Fighting the COVID-19 war

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Fighting COVID-19 is no different from fighting a war.

Perhaps this is why President Rodrigo Duterte has tapped seasoned current and ex-generals to fight this virus: National Task Force Head Carlito Galvez, Jr., Defense Secretary Delfin Lorenzana, Local Government Secretary Eduardo Año, Social Welfare Secretary Rolando Bautista, Philippine National Police Chief Archie Gamboa and Armed Forces of the Philippines (AFP) Chief of Staff Felimon Santos.

GERM WARFARE
COVID-19 is in the realm of germ warfare which uses infectious diseases, such as bacteria, viruses, or fungi, to disable or kill humans, animals, or plants.

It all started in Wuhan, China. Nobody really knows how it was unleashed; only history will tell.

THE ENEMY
Experts call the enemy SARS-Cov-2, i.e., Severe Acute Respiratory Syndrome Corona Virus 2, a strain of the earlier and deadlier SARS COV. It is invisible, insidious and deadly, highly transmissible, knows no borders and targets the vulnerable.

It seems to give mankind some lessons:

First, germ warfare, if unchecked, could be deadlier than wars among nations.

Second, nations must work as one if the disease is to be vanquished.

Third, it has exposed social injustice everywhere — most victims are the poor, colored, ethnic minorities, and the elderly who live in appalling conditions, without access to healthcare.

Fourth, it generally spares children and women (So homo sapiens can survive?).

Fifth, it prefers to strike men. Are men more obsessed with power, fame, and fortune than with humanity — helping others, forgetting self-interest, and giving love?

Finally, it has cleared the skies. Is it time to stop using fossil fuel for cars, factories, and power plants to save the planet?

FOUR FS OF FIGHTING A WAR
The military refers to four Fs which are: “Find ‘em (the enemy), Fix ‘em, Fight ‘em, and Finish ‘em.”

Find ‘em (test, contact trace) — COVID-19, although invisible to the naked eye, is a parasite so it can be detected in the hosts or the infected through testing.

There are two types of hosts: the symptomatic or the asymptomatic. Finding the symptomatic is easy — they generally seek medical help. Looking for the asymptomatic is more difficult — they look healthy; some with mild symptoms like a cough or a cold; and move around freely, shedding the virus. They are like guerillas or terrorists staying in communities while spreading the disease. They can only be found through contact tracing.

There are two types of tests: the first, PCR (Polymerase Chain Reaction) which detects the presence or absence of COVID-19, is the gold standard. The second, an antibody test, looks for antibodies which indicate that someone has been infected in the past.

My layman’s opinion of these two tests:

The PCR test, although the gold standard, is hazardous (possibly infected mucous swabs as samples); expensive (P8,000.00 or more per test); done off site and slow (distant laboratories; hours to produce the result; thousands of samples on queue) and probably with lower sensitivity due to improper sampling. It is, however, a must for diagnostics.

The antibody test, albeit new, is safer (finger prick blood as sample); cheap (P250 to P500 per test); done onsite and fast (15 minutes for result); probably with lower sensitivity as it needs more clinical trials; and not for diagnostics. It can, however, identify those that had been infected for health profiling which could indicate whether it is relatively safe for a business or community to return to normal.

When the existence of COVID-19 was announced in December 2019, the health department could have tested and contact traced incoming travelers, especially those from Wuhan. They did it later, and not much has happened since then. Now, we are like New York State, scrambling for resources, trying to contact trace the infected to isolate them.

Early on, the health department insisted on centralized, slow, and expensive PCR tests done in government laboratories only. After much pressure for mass testing, the Department of Health finally agreed to decentralized, public and private testing, aiming for 8,000 to 10,000 tests per day. They, however, stopped publishing daily test results for no apparent reason. Our tests per million is a pathetic 660; South Korea’s is 11,390; the USA, 13,071; and Germany, 24,738.

Fix ‘em (Isolate, flatten the curve) — The Wuhan experience shows that home quarantine does not work. Ordinary people are not trained well enough to follow safety protocols (the infections in Chris Cuomo’s family while in self-quarantine is an example).

The infected must stay and be regularly tested in authorized, well-secured, and well-managed quarantine centers which must be located away from communities, preferably in economic zones (e.g. the sports facilities in Clark) and military camps (e.g. the drug rehabilitation center in Fort Magsaysay, Nueva Ecija).

Those released from hospitals should also be monitored and tested regularly until proven immune. Some who were released from hospitals subsequently tested positive, possibly due to false negatives — who knows (read Joy Virata’s story)?

Supplementary monitoring and assistance can be done through mobile apps for the infected person’s mobile phone, possibly with Google or Apple applications which, with Bluetooth, can trace other mobile phones that may have been near the infected person’s cell phone.

Nursing homes for the elderly should be protected well; most deaths come from them.

The object of isolation is to slow down the infection, or what they call, flattening the virus growth curve.

Fight ‘em — This calls for mitigation, which ranges from treatment to quarantine to social distancing.

Preventing infecting others is just as important as preventing infection from others.

Finish ‘em — This could be achieved in two ways: first, through vaccines or therapeutics — hundreds are racing to find a safe and effective one, hopefully, within the year — and second, when herd immunity is achieved, with the infection rate down to a safer level.

FINAL THOUGHTS
In any war, command and control is vital. The President, or his designee, with the nation’s trust, should lead our people to defeat the enemy.

So is communications. There can only be one voice.

Science, not politics, should drive the campaign.

We should prepare just as hard for the downstream impact — hunger, economic recession and a gradual return to a new normal.

We should not only prepare for the virus surge which could overwhelm our healthcare capability by reviewing our 5 Ms — Men, Materials, Machine, Methods, and Money. We should also establish the infrastructure for future pandemics.

COVID-19 is the enemy, not our people whose lives and rights the AFP has sworn to protect under our Constitution. We are all in this together. No doubt, we can win this war, as one nation and one community of nations.

This article reflects the personal opinion of the author and does not reflect the official stand of the Management Association of the Philippines or the MAP.

 

Renato C. Valencia is the Chair of the OMNIPAY, INC. a graduate of the Philippine Military Academy and formerly the President and CEO of the Social Security System

map@map.org.ph

rcv3313@gmail.com

http://map.org.ph





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