1. REFERENCES:

a. Executive Order No. 168, œCreating the Inter-Agency Task Force for the Management of Emerging Infectious Diseases in the Philippines  dated May 26, 2014;

b. National Crisis Management Core Manual dated October 2012; and,

c. PNP Memorandum Circular No. 2013-021 re Critical Incident Management Operational Procedures (CIMOP) dated December 13, 2013.

2. RATIONALE:

This PNP Memorandum Circular (PNP MC) prescribes the policies and general procedures in handling emerging infectious diseases that will guide PNP units from the national down to the municipal level. It establishes the authority to exercise their functions and defines their specific roles.

3. SITUATION:

The emergence of the Severe Acute Respiratory Syndrome (SARS), Avian Influenza, the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), ebola infections have been acknowledged by the global community to cause potential health emergencies of international concern.

There are also recurrent threats of other diseases, such as Meningococcemia, Leptospirosis, Antimicrobial Resistance of Tuberculosis, and other bacterial, viral and parasitic diseases that contribute to the high incidence of infectious diseases m the country.

The spread of these diseases persists due to increased globalization and mobility of travelers and products, and thus, threatens the lives and safety of Filipinos both here and abroad, as well as the Philippine economy in general.

Although, presently, the country has no reported case of some of the diseases such as MERS-CoV and Ebola, concerned agencies led by Department of Health (DOH) are continuously monitoring the arrival of foreigners and OFWs coming from the Middle East and Western Africa considering that regions have high threat of EID.

The above-mentioned scenarios alerted the country and spell out the need to come up with a more strategic plan of action. Concerted efforts and preparedness of concerned government agencies are indeed essential to respond against such diseases.

Thus, the PNP deems it necessary to come-up with this MC entitled Emerging Infectious Diseases in support of the Task Force on Emerging Infectious Diseases under E.O. 168. The PNP must ensure that security preparations and mobilizations during worst case scenarios must be strictly observed and must conform with the government agencies efforts.

4. PURPOSE:

The PNP, being a tasked agency, shall assist the Task Force on Emerging Infectious Diseases in enforcing the quarantine of specific areas, facilitating the transport of EID patients, and for such other purposes for the effective implementation of E.O. 168.

5. DEFINITION OF TERMS:

a. Contact Tracing - identification and diagnosis of persons who may have come into contact with an infected person. It plays an important role in containing outbreaks of infectious diseases. The main purposes of contact tracing are to: (1) confirm diagnosis, (2) determine the extent of secondary transmission, and (3) identify appropriate control measures for the specific diseases.

b. Contacts - persons who have had exposure (lived with, worked with, or cared for) exposure to a confirmed case.

c. Ebola Virus Diseases (EVD) - is a viral hemorrhagic fever and one of the most virulent viral diseases known to humans. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

d. Emerging diseases - means infections that have newly appeared in the population, or have existed but are rapidly increasing in incidence or geographic range.

e. Endemic - means the constant presence of a disease or infectious agent within a given geographic area or population group; may also refer to the usual prevalence of a given disease within such area or group.

f. Epidemic - means the occurrence of an illness or health-related event in excess of the usual.

g. Executive Order No. 168 - œCreating the Inter-Agency Task Force for the Management of Emerging Infectious Diseases in the Philippines  dated May 30, 2014.

h. First Responder - any person or unit who arrives first at the place of incident and endeavour to render assistance to the victim and to protect and secure the incident scene.

i. Isolation - used to separate all ill persons suspected to have an EID infections from those who are healthy.

j. Infectious - means the capability of transmitting a disease.

k. Level 1 or Pre-Outbreak Incident - year round activities in preparation for the EID or during peace time. A progressive scenario during this stage may occur: a new bacteria/virus subtype in animals, no poultry outbreaks, no human cases in the Philippines or EID is still outside the country.

l. Level 2 - Upon the declaration of DOH that there are human infections with a new sub-type, but NO human-to-human SPREAD, or at most, rare instances of spread to a close contact. Below are progressive scenarios during this stage:

1) Infected person is detected upon entry in the Philippines via air and sea ports; and,

2) Infected person is not detected upon entry in the Philippines via air and sea ports.

m. Level 3 - Upon the declaration of DOH that there are small clusters with limited human-to-human transmission but spread is highly localized. Below are progressive scenarios during this stage:

1) Outbreak is within the family/household/workplace;

2) Outbreak is affecting several families but within a barangay;

3) Outbreak is affecting several barangays but within a municipality; and

4) Outbreak is affecting several municipalities but within a province.

n. Level 4 - Upon the declaration of DOH, that there are larger clusters but human-to-human spread is still localized up to pandemic phase: increased and sustained transmission in general population. Below are progressive scenarios during this stage:

1) Outbreak is affecting several provinces but within a region; and

2) Outbreak is affecting several regions or nationwide.

o. Outbreak - means an epidemic limited to localized increase in the incidence of a disease, e.g., in a village, town, or closed institution.

p. Personal Protective Equipment - means the materials used to cover the human body in order to prevent contamination from the disease. This includes: facial mask, eye protector or goggles, gown, gloves, and others.

q. Post-Outbreak or Support to recovery and rehabilitation efforts - Upon the declaration of the DOH that the Philippines is already a EID-Free.

r. Quarantine - means the separation of people who have been exposed to an illness, usually an infection, but are not ill or have not yet shown any sign of the illness. The movements and interaction of these people are restricted during the quarantine period which is equivalent to the incubation period of the disease. Those who get ill during the quarantine period are immediately isolated.

s. Re-emerging Infections - secondary to the reappearance of a previously eliminated infection or an unexpected increase in the number of a previously known infectious disease.

t. Republic Act No. 9271 - otherwise known as the œQuarantine Act of 2004 .

The following are considered emerging infectious diseases and other recurrent threat diseases:

1) Ebola Virus Disease (EVD)
2) Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
3) Severe Acute Respiratory Syndrome (SARS)
4) Avian Influenza (AH1 N1)
5) Meningococcemia
6) Leptospirosis
7) Antimicrobial Resistance of Tuberculosis
8) Other bacterial, viral and parasitic diseases

6. PROCEDURES:

The PNP shall implement its preparedness and operations plan namely: (1) Pre-Outbreak Incident for Level 1; (2) During an Outbreak of EID for Level 2 to 4; and, (3) Post Outbreak (Support and Recovery and Rehabilitation Efforts) (see Annex œA * - PNP ™s Response on Emerging Infectious Diseases ).

a. Pre-Outbreak Incident or Level 1 - A year round activities in preparation for the EID or during peace time. A progressive scenario during this stage may occur: a new bacteria/virus subtype in animals, no poultry outbreaks, no human cases in the Philippines or EID is still outside the country.

1) Conduct Health Awareness to include introduction of Personal Protective Equipment (PPE) among PNP Personnel and the community in coordination with DOH;

2) Identify and train PNP personnel in managing EID cases;

3) Forge a MOA/MOU with pharmacies/pharmaceuticals for the supply of medicines, PPE and other medical supplies during outbreak of EID;

4) Procurement of appropriate PPE in coordination with DOH;

5) Conduct of simulation exercises and drills re proper response on EID cases;

6) Maximize the use of QUAD Media in informing the public re EID in coordination with DOH;

7) Conduct information campaign thru quad-media and distribution of information education materials re EID;

8) Identify vital installations to include business establishments and pharmacies/drug stores for the PNP to secure during an outbreak;

9) Coordinate with DOH/DILG/LGU/DSWD on the identification of evacuation areas in case of Outbreak of EID;

10) Closely monitor the status of identified infected Filipinos abroad in coordination with DOH and DFA; and,

11) Conduct medical examination to all PNP Personnel/UN Peacekeepers coming from identified EID infected countries in coordination with BI and DOH.

b. During an Outbreak of EID or Level 2 to 4 - Upon the declaration of DOH that there are human infections of EID, the PNP performs the following during an Outbreak for level 2 to 4 as enumerated below:

1) Get the list of suspected passengers with contact details from BI and DOH;

2) Coordinate with BI and DOH to get the names of infected persons on board an international flight/sea craft;

3) Deploy personnel at the designated area of the airports/seaports in coordination with airport/seaport authorities;

4) Assist DOH in contact tracing of suspected infected person;

5) Assist in the transport of EID patients to DOH accredited hospital;

6) Ensure smooth flow of traffic during transport of EID patients;

7) Enforce RA 9272 otherwise known as œQuarantine Law ;

8) Conduct checkpoint to prevent ingress and egress in the infected families/barangays/provinces/regions;

9) Secure vital installations to include business establishments and pharmacies/drug stores to prevent looting; and,

10) Ensure law and order.

c. Post-Outbreak or Support to Recovery and Rehabilitation Efforts - Upon the declaration of the DOH that the Philippines is already a EID-Free, the PNP shall perform the following:

1) Maintain peace and order;

2) Continue security and traffic management operations; and,

3) Provide security during the entire recovery and rehabilitation efforts.

7. GUIDELINES:

a. The adjacent PROs not affected by the outbreak of EID will be the secondary responders and the NSUs will support/augment when situation warrants.

b. In the conduct of security operations during EID, security and safety of personnel shall always the primary concern. Always wear the appropriate PPE during police operations on EID.

c. All tasked units shall operate on their existing logistical and financial allocation. PNP NHQ shall provide logistical and financial support on a case to case basis.

d. Timely reports on Police Operations during outbreak of EID should be sent to the Directorate for Police Community Relations through the National Operations Center (NOC).

e. The PNP level of response shall be done as much as possible at the lowest level and only seek assistance to the next level when resources (manpower and material) are not enough to manage the disaster incident.

f. Observance of Human Rights in all police operations on EID is a must.

g. All tasked offices/units must at all times state their authority in case of resistance by the suspected infected EID patients. (see Annex œB * - Legal Bases for Quarantine).

h. The submission of reports shall be in accordance to the protocols and guidelines set forth in this PNP MC.

i. Lateral and vertical coordination between echelons of the civil government, private organizations and the Task Force on EID are highly encouraged.

8. RESCISSION:

All issuances, memoranda, rules and regulations issued by the PNP inconsistent herewith are deemed repealed or amended accordingly.

9. EFFECTIVITY

This PNPMC shall take effect 15 days from filing a copy immediately thereof at the University of the Philippines Law Center in consonance with Sections 3 and 4, Chapter 2, Book VII of Executive Order No. 292, otherwise known as, œThe Revised Administrative Code of 1987 .

(SGD) ALAN LA MADRID PURISIMA
Police Director General Chief, PNP

* Text Available at the Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.