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Manageability

FIRST PERSON - Alex Magno (The Philippine Star) - March 23, 2021 - 12:00am

In the end, the IATF decided against returning Metro Manila and surrounding provinces to ECQ status. There were enough voices asking for such a return.

The costs of a blanket lockdown of an area that accounts for nearly half the national economy is simply too costly. The marginal benefits of doing so hardly merit the action.

Given the temptation to indulge in political grandstanding given what might appear to be a setback, the authorities will do well to sharpen the messaging and manage the expectations of what can and cannot be done given the realities.

It should be made clear that the best we can do is to keep the pandemic manageable for what can be an inconvenient period. The main criterion of manageability is the actual capacity of our health care system.

We can extend that capacity by investing more in hospital facilities – but even that will require time. We can buy bed and medical equipment at the soonest. But we cannot produce overnight the health personnel we need.

It is noteworthy our exhausted medical workers have not asked for a “timeout” like they did August last year – even as the daily infection numbers broke records the past week. Instead of a “timeout,” the IATF has asked local governments to undertake “granular” lockdowns of heavily infected neighborhoods.

Now is the time to honestly tell our people that stamping out the virus is not a realistic goal into the foreseeable future. The pandemic will resurge in waves. There are not enough vaccines available to stop those waves, only to contain their severity.

It is, frankly, not our goal to achieve “herd immunity” for our people soon. There is no consensus in the scientific community about what “herd immunity” really means. The estimate that we achieve herd immunity by vaccinating 70 percent of the population is a guess unsupported by scientific evidence.

The concept of herd immunity probably needs to be a global measure rather than a country condition. For as long as infections are breaking out anywhere, there can be no herd immunity.

What “herd immunity” could practically mean is that outbreaks of infection are kept small and confined. COVID-19 infections could keep recurring for years, like the common cold. We might need to be vaccinated repeatedly for the rest of our lives.

We need to tell our people that vaccines, powerful as they may be, are only a part of the comprehensive package of mitigation measures. Even if they arrive in bulk, the vaccines will not displace the other mitigation measures in the near future.

A “silver bullet” solution to this calamity is always a seductive one. We must dissuade our people from the thought a “silver bullet” is at hand.

There was much noise on social media the past few days over health authorities “impeding” private sector efforts to procure vaccines on their own. To be sure, our food and drug regulatory authorities have been pretty conscientious (often mistaken as hard-hearted).

Government messaging should focus on the basic points. All of the vaccines available are experimental in nature. This is why they are dispensed only on the basis of emergency use authorization (EUA). This is why all procurement is tripartite in nature and can involve only vaccines granted EUA.

Otherwise, we will face a terrifying situation where the country becomes some sort of Wild, Wild West for vaccines. We cannot have an unregulated flea market for every sort of snake oil salesman. Otherwise, our people will be put at risk of counterfeit vaccines or jabs of questionable efficacy.

There could be zealots in the regulatory agencies, of course. One proposes that corporations wanting to procure vaccines on their own be screened on the basis of the products they make. That is plainly and simply class legislation. It is arbitrary and whimsical.

The same consideration goes for therapeutic drugs endorsed by all sorts of social media personalities and their respective fan bases. These drugs require rigorous scientific trials. They cannot be allowed simply on the basis of anecdotal evidence or the testimonies of individuals who are not scientists.

This is ultimately the line that must be drawn if we want a truly science-led response to this public health crisis: critical benchmarks for trials must be maintained. The integrity of science must be conserved. Otherwise, the effort to contain this pandemic will be overrun by hacks of every variety.

In an emergency such as we are in, there will always be tension between process and speed. The processes stipulated by our regulatory framework are most rigorous. They must be respected.

We should not sacrifice process to favor speed, the public health emergency notwithstanding. There is peril in that. The best we might aspire for, if that is humanly possible, is to speed up the prescribed processes.

Unfortunately, in our country, we have a paucity of scientists and an abundance of politicians. Social media magnifies the gap. Mainstream media consistently fails to point out that some of our politicians are really unqualified to say the things they say. That is always unhealthy.

For entirely political effect, we have heard politicians pronounce the national effort to contain the pandemic an utter failure. They fail to point out severe waves of infection are surging across the globe. Our own surge must be put in that context.

The fight against the pandemic is a work in progress. It is too early to declare victory or to pronounce defeat – not here, not anywhere else.

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