The head of the snake

If a person has multiple wounds, responders first attend to the deepest or most serious one.

Or to use another analogy, if you are threatened by a snake, you cut off its head.

Dominican priest and molecular biologist Nicanor Austriaco uses these analogies to support his position that pouring 90 percent of COVID vaccines into the National Capital Region, epicenter of the pandemic, would speed up recovery all over the country in terms of both health and the economy.

“If the head of the snake is cut off, what the local authorities in these other provinces will discover is that it actually becomes easier for them to control their pandemic because there are fewer cases coming from the capital,” he explained.

“Whenever we see a surge or a spike in one of the provinces, it can usually be traced to a traveler from NCR who has brought the virus to that province. The idea here is that by cutting the head of the snake off, the provinces would be able to better mitigate the pandemic and you will not have new cases imported from the NCR,” he said.

Citing the sheer population size in the NCR, Father Nic noted that spikes recorded in the provinces are relatively small compared to the number of new cases in the capital.

“It would help the entire country all at once without necessarily reaching herd immunity in the entire country by Christmas,” he said, referring to their vaccine prioritization proposal.

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Any resident of the National Capital Region will be accused of bias in this debate. Father Nic, however, is a visiting professor from Providence, Rhode Island, and he doesn’t need to be prioritized for vaccination in the NCR. He already got his second dose of the Moderna jab in the United States, where he teaches biology and theology.

Father Nic, who faced “The Chiefs” on One News last Friday together with his fellow OCTA Research team member Guido David, said the 90 percent vaccine allotment for the NCR is no idle suggestion. The figure was not plucked out of thin air but was based on vaccine optimization modeling that he and a graduate student from the University of the Philippines in Diliman prepared.

They used five different vaccination scenarios: an “all-country deployment” in accordance with the current 40 percent allotment to the NCR and 60 percent to the rest; NCR first; NCR Plus first; NCR, Metro Cebu and Metro Davao first; and NCR Plus, Metro Cebu and Metro Davao first.

“Which one would lead to the lowest number of cases in the pandemic, given the limited number of vaccines?” Father Nic asked. “We discovered that the most efficient (priority) deployment would be in the NCR.”

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The “NCR first” model entails vaccinating 70 percent of Metro Manila’s above-18 population – an estimated 9.66 million – or 19.3 million doses of two-dose jabs, ASAP. If the government’s schedule of vaccine arrivals is on track, the required jabs would be here by July. Over three months, 200,000 doses must be administered daily, says Father Nic.

Vaccinating 45 percent of the NCR population – about 6.21 million adults – can result in COVID “containment,” which Father Nic describes as the first step in ending the pandemic, allowing full economic reopening.

Cagayan de Oro Mayor Oscar Moreno in fact told The Chiefs last week that whenever there’s a COVID spike or surge in the NCR, similar increases are usually registered weeks later in the city.

Still, the “NCR first” vaccination scenario does not sit well with some local government executives, especially those whose areas are currently grappling with a COVID surge. Iloilo City Mayor Jerry Treñas told The Chiefs that people should not play God, and that he would never forget if more people die in his city because it was not in the vaccine deployment priority list.

Asked for comment, David, a math professor in UP, said, “I disagree that we are playing God. This is a scientific study and the decision ultimately rests with the national government… they don’t always go with the recommendation of OCTA… This is just a scientific model that Father (Nic) and his team undertook.”

He and Father Nic are urging policy makers to assess the science behind the “NCR first” and examine their modeling, which has been released.

“There is no sense of abandonment here. This is a long-term perspective, to try to end the pandemic as quickly as possible,” Father Nic said, adding that they are looking at six months to attain the objective.

“Whether it’s the head or the heart, you want to kill the snake, and we want to kill the snake as fast as possible so that we as a country can heal as fast as possible,” Father Nic said. “This is one scenario that the scientific model is proposing.”

Dakila Cua, governor of Quirino and national chairman of the League of Provinces of the Philippines, said he wanted to look at the modeling first. But he expressed openness to the “NCR first” model. He said he could sell this to his constituents if it is emphasized that it would be for the good of their province and the entire country.

Cua can look at the scientific manuscript, which OCTA has uploaded to an international pre-print server. Father Nic says they can send the modeling manuscript to health and economic managers for consideration in policy-making. OCTA also intends to invite other scientists and experts, to see if the model can be improved.

In assessing the modeling, Guido David has one appeal: please go with the science.