There is an ongoing debate here and in the United States about how much influence physicians should have in deciding what governments should do to protect the population from the coronavirus disease 2019 or COVID-19.
It was initially seen as a health issue, so the default opinion is to let the doctors prescribe what to do. But it is clearly more than a health issue and the current prescription may turn out worse than the threat of the virus.
The Department of Health, through Secretary Francisco Duque, has been stonewalling on mass testing. They have cited scientific reasons why only their way is acceptable. Problem is, the capacity of DOH to do a lot of testing has been extremely limited over the last month or so.
Some LGUs, worried about how the disease is affecting their constituents, are moving to do their own tests. But as in the case of Marikina, DOH had been doing its best to not make that happen. It is almost as if DOH is afraid of losing monopoly over testing.
The Philippine College of Physicians (PCP) and the Philippine Society for Microbiology and Infectious Diseases (PSMID) have issued a joint statement in support of DOH. They are also discouraging the use of rapid antibody tests for COVID-19.
They say the antibody tests are poor tests. They made recommendations that go against the successful experience of South Korea, Taiwan, and Germany.
But I know where our doctors are coming from. I come from a family of doctors and I quickly recognize the paternalistic medical tradition by which doctors are trained.
My late father, a professor of medicine, freely allowed us to express our opinion around the dinner table. But when it comes to matters of health, specially microbes which was his specialty, he was as infallible as the Pope.
Doctors and scientists are not used to having their authorities questioned. Even Dr. Anthony Fauci had admitted in an interview: “There was a feeling in science that doctors know best, scientists know best.”
Given the massive negative impact of the virus threat on every aspect of our lives, it is more than doctors that have the training and experience to have the final say. Unless they are like that Stanford professor of medicine who also has a PhD in economics.
Incidentally, that Stanford doctor’s views on handling the coronavirus pandemic is so different from what our DOH doctors are saying. That’s because he understands economics too.
As I explained last Monday, the doctors can go ahead and do their gold standard test in managing their patients. If I were a patient, that’s what I would prefer too.
But the test for antibodies, even if there is possibility of false positive and false negative results, has a different purpose. It is supposed to generate data to give decision makers an idea of how much the virus has infected the population and where the hotspots are.
Provided the mass testing is done under the supervision of qualified statisticians using random sampling, this is an effort worth taking. I heard they are now talking to Kantar and Nielsen, both reputable market research agencies, on how to design the test. This is good news if it is true.
The doctors shouldn’t worry about the costs of doing so many tests because the cost of the continued lockdown has already been a lot higher. The lockdown is causing serious economic and social problems.
We have closed down the economy and disturbed the logistical supply line for everything, including food. Even the supermarkets are not as quick in filling up their shelves of some food products, processed and fresh.
We are now using up the inventory of products manufactured before the lockdown. Soon there will be no more and it is not easy to restart production quickly enough.
We cannot afford an indefinite lockdown. Some weeks ago, UnionBank chairman Justo Ortiz warned us about problems emerging in our food supply line:
“At this point in time of great global difficulty brought about by COVID-19, we cannot anymore solely (or partially) rely on imports to feed our population. We have to rely on our national capacity and capability to feed our own population.
“The threat of hunger is worse than the threat of a virus. Even those who survive this virus will have to contend with the lack of food and a non-existent food production and producers.
“Every day that we disrupt the supply chain for food security is a day of food off everybody’s table.
“May I remind everybody that food does not appear like magic. It has to come from somewhere. And that somewhere is sometimes called ‘raw materials’. If you think that raw materials cannot be eaten, think again.
“May I also state that these raw materials, including farm produce, do not miraculously come out of a magic box. People, those whom you locked down in their homes and prevented from crossing checkpoints, make your food
“May I tell you, and I will stand my ground on this, this WAR is 90 percent logistics, five percent health, three percent enforcement and two percent common sense.”
Here is an appropriate observation in a recent opinion piece in the Wall Street Journal:
“The demands of health-care experts are not greater than the demands of the economy, for a very simple reason: The health-care system is not separate from the economy, but a crucial part of it.
“The healthcare system saves lives; the economy provides everything we need to live. The damage being done to the economy— if sustained—could easily cost more lives worldwide than the coronavirus.
“Scientific expertise and specialization inform good policy, but they should never be the final word…
“Common sense says that if a disease threatens to kill millions of elderly people already afflicted by disease, those people should be sequestered and protected. But the rest of us should proceed with our work, taking prudent precautions, even if some of us die anyway.”
It’s time to look at the big picture.
Boo Chanco’s e-mail address is bchanco@gmail.com. Follow him on Twitter @boochanco