LAUSR

To the Editor, With great enthusiasm, I find the recent article published in this journal “impeccable” when the authors rightfully highlighted that the “spread of mistrust” worldwide has impacted negatively primary care practice and public health in general during this COVID-19 pandemic. They based this conclusion claiming that even the most advanced countries have had a difficult time grappling with the disease due to nonadherence to the International Health Regulations (IHR) and world leaders undermining the science of managing COVID-19. This undermining from world leaders led to increased deaths due to a lack of testing, contact tracing, vaccine hesitancy, and adherence to public health recommendations.1 With this, I would like to enflesh and validate this claim by exploring what had happened in the public health system of the Philippines. In this way, the country can learn more and be more prepared for a future health crisis. As of this writing, the World Health Organization (WHO) reports that there were already 3,668,268 cumulative COVID-19 cases and 57,066 deaths in the country.2 As of 7 March 2022, a total of 63.1 million are fully vaccinated and that is only 57.6% of the country’s estimated total population.3 What do these data imply? The country has not achieved yet the longed herd immunity and one of the significant reasons for this is due to the “mistrust” behaviour of the different institutions involved in the public health system. First, there has been a huge demand for COVID-19 self-testing amid a rise in cases from the start of January. The government does not have full confidence in these selftesting kits and has yet to approve a self-administered rapid test. Manufacturers in the country have only recently filed for the registration of self-administered rapid test kits, and 11 are currently undergoing review. Reverse transcriptionpolymerase chain reaction, or RT-PCR, tests remain the accepted testing kit in the country4 but even an average-earning Filipino cannot afford it because of its high cost. Second, another “mistrust” attitude is manifested in terms of contact tracing. A year into the COVID-19 pandemic, contact tracing in the Philippines is “deteriorating” in various regions. For each COVID-19 case detected, the close contacts who were traced decreased from 7 to 3 within a month.5 This means that some locals do not put their factual information in the mandatory health declaration forms every time they are asked to after going to public establishments. Third, the unending problem of vaccine hesitancy also seems to be unending. There are still Filipinos who do not trust the essentiality and even the efficacy of the vaccines. There are those in the far-flung areas or remote provinces who think that these vaccines are unsafe and even deadly or the life span of those who are vaccinated is shortened and they only have 2–3 years to live. Vaccines were also viewed as unnecessary to those in older age groups who are not allowed to go out while there are those in the younger groups who felt that others needed the vaccine more than them.6 Lastly, the lack of trust also emanates from the relationship between the government and the public. Some Filipinos are already traumatized by the corrupt practices of some government officials. The country borrowed a record P2.74 trillion in 2020 to fight the health and socioeconomic crises inflicted by the pandemic. Senator Panfilo Lacson had exposed an attempt by some people to pocket $350 million or P16.8 billion in public funds in the form of kickbacks during a Senate hearing on the government’s mass immunization programme.7 On the other hand, some government officials also mistrusted those locals who simply wanted to help their needy fellows by organizing community food pantries during the pandemic. The pantry’s principle was from a popular slogan, “from each according to his ability, to each according to his needs.” A week after the initiative began, over 300 similar donation-driven efforts have popped up across the country. Other variations of the programme were also organized such as community libraries, pharmacies, and even essential needs of pets. However, these initiatives were seen negatively by the government by red-tagging, profiling, or closely monitoring every move of its organizers. Red-tagging is the act of labelling, branding, naming, and accusing individuals and/or organizations of being left-leaning, subversives, communists,