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 figures 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. This 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 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.)
  • Herd 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 these promising results.
  • 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:

1. Protect Risk Groups especially the elderly.

2. Self-Isolate oneself immediately if one has cough, fever or any symptom of illness.

3. Re-open schools for children to hasten achievement of herd immunity.

4. Allow teenagers and the working population, in the various institutions, to continue their normal lives, provided they follow safe distancing and hygienic practices.

5. Re-open regions, provinces, cities, towns, barangays, and institutions on the basis of their low risk densities.

6. Instruct all age groups on how to strengthen their immune system.

7. 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 nottoo 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, Alternative Nobel Prize (2003)


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