Learned helplessness

I first heard the phrase “theory of learned helplessness” uttered in the Senate by the late senator Raul Roco. He expressed metaphorically that when a people are encumbered by excessive central authority, they become as caged birds and forget what it means to be free.

I had the occasion to test this theory when a scruffy, one-eyed pigeon found its way into our yard. We ended up hosting it in comfortable accommodations with nutritious feed, i.e. cooped up in its own enclosure. We released the bird after a few days, fully expecting it to vigorously reclaim its liberty. But, after stepping out of its cage, it hedged. That pigeon perched atop our perimeter wall for an entire morning before finally spreading its wings and taking off.

It’s not difficult to identify the caged bird metaphor thinking of the different enslavements we’ve endured these past months and years with helplessness that has become second nature. Tragedies like the pandemic take us back to the traps we fell into on our life’s journey. How did we deal with the challenges then? How are we responding to what ensnares us now?

“I wondered why somebody didn’t do something. Then I realized I am somebody.” Whether we’ve embraced the fear or have become increasingly antsy for emancipation, we can’t help but applaud the efforts of those who’ve not forgotten what it means to act free. Like the movers behind the community pantries. At 350 and counting, they are numerous enough to be noticed like the dots on an infection distribution map. The mother initiative was that of Ana Patricia Non & Co. over at  Maginhawa Street.

The street name reminds us of the pillar of Ambisyon Natin 2040, the long-term vision developed by the NEDA in 2015 to serve as guide for development planning, targetting a life where all enjoy a strongly rooted (matatag), comfortable (maginhawa) and secure (panatag) existence come 2040.

Maginhawa is understood as freedom from hunger and poverty; a comfortable lifestyle. The Ambisyon Natin 2040 vision speaks of a whole-of-nation approach to attaining our development goals. Surely, this namesake voluntary street movement evinces the spirit of private initiative to contribute towards reaching that objective despite the gauntlets thrown their way by those who construe their efforts as scathing indictments.

Wonder drugs. The Philippine FDA has granted three hospitals compassionate special permits for the drug Ivermectin. But doctors still equate prescribing the medicine with veterinary practice. In any treatment there are going to be arguments and journal articles for and against. Countries like India, Brazil, Peru, Argentina, Greece and the Balkans swear by it. The WHO and the US FDA have not greenlighted the drug but only because of “statistically insignificant evidence of efficacy.”

Last week, Secretary Fortunato de la Peña of the DOST announced the conduct of clinical trials for Ivermectin. We’re not the only ones seeing the possibilities. The gold standard Oxford University is conducting its own clinical trials.

“It has potential antiviral properties and anti-inflammatory properties and there have been quite a few smaller trials conducted in low- and middle-income countries, showing that it speeds recovery, reduces inflammation and reduces hospitalization,” according to Chris Butler, co-chief of the PRINCIPLE trial and professor of primary care at Oxford. “But there’s a gap in the data. There’s not been a really rigorous trial.”

Favipiravir, prescribed and dispensed here by hospitals under compassionate special permits as Avigan, is also undergoing local clinical trials. Both Ivermectin and Favipiravir are low cost, orally administered and readily available generic drugs. To date, the research expenditures worldwide have concentrated on vaccines and novel therapeutics designed to treat the critically ill. There is mounting demand for these early onset treatments that can check the deterioration to severity.

Still, some officials push for the swift adoption of foreign clinical trials. Right now, we are uniquely situated to conduct our own Philippine studies. With our elevated numbers, native variants, poor access to vaccine and other “proven” strategies, we are punished with an abundance of cases. Precisely, it was the large number of cases that occasioned the rapid completion of early phase 1 and 2 trials elsewhere.

Helping ourselves. We spoke early this month with our great friend, top vascular surgeon and scientist Dr. Ricardo DT. Quintos. The discussion foreshadowed the decision to proceed with the local trials coming from no less than PRRD personally who is seeking a solution that works for us.

With the interest in Ivermectin, we are certainly not short of subjects for good trials. As for funding, the DOH and its research arm the Philippine Council for Health Research and Development as well as the National Academy of Science and Technology are awash with research subsidies from the sin taxes. In the past years, in fact, they’ve been beset with budget utilization challenges.

Exploit our situation to find solutions, within the context of our own protocolized studies (not anecdotal testimonies). Be innovative and create the evidence. Other countries’ demographics and their circumstances may not be identical. Desperation at early stages unleashes unfocused energy. Best if we can channel this into a purposeful, creative and constructive paradigm.

Protocolized study is a win-win. All who want to use it should just enroll as a subject. Win for protagonists: they clamor for its use, so go ahead and use but within confines of a clinical trial. Win for regulators (DOH/FDA): no need to disallow/issue emergency/compassionate permit. Win for evidence-based physicians: creating evidence for their recommendations. Win for innovative/scientist practitioners: opportunity to create evidence at the highest standard, not just borrowing work of other people. Win for the Filipino people: safe usage of the drug with proper documentation, monitoring and safety protocols in place.

Glossary of gloom. The reception to last week’s column prompts us to include a section where we share the varied COVID vernacular crashing our everyday usage. We will focus on catchphrases and jargon. Our source is Oxford Languages.

Doomscrolling n. the action of compulsively scrolling through social media or news feeds which relate bad news.