City officials and health authorities on Saturday sought to explain why an Australian person under investigation (PUI), who had turned out to be positive for COVID-19, was discharged by the Ospital ng Palawan (ONP) even before test results coming from Manila were received by them.

In a follow-up media briefing after Mayor Lucilo Bayron announced the first COVID-19 case, city and health officials defended their decision to allow the patient to travel to Clark International Airport en route back to Australia on March 17, and before his test results from the Regional Institute for Tropical Medicine (RITM) arrived.

Mayor Bayron announced in an early morning press conference Saturday the COVID-positive result of the test on the patient.

Dr. Audie Cipriano, chief of the medical professional staff of the ONP, explained that they decided to allow the patient to leave before the air travel ban was imposed last week, on the request of the Australian Embassy and upon the advice of local officials.

Dr. Cipriano said that the attending physician “decided to downgrade” the patient to the category “person under monitoring” (PUM) because his condition had improved and he was only showing “mild symptoms” of possible viral infection.

“He was referred to us because of vomiting and loose bowel because of a drinking spree. The patient category as PUI with mild symptoms was based on the algorithm. He was not supposed to be admitted and could have undergone home quarantine,” Cipriano said.

The patient was discharged and subsequently referred to the City Health Office (CHO) and City Epidemiology and Surveillance Unit (CESU) for monitoring as a PUI.

The local health authorities insisted that the prescribed protocols were followed upon the discharge of the first confirmed coronavirus disease (COVID-19) case in Palawan.

This, after Bayron announced Saturday morning that a 26-year-old male Australian national tested positive for COVID-19, after who has already left the country on Tuesday (March 17).

Travel history

The patient reportedly has travel history from Kuala Lumpur, Malaysia, and Australia where local transmission was reported, then traveled to the Philippines on March 5.

Upon arrival in Puerto Princesa City, he reportedly traveled to the municipality of San Vicente on March 7 where he stayed for about five days.

He first showed symptoms late March 12 and was attended by a local midwife after complaining of vomiting, coughing, and loose bowel. The patient was transported to a government hospital where he was admitted on March 13.

The attending physician categorized him as a person under investigation (PUI) based on his travel history and subjected the patient to a confirmatory test.

Discharged PUI

Ruffia Marie Atencio, the spokesperson of CHO, said that they were informed of the discharge as a PUI, pointing out that they arranged his quarantine at a certain hotel in the city.

“Aware ang hotel. Nagbigay kami ng kit sa dayuhan—thermometer to check his temperature regularly. Strict precautionary and quarantine measures were observed. Binigay ang number ng Barangay Health Emergency Response Team (BHERT) to contact us immediately,” she said.

The COVID-19 patient stayed at the hotel from March 15 to March 16.

The Australian Embassy called the city government and requested to arrange a flight for the remaining Australian nationals in the city due to the impending lockdown.

“Tinawagan kami ng embassy at hiningan ng request at ihabol sa biyahe dahil mawawalan na ng flight. Tumanggi kami at first, pero pumayag na din basta aware sila, from maghahatid hanggang sa magre-receive,” Atencio added.

He remained asymptomatic for three days and was in “good condition, with no symptoms at all”.

The patient was escorted inside a backdoor at the airport arrival terminal where he remained in isolation awaiting his flight.

She said he was also reported to be the last to board the plane and remained in distant isolation from other passengers.

He was out of the country on March 17 and the Australian authorities confirmed his arrival in Perth, Australia, where he will be on continued monitoring if he maintains to show no further symptoms.

The Australian was escorted from the hotel to the airport on March 17 with health personnel on full personal protective gear (PPG).

“Standard protocol ang in-impose sa transfer ng pasyente. Lahat ng tao namin naka PPG (personal protective gear)” said Earl Timbancaya, chief of the City Disaster Risk and Reduction Management Office (CDRRMO).