To be or not to be

Published January 14, 2021, 12:49 AM

by Diwa C. Guinigundo


Diwa C. Guinigundo

We certainly are not Hamlet to contemplate on whether it is better to live or to die. It is quite obvious for us to keep safe and stay healthy. We all want to live unless we give more weight to Hamlet’s musing that life is lack of power. Some of us must feel that we are at the mercy of the “outrageous fortune” or the “sea of troubles.” The only way to oppose it is to end it.

But what a way to end life if we choose to stay away from safe, effective, and affordable vaccines. Going into that “sleep of death” is not exactly our idea of affirmative action.

Therefore, it is about time the Philippine authorities made choosing life easier to understand and more compelling. There is very little sense for the authorities to centralize unto itself the logistics of buying and distributing the vaccines. They have neither the mindset nor the capability to “play God.” No less than life is involved here. In this issue, we support the Philippine Senate in its crusade against what is developing into a government monopoly. There is just too much on the administration’s governance plate, too much demand on its limited resources to insist on a centralized set-up in acquiring and administering the vaccines of whatever brand as long as they are safe, effective and affordable.

Since we all agree on a whole-of-nation approach in dealing with the pandemic and all issues of national concern, with relevant laws amended to adapt them to current emergency, the health authorities should simply prescribe the standards for selecting the various vaccine options. Once the benchmarks are established, let free market forces drive the whole logistics process. Local government units, even without entering into partnership with the national government, and private sector corporates should be allowed to source their vaccines from AstraZeneca, Novavax, Pfizer, Moderna, Sinovac, Gamalaya, Covax Facility as long as the prescribed standards are met. Efficacy levels and prices should be disclosed to the public for them to decide on the brand.

In Hamlet’s soliloquy, Shakespeare talked about a rub, or a catch. While the “sleep of life” could be empowering in that it represents taking action, the fear of death should make us pause and perhaps reconsider. Some of us do not wish to be vaccinated because one, we believe we can vanquish COVID-19 without having to have the jab; two, the jab could have considerable side-effects; and three, it takes at least 10 years to “perfect” a vaccine.

But COVID-19 is real and could be very fatal. As of January 12, 2021, global statistics remain grim. Some 91 million cases have been reported with mortalities at nearly 2 million in 10 months. In the Philippines, our share of the total incidence stood at nearly 490,000, while the number of deaths stood at over 9,400. While many have recovered and we keep on improving our system of testing, tracing, quarantining and treating, hopefully with IT assist for quick turnaround, it would be difficult to restore normalcy with masks and face shields and alcohol at hand. We need to achieve herd immunity and the only way we can do it is through vaccination.

Side effects may not be avoidable because even in administering ordinary medicine or performing more serious surgical procedure, the name of the game is achieving balance. More die of diabetes, or hypertension, than the complication to the liver or the kidney. The point is to reduce the side effects over time.

Perfecting a drug or a vaccine could take a lifetime but the risk is high if one doesn’t take it at all.

To get or not to get the jab—that is the question! As a people, we do not wish to be accused of the so-called omission bias. This is one of Rolf Dobelli’s 99 errors in thinking in his book “The Art of Thinking Clearly.”

Not getting the jab for one’s children, for example, is deliberate inaction and a host of people would readily agree “it seems less grave than a comparable action—say, if the parents intentionally infected them.”

To say we can lick COVID-19 without the vaccine, or to insist against the vaccines’ side effects, or to wait until the vaccines are perfected is simply to omit action. We wait until people get the jabs and all the side effects while we expose ourselves to Hamlet’s sleep of death with all its unknowns which could even be worse than life with all its “heart-ache, and the thousand natural shocks.”

There is moral distortion involved in omission bias.

Dobelli argues that investors and business journalists are more tolerant of companies that develop no new, innovative products than those companies that dared to innovate but failed. Not doing about one’s non-performing stocks

appears superior to actively investing in equally bad equities. Non-filing by public servants of their net worth seems less of a public offense than faking similar documents.

Definitely, taking the jab that promises efficacy of at least 60 percent to 90 percent means we have 60-90 percent chance we shall be immune to COVID-19, compared to zero immunity or 100 percent likelihood of getting infected. On a national scale, one can also look at it as providing immunity to 60-90 percent of the population against the pandemic.

It is indeed difficult to sustain the argument that one can protect life by not getting the vaccine; we seem to have forgotten Hamlet’s fear against whatever dreams may come in the sleep of death.

Omission bias is no different from the country’s FDA which did not lift a finger to decide on the emergency use of vaccines that may put to sleep 10-40 percent of the population while saving 60-90 percent of them.

This column does not pretend to provide Hamlet’s “quietus.” The narrative of the numbers and the probabilities is compelling. Elsewhere in Hamlet’s soliloquy, Shakespeare argued that “conscience does make cowards of us all.” The fear of causing death even becomes more intense, as if there is a more viable option today.

On a national level, committing the omission bias could be devastating. Our longest lockdown has proven counterproductive to the economy, engendered truly social, not just physical, distancing, and of course, led a lot of people to depression andsuicide. We lost output and jobs and we might lose another two years of opportunitiesif we don’t shape up in public health and economic management.

The recent decision of Fitch to keep our investment grade rating at triple B is no less than a grace from God. Even as we bungled it, our position of strength before the pandemic was just too formidable to have been completely whittled away by the virus. Our growth prospects continue to be promising but precarious, our debt levels remain manageable but could blip up with a prolonged economic lockdown and stagnation.

Let it not be lost on the authorities that Fitch “warned a delay in the rollout of COVID-19 vaccines may hurt the Philippines’growth prospects.”

To be or not to be should no longer be the question. There is no other option but to choose life.