I. Construct the family genogram.
II. Discuss the index patient’s family according to:
A. Stage in the Family Life Cycle
In this case the family’s stage of life cycle will be in the category of, “families with adolescents” with
regards to the children’s age, Jake 15 years old and Joy 12 years old.
FAMILY LIFE CYCLE MAJOR TASK 2nd order changes in Family
STAGE Status required to proceed
developmentally
Unattached young adults Disconnect& reconnect Differentiation of self in
with one’s family while relation to family of origin.
being own person Development of intimate peer
relationships
Newly married couple Adjustment and Formation of partner system.
adaptation Realignment with family &
friends to include partner
Families with young children Accepting new members Adjusting system to make
into the system space for children. Joining in
child rearing & realignment
with family
Families with adolescents Flexing boundaries for Shifting of relationships for
children’s independence adolescent to move on.
& grandparent’s frailties Refocus on midlife career
issues. Shift toward caring
for elders
Launching of adult children Accepting exits from Renegotiation of partnership
&entries to family system as dyad. Realignment of
relationships. Dealing with
disability & death
Families in later years Accepting shifting Maintaining functioning
generational roles while facing senescence.
Support for more central role
of middle generation. Dealing
with loss
B. Stage in Family Illness Trajectory
In considering stage of illness trajectory, the most appropriate stage in this family’s case is STAGE 2.
Since the patient is diagnosed and positive in confirmatory with COVID19.
STAGE 1: Onset of illness to diagnosis
-Stage prior to contact with medical care providers
-Nature of onset may play an important role on impact of illness on family (i.e.,
rapid, clear, gradual)
-Medical beliefs and previous experiences influence meaning of illness
STAGE 2: Impact phase: Reaction to Diagnosis
-Presence of emotional upheaval: denial, disbelief, anxiety, anger, depression
acceptance
STAGE 3: Major therapeutic efforts
-The patient makes use of all the available therapeutic options appropriate to his/her
illness
-Affected by the family’s emotional and psychological preparedness, financial status,
cultural characteristics
STAGE 4: Recovery phase: Early adjustment to outcome
-return to full health
-partial recovery
-permanent disability
III. PFC Paradigm
COMPONENTS PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-ORIENTED
DATA Biomedical History: Family Genogram: -Prevalence and
- The patient was admitted -Existing family structure, increasing incidence of
due to DYSPNEA. medical condition of the COVID19 case
A week prior to admission, members - Quarantine facilities and
manifested with flu-like APGAR: - Medical centers for
symptoms associated with Family Map: The patient to COVID19 cases
fever, dry cough, body his family is functional from
malaise. each member
- (+) COVID19 test SCREEM: -
Psychosocial Issues:
-Social discrimination due to
COVID19 stigma.
ANALYSIS/ Biomedical History: -Family is in the parenting - Social discrimination and
CONCLUSION/ - Patient with postive stage with adolescents. stigma
ASSUMPTION COVID19 test, presenting -Patient is the Primary - Available facilities and
with dyspnea, dry cough, provider and the head of hospitals that handles
fever and body weakness. the family. COVID19 cases
Psychosocial Issues: -Discrimination
- Fear of discrimination
DIAGNOSIS Biomedical History: Medical conditions of the -COVID19 has a severe
- Severe Acute Respiratory members: worldwide prevalence
Syndrome -Coronavirus 2 -Mother-in-law is a - Stigma as public problem
(COVID19) hypertensive and threat
Psychosocial Issues: -Wife has Bronchial asthma
- Anxiety due to social -Daughter Joy has Allergic
stigma rhinitis
-Anxiety as well because of
discrimination.
MANAGEMEN - Since the disease does not - Medical quarantine and - Linkage with the medical
T/ have any available monitoring of the members and therapy groups
INTERVENTIO medication/ vaccine, for 14 days for any signs and - Privacy and
NS management of symptoms symptoms and prevention confidentiality of
are focused in the of further infection to patients,PUIs, and PUMs
treatment and stabilize nearby public.
oxygen need. - Support and strengthen
- Individual patient their physical and emotional
counselling must be well-being by providing
conducted supplies and counselling
with precautionary
measures (social distancing,
PPEs especially during
interaction.
IV.
The local Inter-Agency Task Force (IATF) was organized last January 2020 to deal with the growing
viral outbreak which started in Wuhan, China. The government made a resolution to manage the
spreading of the new virus, which was known at the time as 2019 novel coronavirus (2019-nCoV) and
eventually renamed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that
causes coronavirus disease 2019 (COVID-19). President Duterte called the IATF amidst the rising cases
of COVID-19 in the Philippines on March 9, 2020,.
On March 25, 2020, the IATF revealed a National Action Plan (NAP) to delay the spreading of COVID-
19. The NAP was created to effectively and efficiently implement and decentralize the system of
managing the COVID-19 situation. In addition, the IATF created the COVID-19 National Task Force
headed by Department of National Defense Secretary Delfin Lorenzana, which handles the operational
command. Moreover, the IATF became the "policy-making body of operations" while the National
Incident Command administers the daily concerns and operations.
The IATF appointed Metropolitan Manila Development Authority (MMDA) chair Danilo
Lim and Bangsamoro Chief Minister Murad Ebrahim to lead the regional inter-agency task groups in
Metro Manila and Bangsamoro, respectively in April 2020. The Office of Civil Defense was tasked to
lead the regional task forces in other regions.
RESOLUTION NO. 23 Series of 2020 April 13, 2020
the IATF approves the following:
A. All medical and allied healthcare professionals with perfected and signed overseas employment
contracts as of March 8, 2020 shall be allowed for deployment abroad as an exception to the application
of the Philippine Overseas Employment Administration (POEA) Governing Board Resolution No. 09,
series of 2020, upon the execution of a Declaration signifying their knowledge and understanding of the
risks involved as advised by the Philippine Government. Subject to the evaluation of the Department of
Budget and Management (DBM), the Department of Health (DOH) is directed to facilitate the emergency
hiring of additional healthcare workers to assist in the local healthcare system;
B. The following recommendations of the National Task Force (NTF) COVID-19 as revised and
presented are hereby approved;
1. Designating the Chairperson of the Metro Manila Development Authority and the Chief
Minister of the Bangsamoro Autonomous Region in Muslim Mindanao as chair of the Regional Task
Force in their respective regions as established pursuant to IATF Resolution No. 16, series of 2020. For
all other regions, the Office of Civil Defense through its regional offices shall act as chair; and
2. Establishing a Sub-Task Group (STG) for the Repatriation of Overseas Filipino Workers
(OFWs) under the NTF Task Group on Response Operations to facilitate and implement the mandatory
fourteen-day facility quarantine requirement of all repatriated OFWs, whether sea-based or land-based.
For this purpose, a one-stop-shop shall be established and maintained at the port of entry. The STG shall
be composed of the Department of Transportation (DOTr) as chair the Overseas Workers Welfare
Administration (OWWA) as co-chair, and the DOLE, DOH, the Department of Foreign Affairs (DFA),
the Department of the Interior and Local Government (DILG), the Philippine National Police, the
Department of Tourism (DOT), , the Philippine Coast Guard (PCG), the Bureau of Quarantine (BOQ),
and such other agencies as may be determined by the NTF, as members. The Department of Health is
hereby directed to update its guidelines for this purpose.
C. Pursuant to the updated guidelines of DOH on the classification of individuals for the surveillance and
management of the COVID-19 health event, all agencies and Local Government Units (LGUs) are
directed to apply said classification in all subsequent issuances related to COVID-19, as well as to update
existing issuances in accordance therewith;
D. The evaluation tool for the assessment of the demographic vulnerabilities of communities to the
COVID-19 health event, as presented by the Commission on Population (POPCOM), is hereby adopted.
LGUs, including the BARMM, are enjoined to implement such tool to assess communities in their
respective jurisdictions, subject to guidelines as may be jointly issued by the DOH, DILG, National
Economic and Development Authority (NEDA), and the POPCOM; E. The Philippine Embassy in Kuala
Lumpur is directed to coordinate with the Sabah National Security Council (SNSC) for the requested
return of stranded thirty-eight (38) Malaysian nationals to Sandakan. In the meantime, the DFA is
directed to submit
The international collaboration of the intergovernmental agencies (WHO) in the on-going
COVID-19 global crisis.
WHO supports countries to mitigate COVID-19 spread in the South-East Asia Region. As the COVID-19
pandemic spreads, WHO is supporting countries in their containment and mitigation efforts such as by
providing technical guidance, laboratory capacity strengthening for testing, equipment for hospitals and
healthcare workers.
On December 31, 2020, Wuhan Municipal Health Commission, China, reported a cluster of cases
of pneumonia in Wuhan, Hubei Province. A novel coronavirus was eventually identified. Then on 1
January 2020, WHO had set up the IMST (Incident Management Support Team) across the three levels of
the organization: headquarters, regional headquarters and country level, putting the organization on an
emergency footing for dealing with the outbreak. On January 10, 2020, WHO issued a comprehensive
package of technical guidance online with advice to all countries on how to detect, test and manage
potential cases, based on what was known about the virus at the time. This guidance was shared with
WHO's regional emergency directors to share with WHO representatives in countries. Based on
experience with SARS and MERS and known modes of transmission of respiratory viruses, infection and
prevention control guidance were published to protect health workers recommending droplet and contact
precautions when caring for patients, and airborne precautions for aerosol generating procedures
conducted by health workers. On January 23, 2020, the WHO Director- General convened an Emergency
Committee (EC) under the International Health Regulations (IHR 2005) to assess whether the outbreak
constituted a public health emergency of international concern. The independent members from around
the world could not reach a consensus based on the evidence available at the time. Then on January 30,
2020, the WHO Director-General reconvened the Emergency Committee (EC). This was earlier than the
10-day period and only two days after the first reports of limited human-to-human transmission were
reported outside China. This time, the EC reached consensus and advised the Director-General that the
outbreak constituted a Public Health Emergency of International Concern (PHEIC). The Director-General
accepted the recommendation and declared the novel coronavirus outbreak (2019-nCoV) a PHEIC. This
is the 6th time WHO has declared a PHEIC since the International Health Regulations (IHR) came into
force in 2005.
On February 3, 2020, WHO releases the international community's Strategic Preparedness and Response
Plan to help protect states with weaker health systems. Then, 11-12 February 2020 WHO convened
a Research and Innovation Forum on COVID-19, attended by more than 400 experts and funders from
around the world, which included presentations by George Gao, Director General of China CDC, and
Zunyou Wu, China CDC's chief epidemiologist. While on 16-24 February 2020, the WHO-China Joint
mission, which included experts from Canada, Germany, Japan, Nigeria, Republic of Korea, Russia,
Singapore and the US (CDC, NIH) spent time in Beijing and also travelled to Wuhan and two other cities.
On 7 March, the first local transmission of COVID-19 was confirmed. WHO is working closely with the
Department of Health in responding to the COVID-19 [Link] March 18, 2020, WHO and partners
launch the Solidarity Trial, an international clinical trial that aims to generate robust data from around the
world to find the most effective treatments for COVID-19.
V. The coronavirus disease (COVID-19) is an infectious disease caused by a new strain of coronavirus.
This new virus and disease were unknown before the outbreak began in Wuhan, China, in December
2019. This outbreak causes the world to pause, and it is never easy especially to people who are not able
to have jobs and fail to earn money, to the people who are at high risk from contracting the disease, and to
those who lose their loved ones due to the outbreak. As a medical student, since I will not be able to be of
help in a clinical setting, I will do my best to follow and influence others in doing precautionary measures
like educating others through social media on how to prevent the spread of the virus. Being socially
accountable is very important; love of mankind and to environmental health.
1. Planning and coordination is very important in this time of crisis. Especially in an emergency
situation
2. Situation monitoring and assessment is to assess if the risk of a pandemic is increasing, it will be
important to monitor the infectious agent, its capacity to cause disease in humans, and the patterns of
disease spread in communities. It is important to know data on this disease.
3. Help reduce the spread of disease let others know that it will depend significantly upon increasing the
“social distance” between people. Measures such as individual/household level measures, societal-level
measures.
Individual/household level measures include risk communication, individual hygiene and personal
protection, and home care of the ill and quarantine of contacts. Societal-level measures are applied to
societies or communities rather than individuals or families. These measures require a behavioral change
in the population, multiple sector involvement, and mobilization of resources, strong communication, and
media support.
4. The health systems will need to provide health-care services while attending to the invasion of
patients with COVID19.. Planning for surge capacity in health-care facilities will help determine the
extent to which the existing health system can expand to manage the additional patient load. Health-care
facilities will need to maintain adequate triage and infection control measures to protect health-care
workers, patients, and visitors.
5. Communications before and during a pandemic is to provide and exchange relevant information with
the public, partners, and stakeholders to allow them to make well informed decisions and take appropriate
actions to protect health and safety and response and is a fundamental part of effective risk management.
Communications should be based on the five principles outlined in WHO's outbreak communications
planning guid: planning; trust; transparency; announcing early; and listening. Given the complex risks
and perceptions associated with an influenza pandemic, communication strategies that simply disseminate
outbreak information and recommendations will be insufficient. The scope and complexity of the task
demands frequent, transparent, and proactive communication and information exchange with the public,
partners, and other stakeholders about decision making, health recommendations, and related information.
