We need a Dr. Fauci

DEMAND AND SUPPLY - Boo Chanco - The Philippine Star

Our worst problem today is the absence of a credible person to look up to for guidance. In the US, even when Trump was at his worst behavior, they had a Dr. Anthony Fauci to turn to for the real score based on science.

Unfortunately for us, we do not have a man of science with Fauci’s caliber to help us sort out the facts behind this pandemic. The only doctor on our government’s COVID response team is the Health Secretary. Unfortunately, he is more of a politician than a physician.

Sec. Duque damaged his reputation early by citing a political reason in declining a ban on Chinese travelers from Wuhan, the pandemic’s epicenter at that time. He also didn’t seem to understand the value of testing and delayed efforts to expand beyond the testing facility at RITM.

Worst of all, Sec. Duque never developed a plan and neither did the former generals calling the shots.

I have managed quite a few crisis situations in the course of my career and the two absolute necessities to win public support are: 1) credible and up-to-date information, and 2) a credible spokesman. People want to know the score so they can manage their response. The Duterte administration chose to keep us guessing.

A good crisis plan should have an abundance of timely information so that people will not be waylaid by fake news that arises in the absence of anything else. A good crisis manager must always be ahead of the curve.

Over the past year of the pandemic, I have noticed that we could have had our version of Dr. Fauci in Dr. Edsel Maurice Salvana, unfortunately, he damaged himself early by speaking like a spokesman for Duque.

Dr. Salvana even had a very cocky tweet when he thought the country already contained the virus just weeks after it got here: “We saved your butt. You’re welcome.”

Of course, he was wrong because he was playing politics rather than sticking to pure science. The epidemic was just starting to get pretty bad. Dr. Salvana got his dose of humility after being bashed on social media. From then on, he became more circumspect in his public postings.

Indeed, I consider his recent postings very helpful.

Dr. Salvana has the credentials to make sense. He is a specialist in infectious diseases and tropical medicine, the same specialties my late father had.

An honor graduate of UP, Dr. Salvana trained in the US and was a Balik Scientist of DOST. He is now the director of the Institute of Molecular Biology and Biotechnology at the National Institutes of Health at the University of the Philippines Manila.

Dr. Salvana has also co-authored over 60 papers in international conferences and peer-reviewed journals and written 12 book chapters and review articles.

With such good credentials, Dr. Salvana could have kept his academic perch at UP and be the scientist we look up to for facts.

Today I want to share his latest memo because it is an important one that could save lives:

“First, all approved vaccines prevent SEVERE disease in almost ALL patients (near 100 percent at preventing DEATH). The 50 to 95 percent range of vaccine efficacies refer to mild clinical disease.

“It would be nice to not get a cold, but between waiting for a ‘better’ vaccine and taking an available vaccine, take the one offered now. Especially if you are in the vulnerable population. You might not survive to see a ‘better’ vaccine.

“Second, mixing vaccines is still experimental, but the studies are ongoing. This is something we do for pneumonia vaccines, but the sequencing and types of vaccines to mix are still unknown. This needs to be done properly, otherwise it may have consequences on safety and efficacy.

“Third, in general, a delay in the second dose of any vaccine (not just COVID-19) is not a big deal. We have catch-up immunizations all the time.

“What you do not want to do is give it too early. For instance, Sinovac at a two-week interval in healthcare workers was about 50 percent effective in at least mild disease, but this went up to 70 percent when given at four weeks interval. Astra seemed to work better if the second dose was given at 12 weeks compared to four weeks. This is why we are constantly tweaking the intervals as more data comes in.

“Fourth, the issues with blood clots are on the order of one to 10 out of a MILLION doses given. In contrast, the risk of DYING of COVID-19 for people above 60 years old is one out of 10.

“The pauses in administration are to identify remedial measures to further lower risk, especially in people who may be predisposed to clots. Nevertheless, the benefit of getting vaccinated, especially for vulnerable populations, OVERWHELMINGLY favors benefit over risk. The reviews and pauses are part of the safety mechanisms and shows that these safeguards are WORKING.

“Fifth, we do not know how long the protection lasts for any of our current vaccines. This is because the follow-up period for all the vaccines is still at the six-to-eight-month

stage. So far, they seem to all have DURABLE immunity at this stage and chances are this will carry over for at least a year. If they do not last for a lifetime, boosters can be given, but the timing for now is uncertain.

“Sixth, the vaccine passports are still being worked out. The vaccines that will be included are by no means final and there has already been a statement that all available vaccines will be considered. Do not let this stop you from getting an available vaccine.

“I hope this helps people make a decision towards vaccination. The fear of side effects is real, but the actual risk is incredibly miniscule compared to the risk of getting COVID-19, especially in high-risk areas.

“Personally, I am terrified of COVID-19, that is why I got vaccinated with the first available vaccine. Now I have a lot more peace of mind to face my patients. I want the same peace of mind for you. Please get vaccinated when it is offered to you. Stay safe.”

There it is. Clear and concise… just the science and no politics.



Boo Chanco’s e-mail address is bchanco@gmail.com. Follow him on Twitter @boochanco

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