Fear and hope amid uncertainty
Although there was already much talk during the day that the lockdown over Luzon to stop the spread of the coronavirus might be extended till the end of April, President Duterte’s late-night speech last Monday failed to confirm it. He was “inclined,” he said, but he could not say it categorically. The following morning, Secretary Karlo Nograles, spokesperson of the Inter-Agency Task Force (IATF), had to issue an unequivocal announcement.
The IATF recommendation was clearly to extend. It was Mr. Duterte who appeared reluctant. Not because he thought an extension was unnecessary, but because he was worried that a prolonged lockdown would be hard to sustain. The government, he admitted, would run out of money to feed the neediest of the country’s population.
It is the first time I have heard President Duterte sound helpless before a problem. He confessed to getting up at three in the morning, staring at the dark void before him, wondering what he should do. He had previously boasted of having set aside money for a time like this, but now he is afraid it may not be enough to support the “poorest of the poor,” let alone assist the slightly better off who are fast using up their meager savings.
He said he had instructed the finance secretary to look for additional funds wherever he could find them. He called on the wealthy to lend a helping hand. He asked the public to obey the ex-generals he has put in charge during this crisis, and to heed the warnings of science to stay home. He ended his tedious soliloquy with another uncharacteristic appeal — for everyone to join him in prayer on Holy Wednesday, that the nation may survive this pandemic.
I can only imagine how difficult it must be for Mr. Duterte to moderate his default rhetorical swagger. I could see him struggling to contain the virus of narcissism and arrogance that seems to prod him to pontificate on every issue that fancies him. He tells the public to carefully listen to what he has to say—from the “paradigm” that guides him in his choices and decisions to the ”science” that tells him about microbes “in the air.” This is a man who obviously thinks a president must know everything.
If I were in his place, I would say only a few heartfelt words, if at all — and mainly to comfort the nation. I would confine myself to speaking about the fundamental uncertainty that faces all of humanity at this time, the fear that strikes deep in the heart of every person, and the hope and inspiration we must draw from the countless examples of generosity, compassion, selflessness, and creativity that we see every day among ordinary people from all walks of life. I would then quickly step aside, and let those with adequate knowledge explain the situation and the road ahead, and clearly tell us what we must do to overcome the complex challenges we face.
A leader must have enough humility to admit that, at this time, there is still little that is known in any definitive way about this novel virus — its origin, its infectiousness, its mode of transmission, the course of the disease it causes, its defining symptoms, its lethality, its effective treatment and prevention, and the possibility of its recurrence after an initial outbreak.
What we think we know this week could be obsolete next week. And so, the necessary response must change in accordance with the evolving knowledge. A good example is the degree of infectiousness of individuals who test positive but manifest none or only the mildest symptoms. More decisive information about this issue could change entire protocols.
Similarly, there was much discussion earlier on the mode of transmission of the coronavirus. Is it spread by droplets or in aerosolized form? Initially, specialists were confident in saying it was the former. Today, the emerging consensus is that droplets and aerosols form a continuum. Related to this is the ongoing discussion on whether the wearing of masks by noninfected persons has any meaningful effect on the spread of the virus.
Far more questions are being asked these days than there are any clear answers. Why is the coronavirus fatality rate very low in Germany, whereas it is horribly high in Spain and Italy? Japan has belatedly declared a state of emergency but not a lockdown. And yet its infection and death rates from the virus have been low. What aspects of a country’s societal and cultural contexts are relevant to understanding these differential outcomes? South Korea, Taiwan, and Singapore have received much praise for their handling of the pandemic. What exactly did they do right? Or is it too early to tell?
Obviously, much of what governments are doing these days is not based on certitudes but only on the best available information. And that includes some understanding of the lessons of past pandemics. When to lift a lockdown and how to relax the precautionary measures that have been put in place are perhaps the most important questions that those in charge of managing a country’s response to this health crisis need to know. The answers to these questions are, however, inescapably premised on some idea of what will happen.
I don’t think anyone really knows how and when this current pandemic will end. “When it is hard to know what will happen, it is hard to know what to do,” writes the celebrated author and surgeon Atul Gawande in his book “Being Mortal: Medicine and What Matters in the End.” “But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.”
For that, I think, one needs clarity no less than courage.
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