i

Influence of COVID-19 Pandemic to the Views of Grade 11 Students in ESNCHS on the

Hand, Foot and Mouth Disease Outbreak

Abobo, Bryce Kerby Y.

Balagbis, Princess Janel A.

Consultado, Beyonce C.

Deratas, Angeli Dea Paz R.

Pajares, Jamby M.

Pascua, Aljade Faith O.

Ramos, Aisa Jane B.

Rebato, Jan Benedict D.

Grade XI – STEM B

Roxanne Jane A. Quelitano

April 2023
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ACKNOWLEDGEMENT

First and foremost, the researchers would like to express their deep sense of gratitude

for the Almighty God. The researchers felt his grace throughout this research in every instant

as he led them, continually improved their intellect, encouraged them to move forward, and

illuminated their thoughts with his wisdom.

The researchers would like to acknowledge and give their warmest thanks to their

advisor, Ms. Roxanne Jane Quelitano who made this work possible. Her advices and

guidance carried them through all the stages of conducting this research.

Besides their advisor, the researchers would like to also give thanks to the members of

this research for cooperating.

The researchers would like to extend their gratitude to their dear parents for the

immense patience while they were working on this study. The researchers would also like to

thank them for supporting them financially.

The researchers would also like to expand further their deepest gratitude to all those

who have directly and indirectly guided them in writing this research paper. Especially their

classmates, that made valuable comments, suggestions on this research paper, which gave

them the inspiration to improve their research paper.

The researchers acknowledge the contribution of the different authors and sources for

providing information in relation to the study they conducted. They serve as the source of

theory, argument or point of view which provides appropriate additional information which

helps us to gather a lot of knowledge regarding their study.

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Page

TITLE PAGE i

ACKNOWLEDGEMENT ii

TABLE OF CONTENTS iii

INTRODUCTION 1

Background of the Study 1

Statement of the Problem 3

General Objectives 3

Significance of the Study 4

Scope and Limitation 6

Definition of Terms 6

REVIEW OF RELATED LITERATURE 8

METHODOLOGY 18

Research Design 18

Respondents of the Study 18

Research Locale 18

Research Instrument 18

Data Gathering Procedure 19

Data Analysis 19

REFERENCES 20

APPENDICES

TABLE OF CONTENTS
 INTRODUCTION

Background of the Study

The outbreak of Coronavirus Disease 2019 (COVID-19) in the Philippines had

brought a huge challenge to the livelihood and health security of Filipinos countrywide. A

year after the Coronavirus pandemic conquered the Philippines and sent into a months-long

lockdown, classrooms across the country remain empty and children are stuck at home. For

the whole island of Luzon, which includes eight administrative regions, including the national

capital region, the President of the Philippines, Rodrigo Roa Duterte issued an enhanced

community quarantine (ECQ) from March 15 to April 30 in 2020. Since the emergence of

local transmission, other regions of the nation have also experienced various periods of

quarantine. The past years has been one of the toughest in recent history due to the harsh

health, economic and social impacts of the virus.

It is evident that students, particularly senior high school had different experiences on

how the ongoing crisis changed their lives, not only in the field of education but generally, on

their daily living; some of them struggles the rising stress levels and lower engagement with

learning since schools did not hold face-to-face classes for more than a year and opted instead

to have classes through online or distant learning modalities. The crisis has caused

traumatizing experiences on most of students. Along with the possibility from getting

infected by the disease, they are concerned about their families and their lack of financial

resources.

Although, the condition of today is less severe than before, the past involvement of

Grade 11 students in Eastern Samar National Comprehensive Highschool to the serious

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circumstances amidst the pandemic extend beyond traumatic exposure and long term

misery which began three years ago and remains present today. Their personal experiences

from the past years after the Coronavirus disease conquered the Philippines might affect their

views to the recent outbreak of Hand, Foot, and Mouth Disease in Borongan City. Therefore

there will be several perceptions, specifically risk perceptions with regarded on how the

disease might affect their lives and how they see themselves struggling as the outburst of this

disease continue to diffuse.

Hand, Foot, and Mouth Disease (HFMD) surveillance began in the Philippines in

2012 following an outbreak in Cambodia. Since then, the National Reference Laboratory for

Enteroviruses has been providing laboratory support for the surveillance. During a televised,

public briefing, Dr. Rontgene Salonte, the director of the Department of Health’s (DOH)

Vaccination Expert on Panel of Infectious Diseases, Stated the HFMD disease began in

October 2020 in San Pascual, Batangas, when 105 cases were discovered, the majority of

whom were young children and students. Though, this does not mean that adults and younger

children cannot be infected with the virus. The disease is classified by the World Health

Organization as an infectious disease caused by a common virus whereas it is characterized

by symptoms such as fever, painful sores around the mouth, and a rash with blisters on the

hands, feet, and buttocks.

On March 10, 2023, the Borongan City Health Office proclaims an outbreak of the

Hand, Foot, and Mouth Disease due to a two-day increase in cases from 95 to 154. Mayor

Jose Ivan Dayan Agda said health officials have reported cases in 33 of the 61 barangays in

Borongan. Also it was discovered that the disease was affecting more people every week.

Immediately, health professionals dispersed across barangays with an education and

information campaign intended to reduce infections, particularly among youngster who

transmit the disease or contract it via typical play behavior and other activities.
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Grade 11 students in Eastern Samar National Comprehensive Highschool are

requested to adhere to minimum public health standards, such as maintaining physical health

standards, physical distance and donning the correct personal protective equipment,

particularly when symptoms are evident, such as face masks and gloves that are well fitted,

that is due to the rising cases of HFMD in the city of Borongan. Thus, they are definitely

aware of the certain possibility of getting infected by the disease.

Statement of the Problem

Thereafter the Borongan City Health Office proclaims an outbreak of Hand, Foot, and

Mouth Disease on March 10, 2023, more people were being affected by the sickness each and

every day. The city’s current HFMD figure is higher than the 116 cases reported by the DOH

Regional Epidemiology and Surveillance Unit (RESU), covering the period of January 1 to

February 25, 2023. The infection of the disease results painful red blisters on the hand, feet,

mouth, and throat. Considering that it is currently a contentious issue in the community for

it’s a communicable disease. Variety of beliefs with relation to how the illness might disrupt

their lives and how they envision themselves battling it as it continues to spread are now

their concerns.

General Objectives

This study aims to analyze and know how the grade 11 students’ experiences during

the COVID-19 pandemic affected their views on new viral diseases.

This research study, “The Influence of COVID-19 Pandemic to the Views of Grade

11 Students on the Hand, Foot and Mouth Disease Outbreak” seeks to find answers to the

following questions:

1. What are the insights of Grade 11 students to the Hand, Foot and Mouth Disease?
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2. What are their personal experiences on the crisis happened during the epidemic peak

outbreak of the Coronavirus Disease?

3. How did their experiences during the crisis affected their views or perceptions as the

outbreak of Hand, Foot and Mouth Disease has now become an issue of concern in

the community of Borongan?

Significance of the Study

The purpose of the study is to provide information on the selected issue from the

respondents, as well as from current studies or theses, and relevant websites for the following

expected individuals:

For the Students: This study can be significant for students as it sheds light on how

unexpected events, such as the COVID-19 pandemic, can impact their perception and

experiences of another health issues, such as hand, foot, and mouth disease. By understanding

how the pandemic affected students’ views towards this disease, students can gain a better

understanding of how public health crisis can influence their attitudes and behaviors towards

other health issues. Also, this study can be significant for students as it provides valuable

insights into the complex interplay between public health crisis and individual perceptions

and behaviors, which can help them in dealing with similar situations in the future.

For the Researchers: Being exposed to this kind of diseases, this research study

provides new knowledge to the researchers on how it could be prevented from spreading.

This study provides the researchers deeper understanding of how students perceive and cope

up with the outbreak of the Hand, Foot, and Mouth Disease (HFMD). The findings of the

study can provide valuable insights into students perceptions, attitudes, and behaviors

towards HFMD which can help inform public health and policies interventions.
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For the Parents and Guardians: This study can help parents and guardians understand

the impact of the COVID-19 pandemic on their children’s perception of health and hygiene,

and how it affects their behavior towards preventing the spread of diseases such as Hand,

Foot, and Mouth Disease. It can also provide insights on how parents and guardians can

educate their children about the disease and its prevention measures.

For the Teachers: The study on the impact of COVID-19 pandemic on the views

about the Hand, Foot, and Mouth Disease outbreak can be beneficial for teachers. It can

provide them with insights on how to communicate effectively with their students about

maintaining good hygiene practices and preventing the spread of infectious disease.

Ultimately, this study can help teachers become better educators by promoting awareness and

prevention measures against HFMD and other infectious diseases.

For the Local Government of the Barangay: This offers suggestions based on data on

how to improve student safety in classrooms and guarantee the correct application of minimal

public health requirements. The Local Government of the Barangay can help the overall

endeavor to promote a secure and healthy learning environment for all kids by putting these

recommendations into practice. This is significant because every kid has the fundamental

right to an education, and it is the duty of the government to provide that pupils have a secure

and healthy environment in which to learn. The findings of this study can be used as a guide

for other governmental organizations and businesses who are trying to find ways to enhance

their safety procedures and minimal public health requirements, thereby enhancing students'

overall wellbeing and academic success.

For the Future Researchers: The significance of this study lies in its potential to

provide valuable insights for future researchers who are interested in investigating the impact

of unexpected events, such as the COVID-19 pandemic, on the perceptions and experiences
 6

of students. By examining how the pandemic affected students views towards the outbreak of

hand, foot, and mouth disease, this study offers a unique perspective on how public health

crisis can influence individuals attitudes and behaviors towards other health issues. The

findings of this study can inform future research on how to support students in coping with

unexpected changes and disruptions to their education as well as mitigate the negative

impacts of public health crisis on their mental health and well-being.

Scope and Limitations

The general intent of this study is to know how the public health crisis can affect

peoples’ attitudes and behaviors toward other health issues.

This study will mainly identify and assess different factors that influences peoples’

views or perceptions as the outbreak of Hand, Foot, and Mouth disease has now become an

issue of concern in the community of Borongan. Also, this study yearns to identify on how

can the researchers give students better knowledge on how public health crisis can affect their

attitudes, behavior and perceptions toward other health issues.

Definition of Terms

Adhere – stick to maximum health protocol.

Conquered – being present and become nominated

Contentious – presently a topic of concern

Crisis – a period of time being in a difficult situation due to a dangerous society

Disease – an infectious illness

Dispersed – Scatter throughout the community

Envision – how someone imagine a certain situation

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Foster – develop something

Misery – state of suffering as result of facing serious conditions

Outbreak – the start of occurrence

Predefined – established in advance but not permanently

Proclaim – to announce in public

Surveillance – the act of observations to the occurrence of a serious condition

 REVIEW OF RELATED LITERATURE

Hand, foot, and mouth disease (HFMD) is a global public health issue that has gained

significant attention. However, due to the COVID-19 pandemic, forecasting and

comprehending the prevalence of HFMD has become more challenging. This study aims to

demonstrate the effectiveness and practicality of utilizing automatic machine learning (Auto-

ML) algorithms in predicting HFMD's epidemic trajectory and to investigate how COVID-19

impacts its transmission.

In December 2019, the COVID-19 pandemic emerged, presenting a significant global

public health challenge (C. Wang et al. 2020). Subsequently, the World Health Organization

categorized it as a "public health emergency of international concern," prompting nations

worldwide to implement various measures to prevent its spread. As the initial outbreak

occurred in China, the Chinese national health commission promptly activated a first-level

response to public health emergencies and implemented corresponding measures, such as

lockdowns, mask usage, work and school suspensions, and crowd control restrictions

(Bangura et al. 2020; C. Wang et al. 2020).

To diagnose cases of HFMD, healthcare providers follow the "Guidelines for the

diagnosis and treatment of HFMD" released by the National Health Commission of China

(National Health Commission 2018). The diagnostic criteria involve considering factors such

as the patient's epidemiological history, clinical symptoms, and results of pathogenic testing.

By utilizing these parameters, confirmed cases of HFMD can be accurately identified. HFMD

is a highly prevalent infectious disease, with the Asia-Pacific region experiencing the highest

incidence rates. Given the significant public health concerns associated with HFMD, it is
 9

crucial to accurately predict its epidemic trajectory and duration to effectively prevent

and control its spread. Therefore, early and precise forecasting is essential in mitigating the

impact of HFMD. (Chuan, et al., 2023)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly

contagious virus responsible for causing coronavirus disease 2019 (COVID-19). The

pandemic has had a significant impact on the global economy, resulting in a loss of over 1

trillion US dollars and claiming the lives of 4 million individuals while infecting more than

185 million people. In the absence of effective pharmaceutical agents to combat this disease

in the early stages of the outbreak, local governments have implemented non-pharmaceutical

interventions (NPIs) to slow down the spread of SARS-CoV-2 and contain the COVID-19

outbreak.

Hand, foot, and mouth disease (HFMD) is a highly infectious disease that primarily

affects children and has been widespread in China since 2007. In May 2008, it was added to

the national infectious disease surveillance program as a class C infectious disease. HFMD

exhibits semiannual peaks of activity, with a significant surge in the spring and early summer,

followed by a smaller one in the autumn. Despite efforts to control its spread, HFMD

continues to be a severe epidemic, with a continuously increasing incidence rate and a

significant burden of disease.

The implementation of non-pharmaceutical interventions (NPIs) to control COVID-19

has led to a significant reduction in the incidence of hand, foot, and mouth disease (HFMD).

As a result of the widespread use of NPIs, the HFMD epidemic peaks were either delayed or

absent, leading to a much lower number of HFMD cases than anticipated. Closing

kindergartens has proven to be an effective method of preventing outbreaks of HFMD.

(Zheng, et al., 2022)

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The impact of the COVID-19 pandemic on hand, foot, and mouth disease (HFMD)

remains unclear, despite its influence on other common diseases. Google Trends data is a

valuable resource for obtaining real-time statistics and is easily accessible, making it a useful

tool for studying infection patterns from an information-seeking behavior standpoint. Our

study aimed to use Google Trends to analyze HFMD cases both before and during the

COVID-19 pandemic.

HFMD is a disease that occurs seasonally in temperate Asia during the summer and in

subtropical Asia during the spring and fall. However, it does not exhibit a seasonal pattern in

tropical Asia, which suggests that the climate in temperate Japan may play a role in its

occurrence. In the summer of 2011, Japan experienced its most significant outbreak of

HFMD, with 347,362 cases reported.

This study aimed to analyze trends and correlations between hand, foot, and mouth

disease (HFMD) cases and respiratory syncytial virus (RSV) search terms from 2009 to 2021.

Cross-correlation analyses were conducted between HFMD cases and RSV search terms

before and during the pandemic period. Multiple linear regressions were used to identify

significant search terms that could explain HFMD cases during the two periods. Our findings

showed that HFMD cases and RSV peaked in July in most years, except for 2020 and 2021,

and increased after 2011, with peak incidence occurring every two years before 2020. The

search term "HFMD" exhibited a strong correlation with HFMD cases, except in 2020, when

the COVID-19 pandemic emerged. (Qian, et al., Biomedcentral, 2022)

The COVID-19 pandemic has caused over 185 million infections and four million

deaths, with significant negative impacts on the global economy resulting in an economic loss
 11

exceeding one trillion US dollars. Due to the unavailability of effective pharmaceutical

agents to combat this emerging disease during the initial stages of the pandemic, local

governments implemented non-pharmaceutical interventions (NPIs) to slow the transmission

of SARS-CoV-2 and contain the outbreak of COVID-19 to manageable levels.

The non-pharmaceutical interventions (NPIs) implemented during the COVID-19

pandemic provided a unique opportunity to observe the effectiveness of such interventions in

mitigating the transmission of hand, foot, and mouth disease (HFMD) in a real-world setting.

This study adopted a comparative study design to analyze and quantify the impact of NPIs on

the incidence of HFMD in mainland China during 2020. (Zheng, et al., ScienceDirect, 2022)

The causes behind the yearly occurrence of multiple outbreaks of severe hand-foot-

mouth disease (HFMD) in East and Southwest Asia have remained unclear. To investigate

this, data from HFMD surveillance between January 1, 2010, and December 31, 2015, in

Wenzhou, China, was analyzed. The study estimated the daily model-free basic reproduction

number and its annual average by incorporating incubation and infection data. The annual

model-based basic reproduction number was then computed using a kinetic model, and global

and time-varying sensitivity analyses were performed to assess potential contributing factors.

Results showed that all annual model-based and model-free basic reproduction numbers were

significantly higher than one. The study found that school openings during the spring and fall

semesters, meteorological factors in the spring, and their interactions were strongly correlated

with the annual model-based basic reproduction number, which were the primary underlying

factors contributing to the annual multiple-peak pattern of HFMD outbreaks. Based on the

results, it was concluded that school openings were mainly responsible for the peaks of

HFMD outbreaks, and meteorological factors in the spring semester should also be

considered. The study suggested that implementing social distancing measures at the

beginning of every school semester and focusing on personal hygiene and good sanitation
 12

during the spring semester could be effective measures for preventing HFMD outbreaks.

(Chenxi, Zhi, Weiming, Yongqin, & Kaifa, 2019)

Although the seasonal variation of transmission rates is a significant indicator for

understanding transmission dynamics in various childhood infections, it has primarily been

studied in industrialized nations, and its importance in studying pathogen transmission in

China has been overlooked.

Hand, foot and mouth disease (HFMD) is a contagious illness mainly caused by

enterovirus 71 (EV71) and coxsackievirus A16 (CA16), which has been present in Asia and

the Pacific regions since its first outbreak in 1957. Several countries including mainland

China, Hong Kong, Taiwan, Japan, Thailand, Vietnam, Malaysia, and Singapore have

reported cases of HFMD. In China, HFMD is one of the most commonly reported infections

in children, with an average of two million cases reported each year since 2008. It is also a

leading cause of death among childhood infections in the country. Despite the introduction of

two EV71 inactivated vaccines in December 2015 and January 2016, with some provinces

implementing voluntary vaccination from March 2016, there were still 2,468,174 cases and

220 deaths from HFMD reported in China in 2016. (Jijun & Xiangyu, 2019)

Research has demonstrated that non-pharmaceutical interventions (NPIs) for COVID-

19 can aid in the prevention and control of various infectious diseases, including intestinal

illnesses. However, most studies have focused on the short-term effects of these interventions

and have overlooked their dynamic impact over time. This study aims to examine the

dynamic impact of anti-COVID-19 NPIs on hand, foot, and mouth disease (HFMD) over

time in Xi'an City, located in northwestern China. Using data from HFMD surveillance,

meteorological records, and web searches, the study utilizes Bayesian Structural Time Series

modeling and interrupted time series analysis to quantitatively evaluate the impact of NPIs
 13

during different phases with varying levels of intensity, and to predict the hypothetical

number of HFMD cases that would have occurred in the absence of NPIs. (Li, et al., 2022)

Hand-foot-mouth disease (HFMD) is a contagious illness that primarily affects

children and is characterized by the appearance of a rash or vesicles on the hands, feet, and

tongue. It is caused by RNA viruses from the Picornaviridae family, including enteroviruses

and coxsackieviruses, and is transmitted through direct contact with infected saliva or

contaminated objects. Although the majority of HFMD cases are mild, it remains a prevalent

pediatric disease that affects millions of children every year in Asia, resulting in an estimated

97,000 disability-adjusted life-years lost annually.

During the outbreak of hand-foot-mouth disease (HFMD), school-based measures

such as temporary closure and school breaks have been viewed as effective interventions.

Nevertheless, the effectiveness of public health and social measures (PHSMs) in curbing the

transmission of HFMD, as well as the potential aftermath of relaxing these measures, remains

uncertain. (Sukhyun, et al., 2022)

This study aimed to assess the impact of general infection control measures, such as

hand hygiene, universal masking, and social distancing, on pediatric infections in Japan. The

study analyzed publicly available data on 11 pediatric infections reported weekly by sentinel

sites in Osaka and Iwate prefectures from 2010 to 2021. The data for the years 2015-2019

were compared to those for 2020-2021. Results showed that six of the 11 pediatric infections

decreased significantly during the COVID-19 pandemic, regardless of the magnitude of

COVID-19 prevalence in both areas. However, only one of the six infections was endemic in

2021. Exanthem subitum was less affected by the measures compared to other diseases. The

study concluded that the social implementation of infectious disease control measures was
 14

effective in controlling certain infectious diseases in younger age groups, where compliance

with the countermeasures may not be as high as that of adults.

The COVID-19 pandemic, which was first identified in China in December 2019, has

had a significant impact on people's lives globally. To combat the spread of the virus, public

health and social measures were implemented, including surveillance and infection control

measures. In response to COVID-19, the Japanese government declared four one-month

states of emergency in 2020 and 2021. Rather than implementing city lockdowns, the

government requested that people avoid unnecessary outings and work remotely, which was

termed a "mild lockdown". Restrictions were also placed on mass gatherings, limiting them

to 5000 participants or a capacity of 50%. In 2020, the Tokyo Olympics were postponed, and

in 2021, they were held using an "Olympic Bubble". The operating hours of restaurants,

department stores, and sports facilities were reduced, and people were encouraged to wear

masks, maintain social distancing, and practice hand hygiene when going out. Non-

compliance with these measures did not carry any legal penalties. (Naomi, Tomoko,

Toshiaki, Tatsuya, & Jun, 2022)

As of September 1, 2022, the COVID-19 pandemic has affected more than 600

million patients, and there have been over 6.4 million reported deaths worldwide [1,2]. The

mortality rates for COVID-19 differ between Western countries, such as the United States

(1.1%) and the United Kingdom (0.8%), and Asian countries, such as China (0.5%) and

Japan (0.2%) [1,2]. However, the reasons for these differences are uncertain. National

governments have faced various challenges in balancing efforts to control the COVID-19

pandemic while also stabilizing economic activity.

The COVID-19 pandemic has resulted in the adoption of public health measures and

changes in lifestyle that have impacted the epidemiology of other infectious diseases
 15

worldwide leading to a significant reduction in respiratory infections. Nonetheless, the effects

of these measures and lifestyle changes, as implemented under the mitigation policy, on

major communicable diseases in Japan are not well understood. (Kenji, Takayuki, & Hiroshi,

2023)

Before the introduction of vaccines, hand, foot, and mouth disease (HFMD)

epidemics were found to be associated with meteorological factors and air pollutants.

However, there is insufficient evidence for studies examining these associations over a long-

term period.

Hand, foot, and mouth disease (HFMD) is a significant health burden in mainland

China, and there is currently no specific treatment available for it. Between 2013 and 2016,

prior to the introduction of the Enterovirus 71 (EV71) vaccine, HFMD incidence and

mortality rates were among the highest for type C notifiable infectious diseases, affecting

over 2.2 million children each year in China (http://www.nhc.gov.cn/). While three

inactivated monovalent EV71 vaccines were licensed in China in 2016, with an efficacy rate

of 98.8% against EV71-associated HFMD, there is no consensus on their cross-protection

against non-EV71-associated HFMD. Despite large-scale vaccination efforts since 2016, the

average number of reported HFMD cases in China remained high from 2017 to 2019, with

around 2 million cases per year dominated by coxsackievirus A16 (CVA16), coxsackievirus

A6 (CVA6), and coxsackievirus A10 (CVA10) (http://www.nhc.gov.cn/). The situation has

been further complicated by the COVID-19 pandemic, during which the incidence of most

notifiable infectious diseases in China, including HFMD, showed a downward trend.

(Hongxia, et al., 2022)

The COVID-19 pandemic has caused significant disruptions to education globally in

2020. Governments have implemented measures to reduce the spread of the virus, including
 16

limiting social contact, suspending face-to-face teaching and exams, and restricting

immigration for Erasmus students [1]. As a result, many traditional classes have been

replaced with distance learning using books and online resources. E-learning platforms have

facilitated interaction between teachers and students, and in some cases, education has been

delivered through national television shows or social media platforms. Additionally, some

education systems have introduced exceptional holidays to allow for better preparation for

this new distance-learning scenario.

The aim of this article is to provide clarity regarding the assessment process in higher

education during the COVID-19 pandemic. To achieve this goal, we have conducted an

analysis of students' learning strategies before and after the period of confinement. Based on

our findings, we conclude that autonomous learning during this period has improved students'

academic performance, resulting in higher scores. We have also explored the underlying

reasons for this effect. Our study involved more than 450 students enrolled in three different

degree programs at Universidad Autónoma de Madrid (Spain) over a three-year period,

including the 2019/2020 academic year when COVID-19 restrictions were in place. (T.

Gonzalez, 2020)

The COVID-19 pandemic has had a significant impact on the education system

worldwide, resulting in the closure of schools, colleges, and universities to prevent the spread

of the virus. This closure has created various challenges for students, teachers, and parents.

To overcome this challenge, distance learning has been introduced as an alternative method

of continuing the education system. However, developing countries are facing difficulties in

implementing this method due to a lack of network infrastructures, computers, and internet

access. In this paper, we aim to review the impact of the COVID-19 pandemic on the

education system in developing countries. To address this issue, countries have implemented

strategies such as utilizing educational technology, providing zero-fee internet educational

 17

resources, and offering free online learning resources. Educational institutions have also

designed curriculums and teaching-learning strategies for post-coronavirus closures, as well

as developing strategies to recover lost learning and reintegrate students into school when

schools reopen. The pandemic has had a severe impact on the traditional face-to-face

education system of developing countries, and thus, there is a need to enhance virtual class

infrastructures, online teaching, and broadcast teaching. (Seble & Worku, 2020)

HFMD has become an endemic disease in several countries, but it was neglected in

the Asia-Pacific Region until the end of the twentieth century when it caused continuous

outbreaks in countries such as Malaysia, Taiwan of China, Singapore, Japan, Australia, and

the Republic of Korea In China, the first reported case of HFMD was in Shanghai in the

1980s , but it did not receive much public attention until two major outbreaks occurred in

2007 and 2008. The 2007 outbreak in Linyi City, Shandong Province, resulted in 1149 cases

with three fatalities , while the more severe outbreak in Fuyang City, Anhui Province in 2008

led to 6049 cases with 20 deaths Since May 2008, China has established a national system to

monitor HFMD . The disease has become a major infectious disease in the country with an

incidence of approximately 1.2 per 1000 person-years and responsible for a total of 500-900

deaths annually.

HFMD is an infectious disease that can be transmitted through close personal contact,

contact with contaminated objects and surfaces, respiratory pathways, and fecal-oral

pathways (https://www.cdc.gov/hand-foot-mouth/about/transmission.html). Meteorological

factors can affect all transmission channels as well as the survival of enteroviruses in vitro .

However, studies investigating the relationship between meteorological factors and HFMD

incidence have produced inconsistent results. For example, a study in Guangzhou showed an

approximately linear relationship between temperature and weekly HFMD cases, with

weekly HFMD cases increasing with weekly average temperature . Meanwhile, studies from
 18

other areas, such as Singapore and Japan, revealed non-linear associations, with the

relationship varying within the lag range. The discrepancies in the results can be attributed to

several possible reasons. (Yue, et al., 2020)

 METHODOLOGY

This chapter discusses the research design, respondents of the study, research locale,

and research instruments.

Research Design

This study is qualitative research, the researchers use narrative report as the research

design. This will focus on the influence of COVID-19 pandemic to the views of Grade 11

students in ESNCHS on the Hand, Foot, and Mouth Disease outbreak. Furthermore, the

researchers will be distributing questionnaires to a certain number of students from different

sections of Grade 11.

Respondents of the Study

The respondents of this research are Grade 11 students who are studying in Eastern

Samar National Comprehensive High School (ESNCHS). The researchers utilize Purposive

Sampling. By using their knowledge to choose certain participants who would help the study

accomplish its goals, researchers use a non-probability method of sample collection knows as

“purposeful sampling” to collect a sample. Since the purpose of this study is to collect the

views of the respondents on the outbreak of the Hand, Foot, and Mouth Disease, the sampling

technique will fit.

Research Locale

The locale of this research will be done inside the school campus of Easter Samar

National Comprehensive High School (ESNCHS), which is located at Brgy. Alang-Alang,

Borongan City, Eastern Samar.

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Research Instruments

In this study, the research will be conducted using an open-ended questionnaire

(Refer to appendices A). The questionnaire are research instruments used to collect data from

the participants. The survey questionnaires are in the form of bond paper and will be

distributed inside the school campus of Eastern Samar National Comprehensive High School

(ESNCHS). It contains questions designed to gather information about the participants views

or perceptions.

Data Gathering Procedure

Primarily, the researchers must have a request letter that will serve as a consent in

conducting a survey, which will be validated by the subject teacher. The researchers will be

distributing survey forms, particularly an open-ended questionnaires to the Grade 11 students

in Eastern Samar National Comprehensive High School. It must be filled out by the

respondents in order to collect data which indicates their personal experiences and how those

experiences affect their views on the latest topic of concern in the community of Borongan.

The researchers will explain the purpose of the study to the selected respondents and will

make sure that each participant corresponds to the predefined criteria. After the respondents

have taken the tests; the papers will be checked, tallied, interpreted, and analyzed. (Refer to

appendices A and B)

Data Analysis

A Thematic Analysis will be used by the researchers in their investigation. The

emphasis of Thematic Analysis is on finding, understanding, and interpreting patterns of

meaning in qualitative data. Making sense of the data is an active reflexive process where the
 20

researchers personal experiences is crucial. The Researchers will use a textual and descriptive

approach to interpret the participants responses to the questionnaires that they will present.
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AIMS Press: https://www.aimspress.com/article/id/3480

Chuan, Y., Shuyi , A., Baojun, Q., Peng, G., Desheng, H., & Wei, W. (2023). Retrieved from

Springer Link: https://link.springer.com/article/10.1007/s11356-022-23643-z

Hongxia, P., Zhenhua, C., Lin, C., Juan, L., Ke, Z., Shuo, L., . . . Chunxia, Y. (2022).

Retrieved from Springer Link: https://link.springer.com/article/10.1186/s12889-022-

13365-9

Jijun , Z., & Xiangyu, H. (2019). Retrieved from Biomedcentral:

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4153-6

Kenji, H., Takayuki, H., & Hiroshi, K. (2023, March). Retrieved from ScienceDirect:

https://www.sciencedirect.com/science/article/pii/S1201971223000139

Li, S., Minghao, S., Shuxuan, S., Qingwu, H., Nuoya, W., Guangyu, U., . . . Kun, L. (2022,

March 11). Retrieved from Wiley Online LIbrary:

https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.27715

Naomi, S., Tomoko, T., Toshiaki, Y., Tatsuya, S., & Jun, K. (2022, September). Retrieved

from MDPI: https://www.mdpi.com/2076-2607/10/10/1947

Qian , N., Junyu, L., Zixi , Z., Miyu, O., & Asuka, K. (2022). Retrieved from Biomedcentral:

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07790-9
 21

Qian, N., Junyu, L., Zixi, Z., Miyu, O., Asuka, K., Anuradhi, B., . . . Momoko, N.-T. (2022).

Retrieved from Biomedcentral:

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07790-9

Seble, T., & Worku, M. (2020, October). Retrieved from Scrip.org:

https://www.scirp.org/journal/paperinformation.aspx?paperid=103646

Sukhyun, R., Changhee, H., Sheikh, T. A., Chiara, A., Bingyi , Y., & Sen , P. (2022,

September). Retrieved from Research Square:

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18e66f252f67.pdf?c=1664243338

T. Gonzalez, M. A.-L. (2020). Retrieved from National Library of Medicine:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546684/

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Zheng, Z., Canjun , Z., HongChao, Q., Yue, C., Ward, M. P., & Fengfeng, L. (2022, January

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APPENDICES A

Survey Questionnaire

In this paper, this will be the questionnaire that the researcher will use as their

research instrument in gathering data. This will be spread throughout the campus of Eastern

Samar National Comprehensive Highschool, mainly given to grade 11 students. The gathered

data will then be checked, tallied, interpreted, and analyzed.

Name (optional): _______________________________________

Section(required):_____________________

1. What have you experienced during the peak of COVID – 19?

2. What have you done to keep yourself and your family safe during the peak of COVID –

19?

3. What are your thoughts on the new outbreak, the Hand, Foot, and Mouth Disease?

4. How will you respond to this outbreak with the knowledge that you have?

5. How did your experiences affected your views on new diseases, such as Hand, Foot, and

Mouth Disease?
 23

APPENDICES B

Request Letter

Dear Ma’am,

Greetings!

We would like to ask for your permission to allow us to conduct a survey among Grade 11
students. This is in view of our research, entitled, “Influence of COVID-19 Pandemic to the
Views of Grade 11 Students in ESNCHS on the Hand, Foot and Mouth Disease Outbreak.”
The survey will only last for about 5-10 minutes and will be arranged at a time convenient
among the teachers and the students.

The participation in the survey is entirely voluntary. All information provided will be kept in
utmost confidentiality and will only be used for academic purposes only.

If you agree, kindly sign below acknowledging your consent and permission for us to conduct
this survey at Eastern Samar National Comprehensive Highschool. Each parties will have a
copy of the signed form and will be handed to you in an enclosed envelope.

Sincerely,
Abobo, Bryce Kerby Y.
Balagbis, Princess Janel A.
Consultado, Beyonce C.
Deratas, Angeli Dea Paz R.
Pajares, Jamby M.
Pascua, Aljade Faith O.
Ramos, Aisa Jane B.
Rebato, Jan Benedict D.

Approved by:

__________________________ _____________
Printed name and Signature Date