels; and 13.4% had moderate-to-severe stress levels. Female gender; youth age; single status; students; specific symptoms; recent imposed quarantine; prolonged home-stay; and reports of poor health status, unnecessary worry, concerns for family members, and discrimination were significantly associated with greater psychological impact of the pandemic and higher levels of stress, anxiety and depression (p<0.05). Adequate health information, having grown-up children, perception of good health status and confidence in doctors' abilities were significantly associated with lesser psychological impact of the pandemic and lower levels of stress, anxiety and depression (p<0.05).

Limitations: An English online survey was used.

Conclusion: During the early phase of the pandemic in the Philippines, one-fourth of respondents reported moderate-to-severe anxiety and one-sixth reported moderate-to-severe depression and psychological impact. The factors identified can be used to devise effective psychological support strategies.

Keywords: Anxiety; COVID-19; Depression; Philippines; Psychological impact; Stress.

Copyright © 2020 Elsevier Ltd. All rights reserved.

  • Age Factors
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Betacoronavirus
  • Coronavirus Infections*
  • Depression / epidemiology*
  • Depression / psychology
  • Health Personnel / psychology
  • Health Personnel / statistics & numerical data
  • Health Status
  • Mental Health
  • Middle Aged
  • Philippines / epidemiology
  • Pneumonia, Viral*
  • Sex Factors
  • Single Person
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Students / psychology
  • Students / statistics & numerical data
  • Surveys and Questionnaires
  • Young Adult
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Perspective article, the philippine higher education sector in the time of covid-19.

thesis title about pandemic in the philippines

  • 1 Southeast Asian Research Center and Hub, De La Salle University, Manila, Philippines
  • 2 Department of Philosophy, De La Salle University, Manila, Philippines

This paper reports the policy-responses of different Philippine higher education institutions (HEIs) to the novel coronavirus, COVD-19 pandemic. It compares these responses with those made by HEIs in Indonesia, Thailand, and Vietnam. Publicly available data and news reports were used to gauge the general public’s reaction to these policies and how the Philippines’ responses fare with its Southeast Asian neighbors. The paper observes that despite the innovations made by Philippine HEIs in terms of alternative learning modes and technologies for delivering education, there are still gaps and challenges in their responses. It recommends that policy-responses and learning innovations should be grounded on a deeper understanding of distance education and should be sensitive to the call of the times.

Introduction

COVID-19 has become a global health crisis. As of October 6, 2020, almost 36 million people have been infected and over one million have died. In the Philippines, this translates into almost 325,000 infected and 6,000 deaths ( Worldometer, 2020 ). To curb the spread of COVID-19, most governments have opted to employ quarantine protocols and temporarily shut down their educational institutions. As a consequence, more than a billion learners have been affected worldwide. Among this number are over 28 million Filipino learners across academic levels who have to stay at home and comply with the Philippine government’s quarantine measures ( UNESCO, 2020 ).

To respond to the needs of learners, especially of the 3.5 million tertiary-level students enrolled in approximately 2,400 HEIs, certain HEIs in the country have implemented proactive policies for the continuance of education despite the closure. These policies include modified forms of online learning that aim to facilitate student learning activities. Online learning might be in terms of synchronous, real-time lectures and time-based outcomes assessments, or asynchronous, delayed-time activities, like pre-recorded video lectures and time-independent assessments ( Oztok et al., 2013 ). Case in point are top universities in the country, viz., De La Salle University (DLSU), Ateneo de Manila University (ADMU), the University of Santo Tomas (UST), and the state-run University of the Philippines, Diliman (UPD).

DLSU has resorted to remote online learning, which combines both synchronous and asynchronous activities. For students who cannot participate in online learning, there are flexible options for completing course requirements throughout the academic year ( De La Salle University, 2020a ). ADMU has suspended synchronous online classes but continued asynchronous online learning so that “all students can learn at their own pace” ( Villarin, 2020 ). UST, like DLSU, has opted to continue with synchronous and asynchronous online classes, and a flexible grading of student outputs and assessments ( University of Santo Tomas, 2020 ). Other private universities and institutions such as STI College, St. Scholastica’s College, Adamson University, Far Eastern University, the University of the East, Ateneo de Davao University, and the University of San Carlos have continued with their online classes as well.

Arguably, the HEIs’ pivot to modified forms of online learning attempts to concretize the government’s stance to continue learning despite the pandemic. As the Philippine’s Department of Education (DepEd) Secretary, Leonor Briones quipped, “Education must continue even in times of crisis whether it may be a calamity, disaster, emergency, quarantine, or even war” ( Department of Education, 2020 ). The Philippines’ Commission on Higher Education (CHEd), on the other hand, advised HEIs to continue the “deployment of available flexible learning and other alternative modes of delivery in lieu of on-campus learning” ( Commission on Higher Education, 2020 ). These pronouncements aim to encourage the continuance of learning. Without implementing rules and regulations, however, private HEIs are left to make their own policies.

The General Public’s Initial Reaction

For varying reasons, however, different sectors have chastised the proactive online learning measures by these HEIs. For example, through an online petition based on student and faculty sentiments, student governments from different universities urged CHEd to mandate the cancellation of online classes, stating that “while we understand the need for learning to continue, the different circumstances of students across universities are not ideal and conducive for such.” The petitioners argue that “access to the internet connection and learning devices continued to be a privilege up to this day, placing those with poor internet access at a disadvantage when it comes to online classes.” [For a better picture, 45% of Filipino citizens (46 million) and 74% (34,500) of public schools do not have access to the internet ( Jones, 2019 )].

Furthermore, “adding more workload for the students increases their burden and contradicts the purpose of the lockdown, which is to help their families prepare and adjust to the situation at hand.” Finally, there is an issue about the “lack of environments conducive to learning at home and the effectiveness of the online lectures” ( Bagayas, 2020 ). Social media hashtags like, #NoStudentLeftBehind, #NoSchoolLeftBehind, #EndOnlineClasses, #EndTheSem, and #NoToOnlineClasses strengthen these sentiments further.

In consideration of such petitions, the state-run University of the Philippines-Diliman (UPD) suspended all modes of online learning. In his message to the academic community on March 17, 2020, UPD Chancellor Fidel Nemenzo announced the cancellation of online classes due to (i) emergency concerns as “caring for our families and for ourselves comes first,” (ii) “unequal access to personal computers and the internet exists among our community,” and (iii) “the shift to online classes has also not been smooth for our faculty, who have had to learn new skills and revise their syllabi overnight” ( Nemenzo, 2020 ).

It is quite understandable that some of the backlashes stem from the stresses caused by the pandemic. The other concerns, however, have already been noted by experts in the field of distance education. First, there is the issue of social integration and peer culture, and the possibility of transmission of values in a “virtual” classroom. Since there is a lack of human interaction in the learning process, students may learn less in such a set-up as opposed to those in the traditional classroom ( Edge and Loegering, 2000 ; Gamage et al., 2020 ). Second, there is also an issue on the unnaturalness and the results of online learning, since it goes against how natural teaching and learning supposedly take place ( Larreamendy-Joerns and Leinhardt, 2006 ; Adnan and Anwar, 2020 ). The lack of face-to-face human interaction in the online learning space and process appears disconcerting to both educators and learners alike.

On top of these concerns, however, there are deep socio-economic concerns for online learning in a developing country like the Philippines. Students in far-flung areas in the country do not even have roads or electricity, let alone access to computers and the internet. Moreover, given current internet infrastructure, even students in urban areas may have limited internet access. This then results in a “digital divide” between those who do have access and those who do not.

Furthermore, there is also an issue of social policy. The Philippines does not have a national policy dealing directly with online platforms such as Massive Open Online Courses (MOOCs), Open Distance e-learning (ODel), and Open Educational Resources (OERs). While there are laws, like the Open Distance Learning Act ( Sixteenth Philippine Congress, 2014 ), which provide legal bases for funding such platforms, they are not enough as “some national policies will have to be put in place to sustain the growth” of these online platforms ( Bandalaria, 2019 ).

The Idea of Distance Education

At the time of quarantines and viral outbreaks, it would seem that online learning is the only viable way to continue learning at a distance. This, however, seems to rest on a mistaken assumption. It should be emphasized that online learning is just one mode of distance education.

Distance education is broadly characterized as any form of learning experience where the learner and the instructor are physically separated from each other (not only by place but also by time). Arguably, such a dislocation is “the perfect context for free-flowing thought that lets us move beyond the restricted confines of a familiar social order” ( hooks, 2003 ). Moreover, this type of education is a way of providing learning opportunities to every learner, whatever their circumstances might be. This means that distance education may extend access to education through distribution and economies of scale ( Guri-Rosenblit, 2005 ; Owusu-Agyeman and Amoakohene, 2020 ).

One may claim that the main thrust of distance education is to bring education to those who are unreachable, under-resourced, less-privileged and inaccessible ( Biana, 2013 ). Taken as such, distance education “reaches out to students wherever they live or wish to study” ( Guri-Rosenblit, 2005 ). This kind of flexibility gives students more freedom to actively participate in learning ( Guri-Rosenblit, 2005 ; Daniel, 2016 ). Students learn even if they are separated from their instructors by space and/or time ( Edge and Loegering, 2000 ). In the time of COVID-19, distance learning became a necessity for learners and educators all over the world ( Ali, 2020 ).

Such a form of education, however, need not be limited to online learning ( Baggaley, 2008 ). Some have suggested using cell phones and (SMS) texting technology to facilitate learning ( Flores, 2018 ). Others urge to employ TV programs, radio broadcasts, and other non-internet based media ( Punzalan, 2020 ). Perhaps, some teachers might go back to basics and distribute annotated physical textbooks to their students through courier services. As long as the education sector is engaged, teachers and students have ample support, the curriculum and content of the learning modules are well-defined and personalized, technological limitations are acknowledged, and user-friendly and enjoyable materials are present, education will continue one way or another ( Ramos et al., 2007 ; Ali, 2020 ). Such support presupposes a collaboration between teachers and policy makers and authorities to develop the relevant referenced programs as well.

Notwithstanding the various stresses it brings, the outbreak of COVID-19 not only forced us to think about the technologies for delivering education ( Kim, 2020 ), it also compelled us to rethink the very nature of education itself. The government should create and implement concrete policies that will support a new breed of distance educators. Educators in turn need to innovate to ensure that education remains inclusive and accessible, and that distance learning is not limited to pure online learning.

The Current Situation

Several months after the initial backlash in March 2020, CHEd Chairperson, Prospero De Vera qualified the idea of flexible learning as “more encompassing than online learning.” De Vera explains that while online learning requires internet access, flexible learning does not necessarily require connectivity. Instead, it “focuses on the design and delivery of programs, courses, and learning interventions that address the learners’ unique needs in terms of pace, place, process, and products of learning” ( Parrocha, 2020 ).

Similarly, DepEd sets a distance learning approach that utilizes three methods: (1) delivery of printed modules to students, (2) access to DepEd Commons , an online education platform DepEd developed to support alternative modes of learning, and (3) delivery of lessons or self-learning modules via radio and television. The specific guidelines on the implementation of distance learning, however, are still under review ( Magsambol, 2020 ).

Private universities and institutions have likewise adapted to the limitations imposed by the pandemic and are poised to go either fully online, blended learning, or scheduled in-person classes in case the government lifts quarantine measures. In July 2020, DLSU adopted an alternate mode of education that is technology-enabled dubbed Lasallians Remote and Engaged Approach for Connectivity in Higher Education (R.E.A.C.H). R.E.A.C.H emphasizes the importance of engagement between faculty and students and offers three different delivery modes: (1) fully online (synchronous and asynchronous), and whenever possible (2) hybrid (blending of online and face-to-face), and (3) face-to-face. All online academic tools and materials are organized and made accessible via the university’s learning management system (LMS), AnimoSpace ( De La Salle University, 2020b ).

Similarly, ADMU piloted the Adaptive Design for Learning (ADL). ADL combines three different modes of delivery: (1) online, and, whenever possible, (2) blended, and (3) face-to-face; and offers uniquely designed courses that suit faculty style and respond to learner’s needs and contexts. The curricula materials are hosted in AteneoBlueCloud , an online platform branded as the university’s virtual campus ( Ateneo de Manila University, 2020 ).

Meanwhile, UST through its learning management platform, UST Cloud Campus implemented an Enriched Virtual Mode (EVR) that combines both online (synchronous and asynchronous) and offline strategies to ensure accessibility and flexibility in learning. Other than team-teaching, the approaches in EVR include a combination of the following: (1) complementing of professional competencies with industry partners and alumni interactions, (2) collaborative online learning with foreign partner institutions, and (3) remote encounters with community partners ( Alejandrino, 2020 ).

Finally, the University of the Philippines System shifted to blended learning using already existing platforms like University Virtual Learning Environment (UVLE), and UP Open University (UPOU). UPOU maximizes online learning and distance education and also offers free special courses in online learning. UP College of Education presented an Education Resilience and Learning Continuity Plan (ERLCP) to help schools transition to an alternative learning environment. ERLCP recommends enacting flexible learning options that are learner-centered and are made available in various modes of delivery such as face-to-face instruction, remote learning, and blended learning ( University of the Philippines - College of Education, 2020 ).

The Response of Southeast Asian HEIs

The Philippines is not the only country facing these problems. Its Southeast Asian neighbors have creatively responded to the same challenges and started to pivot to a new era of education. Indonesia, Thailand, and Vietnam have initiated some form of distance learning as early as May 2020. Thailand’s Education Ministry originally planned to implement a learning program using a Distance Learning Television (DLTV) platform. Seventeen television channels were set up to broadcast educational courses, vocational education, non-formal and informal education ( Praphornkul, 2020 ). The approach combines television or on-air learning and online learning. The rollout, however, was met with criticisms due to broadcasting problems and poor connectivity ( Bangkok Post, 2020a ). The ministry adjusted its plan and focused instead on preparing for schools to reopen nationally after a survey found that 60–70% of students are not ready for TV education ( Bangkok Post, 2020b ).

As Thailand universities move their operations online, the Ministry of Higher Education, Science, Research and Innovation (MHESI) provided more than 60,000 educators and 2 million students access to Microsoft applications ( Microsoft, 2020b ). Universities have also taken key initiatives and partnerships to ensure that the transition to digital is successful. Chulalongkorn University has launched its own learning platform called the Learning Innovation Center (LIC) which contains resources, information, tools, and methods to support online learning ( Chulalongkorn University, 2020 ). Mahidol University has partnered with Siam Commercial Bank to create an improved virtual platform for both students and teachers ( Siam Commercial Bank, 2020 ). Thammasat University partnered with Skilllane to launch a degree program on data science. Some universities like Chiang Mai University also offer MOOC to encourage online learning ( Phongsathorn, 2020 ).

Indonesia’s Education and Culture Ministry, in collaboration with TVRI, a state-owned broadcaster, released their own distance learning program called “Learning from Home” ( Jakarta Globe, 2020 ). The program focuses on improving literacy, numeracy, and character building for all levels of elementary and high schools. The implementation, however, proved to be challenging given issues like uneven access to the internet, the disparity in teacher qualifications and education quality, and the lack of Information and Communications Technology (ICT) skills ( Azzahra, 2020 ). A survey of 1,045 students found that a majority of students who responded, 53.7%, cited concerns about online learning due to poor streaming, limitation in network quota and reception. Though the reactions are mixed, in general, there seems to be a positive response to online learning in Indonesia ( Yamin, 2020 ). Ninety five percent of Indonesian universities carry out online learning using the Online Learning System Program (SPADA) ( Yamin, 2020 ). SPADA supports LMS across all tertiary education hosting online lectures and course materials made freely available to students.

Vietnam’s Ministry of Education and Training (MOET) hosted a national online conference with 300 live meeting hubs to find ways to improve online learning before launching its educational program ( Nguyen and Pham, 2020 ). The conference was attended by HEI leaders, technology and technical service providers including Viettel Group, VNPT, MobiFone, Vietnamobile, Microsoft, Google, Amazon, and FPT ( Nguyen and Pham, 2020 ). MOET reported that 110 out of 240 HEIs in Vietnam had initiated online training. However, not all HEIs have a fully developed LMS ( Nguyen and Pham, 2020 ). Recognizing that they are presented with a unique opportunity to work together and enhance digital teaching and learning, the delegates started working out plans to implement online education long-term and not simply as a response to COVID-19. Notable partnerships and initiatives seemingly inspired by this collaborative discourse include MOET’s partnership with Microsoft which equipped education institutions with digital tools to implement remote learning ( Microsoft, 2020a ), Viettel’s offer of free 3G and 4G data to teachers and students using their e-learning platform called Viettel Study, and VNPT’s launch of its online learning solution called VNPT E-Learning which also comes with free 3G and 4G data ( Lich, 2020 ).

After months of experimenting, online teaching is now recognized as a formal method in Vietnam, an interesting development considering that any proposal to formally conduct online learning before COVID-19 had been poorly received by the country’s academic community ( Nguyen and Pham, 2020 ). Minister of Education and Training Phung Xuan Nha admitted, however, that issues like connectivity problems, especially in remote areas, as well as some pedagogical concerns, like management of student performance, need to be sorted out for the program to succeed.

Conclusion and Recommendations

The Philippines, Thailand, Vietnam, and Indonesia are on the same economic and socio-cultural boat and are now facing the same COVID-19 challenges in education. What comes with these problems, however, is the opportunity to improve the way we think about education and implement permanent and sustainable changes that will enhance the quality of our educational systems.

Moving forward, the Philippines needs a clear set of policies and guidelines based on an innovative educational framework. This requires a careful and sincere assessment of the country’s readiness to offer learning programs that demand more than the traditional requirements.

As the Philippines ventures into a new mode of learning, several factors need to be considered. This includes teacher capacity, situation and context of the learner, and efficiency of the learning environment. These are, of course, on top of the more obvious issues of internet speed, cost of materials, and mode of delivery. The best way to move forward is to take a step back and design a strategy that engages teachers, students, parents, school administrators, and technology-based companies. This collaborative response based on a collective vision is the kind of creative solution this novel problem warrants.

As the new academic year begins this October, CHEd seems confident in its prescribed flexible learning mode. Stressing the “spirit of bayanihan,” or the unique Filipino value of communal unity, De Vera states that we must find ways to cope with the pandemic during these challenging times and ensure that while “learning must continue,” “we learn as one, we are ready” ( De Vera, 2020b ).

In support of such statements, CHEd together with HEIs sought to provide the following mechanism: (1) free training and capacity building for faculty members on flexible learning, (2) launch of the online resource PHL CHEd CONNECT, and (3) putting up of the CHEd Hi-Ed Bayanihan digital community of educators to “explore innovative responses in the context of Philippine HEIs.” The CHEd Hi-Ed Bayanihan is a partnership between the government and various HEIs in the country -it is said to be the first of its kind in CHEd history. Through this effort, De Vera claims that the challenges in education brought about by the COVID-19 pandemic may only be surpassed “if we altogether educate and learn as one” ( De Vera, 2020a ). These learning innovations, however, should be grounded on a deeper understanding of distance education and should be sensitive to the call of the times.

Author Contributions

JJ and HB conceptualized the study and wrote the first draft of the manuscript. MD validated the data used and edited the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Keywords : COVID-19, Philippine education, policy and institutional actions, online learning, distance education, flexible learning

Citation: Joaquin JJB, Biana HT and Dacela MA (2020) The Philippine Higher Education Sector in the Time of COVID-19. Front. Educ. 5:576371. doi: 10.3389/feduc.2020.576371

Received: 26 June 2020; Accepted: 28 September 2020; Published: 22 October 2020.

Reviewed by:

Copyright © 2020 Joaquin, Biana and Dacela. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Jeremiah Joven B. Joaquin, [email protected]

This article is part of the Research Topic

Education Leadership and the COVID-19 Crisis

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  • v.12(1); Jan-Mar 2021

Early response to COVID-19 in the Philippines

Arianna maever l. amit.

a College of Medicine, University of the Philippines Manila, Manila, Philippines.

b School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines.

Veincent Christian F. Pepito

Manuel m. dayrit.

Low- and middle-income countries (LMICs) with weak health systems are especially vulnerable during the COVID-19 pandemic. In this paper, we describe the challenges and early response of the Philippine Government, focusing on travel restrictions, community interventions, risk communication and testing, from 30 January 2020 when the first case was reported, to 21 March 2020. Our narrative provides a better understanding of the specific limitations of the Philippines and other LMICs, which could serve as basis for future action to improve national strategies for current and future public health outbreaks and emergencies.

The Philippine health system and the threat of public health emergencies

Despite improvements during the past decade, the Philippines continues to face challenges in responding to public health emergencies because of poorly distributed resources and capacity. The Philippines has 10 hospital beds and six physicians per 10 000 people. ( 1 , 2 ) and only about 2335 critical care beds nationwide. ( 3 ) The available resources are concentrated in urban areas, and rural areas have only one physician for populations up to 20 000 people and only one bed for a population of 1000. ( 4 ) Disease surveillance capacity is also unevenly distributed among regions and provinces. The primary care system comprises health centres and community health workers, but these are generally ill-equipped and poorly resourced, with limited surge capacity, as evidenced by lack of laboratory testing capacity, limited equipment and medical supplies, and lack of personal protective equipment for health workers in both primary care units and hospitals. ( 5 ) Local government disaster preparedness plans are designed for natural disasters and not for epidemics.

Inadequate, poorly distributed resources and capacity nationally and subnationally have made it difficult to respond adequately to public health emergencies in the past, as in the case of typhoon Haiyan in 2013. ( 6 ) The typhoon affected 13.3 million people, overwhelming the Government’s capacity to mobilize human and financial resources rapidly to affected areas. ( 7 ) Failure to deliver basic needs and health services resulted in disease outbreaks, including a community outbreak of gastroenteritis. ( 8 ) Access to care has improved in recent years due to an increase in the number of private hospital beds; ( 5 ) however, improvements in private sector facilities mainly benefit people who can afford them, in both urban and rural areas.

In this paper, we describe the challenges and early response of the Philippine Government, focusing on travel restrictions, community interventions, risk communication and testing, from 30 January 2020 when the first case was reported, to 21 March 2020.

Early response to COVID-19

Travel restrictions.

Travel restrictions in the Philippines were imposed as early as 28 January, before the first confirmed case was reported on 30 January ( Fig. 1a ). ( 9 ) After the first few COVID-19 cases and deaths, the Government conducted contact tracing and imposed additional travel restrictions, ( 10 ) with arrivals from restricted countries subject to 14-day quarantine and testing. While travel restrictions in the early phase of the COVID-19 response prevented spread of the disease by potentially infected people, travellers from countries not on the list of restricted countries were not subject to the same screening and quarantine protocols. The restrictions were successful in delaying the spread of the disease only briefly, as the number of confirmed cases increased in the weeks that followed. ( 11 ) Fig. 1b shows all interventions, including travel restrictions undertaken before 6 March, when the Government declared the occurrence of community spread, and after 11 March, when WHO declared COVID-19 a pandemic.

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New cases of COVID-19 in the Philippines, 30 January–21 March 2020

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Timeline of key events and developments in the Philippines, 30 January–21 March 2020

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Community interventions

The Government declared “enhanced community quarantine” (ECQ) for Metro Manila between 15 March and 14 April ( Fig. 2a ), which was subsequently extended to the whole island of Luzon ( Fig. 2b ). The quarantine consisted of: strict home quarantine in all households, physical distancing, suspension of classes and introduction of work from home, closure of public transport and non-essential business establishments, prohibition of mass gatherings and non-essential public events, regulation of the provision of food and essential health services, curfews and bans on sale of liquor and a heightened presence of uniformed personnel to enforce the quarantine procedures. ( 12 ) ECQ – an unprecedented move in the country’s history – was modelled on the lockdown in Hubei, China, which was reported to have slowed disease transmission. ( 13 ) Region-wide disease control interventions, such as quarantining of the entire Luzon island, were challenging to implement because of their scale and social and economic impacts, but they were deemed necessary to “flatten the curve” so that health systems were not overwhelmed. ( 14 ) While the lockdown implemented by the Government applied only to the island of Luzon, local governments in other parts of the country followed this example and also locked down. The ECQ gave the country the opportunity to mobilize resources and organize its pandemic response, which was especially important in a country with poorly distributed, scarce resources and capacity.

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Provinces placed under enhanced community quarantine (ECQ). (2a) The Government declared ECQ in Metro Manila effective 15 March 2020; (2b) The Government declared ECQ on the entire island of Luzon effective 17 March 2020.

[ insert Figure 2 ]

Risk communication

The Government strengthened and implemented national risk communication plans to provide information on the new disease. The Government conducted daily press briefings, sponsored health-related television and Internet advertisements and circulated infographics on social media. Misinformation and conspiracy theories about COVID-19 were nevertheless a challenge for a population that spends more than 10 hours a day on the Internet. ( 15 , 16 ) These spread quickly and became increasingly difficult to correct. Furthermore, the Government’s messages did not reach all households, despite access to health services and information, resulting in limited knowledge of preventive practices, except for hand-washing. ( 17 )

Testing is key to controlling the pandemic but was done on a small scale in the Philippines. As of 19 March, fewer than 1200 individuals had been tested, ( 11 ) as only the Research Institute for Tropical Medicine located in Metro Manila performed tests and assisted subnational reference laboratories in testing. ( 18 ) No positivity rates for RT–PCR tests were reported until early April 2020. Because of the limited capacity for testing at the start of the pandemic, the Department of Health imposed strict protocols to ration testing resources while ramping up testing capacity. Most tests were conducted for individuals in urban areas, where the incidence was highest. ( 19 )

Conclusions

At the start of the COVID-19 pandemic, the country’s initial response lacked organizational preparedness to counter the public health threat. The Philippines’ disease surveillance system could conduct contact tracing, but this was overwhelmed in the early phases of outbreak response. Similarly, in February, only one laboratory could conduct reverse transcriptase polymerase chain reaction (RT–PCR) testing, so the country could not rapidly deploy extensive laboratory testing for infected cases. In addition, the primary care system of the Philippines did not serve as a primary line of defence, as people went straight to hospitals in urban areas, overwhelming critical care capacity in the early stages of the COVID-19 pandemic.

In response to the early phase of the pandemic, the Government of the Philippines implemented travel restrictions, community quarantine, risk communication and testing; however, the slow ramping up of capacities particularly on testing contributed to unbridled disease transmission. By 15 October, the number of confirmed cases had exponentially grown to 340 000 of which 13.8% were deemed active. ( 11 ) The lack of pandemic preparedness had left the country poorly defended against the new virus and its devastating effects. Investing diligently and consistently in pandemic preparedness, surveillance and testing capacity in particular is a lesson that the Philippines and other LMICs should learn from COVID-19.

Acknowledgements

Conflict of interests.

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  • Volume 10, Issue 11
  • The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA study): a protocol study
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  • http://orcid.org/0000-0001-5621-1833 Adrian I Espiritu 1 , 2 ,
  • http://orcid.org/0000-0003-1135-6400 Marie Charmaine C Sy 1 ,
  • http://orcid.org/0000-0002-1241-8805 Veeda Michelle M Anlacan 1 ,
  • http://orcid.org/0000-0001-5317-7369 Roland Dominic G Jamora 1
  • 1 Department of Neurosciences , College of Medicine and Philippine General Hospital, University of the Philippines Manila , Manila , Philippines
  • 2 Department of Clinical Epidemiology, College of Medicine , University of the Philippines Manila , Manila , Philippines
  • Correspondence to Dr Adrian I Espiritu; aiespiritu{at}up.edu.ph

Introduction The SARS-CoV-2, virus that caused the COVID-19 global pandemic, possesses a neuroinvasive potential. Patients with COVID-19 infection present with neurological signs and symptoms aside from the usual respiratory affectation. Moreover, COVID-19 is associated with several neurological diseases and complications, which may eventually affect clinical outcomes.

Objectives The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA) study investigators will conduct a nationwide, multicentre study involving 37 institutions that aims to determine the neurological manifestations and factors associated with clinical outcomes in COVID-19 infection.

Methodology and analysis This is a retrospective cohort study (comparative between patients with and without neurological manifestations) via medical chart review involving adult patients with COVID-19 infection. Sample size was determined at 1342 patients. Demographic, clinical and neurological profiles will be obtained and summarised using descriptive statistics. Student’s t-test for two independent samples and χ 2 test will be used to determine differences between distributions. HRs and 95% CI will be used as an outcome measure. Kaplan-Meier curves will be constructed to plot the time to onset of mortality (survival), respiratory failure, intensive care unit (ICU) admission, duration of ventilator dependence, length of ICU stay and length of hospital stay. The log-rank test will be employed to compare the Kaplan-Meier curves. Stratified analysis will be performed to identify confounders and effects modifiers. To compute for adjusted HR with 95% CI, crude HR of outcomes will be adjusted according to the prespecified possible confounders. Cox proportional regression models will be used to determine significant factors of outcomes. Testing for goodness of fit will also be done using Hosmer-Lemeshow test. Subgroup analysis will be performed for proven prespecified effect modifiers. The effects of missing data and outliers will also be evaluated in this study.

Ethics and dissemination This protocol was approved by the Single Joint Research Ethics Board of the Philippine Department of Health (SJREB-2020–24) and the institutional review board of the different study sites. The dissemination of results will be conducted through scientific/medical conferences and through journal publication. The lay versions of the results may be provided on request.

Trial registration number NCT04386083 .

  • adult neurology
  • epidemiology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/bmjopen-2020-040944

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Strengths and limitations of this study

The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms Study is a nationwide, multicentre, retrospective, cohort study with 37 Philippine sites.

Full spectrum of neurological manifestations of COVID-19 will be collected.

Retrospective gathering of data offers virtually no risk of COVID-19 infection to data collectors.

Data from COVID-19 patients who did not go to the hospital are unobtainable.

Recoding bias is inherent due to the retrospective nature of the study.

Introduction

The COVID-19 has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China, in December 2019. 1 The COVID-19 pandemic has reached the Philippines with most of its cases found in the National Capital Region (NCR). 2 The major clinical features of COVID-19 include fever, cough, shortness of breath, myalgia, headache and diarrhoea. 3 The outcomes of this disease lead to prolonged hospital stay, intensive care unit (ICU) admission, dependence on invasive mechanical ventilation, respiratory failure and mortality. 4 The specific pathogen that causes this clinical syndrome has been named SARS-CoV-2, which is phylogenetically similar to SARS-CoV. 4 Like the SARS-CoV strain, SARS-CoV-2 may possess a similar neuroinvasive potential. 5

A study on cases with COVID-19 found that about 36.4% of patients displayed neurological manifestations of the central nervous system (CNS) and peripheral nervous system (PNS). 6 The associated spectrum of symptoms and signs were substantially broad such as altered mental status, headache, cognitive impairment, agitation, dysexecutive syndrome, seizures, corticospinal tract signs, dysgeusia, extraocular movement abnormalities and myalgia. 7–12 Several reports were published on neurological disorders associated with patients with COVID-19, including cerebrovascular disorders, encephalopathy, hypoxic brain injury, frequent convulsive seizures and inflammatory CNS syndromes like encephalitis, meningitis, acute disseminated encephalomyelitis and Guillain-Barre syndrome. 7–16 However, the estimates of the occurrences of these manifestations were based on studies with a relatively small sample size. Furthermore, the current description of COVID-19 neurological features are hampered to some extent by exceedingly variable reporting; thus, defining causality between this infection and certain neurological manifestations is crucial since this may lead to considerable complications. 17 An Italian observational study protocol on neurological manifestations has also been published to further document and corroborate these findings. 18

Epidemiological data on the proportions and spectrum of non-respiratory symptoms and complications may be essential to increase the recognition of clinicians of the possibility of COVID-19 infection in the presence of other symptoms, particularly neurological manifestations. With this information, the probabilities of diagnosing COVID-19 disease may be strengthened depending on the presence of certain neurological manifestations. Furthermore, knowledge of other unrecognised symptoms and complications may allow early diagnosis that may permit early institution of personal protective equipment and proper contact precautions. Lastly, the presence of neurological manifestations may be used for estimating the risk of certain important clinical outcomes for better and well-informed clinical decisions in patients with COVID-19 disease.

To address this lack of important information in the overall management of patients with COVID-19, we organised a research study entitled ‘The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA Study)’.

This quantitative, retrospective cohort, multicentre study aims: (1) to determine the demographic, clinical and neurological profile of patients with COVID-19 disease in the Philippines; (2) to determine the frequency of neurological symptoms and new-onset neurological disorders/complications in patients with COVID-19 disease; (3) to determine the neurological manifestations that are significant factors of mortality, respiratory failure, duration of ventilator dependence, ICU admission, length of ICU stay and length of hospital stay among patients with COVID-19 disease; (4) to determine if there is significant difference between COVID-19 patients with neurological manifestations compared with those COVID-19 patients without neurological manifestations in terms of mortality, respiratory failure, duration of ventilator dependence, ICU admission, length of ICU stay and length of hospital stay; and (5) to determine the likelihood of mortality, respiratory failure and ICU admission, including the likelihood of longer duration of ventilator dependence and length of ICU and hospital stay in COVID-19 patients with neurological manifestations compared with those without neurological manifestations.

Scope, limitations and delimitations

The study will include confirmed cases of COVID-19 from the 37 participating institutions in the Philippines. Every country has its own healthcare system, whose level of development and strategies ultimately affect patient outcomes. Thus, the results of this study cannot be accurately generalised to other settings. In addition, patients with ages ≤18 years will be excluded in from this study. These younger patients may have different characteristics and outcomes; therefore, yielded estimates for adults in this study may not be applicable to this population subgroup. Moreover, this study will collect data from the patient records of patients with COVID-19; thus, data from patients with mild symptoms who did not go to the hospital and those who had spontaneous resolution of symptoms despite true infection with COVID-19 are unobtainable.

Methodology

To improve the quality of reporting of this study, the guidelines issued by the Strengthening the Reporting of Observational Studies in Epidemiology Initiative will be followed. 19

Study design

The study will be conducted using a retrospective cohort (comparative) design (see figure 1 ).

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Schematic diagram of the study flow.

Study sites and duration

We will conduct a nationwide, multicentre study involving 37 institutions in the Philippines (see figure 2 ). Most of these study sites can be found in the NCR, which remains to be the epicentre of the COVID-19 pandemic. 2 We will collect data for 6 months after institutional review board approval for every site.

Location of 37 study sites of the Philippine CORONA study.

Patient selection and cohort description

The cases will be identified using the designated COVID-19 censuses of all the participating centres. A total enumeration of patients with confirmed COVID-19 disease will be done in this study.

The cases identified should satisfy the following inclusion criteria: (A) adult patients at least 19 years of age; (B) cases confirmed by testing approved patient samples (ie, nasal swab, sputum and bronchoalveolar lavage fluid) employing real-time reverse transcription PCR (rRT-PCR) 20 from COVID-19 testing centres accredited by the Department of Health (DOH) of the Philippines, with clinical symptoms and signs attributable to COVID-19 disease (ie, respiratory as well as non-respiratory clinical signs and symptoms) 21 ; and (C) cases with disposition (ie, discharged stable/recovered, home/discharged against medical advice, transferred to other hospital or died) at the end of the study period. Cases with conditions or diseases caused by other organisms (ie, bacteria, other viruses, fungi and so on) or caused by other pathologies unrelated to COVID-19 disease (ie, trauma) will be excluded.

The first cohort will involve patients with confirmed COVID-19 infection who presented with any neurological manifestation/s (ie, symptoms or complications/disorder). The comparator cohort will compose of patients with confirmed COVID-19 infection without neurological manifestation/s.

Sample size calculation

We looked into the mortality outcome measure for the purposes of sample size computation. Following the cohort study of Khaledifar et al , 22 the sample size was calculated using the following parameters: two-sided 95% significance level (1 – α); 80% power (1 – β); unexposed/exposed ratio of 1; 5% of unexposed with outcome (case fatality rate from COVID19-Philippines Dashboard Tracker (PH) 23 as of 8 April 2020); and assumed risk ratio 2 (to see a two-fold increase in risk of mortality when neurological symptoms are present).

When these values were plugged in to the formula for cohort studies, 24 a minimum sample size of 1118 is required. To account for possible incomplete data, the sample was adjusted for 20% more. This means that the total sample size required is 1342 patients, which will be gathered from the participating centres.

Data collection

We formulated an electronic data collection form using Epi Info Software (V.7.2.2.16). The forms will be pilot-tested, and a formal data collection workshop will be conducted to ensure collection accuracy. The data will be obtained from the review of the medical records.

The following pertinent data will be obtained: (A) demographic data; (B) other clinical profile data/comorbidities; (C) neurological history; (D) date of illness onset; (E) respiratory and constitutional symptoms associated with COVID-19; (F) COVID-19 disease severity 25 at nadir; (G) data if neurological manifestation/s were present at onset prior to respiratory symptoms and the specific neurological manifestation/s present at onset; (H) neurological symptoms; (i) date of neurological symptom onset; (J) new-onset neurological disorders or complications; (K) date of new neurological disorder or complication onset; (L) imaging done; (M) cerebrospinal fluid analysis; (N) electrophysiological studies; (O) treatment given; (P) antibiotics given; (Q) neurological interventions given; (R) date of mortality and cause/s of mortality; (S) date of respiratory failure onset, date of mechanical ventilator cessation and cause/s of respiratory failure; (T) date of first day of ICU admission, date of discharge from ICU and indication/s for ICU admission; (U) other neurological outcomes at discharge; (V) date of hospital discharge; and (W) final disposition. See table 1 for the summary of the data to be collected for this study.

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Data to be collected in this study

Main outcomes considered

The following patient outcomes will be considered for this study:

Mortality (binary outcome): defined as the patients with confirmed COVID-19 who died.

Respiratory failure (binary outcome): defined as the patients with confirmed COVID-19 who experienced clinical symptoms and signs of respiratory insufficiency. Clinically, this condition may manifest as tachypnoea/sign of increased work of breathing (ie, respiratory rate of ≥22), abnormal blood gases (ie, hypoxaemia as evidenced by partial pressure of oxygen (PaO 2 ) <60 or hypercapnia by partial pressure of carbon dioxide of >45), or requiring oxygen supplementation (ie, PaO 2 <60 or ratio of PaO 2 /fraction of inspired oxygen (P/F ratio)) <300).

Duration of ventilator dependence (continuous outcome): defined as the number of days from initiation of assisted ventilation to cessation of mechanical ventilator use.

ICU admission (binary outcome): defined as the patients with confirmed COVID-19 admitted to an ICU or ICU-comparable setting.

Length of ICU stay (continuous outcome): defined as the number of days admitted in the ICU or ICU-comparable setting.

Length of hospital stay (continuous outcome): defined as the number of days from admission to discharge.

Data analysis plan

Statistical analysis will be performed using Stata V.7.2.2.16.

Demographic, clinical and neurological profiles will be summarised using descriptive statistics, in which categorical variables will be expressed as frequencies with corresponding percentages, and continuous variables will be pooled using means (SD).

Student’s t-test for two independent samples and χ 2 test will be used to determine differences between distributions.

HRs and 95% CI will be used as an outcome measure. Kaplan-Meier curves will be constructed to plot the time to onset of mortality (survival), respiratory failure, ICU admission, duration of ventilator dependence (recategorised binary form), length of ICU stay (recategorised binary form) and length of hospital stay (recategorised binary form). Log-rank test will be employed to compare the Kaplan-Meier curves. Stratified analysis will be performed to identify confounders and effects modifiers. To compute for adjusted HR with 95% CI, crude HR of outcomes at discrete time points will be adjusted for prespecified possible confounders such as age, history of cardiovascular or cerebrovascular disease, hypertension, diabetes mellitus, and respiratory disease, COVID-19 disease severity at nadir, and other significant confounding factors.

Cox proportional regression models will be used to determine significant factors of outcomes. Testing for goodness of fit will be done using Hosmer-Lemeshow test. Likelihood ratio tests and other information criteria (Akaike Information Criterion or Bayesian Information Criterion) will be used to refine the final model. Statistical significance will be considered if the 95% CI of HR or adjusted HR did not include the number one. A p value <0.05 (two tailed) is set for other analyses.

Subgroup analyses will be performed for proven prespecified effect modifiers. The following variables will be considered for subgroup analyses: age (19–64 years vs ≥65 years), sex, body mass index (<18.5 vs 18.5–22.9 vs ≥23 kg/m 2 ), with history of cardiovascular or cerebrovascular disease (presence or absence), hypertension (presence or absence), diabetes mellitus (presence or absence), respiratory disease (presence or absence), smoking status (smoker or non-smoker) and COVID-19 disease severity (mild, severe or critical disease).

The effects of missing data will be explored. All efforts will be exerted to minimise missing and spurious data. Validity of the submitted electronic data collection will be monitored and reviewed weekly to prevent missing or inaccurate input of data. Multiple imputations will be performed for missing data when possible. To check for robustness of results, analysis done for patients with complete data will be compared with the analysis with the imputed data.

The effects of outliers will also be assessed. Outliers will be assessed by z-score or boxplot. A cut-off of 3 SD from the mean can also be used. To check for robustness of results, analysis done with outliers will be compared with the analysis without the outliers.

Study organisational structure

A steering committee (AIE, MCCS, VMMA and RDGJ) was formed to direct and provide appropriate scientific, technical and methodological assistance to study site investigators and collaborators (see figure 3 ). Central administrative coordination, data management, administrative support, documentation of progress reports, data analyses and interpretation and journal publication are the main responsibilities of the steering committee. Study site investigators and collaborators are responsible for the proper collection and recording of data including the duty to maintain the confidentiality of information and the privacy of all identified patients for all the phases of the research processes.

Organisational structure of oversight of the Philippine CORONA Study.

This section is highlighted as part of the required formatting amendments by the Journal.

Ethics and dissemination

This research will adhere to the Philippine National Ethical Guidelines for Health and Health-related Research 2017. 26 This study is an observational, cohort study and will not allocate any type of intervention. The medical records of the identified patients will be reviewed retrospectively. To protect the privacy of the participant, the data collection forms will not contain any information (ie, names and institutional patient number) that could determine the identity of the patients. A sequential code will be recorded for each patient in the following format: AAA-BBB where AAA will pertain to the three-digit code randomly assigned to each study site; BBB will pertain to the sequential case number assigned by each study site. Each participating centre will designate a password-protected laptop for data collection; the password is known only to the study site.

This protocol was approved by the following institutional review boards: Single Joint Research Ethics Board of the DOH, Philippines (SJREB-2020-24); Asian Hospital and Medical Center, Muntinlupa City (2020- 010-A); Baguio General Hospital and Medical Center (BGHMC), Baguio City (BGHMC-ERC-2020-13); Cagayan Valley Medical Center (CVMC), Tuguegarao City; Capitol Medical Center, Quezon City; Cardinal Santos Medical Center (CSMC), San Juan City (CSMC REC 2020-020); Chong Hua Hospital, Cebu City (IRB 2420–04); De La Salle Medical and Health Sciences Institute (DLSMHSI), Cavite (2020-23-02-A); East Avenue Medical Center (EAMC), Quezon City (EAMC IERB 2020-38); Jose R. Reyes Memorial Medical Center, Manila; Jose B. Lingad Memorial Regional Hospital, San Fernando, Pampanga; Dr. Jose N. Rodriguez Memorial Hospital, Caloocan City; Lung Center of the Philippines (LCP), Quezon City (LCP-CT-010–2020); Manila Doctors Hospital, Manila (MDH IRB 2020-006); Makati Medical Center, Makati City (MMC IRB 2020–054); Manila Medical Center, Manila (MMERC 2020-09); Northern Mindanao Medical Center, Cagayan de Oro City (025-2020); Quirino Memorial Medical Center (QMMC), Quezon City (QMMC REB GCS 2020-28); Ospital ng Makati, Makati City; University of the Philippines – Philippine General Hospital (UP-PGH), Manila (2020-314-01 SJREB); Philippine Heart Center, Quezon City; Research Institute for Tropical Medicine, Muntinlupa City (RITM IRB 2020-16); San Lazaro Hospital, Manila; San Juan De Dios Educational Foundation Inc – Hospital, Pasay City (SJRIB 2020-0006); Southern Isabela Medical Center, Santiago City (2020-03); Southern Philippines Medical Center (SPMC), Davao City (P20062001); St. Luke’s Medical Center, Quezon City (SL-20116); St. Luke’s Medical Center, Bonifacio Global City, Taguig City (SL-20116); Southern Philippines Medical Center, Davao City; The Medical City, Pasig City; University of Santo Tomas Hospital, Manila (UST-REC-2020-04-071-MD); University of the East Ramon Magsaysay Memorial Medical Center, Inc, Quezon City (0835/E/2020/063); Veterans Memorial Medical Center (VMMC), Quezon City (VMMC-2020-025) and Vicente Sotto Memorial Medical Center, Cebu City (VSMMC-REC-O-2020–048).

The dissemination of results will be conducted through scientific/medical conferences and through journal publication. Only the aggregate results of the study shall be disseminated. The lay versions of the results may be provided on request.

Protocol registration and technical review approval

This protocol was registered in the ClinicalTrials.gov website. It has received technical review board approvals from the Department of Neurosciences, Philippine General Hospital and College of Medicine, University of the Philippines Manila, from the Cardinal Santos Medical Center (San Juan City) and from the Research Center for Clinical Epidemiology and Biostatistics, De La Salle Medical and Health Sciences Institute (Dasmariñas, Cavite).

Acknowledgments

We would like to thank Almira Abigail Doreen O Apor, MD, of the Department of Neurosciences, Philippine General Hospital, Philippines, for illustrating figure 2 for this publication.

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VMMA and RDGJ are joint senior authors.

AIE and MCCS are joint first authors.

Twitter @neuroaidz, @JamoraRoland

Collaborators The Philippine CORONA Study Group Collaborators: Maritoni C Abbariao, Joshua Emmanuel E Abejero, Ryndell G Alava, Robert A Barja, Dante P Bornales, Maria Teresa A Cañete, Ma. Alma E Carandang-Concepcion, Joseree-Ann S Catindig, Maria Epifania V Collantes, Evram V Corral, Ma. Lourdes P Corrales-Joson, Romulus Emmanuel H Cruz, Marita B Dantes, Ma. Caridad V Desquitado, Cid Czarina E Diesta, Carissa Paz C Dioquino, Maritzie R Eribal, Romulo U Esagunde, Rosalina B Espiritu-Picar, Valmarie S Estrada, Manolo Kristoffer C Flores, Dan Neftalie A Juangco, Muktader A Kalbi, Annabelle Y Lao-Reyes, Lina C Laxamana, Corina Maria Socorro A Macalintal, Maria Victoria G Manuel, Jennifer Justice F Manzano, Ma. Socorro C Martinez, Generaldo D Maylem, Marc Conrad C Molina, Marietta C Olaivar, Marissa T Ong, Arnold Angelo M Pineda, Joanne B Robles, Artemio A Roxas Jr, Jo Ann R Soliven, Arturo F Surdilla, Noreen Jhoanna C Tangcuangco-Trinidad, Rosalia A Teleg, Jarungchai Anton S Vatanagul and Maricar P Yumul.

Contributors All authors conceived the idea and wrote the initial drafts and revisions of the protocol. All authors made substantial contributions in this protocol for intellectual content.

Funding Philippine Neurological Association (Grant/Award Number: N/A). Expanded Hospital Research Office, Philippine General Hospital (Grant/Award Number: N/A).

Disclaimer Our funding sources had no role in the design of the protocol, and will not be involved during the methodological execution, data analyses and interpretation and decision to submit or to publish the study results.

Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

Competing interests None declared.

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Patient consent for publication Not required.

Provenance and peer review Not commissioned; externally peer reviewed.

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  • How ethical are the covid-19 regulations?
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  • Racist attacks against the Asian community: what role did covid-19 pandemic play in this?
  • Hoarding and selfish tendencies during the coronavirus pandemic
  • The rise of the internet age during the coronavirus pandemic
  • How streaming services have benefited from the covid-19 pandemic
  • The role of pandemics and epidemics in promoting global change
  • The rate of employee retention among local businesses during the covid-19 pandemic
  • Companies that saw significant profits during the pandemic
  • Controversial theories about the pandemic and the coronavirus

You can also find a quantitative research title about covid-19, specifically focusing on the pandemic and its resulting issues. In addition to a quantitative research topic during a pandemic, research topics for STEM students are also pretty interesting. Here are some research topics during the pandemic that you can write about:

  • A link between the pandemic and employee retention rates in large corporations
  • Global recovery from the pandemic
  • The profoundly detrimental consequences of the covid-19 pandemic on the economy
  • How the global economy can recover from the pandemic
  • The long-term effects of the pandemic on the medical sector
  • The correlation between a decrease in employees in the medical industry and the pandemic
  • Mitigating the detrimental impacts of the pandemic on the education sector
  • The link between the pandemic and increased mental health challenges
  • The pandemic and depression: what is the link?
  • An analysis of the death rates during the life cycle of the coronavirus pandemic

You can also explore various research topics related to the covid-19 vaccines. The vaccine has been a controversial topic to study from various angles. Here are some research topics about covid 19, especially about vaccines:

  • The difference between the acceptance of the covid-19 vaccine in first and third-world countries
  • The role of social media influencers in promoting covid-19 vaccines
  • The controversies surrounding the covid-19 vaccine
  • How effective is the covid-19 vaccines against the virus?
  • An analysis of the covid-19 vaccination rates among conservative Americans?
  • The adverse effects of the covid-19 vaccine
  • An overview of the pros and cons of the covid-19 vaccines
  • The rate of covid-19 vaccination in 2021 vs. 2022
  • Covid-19 vaccine boosters: how many people go for the booster shots?
  • What happens when you get covid-19 after the vaccination?

When choosing a research topic, always pick an interesting and relevant topic. Doing so will simplify your research, help with data collection, and make your paper enjoyable. Get a research title about covid 19 quantitative for 2020 from the list below:

  • An analysis of the start of the covid-19 pandemic
  • An overview of the source of the coronavirus
  • Breaking down the myths about the coronavirus, its inception, and its impacts
  • The link between the spike in opioid addiction and the pandemic
  • The effects of the pandemic on essential social values
  • Quarantine in third-world countries compared to first-world countries
  • The rates of covid-19 infections and deaths in Africa
  • Social barriers during and after the coronavirus pandemic
  • Consumer Psychonomic during the covid-19 pandemic
  • The impact of the covid-19 pandemic on a globalized economy

The covid-19 pandemic offers multiple incredible research topic ideas. Choosing the best research title about the coronavirus can be tricky. So, let’s look at some qualitative research title examples about covid-19:

  • The covid-19 pandemic and what we can learn from it
  • What can global governments take away from the covid-19 pandemic?
  • An exploration of the impact of the coronavirus on the body
  • A look at how a strong immune system fights the coronavirus
  • Mental well-being during the coronavirus pandemic
  • Covid-19: managerial accounting during the pandemic
  • The positive impacts of the pandemic on the environment
  • A compelling city planning approach during the pandemic
  • Covid-19 and social values: what is the link
  • American administration responses to the covid-19 pandemic

The pandemic is a great study area for a thesis. You can choose various directions for your thesis depending on your study area and interest. Whether it is a quantitative research title about the pandemic or an example of a qualitative research title about covid-19, the following research titles about covid 19 should come in handy:

  • The coronavirus pandemic: changes in public spaces and hygiene
  • Development Control Regulations as the perfect medium to navigate and fight the pandemic
  • A revision of housing topologies after the pandemic
  • The drastic effects of the pandemic on the public transformation system
  • Workspace design changes after the pandemic
  • The effects of the pandemic on productivity and company culture
  • The concept of social distancing during the pandemic and its effectiveness
  • Sanitization practices in public spaces and residential buildings during the pandemic
  • Pedestrianization during the coronavirus pandemic
  • Public transportation and its impacts during the covid-19 pandemic

The covid-19 pandemic affected multiple sectors. However, the business industry is arguably the most impacted area beside the medical sector. So, a research title about business during the pandemic is an excellent study focus. Find a research title for the pandemic specifically focused on business:

  • The rate of business launches during the pandemic
  • How online businesses benefited from the pandemic
  • The pandemic and the business sector: the correlation
  • An overview of successful companies launched during the pandemic
  • The rate of business closures during the pandemic
  • How did businesses survive the pandemic
  • How Amazon took advantage of the pandemic to become a global giant
  • Lessons businesses can take away from the pandemic and its impacts
  • Business consumer retention and the pandemic
  • Crisis preparedness: what businesses learned from the coronavirus pandemic

A research title about the pandemic can be a great idea if you want to study a relevant topic. However, the topic relevance will depend on your study area. Find a great topic for research this pandemic from the list below:

  • A comprehensive reflection on the covid-19 pandemic
  • Leadership and management during the coronavirus pandemic
  • Economic factors and consequences of the covid-19 pandemic
  • Religion and the coronavirus pandemic: what is the overview?
  • The role of social media in spreading misinformation on the covid-19 pandemic
  • The role of social media in promoting the covid-19 pandemic
  • How streaming services and the internet helped maintain peoples’ sanity in the pandemic
  • Misinformation handling during the coronavirus pandemic
  • Job satisfaction levels during the pandemic in 2020 and 2021
  • A controversial argument on the benefits of the pandemic

A research title about the vaccine of covid 19 can be controversial. However, it makes an excellent topic for intellectual study. Find the best title for research about the pandemic related to vaccines

  • Mental health during the coronavirus pandemic and what to improve
  • Conspiracy theories regarding the covid-19 pandemic
  • Conservative views on the covid-19 vaccine in the Christian community
  • Public health: the issue of the coronavirus pandemic between 2020 to 2022
  • The changing health behaviors following the coronavirus pandemic situation
  • The impacts of the pandemic on early childhood development the pandemic
  • The pandemic generation: children born during the pandemic and their view of the world
  • A comparison of the influenza pandemic and the covid-19 pandemic
  • The effect of the pandemic on workers in the medical sector
  • Stress and coping mechanisms for nurses and doctors during the covid-19 sector

You can find a thesis statement about social media or a great research title about covid 19 vaccine and other topics online. However, not every research title about covid is relevant or great for academic research. You need the best social media research topics . Find a fantastic title of research about covid from the list below:

  • How social media helped mitigate the impacts of the pandemic
  • The rise of TikTok during the pandemic
  • Social media influence during the pandemic and the changes
  • The positive changes in the view of the coronavirus pandemic on social media tendencies
  • School closure during the coronavirus pandemic and the role of social media
  • The role of social media in promoting mental well-being during the covid-19 pandemic
  • Streaming services for the elderly during the 2020 coronavirus pandemic
  • How did the pandemic lead to increased adverse effects of social media
  • The American mental health population: the impacts of the covid-19 pandemic
  • Business negotiation strategies during the covid-19 pandemic

Third-world countries like the Philippines are among the most impacted nations by the pandemic. So, cover the research title example quantitative or qualitative, depending on your preferred data collection and analysis techniques. Some pandemic research title examples about the Philippines are:

  • The Philippines’ medical sector during the pandemic
  • Mitigation measures by the Philippines government during the pandemic
  • How the pandemic impacted the Philippines’ public sector
  • The Philippines’ education sector after the pandemic
  • Religion and the covid-19 pandemic: God’s existence in Covid-19 times
  • Philippines’ public policies after the pandemic
  • The Philippines food and beverage plan: the impacts of the pandemic
  • Covid-19 vaccination rates in the Philippines’
  • The psychological impacts of the pandemic on the Philippines society
  • A survey on conditions of low-income households during the pandemic

Title research about the pandemic will earn you excellent grades because of the topic’s relevance and multiple study opportunities. However, the quality of the subject matters significantly. Find an example of a research title about covid-19 pandemic below:

  • What has the world learned from the covid-19 pandemic?
  • How has the pandemic influenced the public’s view of health?
  • Why are there fewer medical employees after the pandemic?
  • How did nurses and doctors survive overworking during the pandemic?
  • Is there a link between the global recession and the pandemic?
  • How did the WHO’s response to the pandemic help mitigate its impacts?
  • What challenges did the WHO face while addressing the covid-19 pandemic?
  • Should people continue getting covid-19 vaccinations in 2022?
  • What is the correlation between the pandemic and the current state of global society?
  • What is social solidarity during the pandemic?

The covid-19 pandemic front liners were among the most impacted by the pandemic. So, it would make sense to focus your study on the frontliners. Find an incredible sample of a research title during the pandemic here:

  • Frontliners during the pandemic: how were they affected?
  • An overview of front liner’s view of the pandemic
  • A look into the covid-19 pandemic through the eyes of the pandemic
  • School closures during the pandemic: the impacts on frontline families
  • Effects of the pandemic on social relationships among frontliners
  • Frontliners: how their families suffered from the pandemic
  • Frontliner mental health and the pandemic: the correlation
  • Getting back into conventional practices in the medical sector after the pandemic
  • How frontline helped mitigate the risks of the pandemic
  • The age of online learning before and after the pandemic

You do not have to be in college or university to focus your research on the pandemic. Even high school students can write research topics about the pandemic. Here are some sample research topics for high school students:

  • Organizational risk management strategies after the pandemic
  • Social solidarity and the pandemic: the link
  • A link between the social response to plagues and the covid-19 pandemic
  • Social changes after the covid-19 pandemic
  • The covid-19 pandemic and the World History
  • Healthcare management and quality during the covid-19 pandemic
  • The covid-19 pandemic: The story of the 21 st -century pandemic
  • Child abuse and the pandemic: a correlation
  • The covid-19 pandemic: causes and solutions
  • The reality of the covid-19 pandemic in the elder community

Reach Out for More Interesting Topics About the Covid-19 Pandemic

You deserve the best research titles for high school, postgraduate, and undergraduate studies. Now that you know the best research title about covid-19 to choose from, reach out to us for help with COVID-19 assignments, research papers, essays, thesis for bachelor degree and even more topic suggestions in this area.

Scientists now agree that the COVID pandemic is arguably the most annoying thing to happen in the 21 st century, making it an ideal focus area. It will go down in history as the most challenging time for the economy, environment, and human health.

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Our Way Forward

Covid-19 and its effects on the supply chains in the philippines.

The Philippines has learned to be resilient in times of disasters (typhoons, massive floods, even earthquakes and volcano eruptions) but nothing prepared the country for the effects of this COVID-19 global pandemic.

thesis title about pandemic in the philippines

The Philippines has learned to be resilient in times of disasters (typhoons, massive floods, even earthquakes and volcano eruptions) but nothing prepared the country for the effects of this COVID-19 global pandemic. Most disasters involve disruptions, and in the case of local typhoons and massive floods, we have at least 2-5 days lead-time to prepare since most given a global weather tracking system that monitor weather disturbances in real-time. Forecasting has been very accurate with the infrastructure setup by PAGASA to provide possible trajectories of the typhoons giving disaster agencies (including local government units and the DSWD reliant on local producers and their supply chains for relief goods) sufficient time to prepare for a quick response via pre-positioning of relief items.

This pandemic caught everyone by surprise. The national government never took the threat seriously until infected cases began showing its dangerous “exponential” growth. Although we have disaster management agencies, there are geared toward a different type of disaster, not for a possible widespread health bound disaster. Because of COVID-19, the immediate reaction of the Philippine government was to implement an Enhanced Community Quarantine (ECQ) designed to limit mobility of people by restricting them through a “stay-at-home” directive and thus minimizing the “contact-rate” of people through social distancing.

These 2 directives were aimed at “flattening” the exponential curve till newly infected people daily decreased progressively to acceptable levels. These policy directives which are still in effect right now had several “unintended consequences.” Private and government agencies are forced to shut down except for a very few exceptions. This resulted in impairment of incomes for most employees. The shutdown also affected the manufacturing and the agricultural sector and its distribution systems. Most of our supplies today are current inventories of goods before the declaration of the ECQ. One could only speculate how long these inventories will last. Most local companies have designed a “lean” and JIT (just-in time) supply chain to minimize handling and carrying cost of inventories.

Although suppliers may still have inventories and “safety stocks” the local logistic companies are having a difficult time in moving the finished goods and raw materials because of strict protocols in the checkpoints all around Luzon and the other areas in the Philippines. We also have to contend with perishable goods like vegetables and seafood that have limited shelf life even with refrigeration.

This video clip discusses several simulation models (COVID-19 models, supply chain models, both using system dynamics and agent-based modelling). These models try to “approximate” reality but in the end, the basic insight and “take away” is that, all these systems are interlinked, and we should recognize these “tightly-coupled” interdependencies whenever we make policy decisions that could affect a major segment of society.

An example of this policy decision is the government policy which imposed the ECQ, the government will probably decide at some point to lift (partially?) the restrictions allowing the flow of goods and services, and for employees in critical sectors (health, manufacturing, agricultural and transport sectors) to go back to work. The objectives are the replenishment of critical inventories, and creating money flow in the system to provide relief to consumers wanting to buy basic goods. We all know that lifting the ECQ on the other hand, does come with a risk that the infection rates might go up again, putting the general population at peril. This may really qualify as a “vicious” problem.

What can we do today and in the future to “immunize” our local supply chains in cases of partial disruptions? Most supply chain experts recommend to reconfigure the current supply chains by increasing production and inventory capacities. Other recommendations also include repositioning some inventories in certain regions or facilities under quarantine. Any segment in the supply chain (plant, distributor, wholesaler, retailer, “last-mile” -customer) will be subjected to disruptions affecting the integrity of the whole chain. The critical issue is the ability of individual “segments” time-to-recover when a disruption occurs. Ensuring a “fast” time-to-recover will go a long way in ensuring the performance of the supply chain.

Two supply chain organizations namely the Supply Chain Management Association of the Philippines (SCMAP) and, Philippine Institute of Supply Management. It is recommended that they be part of any government policy effort in managing the effects of COVID-19 in the flow of goods and services.

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Pandemic in 2021: How the Philippines responded to COVID-19

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This is AI generated summarization, which may have errors. For context, always refer to the full article.

Pandemic in 2021: How the Philippines responded to COVID-19

The second year of the coronavirus pandemic in the Philippines was, in a number of ways, similar to the first. 

Lockdowns remained for the most part of the year as two waves of COVID-19 ravaged the country. While several millions of Filipinos were able to get vaccinated throughout the year, experts flagged the vaccination campaign’s sluggish pace. 

In the middle of it all, lawmakers investigated alleged anomalies involving billions of pesos in the Duterte administration’s pandemic contracts. These were probed in marathon Senate hearings that went on for months on end.

It was not until the latter part of the year until new daily coronavirus cases were reported only in the hundreds, restrictions were eased, and mandatory face shield policies were dropped – finally giving some kind of sense that, perhaps, the Philippines was getting out of the woods. (READ: Does wearing a face shield protect against COVID-19? )

While the holidays may be looking up for many Filipinos, the threat of a new variant of concern looms, and experts say that there is still a need to practice “risk-based” decisions when choosing activities and engagements despite the relatively low cases.

Here’s a list of stories reviewing what happened during the COVID-19 pandemic in 2021.

As the Philippines’ vaccination campaign began in March, one of the government’s main goals was to get as many Filipinos vaccinated. We monitored the arrival and rollout of the vaccines in these trackers, as well as where COVID-19 cases were most prevalent. We also chronicle the significant events in the pandemic in a running timeline.

  • TRACKER: The Philippines’ COVID-19 vaccine distribution
  • TRACKER: Status of vaccination in Metro Manila
  • TRACKER: The Philippines’ plans for COVID-19 boosters, third doses
  • MAPS: COVID-19 in the Philippines
  • TIMELINE: The novel coronavirus pandemic

Things we learned about COVID-19

These stories and explainers explore new information about the virus as they came.

Why did we need to pay attention to the virus when it mutated?

  • EXPLAINER: Ano ang pagkakaiba ng mutation, variant, at strain?
  • What we know so far about new COVID-19 variant found in PH
  • FAST FACTS: The coronavirus Lambda variant
  • What the surge fueled by the Delta variant taught us
  • Beyond the Stories: Ano’ng dapat malaman tungkol sa Omicron variant?

How did the public and health experts tackle the ivermectin debate, when it was floated as a possible alternative treatment to COVID-19?

  • COVID-19: The Philippines’ race for a cure
  • Are we missing out on alternative treatments for COVID-19?
  • EXPLAINER: Myths and facts about ivermectin
  • In fierce Ivermectin debate, doctors remind: ‘Do no harm’

How did we learn to understand the dynamics of new variants and vaccines, and was herd immunity the only goal? 

  • Can COVID-19 vaccines in the Philippines beat Delta?
  • 5 myths about COVID-19 vaccines debunked
  • EXPLAINER: COVID-19 patients at PGH mostly unvaccinated
  • In COVID-19 battle, herd immunity isn’t the only goal the PH needs to reach
  • COVID-19 holiday plans: What would experts do?

Plight of health workers

Two deadly surges took an unprecedented toll on health workers employed in a healthcare system which had problems spilling over from before the pandemic began. 

The release to workers of their benefits mandated by law was also a rocky discussion as the Department of Health’s spending was put under scrutiny.

  • Overworked, underpaid health workers are walking away as Delta ravages PH
  • Are the doctors alright? Frontliners in remote areas feel Manila’s neglect
  • Doctors plead with gov’t: ‘We can’t fight this virus with antiquated methods’
  • How Philippine contact tracers lost track of the virus
  • Philippine contact tracers: The forgotten frontliners
  • Underpaid health workers walk out, call for Duque resignation at mass protests
  • What you should know about COVID-19 hazard pay, special risk allowance

The Duterte COVID-19 response

The pandemic response of President Rodrigo Duterte was not without criticism on matters of public health policy, public funds management, and governance.

  • PH scores lowest among ASEAN countries in gov’t pandemic response – survey
  • ‘NCR Plus’ bubble vs COVID-19 pointless with lax LGU borders
  • PH may be among last in Southeast Asia to reach herd immunity
  • What you need to know about Duterte’s COVID-19 loans
  • Many unknowns in Duterte’s COVID-19 jab as PH fights vaccine hesitancy
  • EXPLAINER: What went wrong with Duterte’s pandemic response?
  • EXPLAINER: The Philippines’ fight vs vaccine hesitancy
  • Hesitancy not a major driver for PH’s low vaccination rates
  • President Duterte, you can still get COVID-19 under control
  • Duterte’s longest SONA leaves Filipinos hanging on pandemic recovery
  • Often-ignored COA fuels pandemic outrage vs Duterte gov’t
  • DOH’s poor use of P67 billion COVID-19 funds led to ‘missed opportunities’ – auditors
  • DOH failed to spend P2.07 billion after parking it in PS-DBM in 2020
  • How the Duterte gov’t shut out local PPE producers during a pandemic
  • PH’s last-minute quarantine changes force travelers to spend thousands

Jobs and economy

The health crisis coincided with an economic crisis that was experienced locally and globally. Here’s what it was like for Filipinos in 2021.

  • Philippines offers nurses in exchange for vaccines from Britain, Germany
  • Labor secretary Bello aims to deploy more nurses, healthcare staff overseas
  • With fresh lockdowns, 3.88 million Filipinos jobless in August 2021
  • Philippines lowers 2021 economic growth target over fresh lockdowns, Delta
  • Delta variant puts Philippine economy among most vulnerable in Asia
  • COVID-19 pandemic to cost PH P41.4 trillion over next 4 decades – NEDA
  • Philippine GDP growth slows but beats forecasts at 7.1% in Q3 2021
  • Philippines raises deployment cap of healthcare workers to 7,000

Despair, ‘bayanihan’ amid crisis

The Philippines recorded millions of positive cases and tens of thousands dead – with more added to the health department’s daily tally. These are stories of people behind the numbers, as well as how Filipinos in the country and abroad banded together in times of crisis. 

  • Philippines’ COVID-19 surge tears through families
  • Facebook as lifeline: Desperate Filipinos turn to strangers for help
  • Community pantries: Is it a ‘revolution’ when Filipinos just want to give?
  • ‘Take care of your neighbor’: Communities battle doubts about COVID-19 vaccines
  • Healthcare professionals turn to TikTok to fact-check, debunk health myths
  • Through virus surge and separation, Filipinos in Indonesia closer than ever
  • ‘Last year was nothing compared to now’: Learning from India’s second wave

The Pharmally controversy

As Filipinos struggled to survive, lawmakers investigated allegations of misspending in the government’s pandemic funds. These anomalies, which sprung from irregularities found by the Commission on Audit, had ties to the President himself.

  • Biggest pandemic supplier has links to ex-Duterte adviser Michael Yang
  • Pharmally had P625,000 capital before bagging P8 billion in COVID-19 contracts
  • Pharmally bags P2 billion more deals in 2021
  • PANOORIN: Bakit kahina-hinala ang pagkakuha ng Pharmally ng mga kontrata sa pandemya?
  • ‘We swindled gov’t’: Pharmally changed expiry date of medical-grade face shields
  • 2 days after bombshell testimony, Pharmally exec can’t be contacted by Senate panel
  • Furious Duterte seeks to block Cabinet, witnesses from appearing in Senate probe
  • Rigged favors for Pharmally, substandard supplies are graft – senators
  • Pharmally’s Krizle Mago recants Senate testimony: ‘It was a pressured response’
  • ‘Sue us instead’: Jailed Pharmally execs still won’t budge over missing documents

– Rappler.com

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Home > Theses/Dissertations > 230

Theses and Dissertations

STRATEGIES AND CHALLENGES OF SMALL-SCALE ONLINE FOOD BUSINESSES IN THE PHILIPPINES: AN IN-DEPTH STUDY OF SELECTED INITIATIVES WITHIN THE CONTEXT OF COVID-19 CRISIS

Anna Marie Sales Phillipneris , Saint John's University, Jamaica New York

Date of Award

Document type, degree name.

Master of Business Administration

First Advisor

William D. Reisel, Ph.D.

This research examines the Philippine context, particularly Metro Manila and surrounding regions, during the pandemic which made it possible for budding entrepreneurs to come up with new initiatives like online food business operations by which they could earn an income despite difficult circumstances, and for consumers to purchase meals more conveniently. A survey, divided into six sections, was prepared and sent out to several small-scale food business establishments that operate in the Philippines. Majority of the respondents were female (84%), aged 26 years old and above (96%), with an average total income less than Php 100,000 (US $ 2,000) (68%), and are based in the National Capital Region (NCR) Metro, in the cities Manila and Quezon City. Based on the anchor points used in this research, the analysis is divided into three main sections: 1) Needs: needs of consumers and entrepreneurs, 2) Interventions: interventions of consumers and entrepreneurs aimed at fulfilling these needs, and 3) Evaluation of the effects of these interventions. This study looked at some of these small e-commerce food businesses in the Philippine setting, in order to understand their operational structures, strategies and challenges, and analyzed them with the usage of time-tested analytical models. It was done so not merely with the providing appropriate recommendations for their future operation and growth-oriented undertakings, but also to add to the evolving literature on the impacts and repercussions of COVID-19 crisis that has rocked the world.

Recommended Citation

Phillipneris, Anna Marie Sales, "STRATEGIES AND CHALLENGES OF SMALL-SCALE ONLINE FOOD BUSINESSES IN THE PHILIPPINES: AN IN-DEPTH STUDY OF SELECTED INITIATIVES WITHIN THE CONTEXT OF COVID-19 CRISIS" (2021). Theses and Dissertations . 230. https://scholar.stjohns.edu/theses_dissertations/230

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COMMENTS

  1. Psychological impact of COVID-19 pandemic in the Philippines

    Students report moderate-to-severe psychological impact of the COVID-19 pandemic. Timely and adequate health information has protective psychological effect. Health care workers are less likely to be psychologically affected. Home quarantine is associated with depression, anxiety and stress symptoms.

  2. Understanding COVID-19 dynamics and the effects of ...

    COVID-19 dynamics in the Philippines are driven by age, contact structure, mobility, and MHS adherence. Continued compliance with low-cost MHS should help the Philippines control the epidemic until vaccines are widely distributed, but disease resurgence may be occurring due to a combination of low population immunity and detection rates and new variants of concern.

  3. Frontiers

    China was one of the more severely affected countries in Asia in the early stage of pandemic while the Philippines is still experiencing an upward trend in the COVID-19 cases . The gross national income (GNI) per capita of the Philippines and China are USD 3,830 and 9,460, respectively, were classified with lower (LMIC) and upper-middle-income ...

  4. Assessing the effect of the COVID-19 pandemic, shift to online ...

    Introduction The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and ...

  5. COVID-19: an ongoing public health crisis in the Philippines

    The Philippines is contending with one of the worst COVID-19 outbreaks in southeast Asia. As of April 18, 2021, there were 926 052 cases of SARS-CoV-2 infection and 15 810 deaths recorded. WHO has warned that the country's health-care system risks being overwhelmed. From March 29, 2021, a new round of lockdown was implemented in Manila and four ...

  6. Teaching and Learning Continuity Amid and Beyond the Pandemic

    The study explored the challenges and issues in teaching and learning continuity of public higher education in the Philippines as a result of the COVID-19 pandemic. The study employed the exploratory mixed-method triangulation design and analyzed the data gathered from 3, 989 respondents composed of students and faculty members. It was found out that during school lockdowns, the teachers made ...

  7. PDF Health Systems Impact of COVID-19 in the Philippines

    COVID-19 in the Philippines Abstract Lockdowns and policy actions to curtail the transmission of COVID-19 have widespread health system, economic, and societal impacts. Health systems of low-to-middle-income countries may have fewer buffering resources and capacity against shocks from a pandemic. This paper presents

  8. [PDF] Transition to Post-Pandemic Education in the Philippines

    This literature review is focused on the rallying cry in the transition to post-pandemic education in the Philippines. The country experienced a series of lockdowns that catapulted prolonged closures of school premises for more than eighteen months and was considered the last country to reopen. As steps to conduct and resume limited in-person classes, selected schools have led the priming for ...

  9. Psychological impact of COVID-19 pandemic in the Philippines

    The 2019 coronavirus disease (COVID-19) pandemic poses a threat to societies' mental health. This study examined the prevalence of psychiatric symptoms and identified the factors contributing to psychological impact in the Philippines. A total of 1879 completed online surveys were gathered from March 28-April 12, 2020.

  10. Work Attitudes Of Filipino Employees During The COVID-19 Crisis

    First, it documents work attitudes during crisis situations (like the COVID-19 pandemic) in relation to a broad range of work-related issues such as how work is done (e.g., shifts to telecommuting, increased reliance on technology), job outcomes (e.g., feelings of stress), and employee coping behaviors.

  11. PDF Impacts of COVID-19 on Communities in the Philippines

    The World Bank, in collaboration with the Department of Social Welfare and Development (DSWD), conducted two rounds of a high frequency social monitoring survey that aimed to assess the impact of COVID-19 pandemic on the poorest and most vulnerable rural communities. This survey aimed to also determine the level of understanding and source of ...

  12. The Philippine Higher Education Sector in the Time of COVID-19

    This paper reports the policy-responses of different Philippine higher education institutions (HEIs) to the novel coronavirus, COVD-19 pandemic. It compares these responses with those made by HEIs in Indonesia, Thailand, and Vietnam. Publicly available data and news reports were used to gauge the general public's reaction to these policies and how the Philippines' responses fare with its ...

  13. Early response to COVID-19 in the Philippines

    Abstract. Low- and middle-income countries (LMICs) with weak health systems are especially vulnerable during the COVID-19 pandemic. In this paper, we describe the challenges and early response of the Philippine Government, focusing on travel restrictions, community interventions, risk communication and testing, from 30 January 2020 when the ...

  14. The Philippine

    Introduction The SARS-CoV-2, virus that caused the COVID-19 global pandemic, possesses a neuroinvasive potential. Patients with COVID-19 infection present with neurological signs and symptoms aside from the usual respiratory affectation. Moreover, COVID-19 is associated with several neurological diseases and complications, which may eventually affect clinical outcomes. Objectives The ...

  15. COVID-19 pandemic and the Philippine real estate property cycle

    The Philippines has been one of the countries greatly affected by the COVID-19 pandemic. The country is regarded to be under the world's longest lockdown with an upsurge of cases, and it has also entered into an official recession with record-breaking economic contraction and high unemployment rates, fueling economic uncertainties.

  16. 100+ Exiciting Research Titles About COVID-19 Examples

    Get a research title about covid 19 quantitative for 2020 from the list below: An analysis of the start of the covid-19 pandemic. An overview of the source of the coronavirus. Breaking down the myths about the coronavirus, its inception, and its impacts. The link between the spike in opioid addiction and the pandemic.

  17. Strategies and Challenges of Small-scale Online Food Businesses in The

    BUSINESSES IN THE PHILIPPINES: AN IN-DEPTH STUDY OF SELECTED INITIATIVES WITHIN THE CONTEXT OF COVID-19 CRISIS A thesis submitted in partial fulfillment of the requirements for the degree of MASTER OF BUSINESS ADMINISTRATION to the faculty of the DEPARTMENT OF MANAGEMENT of THE PETER J. TOBIN COLLEGE OF BUSINESS at ST. JOHN'S UNIVERSITY New York by

  18. The COVID-19 Impact on Philippine Business: Key Findings from the

    This report draws on a survey of Philippine businesses to provide initial facts and ideas to help the government develop evidence-based policies to support enterprises hurt by the coronavirus disease (COVID-19) pandemic.

  19. PDF Implementing Crisis and Risk Communication in a Pandemic: Insights from

    Local government units (LGUs) are at the forefront of the Philippine government's COVID-19 pandemic response. One of their most functions is crisis and risk important communication to ease public fear, mitigate the damage caused by the pandemic , and promot e the adoption of health and safety protocols to control the spread of COVID- 19.

  20. COVID-19 and its Effects on the Supply Chains in the Philippines

    Because of COVID-19, the immediate reaction of the Philippine government was to implement an Enhanced Community Quarantine (ECQ) designed to limit mobility of people by restricting them through a "stay-at-home" directive and thus minimizing the "contact-rate" of people through social distancing. These 2 directives were aimed at ...

  21. Pandemic in 2021: How the Philippines responded to COVID-19

    Delta variant puts Philippine economy among most vulnerable in Asia. COVID-19 pandemic to cost PH P41.4 trillion over next 4 decades - NEDA. Philippine GDP growth slows but beats forecasts at 7. ...

  22. [PDF] Food consumption habits of consumers in the Philippines: Changes

    Results showed that the most of the respondent 's diet has wellness, social and psychological influence, and food establishments can make use of the results to strategized to combat the COVID-19 pandemic by improving product quality on the basis of consumer needs and demands. A quantitative descriptive strategy was applied to identify food patterns for Filipino consumers before, during and ...

  23. Strategies and Challenges of Small-scale Online Food Businesses in The

    This research examines the Philippine context, particularly Metro Manila and surrounding regions, during the pandemic which made it possible for budding entrepreneurs to come up with new initiatives like online food business operations by which they could earn an income despite difficult circumstances, and for consumers to purchase meals more conveniently. A survey, divided into six sections ...