Background:
In the Philippines, the earliest pandemic response has been hospital-centric. With looming hospital congestion, a group of public health professionals urgently asserted that the community should be the first line of defense. Volunteers convened to contextualize evidence and practice to the Philippines’ decentralized governance setting, anticipating the need for nonexistent operational guidance.

Method:
A Viber group allowed rapid consultation between public health convenors, technical experts, and local government implementers to determine knowledge needs and tailor-fit guidelines for COVID-19 response, guided by these principles: existing disaster response structures must be activated, primary care resources must be mobilized, and the Filipino family/household as the unit of care must be recognized. The modified Delphi method was used to refine and finalize contents. Modules have been iterated based on user feedback.

Results:
The Community Based Management of COVID-19 (CBMC) toolkit was consolidated in eight weeks. Its four modules contain slide decks, user manuals, and implementation checklists. The first centers on local Disaster Risk Reduction and Management - Health (DRRM-H) for Emerging and Reemerging Infectious Diseases (EREIDS) using disaster response strategies that local governments are already familiar with. The second contains clinical algorithms to guide primary care providers in low-resource settings. The third details the operations of a community-run isolation and treatment facility. The fourth provides a family-oriented approach to COVID-19, including for special and vulnerable groups. Overall, this ensured that the Barangay (village) Health Emergency Response Teams and the primary care system with its community-managed isolation and treatment facilities, take central roles. This strengthened local response and pulled away strain from hospitals.

Conclusion:
The CBMC framework was eventually adopted and institutionalized by the Philippine government for the local government COVID-19 response. This initiative reasserts that pandemic response should empower local communities by building on their local resources and strengthening existing systems and institutions.