Good news/ bad news; better?

Last Saturday, I received word that the Department of Health (DOH) released a report about the current state of dengue in the country. In the report, the DOH announced that the number of dengue-related deaths in 2024 so far has reached 881 and 340,860 recorded cases of dengue since the beginning of 2024 or 81 percent higher compared to 2023 where there were only 188,574 cases.

The “good news” is that the Department of Health has come clean with the actual figures and has admitted that there is an alarming number of dengue cases, which is why the DOH has issued the health alert as well as in anticipation of a potential increase in dengue cases resulting from the series of typhoons the country experienced in the last 30 days.

It seems that the DOH is now forced to admit the record the number of dengue cases and dengue-related deaths, partly because various members of media have been writing about the matter as a result of friends and relatives getting seriously ill or dying from dengue.

Then there are the numerous declarations of a dengue outbreak in several provinces or LGUs such as Dasmariñas, Cavite where they recorded 1,100 cases and seven deaths. Other provinces and cities had done likewise in past months while Quezon City, which is the biggest LGU in Metro Manila and has one of the highest number of dengue cases, will ramp up their anti-dengue campaign this month by staging several dedicated dengue training programs for all their health workers.

As far as the DOH report is concerned, what we don’t know is if there has been an actual 25-percent spike in dengue related deaths in the last two weeks or if it’s another case of delayed reporting from the field.

So anyone trying to figure out the situation has to take out their calculator and do some guess work because the DOH, allegedly, has not consistently reported or complied with RA 11332 by regularly reporting cases of “notifiable diseases” such as dengue.

The DOH used to issue these reports as they did with COVID cases as well as dengue before, but now the DOH reports mostly about cases of Mpox, but that is probably because PBBM took notice of the threat when it first appeared last year.

As far as dengue is concerned, one of my MD sources who monitors World Health Organization (WHO) data told me that the Philippines was mysteriously “inactive” or not participating in the WHO Dengue Surveillance report in 2024. The suspicion is that the DOH leadership does not want to highlight the obvious or bring attention to the fact that we have had, or have, a dengue outbreak in various regions, provinces and even nationwide.

Instead, they have adapted the strategy of “confirmation bias” by comparing cases week by week instead of the running total 10.5 months against the previous year. Comparing week by week, as a doctor pointed out to me, would be inconclusive because weather and conditions change in such a short period of time.

A critic of the DOH reporting style said and I quote, “What an analysis! Week on week talaga ang comparison? Makahanap lang ng decreasing trend. Nakaka-bother ang situation natin sa Pinas.”

The “bad news” is that the communications strategy that was being followed by the DOH remains in place and could be injurious to the public as well as the reputation of the DOH. While I for one support being cautious in their pronouncements, there is no need or logic in trying to paint a scenario of things under control, or that things are not so bad based on week-to-week comparisons of data or cases, at least not with dengue.

A generous and kind analysis would be that the DOH does not want to panic the public unnecessarily and has opted to wait until the last minute to sound the alarm. Unfortunately, that strategy runs counter to the logic and reason for issuing reports and medical bulletins or alerts so that people are informed, aware and prepared.

In the words of Benjamin Franklin: “By failing to prepare, you are preparing to fail,” and fail we did, as evidenced by 881 dead individuals and 340,000 infected. When faced by an “enemy” that takes lives and spares no one, whether child or adult, we need to sound an alarm as loud and as alarming as possible.

Under ordinary circumstance, it is understandable that those who are alarmist or who panic may be taken to task or frowned upon, but in the case of an actual dengue outbreak or a force of nature, people must be warned and prepared in any way or manner. Doing so this late in the game, with 881 dead people, is simply devastating.

So what should be done next? The DOH continues to promote their 4S strategy, namely Search and destroy breeding grounds, Secure self-protection, Support fogging and spraying, Seek early consultation. All of this has been the default since 1993 and partly helps in the fight. But there is a better weapon against dengue.

Today, there is already (to quote the DOH secretary) “a new and better vaccine” against dengue called Qdenga or TAK-003. It is now in use in Indonesia, Thailand, Vietnam, Brazil, Argentina, the EU, etc. The vaccine was submitted for evaluation to the Philippine Food and Drug Administration approximately 18 months ago.

Maybe Secretary Ted Herbosa should consider visiting those countries and find out how good the vaccine is and come up with a real solution.