Systemic Risk of Pandemic Via Novel Pathogens: Commentary, Part 3 of 6
The next part of the note deals with naive evidence-based medicine and naive evidence-based public health:
Early in the pandemic, the position that the World Health Organization and the Department of Health (Philippines) took was problematic on many levels. They discouraged the use of face masks early on, because there was “no evidence” of community transmission. However, to be fair, this was in the context of the Taal Volcano eruption, which led to several ashfalls thus necessitating the use of masks. Both the WHO and the DOH wanted to make sure that the health sector had enough supplies for masks.
However, we should question this. Why were face masks scarce in the first place? Shouldn’t we have built our production capacities for health resources even BEFORE the pandemic?
The National Capital Region is among the top 10 densest urban regions in the entire world, and for the past 20 years, there is virtually no improvement in transportation. All public transportation modes — jeepneys, trains, and taxis are very — extremely — congested. Therefore, it wouldn’t be surprising if there were hidden outbreaks and superspreader events that the currently available surveillance systems did not catch. All the processes are extremely fat-tailed.
A city-wide lockdown was executed last March 15, 2020, followed by a region-wide lockdown two days later. But this may have been too late, and epidemiological models estimate that the introduction of cases occured sometime February [2, 3].
I then tried making my own math model of the transmission dynamics, and look at what I’ve found — imagine if the lockdown, contact tracing, and isolation were done earlier on, more granular. What if we were tracking all persons who arrive at the airports in the country earlier on?
 Joseph Norman, Yaneer Bar-Yam, and Nassim Nicholas Taleb, Systemic risk of pandemic via novel pathogens — Coronavirus: A note, New England Complex Systems Institute (January 26, 2020).
 Haw NJL, Uy J, Sy KTL, Abrigo MRM. Epidemiological profile and transmission dynamics of COVID-19 in the Philippines. Epidemiol Infect. 2020;148:e204. Published 2020 Sep 15. doi:10.1017/S0950268820002137
 Rabajante, J. F. Insights from early mathematical models of 2019-nCoV acute respiratory disease (COVID-19) dynamics. arXiv 2020. preprint arXiv:2002.05296.