Column: Is DOH manipulating the data?

RIGHT? A screen cap of the column, as published on Inquirer Mobile.

Published on all Inquirer platforms on April 27, 2021.

In the last few days, some statisticians and data scientists I follow on Twitter have been raising a warning flag about Department of Health (DOH) statistics. Yesterday, the total number of COVID-19 cases recorded since the start of the pandemic some 14 months ago topped 1 million. That’s a grim milestone, and worrying enough. But the real source of discomfort has to do with the remarkable drop in the number of active cases.

From 203,710 active cases on April 17, the total fell to 77,075 on April 25. (It dropped further yesterday, to 74,623, with 11,333 recoveries and 8,929 new cases recorded.) This should call for, if not a celebration, then at least a round of congratulations. This is good news, right?

“But DOH reported more than 93,000 [new] cases in just the past 10 days, higher than today’s [number of] active cases,” Edson Guido, a PhD candidate in economics at the University of the Philippines and data analytics lead of ABS-CBN, wrote on April 25.

If I understand him correctly, that means that — even assuming that all 93,000 new cases are mild and asymptomatic — all those 93,000 new cases by the DOH’s own standards must still be considered active on the 10th day. (The standard guidance today is if you test positive but do not show any symptoms, you must isolate for 10 days.) Why was the total number of active cases pegged at 77,075? Puzzling, to say the least.

Column: The government is a vacuum

Three warning signs that the national government is losing control of the situation on the ground: Stirrings of unrest provoked by the President’s failing response to the worsening pandemic or by the President himself. Published in the Philippine Daily Inquirer, INQ Plus, and Inquirer Mobile, but (sigh) not in Inquirer.net, on April 20, 2021.

The national government is losing control of the situation. Consider the following:

Military unrest. Over the weekend, Defense Secretary Delfin Lorenzana and AFP Chief of Staff Gen. Cirilito Sobejana denied rumors that “a group of retired and active military officers” was withdrawing their support from President Duterte. Lorenzana’s denial was categorical and comprehensive.

There is no reason to doubt Lorenzana, but the fact that “military unrest” has yet again become a category of possibility is largely the fault of President Duterte. When he emerged on April 12 after another prolonged absence, he took the extraordinary (but also characteristic) step of highlighting a deeply unflattering criticism against him, that he is inutile, and turning it, in his telling, into a weapon against his critics.

Any adequate translation of the President’s Filipino would capture another of his characteristic turns of speech, changing his first-person usage to the third person: “Will I last this long? Will I last this long in this goddamned position if I were inutile? Would the military allow me to govern when that is how you govern? [If] you did nothing?”

This was not the first time the President made the anti-democratic argument that his mandate as president was at the pleasure of the military. Even earlier in his term, when he was at the unquestioned height of his popularity, he would tease the top brass, telling them to form a junta, or to tell him to step aside if their patience had run out. It must be that the President actually believes this, that the military can force him out. The argument is sincere, but nevertheless it is profoundly anti-democratic.

Now that public discontent in the middle of the pandemic can no longer be disguised or denied, the President has again resorted to what is in fact the residual professionalism of the military leadership as proof of his competence. Irrational, but it leads logically to the inevitable consequence: Rumors of military unrest. Expect the rumors to continue.

Column: Deadly incompetence is the red line

The column I wrote for tomorrow’s issue ran too long; I had to edit it down by about 20 percent, to fit the space reserved for me. I thought I’d run the longer version here, now, and post the shorter version tomorrow. To be published in the Inquirer on April 13, 2021.

On March 28, the Department of Health’s daily Covid-19 report recorded 9,475 new cases, 11 new deaths, a total of 105,568 active cases—and a 72-percent use rate of ICU beds in Metro Manila, the pandemic’s worst-hit region. The national government reluctantly ordered a return to Enhanced Community Quarantine status for the region plus the neighboring provinces of Cavite, Laguna, Bulacan, and Rizal: the so-called “NCR Plus.”

On April 11, the DOH daily report recorded 11,681 new cases, 201 new deaths, a total of 146,519 active cases—and an 86-percent use rate of ICU beds in Metro Manila. On the same day, the national government ordered a LOWERING of the NCR Plus status to Modified Enhanced Community Quarantine.

As people on social media say these days: Make it make sense! 

How can the national government relax its guard and lower quarantine status of the worst-hit areas when the numbers, prepared by its own health department, do not show an improvement but rather a worsening of the health emergency? 

Column: The ivermectin surge

Published April 6, 2021.

I have nothing against ordinary citizens who believe that the anti-parasitic drug ivermectin can prevent infection by the SARS-CoV-2 virus or, once they are infected, can cure them of the COVID-19 disease. The administration has so badly mismanaged the worst health emergency in the country’s history that ivermectin presents, for some reasonable individuals, a reasonable alternative with a reasonable risk factor. 

But the current reality is: The medical, scientific, and pharmaceutical consensus is overwhelming. Ivermectin is not recommended as preventive medicine for the virus or as treatment for the disease. The World Health Organization has advised that evidence from a total of 16 controlled trials is “inconclusive,” and that, “until more data is available,” the drug should not be used outside of clinical trials. The country’s Food and Drug Administration (FDA) has warned the public “against the purchase and use of ivermectin veterinary products against COVID-19” and that “ivermectin is not approved by the FDA for treatment of any viral infection.” It added that “the registered ivermectin products in the country for human use are [only] in topical formulations under prescription use only. This is used for the treatment of external parasites such as head lice and skin conditions such as rosacea.”

Contrary to the overhyped idea that a debate among medical practitioners is “raging” in the country, only a handful of medical doctors have come out openly in favor of the use of ivermectin for COVID-19 cases. The consensus among medical societies is that there isn’t enough scientific evidence to recommend its use in the pandemic. And the Philippine Medical Association reminded its members that prescribing unregistered medicines to patients, which runs counter to the paramount principle of doing no harm, constitutes “an unethical act.”

Column: But, SP Sotto, who is to blame?

Published on March 30, 2021.

Senate President Tito Sotto has been the true leader of the Senate in the last five years. He heads a large bloc of politically aligned senators, enjoys a real rapport with almost every member of the chamber, and, with his fourth term almost completed, shares with Minority Leader Frank Drilon the distinction of having served the longest among incumbent senators.

He could have been Senate president from the first day of the 17th Congress if he had wanted the post. I wrote in “How Pimentel became Senate president” (7/26/16) that he, together with Loren Legarda, then a senator, “began to reach out to [Koko] Pimentel. They had also done the math, and recognized that Pimentel had the best chance of putting together a working majority.” But other senators told me Sotto was simply not yet ready to move his bloc behind his own candidacy. When he finally replaced Pimentel in 2018, I acknowledged, in “Du30’s facial powder and the limits of political will” (8/28/18), that in the Senate under President Duterte, “Sotto is an independent power, and the center of an influential power bloc … [who does] not really need the President’s blessing to win the leadership of [his] peers.”

A summary of his current standing among his peers may be read in “Let Leila join Senate teleconferences” (5/12/20): “Despite his residual reputation as a political lightweight because of his background in show business, Sotto actually enjoys his peers’ respect for his readiness to protect the Senate’s institutional dignity. After he was elected president of the Senate in 2018, he paid a long, cordial, and productive visit to De Lima. When the police suddenly showed up in the Senate’s parking area later that year to arrest Sen. Antonio Trillanes IV, he strongly criticized the lack of courtesy and allowed a stand-off that lasted for weeks. And earlier this year, he defended the right of the Senate committee on public services to hold a hearing (aired nationwide) on the ABS-CBN franchise over the vociferous objection of Speaker Alan Peter Cayetano.” We can add more examples.