SEC. ANDANAR: Pilipinas, mahigit limang buwan na mula nang ideklara ni Pangulong Rodrigo Roa Duterte ang isang state of public health emergency kaugnay sa pandemya ng coronavirus. ‘Di nagtagal nagsimula na ang mga community quarantine measures upang agapan ang malawakang pagkalat nito. Masakit ang naging epekto ng community quarantine, humina po ang ating ekonomiya, marami ang nagsasarang negosyo, maraming patuloy na nawawalan ng kita at trabaho, maraming plano at proyekto ang nahinto.
Kaya ang ilan ay nagtatanong: Una, tama ba ang desisyon ng Pilipinas na sa pamamagitan ng mahigpit na mga community quarantine o lockdown ay pilitin natin ang mga mamamayan na manatili sa kani-kanilang mga tahanan bagay na naging dahilan ng – para sa marami – kawalan ng kita at pangkabuhayan? At pangalawa, limang buwan matapos ang mga mahihigpit na community quarantine sa karamihan sa mga rehiyon, sa kapuluan ang karagdagang katanungan ay: Ano na ang plano ngayon na hindi pa tapos ang pandemya at wala pa ring bakuna?
Batay sa National Action Plan, tayo ngayon ay nasa ikalawang yugto ng istratehiyang kontra COVID-19. Ang istratehiya natin ay tulad ng sa maraming bansa – magsimula sa isang matinding hataw ng quarantine o lockdown upang agarang malimita ang malawakang pagkalat ng virus at mapaghandaan ang mga pasilidad, healthworkers at pamahalaan natin, at matapos nito ang sunud-sunod at sari-saring galaw nang bahagyang pagbukas, paghigpit at pag-adjust muli nito nang makapagpatuloy po naman ang negosyo at paghahanapbuhay habang patuloy nating nilalabanan ang pandemya.
Ang istratehiya nang matinding hataw ng quarantine o lockdown na sinusundan nang sunud-sunod at sari-saring galaw at adjustment ay inilarawan ng French-Spanish na manunulat, engineer at technology executive na si Tomas Pueyo. Ang kaniyang mga sinulat tungkol sa pandemyang ito ay masasabi nating naging viral na rin lalo na ang artikulong pinamagatang “The Hammer and The Dance.” Tawagin na nating “hataw at galaw” na madalas na ring banggitin ng mga leader sa iba’t ibang bansa sa pagpapaliwanag nila ng kanilang istratehiya laban sa pandemya.
Sa paglabas ng pamahalaan ng phase 2 ng National Action Plan kontra COVID, mainam na balikan natin ang istratehiya ng pamahalaan. Ang National Action Plan ay ginabayan po ng “Hammer and Dance” theory at ngayong gabi doon tayo magsisimula. Makakapanayam natin ngayon ang may akda ng The Hammer and The Dance na si Tomas Pueyo. Pag-uusapan po natin ang isang teyoryang naging gabay sa pagbuo ng National Action Plan.
Pilipinas, ako po si Communications Secretary Martin Andanar at ito ang Cabinet Report dito sa Radyo Pilipinas nationwide at PTV.
In a time of pandemic, what he wrote on the subject has quite interestingly itself gone viral. And why not? After all, he does know more than a thing or two about virality, albeit the tech aspect of it. On Cabinet Report tonight, we welcome writer/engineer, Silicon Valley Executive and a new father of a child, his fourth, the author of the much-read article – The Hammer and the Dance, from Spain and France by way of the United States, Tomas Pueyo.
Good evening to you, Tomas.
MR. PUEYO: Thanks for having me. It’s a pleasure.
SEC. ANDANAR: You are the Vice President of the online education company Course Hero which is interesting given that your series of writings on the pandemic have informed the thinking of many people. They have been read by over 60 million people and have been translated over 40 languages including Filipino. Would you like to react on that statement?
MR. PUEYO: Yeah, I think nobody can predict that an article is gonna go viral like that, more than 60 million views in total – that’s a very big component of luck that comes with the extent in my case. It’s the luck of all my career, that was relevant for what I did even without me knowing. You mentioned virality before, I created some applications that proved to tens of millions of users through virality and the modeling is very similar for virality of digital products and virality in the real world.
My day job, I take million-dollar decisions frequently on cost benefits and sort of just to follow and if they’re similar to the strategies that governments need to take to fight the coronavirus, there have been lots of examples like these. The fact that I wrote blogs or a book was relevant for me to be able to write my articles the way I did. So it’s just a combination of experiences that could mean the right place, in the right time, in the right skills to write the content that people needed.
SEC. ANDANAR: What particular data should we be looking at apart from the number of cases, deaths and recoveries which is what we commonly are made aware of?
MR. PUEYO: Yeah. The cases really are the most important, right? They do tell us what is happening on high level. They never tell us the reality in the ground but they give a sense of where it’s going. We know that if we can catch few cases then the situation is good and we know if we catch more and more cases is not as good. So it’s always cases first, hospitalization and deaths are gonna come later and usually they do come. And once you look at the top level, the second level is about understanding what’s happening on the top level.
Like for example in the case of the cases, the first thing you wanna understand is how trustworthy is that number and the number that we have to follow for that is test positivity. So, what percentage of our tests turns out positive? If 50% of our tests turns out to be positive, it means that one in two people that we’re testing is positive which means that there’s a lot of people who have the illness and we’re not catching everybody. Conversely, countries like South Korea or Japan or Taiwan who have controlled the virus really well, they have a positivity of around 1%. Meaning one in 100 tests that they make is positive and that’s because they are testing really everybody – everybody who has symptoms but also their friends, their family, anybody who wants to come in and get tested.
And so if it’s around 1 to 3 percent positivity, you know you have a good sense of the situation. Conversely if it’s 10, 20% and it’s going up, you know we don’t have a good sense. So testing is really core.
A second one is, one that translates, that represents one of the key measures against the coronavirus which is contact tracing and isolations and quarantines. And so testing is useful so that we can treat the people who are sick but also it is very important because you can identify who else may be sick and then trace the contacts and test those contacts and quarantine them.
The key point of all testing is not just testing and knowing who’s sick; it is being able to identify all who might be sick and quarantine them all. And so there’s a key number there which is what percent of the contacts of people who are sick and isolated or in quarantine.
So for example, imagine that out of a hundred people who are sick, you try to contact them all, then only 90% of them respond. And out of the 90% who respond, only 80% of them tell you about their contacts. And out of all the contacts, let’s imagine that only 80% of them are going to respond. And out of the people who respond, let’s assume that only 50% of them get quarantined. You add all these scenes, and you might end up with 30-40 percent of the contact who are quarantined – and that just not enough. So that number is key to really stop the virus.
SEC. ANDANAR: Tomás, tell us about your theory, The Hammer and The Dance, and what you have observed in countries around the world in the five months since you wrote it. Just an aside, you actually made mention of the Philippines already in this article.
MR. PUEYO: Yes. The theory of The Hammer and The Dance is that for most countries in the world, they just didn’t know what was going on and cases were exploding in the countries. And so, the only thing that you can do is buy yourself time. And you buy yourself time by applying The Hammer. The Hammer is a very heavy set of measures to stop the economy so the number of cases that were growing exponentially start to slow down, hopefully goes completely down that reduces the death and more importantly, it gives the country time to figure out the second piece which is The Dance.
And then in the Dance, we replaced all these heavy measures which are lockdowns and closure of schools and closure of businesses, and we replace them with the set of intelligent measures that can achieve the same goals but without the same cost. We are talking a second ago about testing, contact tracing, isolations and quarantines. That’s the key tool that most countries didn’t know about doing any of these. And so they never applied the Hammer [unclear]; and many more things such as treatments right. Now we know that Dexamethasone, for example or Remdesivir work really well to reduce fatality rates or hospitalization rates. We know that masking now really has an impact.
So all these things we can learn thanks to the time that we borrow ourselves during The Hammer. But the point of the Hammer is that it’s very expensive so you actually want to get that for as short as possible so you can move into the Dance as fast as possible.
The measures of the Dance are specifically testing, contact tracing, quarantines, isolation, masks, hygiene, public communication, physical distancing, travel restrictions and social gathering restrictions, right. We can’t have a lot of people coming in from countries which are infected. We cannot have very big weddings, very big funerals, and dinners with friends because all of these are gatherings that can increase the infection rate. So these are all the measures for The Dance.
So what has happened in most countries? There are two very different types of countries: there are the countries that are wealthiest and then the rest of the countries. The countries that are on top of wealth usually when they apply the Hammer, it worked well. So countries in Europe usually ignore them; North America, in Australia, New Zealand, all these countries applied Hammers and the number of cases really, really went down.
After that though, different countries learned very differently what to do. So you have a country like Germany or Iceland that did really, really well in The Dance and were able to behave similarly to South Korea or Japan, for example. And then you have countries like the US that never learned to dance and then had a second wave even before the first wave started.
And then you have the countries that are not on top of the wealth in the world and a different dynamic happened there. In many cases, the Hammer slowed down the epidemic but didn’t stop it. And an example is Peru, Argentina, South Africa, Kenya, I think Philippines is close to that. And nobody really knows exactly what happened. There are some hypotheses. And what I have seen in most of my study of the situations is that, in countries where a lot of people don’t have enough savings or cannot work from home, they are forced to leave home to work, to make money, to survive. They may not also have a fridge at home, they might not have running water and so a lot of people are forced to leave. In the areas of the country that are the most dense, when people go out, they’re going to catch the virus; they’re going to come back into their communities and the virus is going to spread.
So what do you see in cities like Lima, like the Cape in Buenos Aires is that the areas in big metropolises that are the poorest are the ones where the Hammer never worked and the virus was not contained. And what worked in many of the cities, a good example, in Medellin in Colombia or Cordova in Argentina is when the government went to the neighborhoods, tested everybody in those neighborhoods, stopped the neighborhoods, and then brought food and water and money and drugs to the population of those neighborhoods. In those cases, they had the Hammer—I mean, these measures made the Hammer work in those cities.
SEC. ANDANAR: Let’s talk about The Dance. We’re now in the Dance stage in the Philippines and in other regions also. First of all, what do you see as the most difficult challenge that the Philippines, especially Metro Manila, you mentioned about the density of the population, at this point?
MR. PUEYO: That is going to be the biggest challenge. You have millions of people working very close to each other; many of them can’t just not stay home because they are going to starve and how do you handle that situation? As I mentioned, it is a very, very hard situation. I think also, the cost-benefit is slightly different because in countries – I haven’t seen the detail in the Philippines – but in many other countries, the fatality rate is actually lower. In Kenya, for example, the emergency rooms never got filled. And so, it might be that in different countries, the fatality rate is lower and it is harder to control the virus, and that balance changes the calculation on how you want to handle it.
But if a city like Manila wants to stop the virus, the set of measures are the following, as we said, testing, contact tracing measures and quarantines. Meaning that you need to find everybody who has the virus, find all the contacts and you need to isolate them either at home, either not infected or somewhere else if they are there’s the isolation; because if they are infected, they cannot stay home because if they stay home, they will infect the rest of the household and their neighbors. So that’s the basics.
And we need to support them in order to do that. If you want people to stay home, you need to give them money, you need to give them food, you need to give them water and you need to give them drugs. So, that is the core and then you have all your measures, masking for example is a ‘no brainer’. Everybody should be wearing a mask; everybody should wear a mask. There’s no reason why not to, it is the cheapest way to solve the problem.
And then you have the measures, like this education, there’s hygiene, limiting social gatherings, is another key tool. Because what happens usually is, for example, these homes are small and people are more likely to go out and meet other peop0le and you want to prevent that, right? So the big gatherings such as parties, clubs, bars, weddings, all these things you really, really want to try to curtail as much as possible. And you want to give people authorities, right? So lots of outdoors, as much as possible, all the activity that’s outdoors usually is much safer and again, give them resources so that they can do that for a long period of time without starving to death.
SEC. ANDANAR: There are so many statistics and reports generated on a daily basis related to COVID-19. What are the ones that to you, are the most important trends to keep track of at these points in time?
MR. PUEYO: There are many, and a lot of it I could talk about and that’s good, but it’s important to know them. Vaccines are obviously important, but not just when the vaccines are proven, but also how drugs act. Because there’s going to be a lot of months of delay, between the moment when a vaccine is proven and when a lot of the population has taken it.
Treatments are super important and we already talk too much about the ones that work. It is a little bit of irony because there is a lot of debate around hydroxychloroquine. But for example, there should be talk about dexamethasone and really works well, now there should be talk about procaine that works very well. And so, there’s a lot of—these things are super important. It’s possible that the fatality rate has gone down between 20 and 50% – thanks to its better treatments that suits, that’s important.
Again, the other key thing that people don’t talk about enough is this metric that I was talking about a second ago, around testing, contact tracing and isolation and quarantines. I’m sure, you cannot tell me what percentage of contacts of sick people are isolated or quarantined. And that metric in supreme form, you probably can’t, because most countries actually don’t have enough contact tracers.
The contact tracers that they have are not contacting enough people, or the people might not taking those calls. If they do take these calls, they might be not be enough resources to put these people in isolations and so there’s a lot of breakdowns in that process, and that process doesn’t work well and you cannot contain the virus.
And then finally, again, very important that we’ll talk about is travel. A lot of countries, especially the ones that have had tourism like the Philippines, are very open to travel because otherwise, the economy goes down and that could—You need the economy to work to stand the virus. That you need to be very cautious on who you let in, and you should not let in everybody, you are going to get the infections back and you could infect the country and you could infect the community.
So you need to be very careful in who you let in. You want to let the people from the countries that have the lowest prevalence and after that, you want to be very careful from the process to you let them in. For example, somebody comes in from a very infected country, you might want to have a couple of weeks of quarantine for everybody. And maybe instead of that, if you really cannot afford to do that, at least everybody coming in gets the PCR test to know if they are infected or not.
And those who are not perfect, that they are going to catch 70% of the people who are infected and that might reduce dramatically the infection right in your community. So, these are some of the big tranche – vaccines, treatments, contact tracing, isolations and quarantines and travel bans.
SEC. ANDANAR: Last question, Tomas, at this point in our fight against COVID-19. What do you see as the non-negotiable must do’s for both countries and their citizens?
MR. PUEYO: We can’t be dramatic about it. There’s never something that is, this one single bullet that is going to solve everything, especially here. I think there are three big parts of the strategy that are important to do well. You don’t want to get infected people in, once they get in, you want to reduce as much as possible infections. And if you cannot reduce the enemy – those infections, you want to catch them quickly, hence, neutralize them.
Next, we have these three parts of the strategy: Don’t let them in; if they are in, don’t spread it; if they do spread, identify them and neutralize them. The stronger you are in all three, the better you are going to be overall.
In fact, you can [unclear] these three. If you are stronger in some of these, you can afford to be weaker in others. For example, South Korea and Taiwan are very, very good and not letting any infection in, and they are also very good at when there are some movements, somebody is infected, they are going to identify this person, they are going to quarantine this person. Thanks to that, they don’t need to be time measures, such as school closure, some business closures, because they have these other measures. You have, instead of tools that you can use and you need all these strategies to work out together and you need to be doing a good job to all of them.
SEC. ANDANAR: The author of the much-read article, The Hammer and the Dance, Tomás Pueyo. Thank you so much, it’s been a pleasure talking to you.
MR. PUEYO: Likewise, thank you very much.
SEC. ANDANAR: Pilipinas sa ating laban kontra COVID-19, maganda sana na ang buong bayan ay nagkakaisa. Kaya natin ginagawa itong special episode ng Cabinet Report kung saan nagso-zoom out po tayo at ibinabahagi natin ang plano ng ating pamahalaan sa pagpapatuloy ng matinding laban natin kontra COVID-19.
At ang basehan, ito: Matindi ang laban, lahat tayo may kanya-kaniyang papel. Ang ilan sa atin, dapat nasa labas ng tahanan, upang makipagtulungan na ibangon ang ekonomiya ng bayan. Ang iba naman sa tahanan ang laban kontra bagot o boredom. Stay at home muna para mahirapang kumalat ang coronavirus. Anuman po ang ating papel sana magkasama tayo at nagkakaisa para sa kinabukasan po ng ating mga susunod na henerasyong Pilipino.
Para sa Cabinet Report, ito po si Communications Secretary Martin Andanar. Kagaya ng sinsabi nila sa Cebu, ampo, amping, ambit. Let us all pray for each other. Let us take care of ourselves and practice all the prescribed health protocols. And let us share particularly with our fellow Filipinos who have been the most affected by this pandemic. Maayong gabi, Pilipinas.
Source: PCOO-NIB (News and Information Bureau-Data Processing Center)