We need clarity

Every physician goes through training on the “Art of Medicine,” or variations thereof. Famed doctor Sir William Osler wrote that “The practice of medicine is an art, based on science,” and effort is extended throughout medical training to help doctors to do more than just diagnose and treat disease, but to be interpreters of data, to be responsible for relaying complex information in ways that are easily understood by patients and their families, and to make informed decisions. In the case of the novel coronavirus, there is still much that is unknown about its transmission, diagnosis, and management; in cases such as these, it becomes the responsibility of the scientific and medical communities to explain what is known and unknown, to explain what evidence suggests as the best possible practice, and to clearly dispute statements that are wrong and harmful to the health of the community.

The Department of Health (DOH) has released fairly frequent updates and statements, while scientists and physicians have taken to social media to fill in gaps in the public’s knowledge using infographics, explainers, and mythbusting posts—in ways that make it easy for laypeople to understand the threat and to act accordingly. If the ailing nation is the patient, then the physician is the combination of all these forces — scientists and other health care workers working in laboratories, hospitals, government offices, and in the shelter of their homes, fighting the double burden of both contagion and ignorance. We cannot expect the public to immediately understand the magnitude of the COVID-19 issue unless we take pains to explain it.

This is why it is so discouraging to hear recent statements from Health Secretary Francisco Duque III. This is meant not to disparage the honest and earnest work of hidden faces in the Department of Health and related agencies as they try to handle a pandemic while hurdling limited resources, politics, red tape, and pressure from every possible sector. This is a simple request for clarity.

As early as April 2020, motions were already made calling for the health secretary’s ouster, citing lapses in the DOH’s response to the pandemic. Since then, we have had to watch as he continued to downplay the seriousness of the local COVID-19 situation, and then recently, his statements about “first” and “second” waves of infections and asymptomatic transmissions gave rise to so much unnecessary confusion.

The “waves” issue, referring to the rise and ebb of infections, met with much rancor and was later explained as a matter of semantics. His other statement, that there is no evidence yet of asymptomatic transmission of COVID-19, was more dangerous. While it is true that the World Health Organization website has claimed no record of asymptomatic transmission, the secretary’s statement is riddled with problems: first, that independent researchers and other agencies have opined otherwise; second, that a dearth of evidence of asymptomatic transmission does not exclude its possibility; and third, that the statement is an irresponsible one to make as it is easily misconstrued, and because it can impact the decision-making of individuals and entire industries, if the layperson comes to believe that asymptomatic persons cannot be contagious.

It is regrettable that, over time, Doctor Duque’s statements have now begun to resemble those of the President and presidential spokesperson Harry Roque — statements that must be taken with a grain of salt, and which may need clarification or explanation by other persons later on. The scientific-medical community is in a unique position of being able to use the best available evidence to guide decisions that affect the whole nation. We need for the head of our community to present information with conviction, with clarity, with as much accuracy as possible, and with the foresight to use the art of medicine to interpret data to a public hungry for correct information. We should at least be able to demand clarity and good communication when so much hangs in the balance.

kchuarivera@gmail.com