When some lives are worth more than others

BEFORE the headline item, a quick note on the Philippines’ wise decision, announced this week, not to join planned naval exercises in the South China Sea (SCS) led by the United States.

One maritime expert argues that staying out of the military maneuvers sends mixed signals, especially after President Rodrigo Duterte earlier this year suspended moves to abrogate the 1998 Visiting Forces Agreement (VFA) with the US, and Foreign Affairs Secretary Teodoro Locsin Jr. affirmed LAST MONTH THE FOUR-YEAR-old arbitral decision on Beijing’s “nine- dash line” sovereignty claim over nearly all of the SCS.

What comes across as mixed signals to one analyst can be calibrated positions to another. In his China policy, President Duterte has been careful not to swing totally to one end of the regional big- power rivalry. Hence, he has maintained the closest ties with and accepted the most aid from China and Japan. And after recent worrying Chinese moves in the SCS, he pulled back on VFA termination and allowed Secretary Locsin to affirm the 2016 Hague ruling.

But joining US-led naval maneuvers, which could provoke strong reactions from the People’s Liberation Army, would do more than just signal to Beijing our concern over the PLA’s recent maritime actions. Rather, it may be seen as taking America’s side in its escalating test of wills with China. President Duterte is right and prudent to stay clear of any move that casts the Philippines as a US ally in its game of Asian thrones with the Chinese.

All lives matter

Turning to the headline topic, the Center for Strategy, Enterprise and

Intelligence or CenSEI, headed by this writer, raises a life-and-death question from last week’s call by medical professionals to put Metro Manila back under enhanced community quarantine (ECQ), the government’s strictest lockdown protocol.

Who should we save — coronavirus disease 2019 or Covid19 patients gasping for breath, or cancer and kidney disease victims grasping for money to have life- saving chemotherapy and dialysis?

Both, of course, but the way arguments went in the ECQ controversy, it seems lives threatened by Covid-19 matter more than those snuffed out by other ailments.

President Rodrigo Duterte and his Inter- Agency Task Force for the Management of Emerging Infectious Diseases did not mean to put one category of lives above others. But that’s what they may have effectively done in returning Mega Manila — the metropolis, plus Bulacan, Cavite, Laguna and Rizal provinces — to the stricter modified enhanced community quarantine ( MECQ) restrictions from the general one or GCQ.

To be sure, the MECQ decision remains valid, whatever the resulting overall body count may turn out to be. Our health workers braving disease and death to battle contagion and preserve lives greatly deserve the long- overdue respite they demand. And after MECQ was declared, they rightly said they were not pushing for an extension beyond the two- week period ending August 18.

At the same time, in deciding to ease or elevate quarantine restrictions in future, the government should make sure to check if nonCovid deaths surged under lockdown. Then the next time President Duterte ponders what to forbid and what to allow, he will have full knowledge of how protocols save lives — or snuff them out.

Plainly, all lives matter, so the ideal policy is the one that saves the most overall.

Your money and your life

Notably, loss of jobs and income under lockdown can lead to thousands of deaths if layoffs, work suspensions, and business disruptions leave the sick unable to afford needed treatment or cannot even get to hospital due to absent public transport.

To be clear, this is not an argument about Covid-19 and other cases jostling for hospital beds and medical attention and treatment. Rather, it is about ECQ restrictions making it harder for affected communities, especially the poor, to get treatment due to lack of funds, transport restrictions, or both.

Consider this hypothetical analysis: neoplasm ( cancer, accounting for 64,125 deaths in 2017) and cerebrovascular ( strokes, 59,774) cause more than 120,000 fatalities a year.

If loss of income due to ECQ makes just those two categories of deaths rise just 1 percent from inability to pay for or get to treatment, that’s 1,200 deaths a year that could be attributed to lockdown.

And with more than 10,000 kidney disease deaths annually, if ECQ income losses make dialysis unaffordable, that could add maybe 300 more deaths.

So, just considering three leading causes of death, lost income and suspended public transport due to ECQ could kill 1,500 more people a year, or about 400 during the ECQ period between March and June.

Add other major killer diseases, excluding respiratory ailments, which cause about 170,000 deaths annually. If they rise 1 percent due to ECQ, that’s 1,700 more, or about 500 in the ECQ period.

There are also deaths due to illness from severe hunger, now afflicting MORE THAN 7 MILLION Filipinos, up 3 million under ECQ, based on the Social Weather Stations survey last month. If just 0.1 percent of that addition died of hunger-related ailments, that’s 3,000 more deaths.

Hence, ECQ could be said to cause nearly 5,000 deaths between March and June from the top non-respiratory diseases, plus hunger.

To be sure, that’s all hypothetical — hence, the need to get hard data on non- Covid- 19 deaths during lockdown, so that, as urged above, “the government should make sure to check if non- Covid deaths surged under lockdown.”

Whatever that body count may be, it should be considered along with the projected Covid- 19 fatalities that might have occurred if ECQ were not imposed and serious Covid- 19 cases overwhelm the health system, as well as the more than 2,100 Covid- 19 deaths recorded so far.

To repeat: all lives matter, so the ideal policy is the one that saves the most overall.