AN OPEN LETTER TO RODRIGO R. DUTERTE President, Republic of the Philippines

World Experience and New Scientific Findings:
Relevance for Containing COVID-19

18 April 2020

Dear Mr. President,

Given the incomplete and sketchy scientific and global information available to you then, you understandably had no real choice but to lock down the entire country in an attempt to control COVID-19 infections and deaths. Your quick and decisive action gave the nation some breathing space in the face of the unknown. However, in the meantime, new challenges have surfaced, needing to be addressed urgently.

As you acknowledged from your recent addresses to the nation, you are now caught in the middle of a cruel choice: Saving lives or saving the economy?

One way to express this with more elaboration is as follows. In the attempt to save lives (from an enemy that cannot be killed by bullets – your comparison), shall you continue to collapse the economy, generate mass unemployment and spawn starvation and social unrest that ironically may result in more misery and deaths than the disease itself? Shall you continue to save lives and destroy the economy in the process, including endangering government stability itself with a significant shrinkage of its tax base, among others?

You have recently mentioned (April 9) that government has only two months worth of funds to fight the pandemic. What if, as scientists are starting to warn heads of state around the world, a second wave will hit the nation, a side-effect of the lockdown and flattening the curve approach? We are already beginning to witness this in China.

What shall we all do then?

Mr. President, what if you can have it both ways: save Filipino lives while at the same time save Philippine society and its economy from self-imploding? Will you be open to a scientific approach that can achieve this balance?

Reason for Writing

Encouraging rapid developments in the world, especially in the field of scientific understanding and innovative societal approaches, are showing that there can be an approach that can save lives WITHOUT necessarily destroying Philippine society and its economy. (For details, kindly see attached Briefing Paper.)

Prominent mainstream scientists and experts on viral pandemics, including a Nobel Prize winner, have analyzed the global experience in controlling the viral pandemic. And they are coming up with very interesting ways of controlling the virus without compromising the economy and society.

Overview of the Current Philippine Experience

• Current health statistics of the Philippines strongly show that there is a reason for grave concern. (All Tables and Figures cited in the overview are found in the attached Briefing Paper.)
• Even as the cumulative cases per day are increasing, the number of new cases per day in the Philippines is tending towards decline as compared with previous days. This is already being hinted at in Table 1 and Figure 1 of the attached Briefing Paper. (Table 1 and Figure 1)
• This conclusion is more clearly seen when one looks at the growth rate of new cases per day. It is definitely declining. (Table 2 and Figure 2 )
• The Case Fatality Rate (CFR) or death rate of the Philippines is also decreasing significantly. (Table 3 and Figure 3 below)
• Furthermore, our deaths per capita from COVID-19, is one of the lowest in the world. (Table 5 in comparison with Table 6.)
• These results and the conclusion arising from the Figures and Tables below serve as necessary reality check to the daily figures being announced by DOH and the media. In fact in your televised Cabinet Meeting on April 9, the Secretary of DOH acknowledged the declining rate of infection.
• The figures from DOH, which then gets press coverage, overstate the number of infections for many reasons, including the use of tests resulting in large numbers of false positives. These inaccurate test results create unnecessary panic and hysteria among our citizens. (See Briefing Paper for scientific evidence of a similar phenomena around the world.)
• The declining rate of new cases and low death rates (CFR) indicate that the virus behind COVID-19 is not a virulent as feared. At most it is a stronger version of the flu as scientists from all over the world are discovering.
• A more precise elaboration of the death rate data enabled Nobel Prize winner, Dr. Michael Levitt, to successfully and accurately predict the decline of the pandemic in China. (See attached Briefing Paper.)
• The Philippines has suffered more deaths from pneumonia and flu when compared with the deaths from COVID-19 for the same period of time. (Table 4)
• Yet we never locked down our society every time there was a pneumonia or flu epidemic.
• The reason for the declining growth rates is that health authorities around the world understand the huge importance of natural individual immunity and collective ("herd") immunity in stopping the virus. (See Briefing Paper.)
• Collective immunity is on the way in many countries. This means that the collective natural immunity of people can withstand viral attack, as manifested in the huge numbers of humans who have not succumbed to COVID-19. (See Briefing Paper.)
• The lockdown and social distancing of the past weeks may have helped achieve the promising results above.
• However, continued lockdown and social distancing will predispose the country to another epidemic wave of the COVID-19. (To be explained more fully below.)
• This will worsen the economic and societal impact that has already resulted in massive unemployment, decline in the GNP/GDP, and a likely increase in poverty and increasing social unrest which could result in even more deaths due to loss of livelihood, starvation, and stress.

In short, Mr. President, there is really no need to extend the tight lockdown any further. Instead we can build upon existing gains you have achieved and refine it with a sister approach: Precision Quarantine and Immunity (PQI) approach, a scientifically more precise version of the “selective quarantine” alternative being proposed by many sectors, especially the business sectors.

Regarding lockdowns, kindly see Appendix A of Briefing Paper on the Open Letter of Prof. Dr. Sucharit Bhakdi to German Chancellor, Angelina Merkel on 26 March 2020. Dr. Bhakdi is a world renowned scientist and expert in pandemics and is one of Germany’s most cited scientists in the field of medicine.

Based on the updated scientific understanding of the virus and the experience of nations, we can promulgate PQI’s seven basic principles that would enable you, your team and concerned citizens to save lives and regenerate our badly damaged society especially our economy.

The seven principles of PQI are based on the medical understanding that the gravity of a pandemic depends on: a) the virulence of the pathogen; and b) the prevailing strength of the immune system of countries. The virus spreads faster when the immune systems of people are weak and/or compromised by pre-existing illnesses. (Italy and Spain are the prime examples of this.)

We gathered these seven principles from the on-going experience of nations in dealing with the COVID-19 pandemic.

The seven principles of Precision Quarantine and Immunity (PQI) are:

Protect Risk Groups especially the elderly.
Self-Isolate oneself immediately if one has cough, fever or any symptom of illness.
Re-open schools for children to hasten achievement of herd immunity.
Allow teenagers and the working population, in the various institutions, to continue their normal lives, provided they follow safe distancing and hygienic practices.
Re-open regions, provinces, cities, towns, barangays, and institutions on the basis of their low risk densities.
Instruct all age groups on how to strengthen their immune system.
Install a communication, monitoring and enforcement system, to ensure that this new approach works. This would include occasional randomized antibody testing, using the most accurate tests, to determine progress towards herd immunity.

Kindly find attached a copy of the Briefing Paper that provides detailed support for all the conclusions and recommendations given above including the PQI approach and its seven Principles.

Mr. President, we now have a better scientific understanding of how to contain the not too deadly virus after all. We all truly hope that you will decide to save both lives and the stability of Philippine society including its precious economy.

(Sgd.) Nicanor Perlas
Former Undersecretary-Designate, Department of Environment and Natural Resources (2016-17)
Recipient, Right Livelihood Award (Alternative Nobel Prize) (2003)

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116 replies on “AN OPEN LETTER TO RODRIGO R. DUTERTE President, Republic of the Philippines”

Thank you for this initiative. Everyone deserves to be educated on what every one needs to know about and behind the COVID 19 pandemic.

To all who have given their support for the Open Letter and its Attached Briefing Paper, I just want to give our heartfelt THANKS for your postings. It gives us energy to keep on doing the work. It would be difficult to respond to all of you individually as time needed for research has to be set aside. There are larger struggles ahead. Thanks for engaging. The Truth shall set us all free from darkness and fear. And for the few who have a different perspective, I will address your concerns in due time.

I agree with you mr Perlas the President should replace some of his advisers. To lock down the entire country.more people will get sick if you lock the family of four in one bedroom. Let the people have some exercise and eat healthy foods to boost their immune system. Do not let the people become lazy by giving money without working.

Agreed on this open letter. Hope that President will take this into consideration…for all!

I am very supportive of this approach. This is the first time in world history that governments have quarantined the healthy instead of the sick. We are required to stay in our house with no sun, no fresh air, little exercise and the high stress of not having income and seeing the economy crash all around. These measures will decrease intead of enhance community health. I am lucky to have resources to survive, for now. So many others don’t. All our normal health and wellness measures have been denied us. All our normal social supports have been denied us. My business cannot survive if this continues. My business is small. I am insignificant. But i am one of 100s of 1000s… i paid staff, i paid taxes… i want to get back to that. I want my kids back to school. Thank you.

Thank you Mr. Perlas for providing this forum.
There’s a price tag for every chosen approach to this crisis, but whichever way we want to balance how much resource goes to health security & how much for the economy, the truth is we have insufficient budget. If only we could afford more.

But Billions were allocated for Highways, Skyways, Bridges, Airports & such… from pork barrel. Could we not do something about this ? It feels so insensitive & unfair to the majority.

Couldn’t we wait until our economy can once again afford this, then resume our build, build & build ?

Will continue praying for the President,that he may be blessed with wisdom and to make the best decisions for our country.

SC FIT TO WORK. With the pandemic, many SCs who are Consultants to companies lost their jobs. SCs can also make great contributions to Phil society and such work makes them fit, healthy and are more conscious of sustaining healthy lifestyle. The proposal of Dr Perlas is very scientific but should also consider inclusion of the SCs in the economic picture, not only in identifying our group as 1st to be protected (but thank you for this) health wise but as productive citizens as well. I have been working overseas for 9 yrs now teaching ofws on how to become more financially responsible and to set up their own enterprises while working overseas. If people like me will be locked in or locked down, we will die, not because of COVID, but because of frustration and maybe because we can’t buy our own food, vitamins and maintenance medicine… Lockdown of President Duterte is a show that his priority is saving lives and I salute him for that.. Short term pain for long term gain..

Many views had already been said and they are all EQUALLY and Meaningfully meritorious….let’s all work together to deliver without further delay the open letter to the president .

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