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Article

COVID-19 Control in Highly Urbanized Philippine Cities: Leveraging Public Health Open-Source Government Data for Epidemic Preparedness and Response

by
Maria Catherine B. Otero
1,2,*,
Lorraine Joy L. Bernolo
3,4,
Refeim M. Miguel
5,
Zypher Jude G. Regencia
1,6,7,
Lyre Anni E. Murao
8 and
Emmanuel S. Baja
1,9
1
Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Ermita, Manila 1000, Philippines
2
College of Biology, Davao Medical School Foundation, Inc., Davao City 8000, Philippines
3
Center for Research and Development, Davao Medical School Foundation, Inc., Davao City 8000, Philippines
4
Graduate School, Davao Medical School Foundation, Inc., Davao City 8000, Philippines
5
Center for Applied Modelling, Data Analytics, and Bioinformatics for Decision Support Systems in Health, University of the Philippines Mindanao, Davao City 8000, Philippines
6
Department of Sociology and Behavioral Sciences, College of Liberal Arts, De La Salle University, 2401 Taft Ave, Malate, Manila 1000, Philippines
7
Data and Implementation Sciences for Health, Mandaluyong City 1550, Philippines
8
College of Science and Mathematics, University of the Philippines Mindanao, Davao City 8000, Philippines
9
Institute of Clinical Epidemiology, University of the Philippines Manila, Ermita, Manila 1000, Philippines
*
Author to whom correspondence should be addressed.
COVID 2025, 5(3), 42; https://doi.org/10.3390/covid5030042
Submission received: 24 January 2025 / Revised: 12 March 2025 / Accepted: 14 March 2025 / Published: 19 March 2025
(This article belongs to the Special Issue COVID and Public Health)
Browse Figures
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Abstract

:
Highly Urbanized Cities (HUCs) in the Philippines were at the forefront of public health surveillance and response during the COVID-19 pandemic. With the rapid spread of COVID-19 to Philippine cities, local government units continuously assessed, adapted, and implemented public health interventions (PHIs) and depended on available open-source government data (OSGD). This study consolidated PHIs in selected HUCs in the Philippines using high-quality OSGD to create a timeline of interventions and document good practices in local COVID-19 control. OSGD resources were collected from February 2020 to January 2023, and the data quality of OSGD was evaluated using the Journal of the American Medical Association (JAMA) benchmarks. A total of 180 metadata sources that met at least two core standards (Authorship and Currency) were included in the analysis. COVID-19 control strategies were analyzed vis-à-vis the rise of COVID-19 cases and types of PHIs, including the control of imported cases, case management, contact management, behavioral modification, and pharmaceutical intervention. Travel bans and hard lockdowns in Luzon early in the pandemic delayed the introduction of COVID-19 to other parts of the country. Good practices of LGUs for local COVID-19 control, such as quarantine passes, curfews and liquor bans, using QR-based contact tracing, massive community testing in high-risk communities, and free public swabbing centers, were implemented to slow down the local spread of COVID-19. With the evolving scenarios in city-level COVID-19 epidemics, local risk assessments based on available OSGD drove the adoption of relevant and innovative control strategies in HUCs in the Philippines. Lessons learned must be integrated into epidemic preparedness and response programs against future emerging or re-emerging infectious diseases.

1. Introduction

The World Health Organization (WHO) recognized the novel coronavirus disease (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that spread in countries and territories as a global pandemic on 11 March 2020 [1]. As early as May 2020, over 5 million people had been infected with the virus across 213 countries and territories, which led to more than 300,000 deaths [2]. During these times, both the national and local governments in many countries have been at the forefront of the COVID-19 pandemic response [3] and continuously implemented, reformed, and adapted public health interventions (PHI) based on WHO guidelines and recommendations to curb the widespread transmission of COVID-19 among their constituents [4].
The Philippines is one of the hardest-hit countries because of the COVID-19 pandemic. COVID-19 cases maintained a steady rise during the first months of the pandemic, which prompted the Philippine government to close international and local borders and implement stringent screening measures. Almost 80% of new cases from contact tracing were quarantined within 48 h of detection [5]. In addition, based on numerous research studies that implemented optimal control theory, the Department of Health (DOH) set the minimum public health standards as a guide for implementing non-pharmaceutical interventions in the COVID-19 response [6,7,8,9,10]. The ramping up of different combinations of rapid testing, contact tracing, and awareness campaigns, along with the minimum public health standards, such as physical distancing, cough etiquette, respiratory hygiene, personal and environmental hygiene, symptom monitoring, and promotion of mental health were prioritized by the national government [11].
Highly Urbanized Cities (HUCs) naturally became the hotspots for COVID-19 because of denser populations, more economic activities, and greater mobility of people [12]. While the Philippine national government implemented policies to support the Philippine National Action Plan for the COVID-19 pandemic, the local government units (LGUs), especially in the urban cities, bore the strict implementation of PHI. As such, LGUs all over the Philippines continually assessed the effectiveness of existing PHIs and strengthened these control measures to suit the prevailing local contexts [4], as poor PHIs translate to substantial public health consequences [13].
The COVID-19 pandemic was multifaceted; there were innumerable effects on society. Therefore, governments all over the world must make use of data coming from all fronts. With this, the WHO enjoined governments to facilitate open data sharing to support policies related to the COVID-19 response [14]. According to the Organization for Economic Cooperation and Development (OECD), Open-Source Government Data or OSGD is a “non-discriminatory data access and sharing arrangement where data can be accessed and shared free of charge and used by anyone for any purpose, subject to requirements that preserve integrity, provenance, attribution, and openness” [15]. The use and reuse of COVID-19-related OSGD facilitate informed decision-making to provide appropriate and timely interventions, mitigate the consequences (health, social, and economic) of COVID-19, rebuild and transition to the new normal, and prepare for future pandemics. Moreover, it encourages citizen engagement, fuels innovation in the private sector and the academe, and increases government accountability and transparency [16]. This study shows that curated web resources from credible sources can provide reliable public health information during epidemics or emergencies of a similar scale as COVID-19.
Data sharing and open knowledge are essential in guiding decision-makers in mitigating the COVID-19 crisis. Several data hubs for COVID-19 policies and non-pharmaceutical interventions (NPIs) collected country-level metadata from publicly available online resources [17] that reused OSGD, including the CoronaNet Research Project (https://www.coronanet-project.org (accessed on 3 November 2024)), the COVID Analysis and Mapping of Policies (https://covidamp.org (accessed on 3 November 2024)), and the Complexity Science Hub COVID-19 Strategies List (CCCSL) (https://covid19-interventions.com/ (accessed on 3 November 2024)). Various public health interventions (PHI) data collection approaches were identified [18]. Some of these approaches were particular to specific PHIs, such as discontinuing face-to-face school learning [19], mobility and travel restrictions [20], and initiatives to guarantee the uninterrupted supply of personal protective equipment and critical medical products [21]. In contrast, others dealt with a more extensive scope of PHIs. These data hubs and their visualizations may give insights into the effect of PHIs implemented in a country. In the Philippines, OSGD related to COVID-19 surveillance and interventions was made publicly available by national and local government units and health agencies primarily for information. This study highlights the importance of documenting city-level interventions against COVID-19 and incorporating local metadata in PHI assessments since these may provide unique insights into epidemic response and preparedness in HUCs.
Open data must be publicly available and accessible, in an open or machine-readable format, with an open license, and be timely and updated regularly [22]. Steps to make government data “open” in the Philippines have been taken as early as 2013 with the launch of Open Data Philippines (ODPH) (https://data.gov.ph/ (accessed on 3 January 2024)). ODPH is the repository of open government data from different government agencies [23]. Other government data can also be accessed through the Electronic Freedom of Information (eFOI) Program created in 2016 to increase government transparency. During the COVID-19 pandemic, the Philippine Department of Health regularly released national and local COVID-19 surveillance data. PHIs were reported as part of regular bulletins of the national Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID). However, reports on PHIs are commonly aggregated at the national and regional levels.
How did HUCs in the Philippines respond to the COVID-19 pandemic? This study aimed to consolidate COVID-19 public health surveillance and interventions in selected HUCs in the Philippines using OSGD. The results of this study can be used for post-pandemic assessments and improvement of local and national epidemic preparedness and response programs against future emerging or re-emerging infectious diseases in the Philippines. This approach can also be applied to other emerging or re-emerging public health events in countries or cities with constrained or developing public health surveillance infrastructure. HUCs from low- and middle-income countries may also benefit from the experiences of Philippine HUCs at different stages of the COVID-19 pandemic.

2. Materials and Methods

2.1. Study Design and Setting

This study is a descriptive documentation of the COVID-19 PHIs in the Philippines from February 2020 to January 2023, based on OSGD data. Based on the Philippine Local Government Code of 1991 (Republic Act 7160), a city is classified as a Highly Urbanized City if it has a population of at least 200,000 inhabitants and an annual income of at least P50,000,000.00 (~USD 870,000.00) [24]. HUCs for the three major islands were selected based on their population numbers: Quezon City and the City of Manila for Luzon, Cebu City for the Visayas Region, and Davao City for Mindanao. OSGD information on COVID-19 statistics, control strategies, and vaccination coverage for each city was searched and collected.
The study protocol was approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-0314-01).

2.2. Open Data Sources

We obtained metadata for this study from an internet source, Google/Google Trend Index, and used this data to facilitate subsequent analysis. In the Google search engine, the following general keywords were used to retrieve metadata:
“COVID-19 Philippines”, “DOH COVID-19 tracker”, “DOH COVID-19 vaccination”, “COVID-19 protocol Philippines”, “COVID-19 protocol+[HUC]”, “COVID-19 vaccine coverage+[HUC]”, “COVID-19 vaccination report+[HUC]”.
We collected country-level metadata for all analyses and retrieved data for a specific time. In addition, we did not select any particular categories and/or subcategories when searching for keywords. The time for the data retrieval started from the first confirmed COVID-19 case in the Philippines and ended on 31 January 2023. This time frame allowed us to conduct a more in-depth examination of the search trends.
Data on COVID-19 cases reported by date of illness onset for each HUC, beginning 27 February 2020 until 31 January 2023, were extracted from the DOH COVID-19 Tracker Dashboard (https://doh.gov.ph/diseases/covid-19/covid-19-case-tracker/ (accessed on 1 September 2024)). The DOH COVID-19 tracker is a public dashboard showing a daily tally of confirmed COVID-19 cases, positivity rate, occupancy rate of medical health facilities, and aggregated case information [25].
To obtain data on control strategies/PHIs implemented in the selected HUCs, different local and national COVID-19 policies were retrieved from their respective websites. National and local legislations and executive issuances (e.g., executive orders, proclamations, memorandum orders, memorandum circulars, presidential decrees, letters of instruction, letters of implementation, administrative orders, special orders, and general orders) were reviewed. Recommendations of the Interagency Task Force (IATF) and the National Task Force (NTF) for COVID-19, official LGU web pages and verified Facebook accounts, official newspaper articles, and COVID-19 protocols, guidelines, and action plans from 3 March 2020 to 31 January 2023 were also evaluated.
National and regional vaccination statistics were obtained from the DOH National COVID-19 Vaccination Dashboard (https://www.covid19.gov.ph/ (accessed on 19 March 2023)). Each selected HUC’s most recent reported vaccination coverage was obtained from either the LGU’s official Facebook account, the Department of Health Regional Center for Health Development, or reputable newspaper articles.

2.3. Data Analysis

2.3.1. Categorization and Data Quality Assessment of Web Resources

Web resources were categorized based on the sources of data (website or social media), types of affiliation (international organization, national or local government, news), and language (English or Filipino) [26]. The web resources were also grouped based on the type of analysis presented.
The quality of web resources was assessed using Journal of the American Medical Association (JAMA) benchmarks. The JAMA benchmark employs four core standards to evaluate web resources: Authorship, Attribution, Disclosure, and Currency [27]. Authorship was scored if the web resources showed the author/s, contributors, affiliations, and credentials. Attribution is the provision of all references and sources for the web resources’ content and relevant copyright information. Disclosure refers to the web resources’ “ownership’’, such as sponsors and funding arrangements. Currency indicates the date of posting and updating of the web resources.
Two evaluators (LJLB and RMM) initially assessed the included web resources using the JAMA benchmark, and a third evaluator (MCBO) settled conflicts in scoring if a dispute arose. There was no established or acceptable JAMA Benchmark score cut-off across the literature. Hence, the authors included all web resources with scores of 1 and above.

2.3.2. Open Government Data Analysis and Synthesis

The timeline of COVID-19 PHIs was generated using the reconstructed epi-curves for the entire Philippines and each representative HUC from February 2020 to January 2023. The prevention and control strategies (PHIs) implemented from February 2020 to January 2023 in the City of Manila, Quezon City, Cebu City, and Davao City were categorized into non-pharmaceutical interventions (case management, contact management, control of imported cases, behavior modification) and pharmaceutical interventions. The categories of non-pharmaceutical interventions were adapted from previous literature [28].

3. Results

3.1. Identification, Screening, and Assessment of OGD Web Sources

A total of 1967 metadata from Google searches were identified, of which 1747 were removed as these did not include/use OSGD, did not report about the Philippines, or had the same content. From the 220 metadata, 40 were removed after screening because the web addresses were no longer available or the reports were done outside the Philippines (see Figure 1 for details). After data quality assessment using the JAMA benchmark, all web resources included in this study achieved at least 2 of the four core standards, with a mean (±SD) JAMA score of 3.03 (±0.90). About 30.0% of the identified OSGD sources achieved 2 JAMA benchmark criteria, 11.1% achieved three criteria, and 58.9% achieved all four criteria. All web resources have Currency and Authorship, while only 36.1% had Attribution and 35.0% had Disclosure (Table 1).
In terms of data sources, 93.3% of the web resources were from official websites, while only 6.7% were from social media. Most of the web resources on control strategies (PHIs) were published by the National Government (43.3%) and the Local Government (28.9%), followed by online newspapers (25.6%), and, lastly, academic institutions (1.7%). Reused OSGD appearing in news articles were published by private news agencies (56.5%) and the government-owned Philippines News Agency (43.5%). Most web resources were written in English (97.8%), and only 4 (2.2%) were written in Filipino (Table 1).

3.2. COVID-19 HUC Control Strategies (PHIs)

Figure 2 shows the epidemic curves and timeline of the major PHIs against COVID-19 in the Philippines and the four representative HUCs (Quezon City, City of Manila, Cebu City, and Davao City). At least five surges of COVID-19 cases were observed in the entire Philippines and the representative HUCs, with the most significant number of reported cases occurring from 30 December 2021 to 5 January 2022.
Table 2 summarizes the specific control strategies implemented in the four HUCs categorized by the focus of the interventions. The first case of locally transmitted COVID-19 in the Philippines was confirmed on 7 March 2020 [29]. In response, the entire country was placed under a State of Public Health Emergency on 8 March 2020 and a State of Calamity on 16 March 2020 [30]. The National Capital Region and most of Luzon were placed under Enhanced Community Quarantine (hard lockdown) from 17 March until 15 May 2020 [31].
For the first twelve months of the COVID-19 pandemic, prevention and control strategies were focused on (a) the control of imported cases (travel restrictions) and (b) behavioral modifications (lockdowns, wearing face masks), while (c) case management and (d) contact management (QR-based contact tracing, use of quarantine pass, community testing) were important once sustained local transmission of COVID-19 was observed. Free flu and pneumococcal vaccinations for older people were also implemented starting in March 2020 to protect older people against severe COVID-19 infection (Table 2). In Davao City, only one COVID-19 Referral Hospital, Southern Philippines Medical Center (SPMC), operated from March to November 2020 to maximize the use of scarce resources for the COVID-19 response while effective management and treatment were being optimized, and while testing capacity in private laboratories and hospitals was still being developed [32]. Private hospitals were requested to open COVID-19 wards only during COVID-19 surges when bed capacity in the SPMC reached critical levels. All confirmed COVID-19 cases from March 2020 to September 2021 were isolated in Temporary Treatment and Monitoring Facilities (TTMFs) since home isolation was prohibited [33].
COVID-19 vaccine roll-out in the Philippines began on 1 March 2021 [34]. Frontline health workers were given priority, followed by senior citizens, people with comorbidities, indigents, and the rest of the population, considering the risk of exposure, death, and vaccine supply [34]. As of 19 March 2023, over 179.04 million COVID-19 vaccines have been administered in the country, and 103.34 million Filipinos are fully vaccinated or have received one booster dose (https://www.covid19.gov.ph/ (accessed on 19 March 2023)).
The national and local government units in the Philippines also engaged the private sector, local and international civic groups, and the academe to support the implementation and improve the effectiveness of PHIs against COVID-19. Civic societies provided massive donations (cash and in-kind) of medical supplies, COVID-19 testing kits and equipment, and logistical and training support to the medical front liners before COVID-19 vaccines were available [35].

4. Discussion

Open-source data, whether from the government, non-government agencies, or the private sector, is a vital source of health data for public health surveillance and interventions in lower middle-income island countries like the Philippines, which have variable public health surveillance resources and infrastructure. Because of the COVID-19 pandemic, massive amounts of health-related government data on the COVID-19 response were made available to the public [36], and open data infrastructure in Philippine HUCs evolved quickly. COVID-19-related open data (e.g., case information, COVID-19 epi curves, COVID-19 risk categories, health facility utilization, vaccination accomplishment and coverage, etc.) were regularly shared not only by the Department of Health (https://doh.gov.ph/diseases/covid-19/covid-19-case-tracker/ (accessed on 19 March 2023)) and other national government agencies but also by local government units and DOH counterparts in the regions, provinces, cities, and barangays (or the smallest unit of government in the Philippines). Our study demonstrates how major public health interventions implemented by the national and local government units in the Philippines as part of the COVID-19 response can be reconstructed chronologically from high-quality web resources that contain or reuse open-source government data (OSGD).
The timely declaration of travel restrictions was vital in reducing the importation rate of SARS-CoV-2 and its more contagious variants. International air travel significantly contributed to the global spread of COVID-19, prompting the Philippines to implement early travel bans to delay the introduction of the virus to the cities and provinces [37]. Its effects are evident in the flattening of the epi curves in the Philippines during the first three COVID-19 surges (between June 2020 and November 2021) (Figure 2A). However, their benefits diminish once local transmission becomes widespread [38].
With vaccines and effective treatments unavailable during the first year of the pandemic, the Philippines relied heavily on non-pharmaceutical interventions (NPIs) like mobility restrictions and social distancing to curb COVID-19 transmission. Social distancing reduces the interaction between susceptible individuals and pre-symptomatic, asymptomatic, or symptomatic COVID-19 cases [39]. The hard lockdown in Luzon from February to May 2020 delayed the spread of SARS-CoV-2 to other regions and cities in the Philippines, and this was crucial since testing capacity and healthcare infrastructure were still developing [40]. A study of 27 countries, including the Philippines, showed that hard lockdowns significantly reduced the growth of daily COVID-19 cases and deaths after 15 days [41]. Manchein et al. also found that soft lockdowns alone were inefficient in reducing COVID-19 transmission during the alert phase (early stages with limited human-to-human transmission) of the pandemic [42].
During lockdowns, significant social and economic hardships emerged while the spread of COVID-19 was controlled. Nine HUCs in the Philippines found that over 62% of households faced food insecurity during hard lockdowns due to a lack of funds [43]. National and local governments have carried out economic support measures (ESM) such as food subsidies and the distribution of food packs as sanctioned by national and local policies. ESMs can enhance the effectiveness of high-severity interventions (such as large-scale lockdowns) in reducing COVID-19 infections by lowering the work hours needed to provide the basic needs of low-income households [39,44]. Moreover, ESMs must be put in place, especially in HUCs, to increase the acceptance and adherence of the constituents to stringent lockdowns.
Local government units played a key role by conducting local risk assessments while adhering to national guidelines. Aspects of COVID-19 outbreaks may vary in each locale and require comprehensive and tailor-fitted PHIs in HUCs. The country’s unique geography and high population density, especially in urban areas like the City of Manila and Quezon City, influence the spread of contagions and the effectiveness of response measures. Moreover, higher population density complicates social distancing and predicts increased COVID-19 transmission rates, highlighting the need for localized prevention strategies [45,46,47,48,49], which most of the HUCs implemented in the Philippines.
The scenario of local COVID-19 epidemics in cities and provinces may vary at certain time points; hence, specific interventions may be needed to control local outbreaks. The availability of OSGD may have enhanced local COVID-19 responses, enabling data-driven decisions and sharing of good practices among LGUs. Among the good practices in the local control of COVID-19 were face mask wearing mandates and corresponding penalties for violators, and the use of quarantine passes, curfews, and liquor bans during hard lockdowns to limit the movement of their constituents to access basic needs only.
Mask-wearing was one of the most widely implemented control measures to reduce the transmission of COVID-19 worldwide, especially in the first year of the pandemic [50]. Mask-wearing was crucial when social distancing was inadequate or impossible. In a study analyzing face mask-wearing data sets from 92 regions, including the Philippines, it was found that the proper use of face masks reduced the reproductive rate (R) of COVID-19 by 19% [50]. Even before face mask-wearing in public places was made mandatory, voluntary mask-wearing was already prevalent in the Philippines. Many HUCs in the Philippines (e.g., Davao City) passed City Ordinances that imposed fines on violators of this mandate. The Philippines was one of the last countries to lift the outdoor mask-wearing mandate in September 2022 [51]. To this day, indoor mask-wearing is still imposed, especially in poorly ventilated or crowded areas, because mask-wearing benefits extend beyond COVID-19 prevention [52].
Quick Response (QR)-based contact tracing was also adopted in HUCs included in this study to aid the government in identifying cases and their contacts [53]. LGUs in the Philippines mandated the use of QR codes when entering enclosed buildings (e.g., schools, offices, shopping malls). QR code scanners were installed at the entrance of the building, and people entering and leaving the establishments presented their unique QR codes (either printed on paper or as an image on a mobile phone or a smartwatch). Unlike Internet-of-Things (IoT)-based digital contact tracing systems in other countries that require contact tracing apps to be online and continuously updating geolocations [54], the QR-based contact tracing system adopted in many Philippine HUCs placed the burden of QR data collection on the establishments. Web-based sign-up to the contact tracing application reduced the exclusion of digitally illiterate individuals since QR codes can be generated without linking the data to one smartphone. Identifying persons with an increased risk of infection due to exposure to confirmed COVID-19 cases assisted the gradual resumption of normal activities without sacrificing COVID-19 containment and mobility control [55]. Fears of data privacy breaches during contact tracing were allayed by the Philippine National Privacy Commission, with their statement saying, “In this pandemic, public health and data privacy are on the same side” [56].
Community testing in high-risk areas and free public swabbing for RT-PCR were also implemented in selected HUCs in the Philippines to quickly identify cases and their contacts [57]. Regular mass testing of the general population, as done in countries like South Korea and Germany, drastically reduces new cases of emerging infectious diseases like COVID-19 by detecting symptomatic, asymptomatic, or pre-symptomatic individuals [39,58]. Early detection of infections, timely isolation of cases, and quarantine of their contacts can be implemented to curb further COVID-19 transmission [59]. Mass testing is more effective than contact tracing, considering the airborne transmission of COVID-19, where transmission may extend to individuals with no contact with known cases [58]. Furthermore, non-invasive wastewater surveillance can complement individual or pooled testing for faster and more cost-efficient screening covering a large population at one time [60].
Among the PHIs implemented in the Philippines during the pandemic, the pharmaceutical intervention of massive COVID-19 vaccination was the most effective and long-lasting. In the Philippines, COVID-19 vaccination by priority groups started in March 2021 with healthcare frontliners. Moreover, it expanded to older people and persons with comorbidities, other frontliners in essential sectors, the indigent community, and the rest of the population as more COVID-19 vaccines became available [61]. By July 2022, 70.5% of the population was fully vaccinated [62].
COVID-19 vaccines protect against severe illness, even with the emergence of more transmissible variants like Delta and Omicron [63]. Using global vaccination data, Singh et al. observed that COVID-19 vaccination substantially reduced the incidence and number of hospitalizations due to COVID-19 as early as 90 days after targeted immunizations [64]. However, it should be emphasized that continued adherence to non-pharmaceutical interventions (NPIs) like contact tracing, social distancing, mask-wearing, and isolation is essential to benefit from the protection afforded by COVID-19 vaccination [64,65]. In the Philippines, the beneficial effects of COVID-19 vaccination were initially limited, possibly due to the prioritization of high-risk groups, constrained vaccine supply, vaccine delivery challenges in the Philippine archipelago [66], and vaccine hesitancy, especially in the older population [67]. A good practice in Philippine HUCs like Davao City is their mobile vaccination campaign targeting older people to ensure broader vaccine coverage in this vulnerable population [68].
As cases of locally transmitted COVID-19 rose daily, and new variants emerged, it became apparent that a successful national and local control program against COVID-19 required a whole-of-government and whole-of-society approach [69]. Public-private partnerships facilitated speedy vaccine procurement, efficient vaccine distribution systems, and incentivized vaccination [70]. Similar trends were seen in low-resource countries like Nepal, Ghana, Bangladesh, and Nigeria, where public–private partnerships augmented the resources for public health response and mitigated the economic impact of the pandemic by ensuring that industries and services continued to operate [71]. Furthermore, public-private partnerships and engagement of stakeholders must be strengthened in the national and local EID preparedness programs, and regulatory frameworks that align with these programs must be developed [72].
In this study, only the internet sources with at least two JAMA benchmarks (Authorship and Currency) were considered good-quality resources with valid and reliable information. JAMA benchmarks can be used to assess the quality of any web resource, whether health-related or not; however, JAMA benchmarks cannot be used for comprehensive assessments [73]. Other quality assessment tools, such as HONcode and Google Ranks, can also be used, but the choice of tool should be based on the study’s objectives. HONcode is a website certification issued based on ethical standards in offering quality health information and is approved and used by the World Health Organization [74]. HONcode certification can be obtained after the voluntary registration of the website; hence, there may be credible websites without this certification [75]. Google ranks can also be used to determine the relative importance of a web resource by ranking the number and quality of links associated with it [26]. In addition, whether the health information written is credible cannot be reliably determined using Google ranks alone.
Our paper assessed control strategies from four HUCs in the Philippines. However, our study does not capture all innovative and locally relevant measures implemented in other HUCs, independent component cities, municipalities, and provinces across the country. We also observed varied depths of city-level COVID-19-related data available in web resources included in this study. For example, vaccination accomplishment data was not reported in some HUCs. These gaps prevented quantitative comparisons (e.g., vaccination coverage and incidence during surges) from being made. In addition, the OSGD used in this study to assess the COVID-19 public health control strategies and interventions only included data repurposed from online news outlets and official social media accounts of local government units (LGUs). Furthermore, a comprehensive analysis of the utilization and re-utilization of OSGD throughout the COVID-19 response in the Philippines is warranted since it is beyond the scope of this study.
The timely declarations of international and local travel bans and hard lockdowns were crucial in the alert phase of the pandemic as they controlled case importation and modified behaviors to reduce COVID-19 transmission. Once sustained local COVID-19 transmission was observed, case and contact management PHIs were widely implemented in HUCs before COVID-19 vaccines became available. Pharmaceutical interventions, specifically the COVID-19 vaccination, were the Philippines’ most effective and longest-lasting PHIs. Massive vaccination campaigns in the HUCs were achieved by engaging the private sector, academe, and civic societies. Data sharing and open knowledge of locally implemented public health interventions against COVID-19 were vital to the COVID-19 response in the Philippines since the availability of PHI-related OSGD promoted innovation and rapid sharing of good practices among local government units.
The COVID-19 pandemic will not be the last. Lessons learned during the COVID-19 pandemic must be integrated to maintain or improve national and local epidemic preparedness programs against emerging or re-emerging infectious diseases. Inbound international travel bans at all international airports in the country should be issued as early as possible to prevent the introduction of pathogens and delay widespread local transmission. Granular lockdowns should be implemented with economic support measures (i.e., food distribution and subsidies) for low-income households. Digital contact tracking technologies (e.g., QR codes, Bluetooth Low Energy, Internet-of-Things) should be maximized to augment contact tracing management interventions. Local governments should continue to engage the private sector, the academe, and civic groups to enhance the effectiveness of public health interventions, especially pharmaceutical interventions such as vaccination. Lastly, developments in open government data infrastructure must be sustained, and more government data must be transformed into genuinely open data. These improvements in government open data will increase government accountability and transparency, encourage citizen engagement, and fuel innovation in the private sector and the academe.

5. Conclusions

Hard lockdowns at the start of the pandemic delayed the introduction of COVID-19 to other areas in the Philippines. Local risk assessments using OSGD prompted LGUs to be innovative and to follow good practices of other LGUs to improve local control of COVID-19 while still adhering to the minimum community quarantine protocols set by the national government. These COVID-19 public health control strategies and interventions include quarantine passes, setting curfews and liquor bans, using QR-based contact tracing, implementing massive community testing in high-risk communities, and opening public and free swabbing centers. The national and local governments engaged stakeholders such as the private sector, the academe, and civic groups in improving the country’s COVID-19 response. Lessons learned during the COVID-19 pandemic must be integrated into maintaining and improving national and local epidemic preparedness programs against emerging or re-emerging infectious diseases. Reused OSGD found in good-quality web resources may provide vital information on public health interventions even as health emergencies unfold. The developments in health-related OSGD brought by the COVID-19 pandemic should be sustained and extended to other sectors of society to encourage innovation and involvement.

Author Contributions

M.C.B.O.: Conceptualization, Methodology, Formal analysis, Investigation, Visualization, Writing—original draft, Writing—review and editing; L.J.L.B.: Methodology, Formal analysis, Investigation; Writing—original draft; R.M.M.: Methodology, Formal analysis, Visualization, Writing—original draft; Z.J.G.R.: Conceptualization, Methodology, Writing—review and editing; L.A.E.M.: Conceptualization, Writing—review and editing; E.S.B.: Conceptualization, Methodology, Formal analysis, Writing—review and editing. All authors contributed substantially to the manuscript’s development, revision, and finalization. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by the (1) Science Education Institute of the Department of Science and Technology (DOST) through the Advanced Science and Technology Human Resource and Development Program Scholarship awarded to MCBO at the University of the Philippines Manila, and (2) the DOST Philippine Council for Health and Research Development (PCHRD) funded project, “Integrated Wastewater-Based Epidemiology and Data Analytics for Community-Level Pathogen Surveillance and Genetic Tracking” under the University of the Philippines Mindanao.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of the University of the Philippines Manila Research Ethics Board (UPMREB 2021-0314-01 approved on 6 March 2023).” for studies involving humans.

Informed Consent Statement

Informed consent was not applicable to this study as it exclusively utilized secondary data from existing records, with no direct interaction with participants or collection of identifiable personal information.

Data Availability Statement

The datasets generated and analyzed from this study are available from the corresponding author upon reasonable request.

Acknowledgments

The authors acknowledge the contributions of Eunice Gadgude-Ariar in the early stages of this research.

Conflicts of Interest

The authors declare no conflict of interest.

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Figure 1. Flow diagram for identifying, screening, and assessing open government data from web sources.
Figure 1. Flow diagram for identifying, screening, and assessing open government data from web sources.
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Figure 2. (A). Epi curves and timeline of major public health interventions against COVID-19 implemented in the entire Philippines; (B). Epi curves and timeline of major public health interventions against COVID-19 implemented in representative HUCs (Quezon City, City of Manila, Cebu City, and Davao City).
Figure 2. (A). Epi curves and timeline of major public health interventions against COVID-19 implemented in the entire Philippines; (B). Epi curves and timeline of major public health interventions against COVID-19 implemented in representative HUCs (Quezon City, City of Manila, Cebu City, and Davao City).
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Table 1. Quality assessment results of OSGD web resources (n = 180).
Table 1. Quality assessment results of OSGD web resources (n = 180).
Categorizationn (%)
Based on JAMA Scores
00 (0.0)
255 (30.6)
319 (10.6)
4106 (58.9)
Based on sources of data
Website168 (93.3)
Social Media Platforms12 (6.7)
Based on the type of affiliation
English176 (97.78%)
Filipino4 (2.22%)
Table 2. Summary of non-pharmaceutical and pharmaceutical interventions against COVID-19 implemented in selected Philippine HUCs (Quezon City, City of Manila, Cebu City, and Davao City) by focus of intervention.
Table 2. Summary of non-pharmaceutical and pharmaceutical interventions against COVID-19 implemented in selected Philippine HUCs (Quezon City, City of Manila, Cebu City, and Davao City) by focus of intervention.
Intervention FocusPublic Health Interventions *
Control of Imported CasesBan on international and domestic flights
Border control and restriction of land and sea travel
Test-Before-Travel requirement for arriving passengers
LGU-Coordinated transport of ROF and LSI
One Health Pass for all travelers entering the Philippines
Behavioural ModificationHard (ECQ) and Granular Lockdowns
Curfew and Liquor Ban
Use of Quarantine Pass
Face Mask Ordinance and Fines for Quarantine Violators
Incentives for vaccinated individuals
Food Subsidy
Intensified Media Presence
Case ManagementDesignated COVID-19 Referral Hospitals
Operation Public and Private TTMFs
Telemedicine and Home Isolation
Contact ManagementCommunity Testing in High-Incidence Barangays
QR Code-Based Contact Tracing System
Public Swabbing Centers
Mandatory and Free RT-PCR testing of close contacts
Pharmaceutical InterventionsIntensified flu and pneumococcal vaccination
COVID-19 vaccination by priority group
Distribution of COVID-19 vaccines to private entities
Mobile vaccination campaign
Administration of COVID-19 vaccine booster shot
* Acronyms used: LGU—Local Government Units; ROF—Returning Overseas Filipinos; LSI—Locally Stranded Individuals; TTMFs—Temporary Treatment and Monitoring Facilities; RT-PCR—Real-time Polymerase Chain Reaction.
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Otero, M.C.B.; Bernolo, L.J.L.; Miguel, R.M.; Regencia, Z.J.G.; Murao, L.A.E.; Baja, E.S. COVID-19 Control in Highly Urbanized Philippine Cities: Leveraging Public Health Open-Source Government Data for Epidemic Preparedness and Response. COVID 2025, 5, 42. https://doi.org/10.3390/covid5030042

AMA Style

Otero MCB, Bernolo LJL, Miguel RM, Regencia ZJG, Murao LAE, Baja ES. COVID-19 Control in Highly Urbanized Philippine Cities: Leveraging Public Health Open-Source Government Data for Epidemic Preparedness and Response. COVID. 2025; 5(3):42. https://doi.org/10.3390/covid5030042

Chicago/Turabian Style

Otero, Maria Catherine B., Lorraine Joy L. Bernolo, Refeim M. Miguel, Zypher Jude G. Regencia, Lyre Anni E. Murao, and Emmanuel S. Baja. 2025. "COVID-19 Control in Highly Urbanized Philippine Cities: Leveraging Public Health Open-Source Government Data for Epidemic Preparedness and Response" COVID 5, no. 3: 42. https://doi.org/10.3390/covid5030042

APA Style

Otero, M. C. B., Bernolo, L. J. L., Miguel, R. M., Regencia, Z. J. G., Murao, L. A. E., & Baja, E. S. (2025). COVID-19 Control in Highly Urbanized Philippine Cities: Leveraging Public Health Open-Source Government Data for Epidemic Preparedness and Response. COVID, 5(3), 42. https://doi.org/10.3390/covid5030042

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