First word

IMAGINE how different the Philippines’ pandemic response (policy, strategy and program) would have been had the members of our coronavirus task force (Inter-Agency Task Force for the Management of Emerging Infectious Diseases), and the czars of the National Action Plan (NAP), possessed some familiarity or background in addressing the special concerns of public health and medicine.

With such background and knowledge, the officials would have borne in mind the words of the Hippocratic oath, “First do no harm,” in framing the action plan to meet the challenge and in writing the specific measures and protocols that would govern national life during the pandemic.

There is wide debate today about the government’s Covid-19 response because President Duterte opted to lean again on people with a military or police background to man the ramparts of the government’s program to contain the pandemic.

He neglected to include in the task force civilians and professionals with a working knowledge of infectious diseases and viral outbreaks, and how these can best be fought off by the public health system.

First do no harm

The phrase “First do no harm” (Latin: Primum non nocere) forms part of the original Hippocratic oath, a pledge of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it required a new physician to swear, by a number of healing gods, to uphold specific ethical standards.

The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today.

As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. Swearing a modified form of the oath remains a rite of passage for medical graduates in many countries, and is a requirement enshrined in legal statutes of various jurisdictions, such that violations of the oath may carry criminal or other liability beyond the oath’s symbolic nature.

Today, when governments and nations are scrambling to find an effective and sustainable strategy for fighting SARS-CoV-2 (the virus) and Covid-19 (the disease), I suggest that the best way would be for nations to work through the principle of doing no harm 1) first to the people as potential victims of Covid-19; and 2) doing no harm to the society or the nation that ultimately must bear the full burden of the pandemic.

Now when effective vaccines and therapies against Covid-19 are being produced by modern medicine, policymakers will do their best work with a Covid strategy and program of doing no harm and being always beneficent.

Lockdown lunacy

Early in the pandemic, in March and April last year, most countries followed the policy and strategy adopted by China in its attempt to eradicate the viral outbreak that was believed to have originated in the city of Wuhan in Hubei province. China imposed a mass quarantine or lockdown in Wuhan and stopped travel to other Chinese cities and countries.

In these circumstances, lockdown lunacy was born during the pandemic.

The author Jeffrey Tucker describes vividly what happened to the world during this time in his book, Liberty or Lockdown (American Institute for Economic Research, New York, 2020). He wrote:

“The politicians panicked. They feared being blamed for any and all deaths from this one virus while forgetting other ailments. The Covid-19 fear drove out every other consideration. It was madness but it was only supposed to last a couple of weeks until it turned out to last six months and longer.

“Why didn’t we revolt? Part of the reason was that most of us were in shock. We had to believe that there was some good reason, some rationale, for these policies. But as the weeks and months rolled on, the terrible truth began to dawn on more people. This was all for naught. We destroyed the country, and much of the world, and everything people had worked hard for centuries to build, to try out something that had never been tried before. It didn’t work. The virus took its own path. And today we are left with the wreckage.

“How do we come back from this? By reflecting, learning and acting on the promise of renewal. It can happen, but only once we fully come to terms with the stark choice between liberty and lockdown. Liberty is right and it works. Lockdown is wrong and it does not. It’s not complex, but it takes courage and determination to live out that principle.

“The virus will vanish from the public mind as viruses do — inauspiciously as our clever immune systems incorporate its properties into our internal resistance codes. But we will have another struggle facing us in the years ahead concerning what precisely we are going to tolerate from our state officials and how much of a priority we are going to place on retaining our rights and liberties. This choice is something we must all face in our own lives, and then work to see instantiated in the legal structures of societies we hope can maintain their freedom.”

I want to refer next to the counsel of Dr. Scott Atlas of Stanford who was added by then President Donald Trump to the White House coronavirus task force. This effectively sidelined the headline-hogging Anthony Fauci, who told America that we would never be able to shake hands again. Fauci demanded a lockdown of the economy for an indefinite period.

Last December. Dr. Atlas wrote an op-ed article on pandemic policy in The Hill website titled: “Restore our lives using medical science, data and common sense.”

He spoke to the need for a practicable strategy to exit from the pandemic. He wrote:

“Americans are anxious to get back to work and to send their children to school. The science backs them up. We have learned a lot over the past months, and we are putting that knowledge to use. We are capitalizing on the advanced capabilities that we have developed, as we redouble our efforts to protect vulnerable populations and deliver new and effective treatments in record time.

“Here’s what we now know:

“We know who is at risk. Only 0.2 percent of US deaths have been people younger than 25, and 80 percent have been in people over 65; the average fatality age is 78. A JAMA Pediatrics study of North American pediatric hospitals flatly stated that “our data indicate that children are at far greater risk of critical illness from influenza than from Covid-19.

“We may see more cases as social interactions pick up because this is a contagious disease. However, the overwhelming majority of cases are now occurring in younger, low-risk people — decades younger, on average, than seen in the spring. And the vast majority of these people deal with the infection without consequence; many don’t even know they have it.

“We are doing much better with treating hospitalized patients. Lengths-of-stay are one-third the rate in April; the fatality rate in hospitals is one-half of that in April. Fewer patients need ICUs if hospitalized, and fewer need ventilators when in ICUs.

“We are progressing at record speed with vaccine development.

“Despite these gains, our economy has yet to fully reopen.

While the lockdown may have been justified at the start, when little data was known, we know far more about the virus today. It’s time we use all we have learned and all we have done to reopen our schools and our economy safely and get back to restoring America.”

Catch-22 situation

The Philippines cannot continue with the present policy of renewing month after month the community quarantine policy. It is unsustainable and dumb.

It is a classic catch-22 situation for the nation.

The IATF-EID never had success with its quarantine strategy and health protocols through all of last year.

The task force is reluctant to move toward an exit strategy from the pandemic because without the crisis it will lose its powers and privileges, along with being called czar.

[email protected]