Diana Beatriz S. Bayani and Soon Guan Tan
Lockdowns and policy actions to curtail the transmission of COVID-19 have widespread health system, economic, and societal impacts. Health systems of low-to-middle-income countries may have fewer buffering resources and capacity against shocks from a pandemic. This paper presents a preliminary review on the collateral health systems impact of COVID-19 in the Philippines through review of academic and grey literature, supplemented by a qualitative survey. Community quarantines alongside transport and boarder restrictions have universally impacted health service access and delivery, affecting patients requiring specialist care the most. Existing record-keeping and surveillance measures were hampered as existing resources were tapped to perform COVID19-related tasks. Local health systems reinforced gatekeeping mechanisms for secondary and tertiary care through referral systems and implemented telemedicine services to reduce face-to-face consultation. The health system impacts in the Philippines have been variegated across municipal income class and topography, contributed by long-standing symptoms of inequitable resource allocation.