 and welcome to the 38th installment of the Stop COVID-Dets webinar series. I'm Dr. Raymond Francis Sarmiento at the Telehealth Center, National Institutes of Health, University of the Philippines, Manila. Today, our topic will be all about the safety of the COVID-19 vaccines. Ligtas po ba ang mga COVID-19 virus i-deploy po ng ating gobyerno para maturukan ang ating mga kiltik ng mga And to join us today, we have really a spectacular panel of experts to talk about the safety of vaccines. For that, let me introduce my partner in crime and my mentor, the Special Envoy for Global Health Initiatives and the director for systems over at Honolulu, Hawaii, Dr. Susie, Penedam or Dr. Susie. Hi, good morning, good afternoon. Good evening, everyone. Raymond, kamusta kayo? Kamusta po lang mga nasa audience natin atutawa ko? I was trying to learn the different ways you say, you say good morning or good afternoon, no? So we'd like to welcome you. We do have very, very interesting speakers today. Usually, we have clinicians talking about clinical management, but today from beginning to end, you will have clinicians who are also experts in public health. So we are going to talk about vaccines and we're going to talk about vaccine safety, which I think you are all very keen to learn more about that. Raymond, we thought that we'd like to get some idea about the audience and you must have been seeing surveys about what people think about vaccines, but we're going to do a survey with you, with the audience. So, Raymond, you want to introduce our little survey so we get a picture of who's out there, who's out there with us right now. Go ahead, Raymond. Thank you, Dr. Susie. So for those who are our attendees now numbering at nearly, oh, log pass na pala, 1600 plus attendees po for this webinar not accounting for our speakers. This may or may not be the first poll question or series of poll questions for today, but we hope you'll be able to join us for this survey. So the first question would be, what place are you viewing the webinar from? So we understand that a lot of you have already inputed in the chat box your whereabouts, pero sada po kung mailagay nyo rin po ito sa ating survey na nasaharap po natin ngayon, mas mainang po ito para mas malaman po natin kung saan po ang ating distribution. We understand that there are those who have registered outside of the Philippines to be able to get them in the program soon as possible. The second should be, what is your line of work? So meron po tayong mga from medicine, from nursing, from pharmacy, so please continue to input your answers po in terms of line of work. For those who are asking, we have nearly 4,800 registrations for this webinar alone. So that goes to show how important the safety of COVID-19 vaccines is to all of our audiences in stuff COVID-19's webinar series. The third question here, kayo po ba ay papaya, would you consent to the vaccination kung ito po ay libre? So okay, marami na po ang nag-input so we'll try to wait for a finalization of that count. The fourth question, ang babayan po ba kayo para sa inyong baka po na would you pay for your own vaccination? Okay. The fifth question, what will convince you that COVID-19 vaccine is safe? So multiple choice po ito. So ano po ang makukonbin si sa inyong naliktas a COVID-19 vaccine is someone I know has received it. Second option is my doctors. The third option, the LGU provides it for free. So it is more of a financial burden more than anything. The DOH provides it for free and then finally, kahan po ako ng mga kaibigan po para magpabakuna kasama sila. So yun po ang last option for question number five. And then finally, we have the sixth question. If you were to refuse an offer for a free COVID-19 vaccine, ito po ay maaring sa kadahilan ng ano. So marami po dito na kalagay na mga options. So for those who are inputing, we now have more than a thousand attendees po, who are keying in their answers and we hope to be able to get a final number for each of those answers later on. Okay. Over to you, Dr. Suzie. Thank you very much everyone for participating in that poll. And it looks like we are having a good picture. Later, we'll talk about the results. But we just wanted to get a sense of what you're thinking. And I think that will help also our speakers try to address some of your concerns and your issues. So Raymond, I think before we go into our opening remarks, you might want to talk about the certificates first. And to thank everyone. Yes. So thank you so much, Dr. Suzie, for those who are joining us for the very first time in Stop COVID-19 Webinar Series. We are now, may I call on TVUP to flash on in our certificate, ang itura po ng ating certificate na dinid-distribute for those who are eligible to receive it. And by eligibility, this will be those who have spent at least 50% of the webinar duration dito po sa Zoom. Ang more or less itchura na matatanggap po ninyong certificate, along with the presentations of the speakers and of that particular webinar. So we understand na merong po mga nagsabi po sa amin. At pakapedikan po itong pangalan ko, pwede po ang pakichek kung ako po ay makakatanggap ng certificate. So just an update for everyone, we have already distributed all the certificates that for eligible recipients po, for all previous 37 webinars that we have held. So if you feel that you are qualified to receive an electronic certificate by virtue of your attendance in that webinar, please let us know through our email. We stop COVID-19 at up.edu.ph. We also would want to make sure that you are keying in your correct, how it's correctly spelled in your name in the registration link para alam po natin na yun po kasi ang makareflek dun po sa ating electronic certificate. Okay, but before I turn the floor over again to Dr. Suzy for an intro of our opening remarks speaker, I'd like to thank very, very much the hardworking team behind the stop COVID-19 webinar series, at University of Philippine System, at UP Manila, at Office of the Chancellor, at National Institutes of Health and National Telehealth Center. We also have very much appreciated support and guidance from our colleagues at the Philippine General Hospital and the College of Medicine. For those who are viewing this in the Zoom, maraming salamat po. At ito po ay very, very successful because of the support that we are getting from the UP Information Technology Development Center or ITBC. And then finally, for those who are watching this in YouTube, maybe that's easier for them or masgamay po nila sa YouTube. This will not be possible. Actually, this whole production will not be possible without our very hardworking team at TVUP, which is the Internet Television Network of the University of the Philippine. So for those who want to watch this in the playback, just go to the YouTube channel po of TVUP. We are also being livestreamed in our Facebook channel and stop COVID deaths. Over to you, Dr. Susie. Okay, thanks Raymond. And apart from all of the people involved in production, without you, our audience, we wouldn't be able to do it. So, I'd like to just mention some of those who are put their location on the chat box. So, Kabalatuan City, Cebu, Bulacan, Baguio, Palo, Leite, the UP campus in Leite. Uy, wala daw tayong Center Visayas Choice. Okay, we're going to fix that. We're going to have that next time. Osir, Reyes Memorial Medical Center. Okay, Sambales, Bulacan, Togelgaraw, Kagayan, Cebu, Abu Dhabi. Oh my goodness. Okay, Lipa Medical Center, Philippine Red Cross, Dumagete City. So indeed, we are seeing participants from all over the country. And we just want to thank you for making it possible because without this audience, we would not be able also to understand what the issues are. And I encourage you to use the Q&A box. So, if you have questions, you can put them in there. So that we'll ask our speakers to start answering them when they're not speaking. Alright, so without further ado, let's go to our opening speaker. You know him. He is, as I said, all of our speakers are clinicians. They have been practicing medicine, but they also cross over into public health. So Ted Robosa is a very well-known surgeon. But he is also Executive Vice President of the University of the Philippines. And he is Special Advisor of the National Task Force on COVID-19. So he's in the know on what's going on. And we'd like to welcome Ted into your home webinar. So welcome, Ted. Thank you, Susie. And in behalf of the good afternoon to all the participants, the speakers, all the way from Abu Dhabi and as far north, I saw as La Union and Tugi Garaw and as far south as General Santos and Sambuanga City. I think as of now, we have over 2,000 participants on the Zoom webinar plus many more on the YouTube. So in behalf of the President of the University of the Philippines, the Office of the Vice President for Public Affairs, TVUP, our ITDC, UP Manila, our National Telehealth Center, I would like to welcome all of you to the 38th episode, 38th episode of Stop COVID Death Webinar Series to discuss the hottest, really the hottest blockbuster topic of COVID-19, the COVID-19 vaccines. And based on the communications with me last night, one of our speakers, Dr. Anna, only was saying that her friends cannot register. There was a registration block that was happening last night. I believe this is again the reason why this is going to be a hit webinar episode. And if you heard, this is our 38th webinar and it started last year actually during the time of the emergency enhanced community quarantine period, Dr. Susy Mercado requested me to hold the webinar. In that week, I think she asked me on a Tuesday and wanted the webinar by Friday. So, and she said she heard about the respiratory therapy being used by the PGH doctors to save the lives of our fellow physicians who were dying of COVID pneumonia at that time. Very successful therapy. You all know that now the high flow nasal cannula procedure. And of course, as the Executive Vice President of UP, I abused my authority and basically mandated UP units that were used to webinars to work together. And this was the National Telehealth Center led by Raymond Sarmiento, the Office of the Vice President for Public Affairs, led by Vice President Nany Perna together with her colleague, Assistant Vice President Rika Abad. And lastly, we utilized the experience of TV UP under Professor G.G. Alfonso. Dr. Sushi helped us with Phil help to make sure that the whole country would hear about what webinar and we had a blockbuster webinar because of the thirst for knowledge for things about COVID-19 and how to treat it. After that success, our team committed to deliver more webinars and I congratulate the team today because this is now our 38th imagine in a year we've produced 38 webinars and several of them were blockbuster or box office hits. For today, our Stop COVID Death Team has tried to address the most pressing issue and that is the issue of vaccines for COVID-19. I have suddenly seen many talk about vaccines and seem to be pseudo experts on vaccine after what they've read on social media and I've also seen many misinformation being shared innocently or intentionally. And our goal today is to answer the question what we don't know. But I guess there is a dictum that comes in this types of cases that we use in emergency medicine. We really don't know what we don't know. So that's part of I think what we need to discuss. The characteristic of Stop COVID-19 Deaths webinar is really the fact that we invite the real experts, people who know their topic and understand what they're doing. Today our expert indeed is a real one, our experts are real ones to talk on the topic that he will share to us on how to understand clinical evidence or research evidence. And that is Professor Antonio Danzo. This happens to be my classmate in medical school. I used to compete with him in high school, in the track team, in the hurdles events. He was in another school run by Jeswits and I was in a school run by Benedictines. He was also my internist and cardiologist for most of my surgical patients. And I trust him. I trust him with my patients and to analyze and tell me the risk of surgery for most of my patients. He was our class president and of course I was the class clown. I do the stand-up comics during lunch breaks and relieve everybody's stress so that they could all graduate from med school. I also like to thank Dr. Anna Onglim, who like me have been helping the IATF throughout the crisis since the beginning of this pandemic. Also, as Eriq Tayag of the Department of Health who I worked for five years when I was under Secretary of Health and we together have responded to several epidemics and he has also taught me several dance steps as well. So again, to our constant participants in this series, do we hope you will be enriched by the program today and of course to the new ones in the webinar series, our past episodes are still available po. They are free, online. You just type in the search bar of YouTube, TV, UP, stop COVID-19 deaths and you will see all 37 of them. With that, I'd like to thank you all. Let's all listen and learn. Welcome and good afternoon. Good morning to the ones in Abu Dhabi. Maraming salamat. Thank you very much Ted for an energizing introduction which is what we need. We're going to talk about something safety and also I think this is all that this is something that concerns us on a very personal level and I think we really want to hear the latest, most reliable information and as Ted has described our speakers, I am very sure you are going to get the best information available today. Raymond, we have another poll. So today po, we thought we were going to have a number of interactive activities for you so that you'll be up on your feet and answering and thinking with us and tutuanaman kami. You're very engaged. So Raymond, let's go to our opinion poll. Thank you Dr. Susean. Thank you EVP Ted for that lively and inspiring message po. And I'd like to preface this poll by saying that this may or may not be the last survey question or poll po for today. So hope you will sustain your answer questions right in front of you. Number one question it reads, how do we know if a COVID-19 vaccine is safe? We have four options and namely clinical trials were done properly and published in scientific journals. Option two, it meets FDA standards for safety and efficacy. Option three, side effects are generally minimal and option four, all of the above. Okay po. The second question po, it reads, we have four questions po. The second question reads how can decision makers ensure safety of the COVID-19 vaccine? So the first question the first option states and experts are allowed to do their job without political interference. Option B, all initiating steps for approval of COVID-19 vaccines are properly followed. Option C, under the emergency use authorization all partners follow government guidelines for use. And option B is all of the above. Before we last two questions I'd like to just give a shout out po to our registrants and for those who are joining us, either locally or internationally, we have those who are joining us all the way from Dr. Paulino J. Garcia, Memorial Research and Medical Center from Talugtong Meduaisija, Laurel Memorial District Hospital in Canawan Batangas, Dr. Pablo Otore, Memorial Hospital in Bacolod City, the RHU CIA in San Juan del Norte and RHU Bumbaran may manabilang in Lanao del Barm. So, those are just a few of those who have signed up. We continue to see people inputting where they are from and giving a shout out from where they are currently viewing this webinar in the chat box po. So, please continue to do that. Internationally, we have those who have signed up all the way from Kandimia Sinica from Taipei, Taiwan, the National University Health System in Singapore Elizabeth Nuvina Hospital in Singapore. We also have the World Health Organization Country Office in Indonesia. Tuning in the Filipino community in Indonesia in Jakarta, Maria Regina School Semarang Indonesia, the Quasya Diagnostic Services in Bandar Serig Begawan and the Prestige Hospital in Nongpen, Cambodia. In the Middle East, we have representatives from the Almasara Hospital Ministry of Health in Muscat Oman, the Institute of Research and Medical Consultations in the Mam Saudi Arabia, Imam Abdul Rahman Bin Faisal University and Alkobar Saudi Arabia also and Aljubail Alkarj. We also have Cambridge Medical and here we have Rehab Center in Abu Dhabi, the Ministry of Health of Kuwait. Wow. The Adam University at a very first, Adam University in Jistan. I think that's the very first time I'm saying someone is from pure Jistan and then we also have ones from Tripoli, Libya, Long Island, New York, Jacksonville, North Carolina, Keyport University, Bridgewater University in New York, Ontario, Canada, sorry, North York, Ontario, Canada, Niagara Falls, Winnipeg Manitoba and East Melbourne, Australia. So, gato kandami tayo but we are just a little over 50% of those who have signed up for our webinar for today. We are now numbering a little over 2400 attendees for this webinar. The third question po just to complete this is this statement true? A drug cannot be safe if it is not efficacious and then finally the very important question that we want to answer at the end of this webinar ligtas po ba ang COVID-19 vaccines? So, thank you po for those who have came in their answers. Maraming salamat po and we will try to circle back to these questions later on in the webinar. Apos to see? Thank you very much Raymond and again just like to to welcome those who are just coming in right now because we have people when we started we had a big number of people but we still have people who are here so welcome to everyone and we are now going to the introduction of our first presenter and as I mentioned earlier our speakers today are clinicians who have crossed over into public niya and have done so very successful and our next speaker Dr. Tony Dance you have seen him testify on tobacco control he's been in all these hearings on safety and currently his new role is he's the spokesperson of the healthcare professions alliance against COVID-19 but I agree with Ted if there's a cardiologist at trust it's going to be Tony Dance and he is professor at the UP college of medicine and I would say a good friend somebody who just wants to use science properly to save lives and that pure intention is obvious whenever Tony Dance speaks kung baga walang agenda si Tony Dance gusto lang niya scientific time and I think that's going to be an underlying theme for his talk so Tony how are you doing before you give your presentation kung sana hi Susie staying safe thank you for inviting me here okay so we're very happy to have you Tony and please go ahead with your presentation okay thanks Susie and greetings to everyone our VP Ted Herbosa my classmate and Chancellor Padilla is here mentioned good afternoon and our Dean Charlotte Cho and the other ordinary citizens like me so good morning oh and a special call out to our emce Dr. Raymond Sarmiento who was recently awarded ten outstanding young Filipinos na nainggit ako sa you Raymond kasi nainggit ako dun sa young kasi hindi na ako kasi sa young ngayon so I'll start with a poll if I can share with some decorations just a minute is my slide showing Susie it's not yet moving sir we just see your intro poster yes yes that's the one I just wanted to emphasize kasi I speak on behalf of the healthcare professionals alliance against COVID-19 an amalgamation of more than 150 professional organizations not just doctors but nurses midwives pharmacists, med techs dentists and others who have joined hand to help the government to help the people in surviving this pandemic and managing this pandemic slides I present have been vetted by HPAP in previous meetings I'm going to start with a quick poll so I'm hoping people can log on in your phone or in your laptop to menti.com and use the code that's shown 8159627 or you can scan the QR code to get to that page I'm going to give you data and ask you which vaccine you prefer the situation is this let's imagine you are a policy maker you could be a mayor or a governor or you could be the president of a private corporation or the secretary of health depending on who you want to represent and you were given data on the vaccine two vaccines let's say which one would you prefer if I told you that vaccine A is 95% effective against COVID-19 and vaccine B is only 75% effective but one is slightly cheaper the less effective one is cheaper and the more effective one is more effective more expensive one is more effective which one would you prefer to procure as that policy maker so after you answer this question just stay on menti.com because I'm going to be asking the same question as the lecture goes on so now we can show here most people will prefer the slightly more effective but slightly more expensive but the more effective vaccine okay understandable some are hesitant now I'm going to add the data I give to you now what if because of maybe storage and transport technical requirements we find that vaccine A is only accessible and can only reach 20% of Filipinos while vaccine B probably easier to manage transport and store less logistics necessary can be accessed by 90% of Filipinos I'm going to clear this so right now an overwhelming just stay on that on that web page and now ask the question again and you can answer parang nag rally yung vaccine B if you look ano naman if it's 75% effective mga 63% ang nabibenefit mo ito if it's 95% effective and only 20% of Filipinos 18% ang nabibenefit mo so now we see a rise in B and then the third question is this if you had long term side effects nakita mo is the topic for today 2 in a thousand sa vaccine B and then 1 2 in 10,000 yung serious long term side effects yung effectiveness against the UK variant so mas marang yung side effects sa B pero mas effective siya against the UK variant and the duration of protection but the duration of protection is shorter compared to vaccine A then which one would you use i'm going to reset it first mag muna kay sumagot para reset results and now you can answer which one would you prefer now parang naging neck to neck na yung A and B okay i'll go back to this later you can continue answering what's my point my first point is well we hardly know the answers to many of these questions as of now we only know efficacy for 3 months because that's the published results we don't know long term efficacy and when we will need a second or a third booster and we only know efficacy and cost we don't know what the logistic problems will be fully we don't know the long term side effects because follow up is very short we don't know effectiveness against UK variant we'll find out in a few weeks or months and most of all we don't know the duration of protection what if we put all our money on one vaccine only to find out that we need a booster in 4 months siguro rich countries can afford that to cuff out another 80 billion but maybe we need to be more careful when we try to make that decision so my message in this first slide is it's a complicated decision it's not easy and giving you this hypothetical data if you look ano tayo di ba almost evenly split between the two depending on what data is provided so, added to that difficulty or complexity is confusion everyone wants to procure everyone wants to distribute people have opinions on what is effective and safe there's a lot of rhetoric going around pero sino ba talaga who authorizes who chooses who distributes because if we get if we bury the complexity in this confusion then we ruin vaccine trust and the whole thing falls apart so I'm going to spend most of my talk on that process for approving it before I start, I want to declare my conflicts of interest and the next time you hear anyone talk about vaccines for their conflict of interest I've been involved as a national leader of clinical trials and performed systemic reviews on many drugs I think I did one vaccine the flu vaccine to prevent complications in heart failure patients the funders of the studies I conduct have been Manila, PCHRD Canadian Health Research Institute Welcome and Newton fund also some companies like AstraZeneca and Pfizer are here my studies were on cardiovascular drugs and they were years ago but still, I need to declare that and make it clear so that people understand where I come from I have always insisted on independent analysis and freedom to speak and have never used slides issued by the pharmaceutical company and no financial stakes on any of the COVID-19 vaccines I'm an advocate of evidence-based medicine as my students know and have at some time lectured or lobbied against the overuse of several technologies including vaccines in the past and rapid antibody tests for COVID and other technologies so with that said ano ba talaga yung process we find out if the drug is safe and effective now, all of us or most of us here mostly doctors, nurses midwives, healthcare professionals and even the media and lay people know this when you do trials on humans there are several phases phase one is you do it on a handful of volunteers you can see my pointer and then phase two you do small trials a vaccinated group against a placebo group perhaps to see if it's hopeful and if you'd like to go on to a phase three or a large trial and that's what we're seeing now phase three large trials randomizing sometimes tens of thousands of patients based on phase three trials the Food and Drug Administration issues a certificate of registration which allows them now to enter the flipping market and sell it and this is a power provided to FDA by the FDA law or RA9711 which I think is 2009 or something once in the market we still need to follow up these people who are given the drug based on phase three trials so we conduct phase four marketing surveillance on people who receive the drug and what happens after phase four the health technology assessment council based on the universal health care law gives a positive recommendation on which of these drugs in this case vaccines may be considered now this is the wording positive recommendation but it's actually a powerful function because a positive recommendation from HTAC is required for PhilHealth or DOH to procure any of these medications or vaccines so that's the normal process parang HTAC gives you a menu of the vaccines that you can procure based on that central government through the DOH will now procure the drugs national government will procure the drugs plan the storage and distribution and transport in the case of vaccines it's the national immunization technical advisory group who plans the distribution and prioritization tapos na ba? hindi pa hindi distribute mo pa doon actually provided to the people and who does that it's going to be the local government units parang planning pa lang ito actual distribution by the local government units at the end of the day when you're talking of vaccines they are the final deliverers tapos na ba? hindi pa rin those who are given the drug as dictated by need to be monitored in the case of vaccines this is monitored through the national adverse events following immunization committee or the NAFE yan na ba lahat ng agencies mayang pang isa ang vaccine expert panel which is concerned with research development here and development here on the left column okay now mayang isang panggulo sa COVID because it is such a dire emergency at many of those who are dying we have interim or preliminary phase 3 results coming out hindi pa yung final phase 3 and we need to take a look at it because we need something against this pandemic and how does the FDA approve that they are required to approve based on completed trials well they were given the authority by executive order one-to-one to issue an emergency use authorization or EUA based on preliminary phase 3 data so does that solve it may problem pa how does HTAC make a recommendation because they are required to make phase 4 and how can the procurement process go on if FDA issues an EUA it did not exempt it required phase 4 so nagkaron ng bayanihan app as you know last year authorizing HTA for the health technology assessment council to issue the recommendations based on phase 3 trials without phase 4 okay na ba hindi pa rin kasi they need the completed phase 3 trials we need to authorize they need to be authorized to base their preliminary recommendations on the preliminary phase 3 trials ito wala pa I think there's an administrative order for this but we need an executive order for our republic app and we are working on getting this done as soon as possible so HTA is not sleeping while this is we're waiting for this they are working day and night to get the evaluations done now ano ba yung mandates ng agencies na to the food and drug administration their main mandate is to assess safety and efficacy meaning uubra kaya ito they will be reviewing the trial submitted which is hundreds of thousands of pages if you consider all the vaccines available there ang mandate ng health technology assessment council effectiveness will it work itong efficacy can it work itong effectiveness will it work in the real world and that's a difficult decision I'll show you later they also want to look at efficiency sulit ba ang gagasto si natin dito kaya ba natin with minimal resources and of course they are mandated also by the UHC law to address context of interest sila lang yung meron talagang sunshine provision na kung meron siyang may context of interest manage it kung kawari may declarations katulad ko kung ako na sa HTA I should not be allowed to vote because of my hindi nga ako talagang involved sa vaccine trials I did trials for Pfizer and AstraZeneca years ago but I would decline from and they were not on vaccines so I would decline from voting because of the potential conflict of interest we need to protect the process ang DOH and NITAG their main issue will be equity patas ba makatarungan ba ang pag-distribute ng ating vaccine ayaw natin itong maging labanan ng capacity to pay na we are going to vaccinate those who can afford sa ka na yung mga hindi hindi makabaya this has to be equitable unahin yung nangailangan ng mga tao so there are also advisory groups like expert groups yung mga society professional societies in civil society groups private corporations have their own evaluations and very ample support for the usual agencies yung IAP at vaccine cluster they have a technical group on vaccine evaluation and selection diplomatic engagement kasi kausap mo rito mga pangulo procurement and financing maintenance of the cold chain communication with the public and the program itself as it will be implemented we need to be clear about this processes on the left here research and development yan on second column we have the core agencies and their mandates in red the core processes they use to get the vaccine approved and available in need and we have the support groups this has to be so clear na procurement is central government and they have guidelines of distribution which shall be implemented by the LGUs so ang tanong ba pwede tayong pumili at ito ang process ng batas para tayo makapili ng tamang vaccine para sa lahat to do we listen to for final approval it's the FDA for final recommendation the H-TAP and for final distribution according to unequitable plan we look at central government under the leadership of the IATF and the department of health na yung just to show you how complicated it is ito yung health technology assessment framework ng H-TAP which I borrowed last night thanks to Dr. Mehmed Guerrero and Marfori and Dr. Marita Reyes. Ito yung nga gawin nila. They will assess the magnitude of the pandemic, safety and efficacy of the drugs, the social impact. Tatanggapin ba na mga tao yan? And then ito, yung cost and efficiency, and then will it be fair? And what's the impact on customers at the front lines? And andaming data po niyan, to assess magnitude and severity. They have to look at the deaths and morbidities, the expenses from the vaccine, the diseases we've neglected, and the impact on the economy. For safety and efficacy, they review the trial data, but they go beyond that. They need to project the impact in the real world on the number of cases, deaths, confinements, quarantines, and the impact on special groups. And adverse events. So, kahapun niya ata, meron ng special advice on pregnant women from WHO, and this change almost daily. They do focus group discussions with key leaders and public. Ano bang expectation niyo on safety, efficacy? So si pwede n'yung padala yung results ng surveying niyo sa HTAC. Transparency, very important to the public and equity, fairness, kung tayong magunahan, unain natin yung mga nangangailangan. And then indemnification, ibig sabihin po merong side effect, how are you compensated? And then affordability and viability, hindi lang unit cost ng vaccine po. Kasama po yan ng logistics, may gastos yan, training of people, monitoring, yung information technology para ma-enter natin sa database, impact on the budget, handling and distribution. Ito vulnerable groups by gender, by religion, by residence. And sa household, ano ba yung impact nito on averted costs like testing, treatment isolation, income loss, and transport costs. Ang alam lang natin, red trial data and unit cost, that is natin na. This is a very complicated task and you need a master's degree to do it. Kung kaya n'yung gawin yan, bihirang may kaya n'yung gumawa niyan, pero kung kaya n'yung gawin yan, pakisabit ng pangalan niyo, dapat member kayo ng HTAC. Kasi kong konti lang ang tao makakapag-integrate ng lahat ng information na to. And they have to do it continuously kasi data is moving. So ano ba ang... While we wait, alamin na nila. Gano patagal ba ang protection? Is it effective against new variants? What are the rare side effects? How do they compare to each other? And what's the effect on elderly, pregnant, lactating women and children? And will it end the pandemic? All eyes on the US and UK. So to conclude, people must have access as soon as possible. Okay yan, as soon as possible. Kaya lang dapat, we made to make sure it's safe and effective. And distributed equally regardless of race, religion, or ability to pay. We must protect the core processes and mandates of the vaccination program. And distribution must be equitable and not become a battle of purchasing power which we sometimes see. Rich corporations can buy it. Poor corporations cannot. Rich communities can pre-purchase. The poor cannot. Preventive measures must continue. So my last slide. Are the COVID-19 vaccines safe? Sa akin, we need to nuance that question. Is it safe enough compared to the cost, compared to the benefit? So we balance that. And we need to note that there will be no permanent answer as of January 29, 2021. And tomorrow we may have a different answer from today. And my answer is it's safe enough. It depends. If the agencies are untainted, their processes are maintained and followed. And their mandates are protected from political, commercial, and self-interest. Sinama ko yan yung self-interest. Wag hu tayo mag-unahan. Pumbata pa tayo, malakas pa tayo, kahit kaya natin bumili. Paunahin natin yung mga kailangan talaga at yung mahi-fila. And if we do this, then this is my answer. It depends. Because that's my whole point. We need to wait for what? FDA says and what? H-taxes. And we need to help them come up with a credible answer by being vigilant. Sayang tayo yung mga tao para natin ang ginagamit. We need to make sure all of this happens. And we need to maintain solidarity. And make sure that self-interest, including our own, will not be a determinant of who gets the vaccine first. Yan po ang promise ng healthcare professional alliance against COVID-19. We will be vigilant. We will speak up when we need to speak up in the past. So, thank you very much for your attention. Thank you very much. That was Dr. Tony Dance. Very clear as always to me. And really giving us multiple perspectives. Kasi maingayin, it's a very noisy environment. And we really hope that this webinar series is a space for all of you, our audience. To just calm down. Listen. So that we are not contributing to the noise unnecessary. And I think Tony has made some very clear points that we're going to go back to later on. So thank you very much, Dr. Anthony Dance. Next speaker. Another very well-known, very credible person. And I'd like to welcome Eric Taya, who is Director for of DOH KMITS, Knowledge Management Information Technology. But I don't know Eric, if you'll allow me to say this. But I met Eric many, many, many years ago. Eric, it's okay to tell the story about our meeting. He's taking a deep breath. He was starting in the Department of Health. And I can't remember if it was Dr. Flaviers time or maybe Dr. Romal this time. He wanted very badly to go to San Lazaro Hospital. Very, very bad. Because again, as I said, our speakers today are very good in clinical work. Okay? And he wanted to, I said, what do you envision? I want to be in San Lazaro. Maybe be the director of San Lazaro. And I looked at Eric and I was listening to him. I said, you know, you're meant for much more much more than that. Not that I'm belittling Dodian's position in San Lazaro. But I could see that Eric had a passion for the public. He had flair in communication. And he was very good in epidemiology. So it's great to have Eric with us. He's frank, straight to the point. Speaks his mind, sometimes gets into trouble for doing that. But that's okay. We like that in this webinar. So Eric, welcome to the webinar. You're speaking here not director of gametes, but as an epidemiologist and as a public health expert who is in a decision-making position and who's been through, who stayed in the department for a long time. You've been an aspect of many of your colleagues. So welcome to the webinar. Eric Okay. Thank you, Susie. Good afternoon, everyone. My greetings to Chancellor Menchit to the Dean of the UP College of Medicine and other affiliated sciences in the UP system to the Executive Vice President Teder Bosa to Dr. Tony Danz and to you, Susie, and of course Raymond and everyone who's watching this afternoon's webinar. My virtual background is the SARS-CoV-2 virus. This is to remind me and everyone that the danger lurks and this danger is something we can manage with what we have now and we can manage in the future. Let me share my screen. Is this screen on now? Thank you, Director Taya. You can go ahead. So are the COVID-19 vaccines safe? Let's get the proper perspective. As of January 17, the World Health Organization reported over 93 million cases and over 2.6 million deaths. In your screen, the countries are marked in terms of the cases reported in the last seven days per 100,000 population. The Philippines belong to those countries were in 10 to 50 cases were reported in the last seven days per 100,000 population. What's happening in our country? We have reported thus far as of January 27, 518,407 cases and 10,481 have died. The case fatality rate is 2%. It is also the global case fatality rate. On the top of the screen, 45% of cases per region are age 20 to 39 years old. 70% of severe cases are age 50 years old and above. And 62% who died are age 60 years old and above. Below these two frames are the confirmed cases by date of onset and the confirmed death by date of illness. So what have we done so far? It was so simple. The messages were delivered to the public. It's ICT. It's our individual health measures. Please wear your mask when you're outside your homes and even at home when you need them. Observe physical distancing. Avoid large crowds. Of course, the IATF would weigh the data that is submitted to them on a regular basis and make assessments on the level of community quarantines that may be imposed in any local government unit. The last one, so we have the IC and the T, the T3 strategy, while we teach people so that they can prevent and promote health during this pandemic. We should test. We should trace and identify those who may have been exposed and those who have illness so that they can be isolated and treated. Then the good news came. The COVID-19 vaccines are coming, especially when the FDA has granted emergency use authorization to Pfizer and just recently to AstraZeneca vaccine. Did you know, for example, that this on this screen, we have countries that have vaccinated most, many of their population and it's reflected in this screen. So the cumulative COVID-19 vaccination doses administered per 100 people as of January 27. Israel leads the pack with 49. If there were 100 people in Israel, half of them were already vaccinated, followed by the United Arab Emirates, Italy and China. Over 70 million have already been vaccinated. But what else is in the news? It has been lurking around these items that there are those who died after receiving a dose of the vaccine that is happening in many parts of the world. Did you get surprised that Myanmar already started their vaccination ahead of the Philippines? Well, what else in the news? It has been lurking those of the vaccine and that there are articles that say that MRA vaccines have their risk and that the Pfizer and Moderna can be sued if anything that is harmful happens to those who receive the vaccines and that the specter of a new coronavirus variance raises questions on the efficacy of these vaccines that have been deployed. Then we have a survey. Competing truths will always get unresolved. In this survey conducted between January 26 to 31, Pulse Asia cited reasons that influence the respondent to distrust the vaccines. Overall, in the Philippines, 72% of the respondent relay their distrust to the reports on the infection and you can see the red box. Of course, there is a 14% to 21% range where in the information opinion from a public health care provider actually differs from other spokesperson or from other personalities that deliver the message. And so it was suggested that limiting the negative news that then and that the information and opinions from various government offices need to be aligned. So is vaccine safety a real concern? UNICEF in September 2020 showed that when we want a specific information that is most important in order to decide whether or not to get a COVID vaccine well many cited side effects and the safety risk. Over and under right, what is the most important reason why you would not get a vaccine vaccine may not be safe. But are these safety issues also tied to trust issues? In the same survey it is revealing that for the Philippines the survey said I do not trust the vaccines provided by the Department of Health. Although the overall trust is at 65%, one fourth of those who survey do not trust the vaccine provided by DOH. And what's telling about this is that in the national capital region it's 47% who do not trust the vaccines provided by the Department of Health. But wait are COVID-19 vaccines really safe? Let's run them down. One, the COVID-19 vaccine front runners rush the vaccine development. Many know that vaccine development can range from 10 to 20 years. And so having a vaccine and deployed even with an emergency use authorization in less than 12 months exactly 10 months for these front runners everything has been rushed. But what people don't know is that the front runners like the mRNA vaccines that technology started since 20 years ago and it has been perfected for almost a decade and those who discovered and are implementing this new technology waited for an opportunity to use this rushed it was something that they didn't recognize would be advantageous to them. Who would have imagined that the pandemic was to an illness a new illness that has high prevalence and so therefore when they conducted their clinical trials able to see the impact or the efficacy of the vaccines because this increases the chances of exposures and so therefore they can measure it. So our mRNA vaccines a technology that can alter our DNA well, you have to look at your sources because it's a one-way street for mRNA it doesn't become your DNA and so we have to know our biology. People have died after getting vaccinated as was reported at Norway and it will be reported again but is this something that needs investigation of course is this something that we should be worried about of course it's natural for us to worry about these reports anyone can be sceptic especially if these are reported in social media severe allergies have been reported after vaccination in fact anaphylaxis is a contra indication many worry about long-term safety effects yes this was only an emergency use authorization and we have the regulatory authorities base their approvals with EUA on trials that are in the interim of phase three and it's only after two months but there is a independent safety monitoring board that help them make this decision good in paper until you get punch in the phase so that's all saying press release don't don't believe them we should look for evidence that really it's bad yes if vaccine is not from China or Russia remember the juicy um juicy perspective okay and it played out and it can even have impact on our choices for these vaccines oh it's not been tested enough for diverse groups of people true oh our healthcare professionals also express doubts of getting vaccinated is that true okay the sage the WHO experts the advisor group of experts if you read them for either the Pfizer vaccine or Moderna vaccine this is what they have to say okay older persons and persons with comorbidities can be vaccinated for persons about 85 years old we have to wait if their current health status especially if we anticipate that their life expensive within the next three months is not so good lactating matters only for those if they belong to the priority groups persons with autoimmune disease persons with history of Bell's policy persons with previous SARS-CoV-2 infection can be given the vaccines and for those with previous SARS-CoV-2 infection you can delay it up to six months you can wait on cue and so therefore if the supplies are scarce we can give them to persons who have not had SARS-CoV-2 infection we can give them to persons living with HIV if they belong to the priority groups but what is not allowed persons who receive vaccines other than COVID-19 should have a waiting period of 14 days persons who have anaphylaxis due to vaccine components is a contra indication pregnant women we're waiting for new recommendations is the risk versus benefit in fact there are those who recognize that if you're a healthcare worker and there's pregnancy then you weigh the risk against the benefit persons below 18 years for Moderna and SN16 years for Pfizer it's now they didn't include them in the clinical trials but now we understand that they are enrolling volunteers in this age group persons with current acute SARS-CoV-2 infection don't get the vaccine please take your rest sure you're strong enough persons who previously receive antibody therapy there should be a waiting period of 3 months persons living with HIV if you do not belong to the specific group that was prioritized and persons with previous SARS-CoV-2 infection no if there are scarce supplies so let's go is it true that healthcare workers don't want to be vaccinated in the recent survey of those we asked discussion 1245 67% of doctors said yes 6.8% said no number of doctors in this survey was 689 and listen to this 26% are not sure but what is most telling is that midwives numbering 9 almost half of them said no and this is the survey for that particular question so when we ask them how safe do you think how concerned are you okay they are concerned but they think it is safe the vaccines are safe that's their perspective those included in this survey so let's seek first to understand then to be understood let's not fight the anti-vaxxers let's not fight those who doubt it's normal, natural to be skeptic like dr. Tony Dunn said I want more data I want results from the age stack I want them to finish the pastry clinical trials I want pharmacovigilance so for everyone's understanding the emergency use authorization means it will take time to vaccinate the eligible population the first jabs will be for the most vulnerable individuals or areas so it's the healthcare workers because you saved lives we don't want you to be heroes and risk yourselves we want you to be heroes that actually saved lives and continue to save lives the eligible individuals get to be in road screen master listed prior to vaccination that's my office I hope you have been included in the master list because healthcare workers are priorities followed by senior citizens the indigents the uniform personal and this will be followed by essential workers so promoting vaccine confidence health education and counseling are part of the vaccination process but wait you can also be part of this endeavor especially after listening or watching this broadcast the management and treatment of anifact anapphylaxis are available we are ready for it it's part of our logistics and vaccine management the surveillance of adverse events following immunization is routine and pharmacovigilance is something that FDA should deliver so where are we we test, we trace, we treat let's include another T to make it a T4 take the vaccine please atin ang labanan 19 sabakuna tagumpay ay atin and let me end this presentation vaccines do not save lives vaccination saves lives maraming salamat po good morning, good afternoon and good evening thank you very much that was Eric Taya who is the director of Hamits a knowledge management information technology at the department of health but also an epidemiologist and a public health expert and truly the perceptions around vaccines contribute a lot to people's behavior so beyond the science that Tony has talked about there's also what are people thinking how can we have them understand and what information is useful for them including healthcare workers and we're going to discuss this a little bit more so let me turn you over to Raymond for our next speaker thank you director tayag for that informational presentation thank you also doctor Susie at this point we will be moving on to the reactions and we only have really one reactor for today's panel I'd like to introduce dr Anna Ong Lim who is a well-known pediatric infectious disease specialist but more importantly in our fight against COVID-19 she has been serving as one of the health technical advisory group on COVID-19 dr Anna has a brief slide presentation dr Anna please go ahead with your presentation okay so Raymond I'm not able to bring my slides up but in any case thank you for the opportunity to be able to give a reaction to the two excellent presentations I'd like to start by stating my disclosures I'm a principal investigator of pediatric clinical trials in vaccines as well as in antibiotics so that should show you that I do have a bias towards favoring vaccines and I'd like to say publicly that I'm a vaccination advocate so once again that does show my bias but I hope despite that disclosure you'll be willing to keep an open mind as I give my reactions to these two talks dr Dance actually gave an excellent presentation on the process and you know when we were starting on understanding the whole vaccine procurement process all of us in HVAC because I am also with that team we're really quite confused about how the process was going to be to be run and we have to admit or I have to admit that that confusion was very crucial in my skepticism about the program and by showing or walking us through the process by showing us the various steps and the various groups that are involved in assessing the vaccines every step of the way dr Dance showed us that understanding the process understanding the scientific rigor within which each of the groups evaluate the vaccines that will eventually into the program and understanding the built in safeguards play a role in our decision or our effort to trust this particular system and the trust that is built is going to be critical to the development of vaccine confidence and acceptance of the public Although he did end with a I'd like to see more data statement I think this is really just prudent being a prudent consumer because all of us will eventually be vaccinated and I think with or without the scientific training that we've gone through as healthcare professionals magandang maging masusing consumer and I think by saying that you can't be choosy or you just accept whatever it is that comes in actually is how should I put this maybe saying or I can't find the word underestimating the public and underestimating their capacity to understand these issues and concerns even if we say that these are fairly technical it becomes our responsibility as science communicators to be able to share the information in a way that allows people to make these decisions in an informed manner Now going to Dr. Tayag's presentation he focused first on sharing with us the data that public opinion service will show that vaccine update unfortunately and if I remember the number it's less than 50% which is really very concerning and shared with us multiple news headlines and social media posts that seem to be driving this poor public opinion at the same time debunking some of the myths and I know as individuals we've been bombarded by so many different headlines just today we heard about this headline coming from Germany saying that AstraZeneca would not be given to individuals in the elderly population and I have to say that's actually clickbait because if you read the study and you read the decision that's not what it says there are new ones to that particular headline that actually you need to understand to be able to appreciate why the decision was made in that way but having said that on a daily basis we're really bombarded with all of these headlines and social media posts and even for us as healthcare professionals it may be a little difficult to separate the wheat from the chaff meaning something sounds a little scientific it's not part of our specialty our bias is okay maybe this is true because it sounds correct but when you delve into it and do a deep dive and think about the science parang it doesn't make sense and it doesn't connect this challenge is really again being close to us as healthcare professionals to be able to translate this information for ourselves first so that we can understand it better and share it to the public in a way that they can understand in a truthful manner so having picked those points up from the two presentations I just like to now go on to something that I notice in these two talks it's that actually talk about vaccine safety per se despite the fact that our webinar is entitled are the COVID-19 vaccine safe they actually talked about three important things vaccine confidence, vaccine acceptance and vaccine trust and I think these are the really critical issues to answer for our public now we've been battered our vaccination system has really been battered by the controversies that has undergone in the past as a pediatrician who has to vaccinate children on a daily basis I'd like to share that for the longest time my dialogue with parents has always been mommy kailangan po ng anak ninyo ng ganitong bakuna ito po yung matatanggap ito po yung gagawin ng bakuna may mararam daman po, maaaring mag-galagnat and there has not been many questions the usual response has been dok kung sa tingin nyo kailangan ok lang po yan now three years ago, four years ago we know what happened there was this very huge controversy about vaccines and at that point in time the landscape really changed that even in my tiny private practice I would get queries about dok safe ba yan I even had this one patient a walk-in fare nine-year-old child and the mother was so distraught this parent was referred to me by another subspecialist and neurologist because the child needed a Japanese encephalitis vaccine because she had some neurologic disorder which required us to provide protection for all other neurologic infections and so the child had already received her first dose and required a subsequent dose now in the meantime the vaccine controversy erupted of course they were seeing everything on the news day in and day out and the mother was saying the child refused to be vaccinated because she thought she would die and so it took a lot of effort to really communicate with the parent and the child to reassure them that this was not going to be the case that the reports on media were vastly exaggerated and that this vaccine would benefit her but this scenario played out in a private clinic with a clinician who had the time and the information to be able to relay this knowledge and communicate this to the family but we're talking now about 100 million Filipinos who might not have that opportunity and all they're going by is the headlines in the news and a lot of social media posts so safety has actually been converted of do we trust the government agencies are we confident in industry and can we accept these vaccines now I leave that up for discussion because it's a really huge topic and I'm sure we're going to get a lot of questions in our chat box but maybe as an additional talking point I'd just like to share this phrase that coincidence does not necessarily equate with causality a lot of events that happen after vaccination don't necessarily have to do or are directly related to the vaccine itself now I mentioned at the start that I'm actually a pediatric clinical vaccine trialist and one of the things that we usually are wary about is when we start our trials over the summer season alam kasi natin that during the summer a lot of our kids so pre-pandemic a lot of our kids are at home and medyo matasang incidence ng dog bites during that time of the year now, kung nagsisimula kami ng trial during that summer season pag kanagkakaroon ng dog bite inirereport yan of course as a severe adverse event and if you have enough of that coming into play it's entirely possible that the product literature for that particular vaccine will say dog bite is an adverse reaction and that's ridiculous right why would you even think that a vaccine can lead to dog bites so that's an example of coincidence not necessarily indicating causality but even for these ridiculous events what if it happened that globally they actually saw that administration of this particular vaccine predisposed to dog bites and there was a causal relationship of course because we had a system that safeguarded consumers and was monitoring all of this then we would be able to pick it up and then really say that poisan dalila, we should not be using this vaccine because it really does cause dog bites so my point is this for vaccines there's a lot of times where events that happened after vaccination are attributed to the vaccine when in fact they are not causally related but because we need to monitor just on the off chance that these rare events are actually related then having a system that takes care of that that monitors this closely will be able to contribute to vaccine trust and confidence because it assures that vaccines are safe because they are undergoing constant monitoring so I'd like to end my presentation with that and turn the event back to the MCs thank you very much Dr. Ana we have been having a whole lot of discussion and reactions po na in the chat box but maybe we could start the ball rolling with our first question Dr. Suzie, did you have an initial question for our panelists? Yeah, well before that what I wanted to do was to of course thank you Ana, thank you very much for what should I say a very underground kind of reaction what do the clinicians see I'd like to start by looking at our audience poll so that our speakers know what our audience is thinking so can we take a look at that the first one? Can we TVUB, can you help us? I can't understand the other poll manangitang poll to-day na so we're so it looks like we have half of our participants come out of Metro Manila Central Luzon 12% Northern Luzon 7% Southern Luzon 15% East Visayas 4% 6% West and we will do Central Visayas next time sorry we forgot that North Mindanao 3% Central Mindanao 1% West Mindanao and we should have put also Southern Mindanao so half from Metro Manila Most of the people watching 38% are doctors 29% are nurses and we have a screening well a number of pharmacists 44 of the whole group a lot of public health people and a lot of educators we always have people from DepEd who are on the webinar alright now would you consent to vaccination it was free 86% are saying yes 14% are saying no would you pay for own vaccination 65% said yes 35% said no what would convince you that a COVID-19 vaccine is safe 49% said because of someone they know who has received it and remember Filipinos have relatives all over the world so knowing that so 49% not my doctor says so and I think this is what Ana was talking about the power of the face-to-face communication between the health worker and Ana you've got 3,000 people in this webinar who can multiply the message LGU provides for free very small 25% at the DOH and that friends would invite 7% if you were to refuse COVID-19 vaccine what would be the reason 46% are talking about the brand and the country where it comes from so that's giving us an indication around perceptions you are not convinced it's safe 44% okay so safety is a big issue we need more time you want to wait 30% believe optional the vaccine was too fast 14% 17% believe that the procurement what is this ko lang yung statement natin it's not probably not reliable you don't trust free vaccines 3% you would rather choose the brand at the time of vaccination 3-8% so that's the audience for our for our speakers and I think we're going to try something different for our before we start the Q&A and the questions coming from the audience Raymond and I think what I'm going to do is I'm going to ask um anyone of the panelists to ask to anyone of the panelists so take it away whoever wants to fire a question hello okay go Eric this is for a group that's for Tony Anna and me yes for you for me okay okay Tony what happens if there's no H-TAC recommendation and the vaccines will have to be deployed and used and the H-TAC has no recommendation yet so what happened? that's going to be a legal bind because it's mandated by law so I think we need to figure that out now we should have figured it out last year and so if they don't make a recommendation because they can't make a recommendation parang nakakayak yun I guess DOH or there needs to be an executive order mandating that they can make a recommendation even based on an UA without a certificate of product registration yeah so but we're hoping that doesn't happen Eric that that the law will be we're lobbying for that quick law it's just one page and we're allowing them to make a recommendation based on an EUA without the need for a CPR and they are making the evaluation already and di na natutolog mga yan so and we're helping with some of the data and the evaluations so yeah I think the main problem will be will their recommendation matter because if there's no law at the moment allowing them to give then I'm not sure what will happen can I ask Eric? yes of course hit for that can I ask you the same question because I don't know the answer okay this is an emergency use authorization there may be legal complications regarding this but we have to pay science and policy Tony we have over 500,000 cases there's the variant strain there's 10,000 who died the economy has to open we are all reeling from the short and long term effects of the pandemic we should weigh our decisions based on science we balance it with policy is that not everyone will get their vaccines if you think that even with the promises and commitments the advanced market commitment of the Philippines with the COVAX facility it's not going to happen this year who will get vaccinated will be the healthcare workers and this is the purpose of the webinar to educate you give you the information that if you doubt the healthcare workers and it is the healthcare workers that people trust that will tell them that these vaccines are safe so they can line up and be vaccinated to the vacuna centers na ma-approvahan ng DOH in the priority areas then, Houston we have a problem isipin nyo na unahan pa tayo ng Mayanmar gumagawa ng paran ng ating pangulo secretary Galvez ginigisan na nga sa congress at sinado secretary Galvez at team ng DOH pero hindi nyo alam gumagawa kami ng paraan ang araw ginagawang gabing ginagawang araw para makabigyan tayo ng vacuna may hirap, makipag-usap po at pag-dumating baka umabot ng 40% yung ayong mag-vacuna mag-pabakuna, ay anong gagawin natin dun sa mga vacuna tandaan nyo may mga masisailang vacuna, kailangan mag-ibigay kagad so yung iba naman gusto talaga, ayon ayokon ng China, ayokon ng Russia pwede ba yung Pfizer at Astra na lang sa real world, it doesn't work that way kasi po kung anong may mabigay ang haba pw ng pila at sa United Arab Emirates nga nagkakaubusan pero tignan nakita nyo naman pangalawa sila sa Israel may marami ng mga vakuna at mag-roblema din tayo dito may mga balita ngam, may mga naon nagpabakuna sa atin may mga illegal na vacuna kailangan mahudyan ng FDA ... di discardi pa yung mga piritin. So kahit na sinabi namin ito mga una, na kung tiritiak namin sa inyo pagdating ng bakuna, yung hindi dapat mga una, mga una pa. Ako namin nilisip ko na na mga uhuli ako e. So thank you Tony. ... So you used a lot of times sir in discussing the process and ako personally I have to say nung naintindihan ko yung proceso, medyo kumalmakalma yung lub ko. Kasi alam ko andaming tumingin yan na alam naman nila yung tiniting na nila and after looking after six or seven panels looking at that, siguro naman pwede ko ng pagkatiwalaan yung decision nila. So yung tanong kasi doon is given that there's a critical point at which an approval needs to come out and ngayon pa lang na-identify na natin siya as a particular, how would you put this, roadblock. Hindi ba dapat that there should already be efforts to address this in the same way that actually FDA look at a process change that allowed them to issue EUAs kasi na anticipate nila nila ito last year over something else. ... Awa na lang talaga ng JOS na doon na yung groundwork kaya nung pumutok tung COVID, mabilis na nilang napakilo. So in the same way we're identifying this issue with HTAC, napat siguro i-recognize na siya at nawa na siya ng paraan. Ang magandang balita rito, Anna, yung sinabi ni Tony behind the scenes, nagumbisan ng magtrabaho yung ating HTAC. So baka may resultan na sila jyan malay mo tapos ang iniintay nalang nila yung legal imprimatur na saan na madaliin, napakinggan yung mga recommendation at mailabas na kakan. Actually there's a move in the Senate if I'm not mistaken, tama po ba, Dr. Tony? Yes. I-recognize siya, actually. Senator Piakayatano is the principal of the bill which will allow HTAC to come up with a provisional recommendation based on the EUA. I'm optimistic about the results. Maganda yung anong eric yung poll kanina, 85% will get it. So kailangan nanuhin natin, magamit natin yung momentum na yan. I think the other 15% will just wait for HTAC's final recommendation. Tapayag na sila. Nakakakainggan yung naman yan. Magandang balita yan. Kasi kanino pa ba magtitiwala yung mga ordinari yung tao kundin magtatanong kidok? Ano ba doc? Papabakuna ba o hindi? Aykong tayong mismo nagdududa, mayirapan mo talaga tayo. So, I'm going to receive the vaccine. Are well aware. And as Anna said, I agree with you, Anna, like, let's not underestimate the public. I think people know. Actually, there's lots of noise and disinformation there, but I trust the public. I think the public can discern. And I think if we continue to talk about this and that face-to-face, that face-to-face discussion is very, very important. Kailangan lahat ng barangay health worker, lahat ng midwife, lahat ng nurse. Everyone should know what the talking points are in relation to the importance of vaccination as we progress. In the beginning, you're going to have just the health workers and older people, but later on, we want to vaccinate many more people beyond those two groups. Okay, so Raymond, let's go to your upvoted questions. 90 questions in the Q&A. And I'm going to encourage Naomi and Eric and Anna to please try to answer some of them because, you know, you can do a big answer, but I think there's really a hunger for information out there. And we hope that, you know, the short time that we're together, you can give your thoughts to our audience. So, Raymond, go ahead. What's the upvoted? What are the upvoted questions? Actually, this is probably our most upvoted question ever in the history of the webinar series. It has to do with, ang priority ko kasi, di ba, medical frontliners. The question comes from Joseph Thornton, who is one of our regulars, really. The question was, will the immediate household members of medical frontliners be included? I think that's an information that is it really, that definitively stated ko ay, may be in official statements. Can someone from our panel give or director tayo, go ahead. Okay. Thank you, Raymond. Ang nasabi na at sinusubay ba yan ng public ko ay ang nasabi ng ating presidente na yung pamilya ng uniform personnel ay ma-isama. Kaya naintindihan namin, bakit uniform personnel lang at bakit yung hindi yung healthcare workers? Yung pagpili po ng priorities ay based na recommendation ng WHO at sa isang framework kung saan dapat ma-onay mga healthcare workers kasi ayun na natin silang malagay pa sa anumang panganim, sa pag-atambakunang ito, can't save their lives. At kailangan silang manatili yan. Eh, sino pan-titingin kung silay wala na. Pagalawa yung mga senior citizen natin, matatanda na po at nag-share ako ng data, hindi po sabi-sabi yan. Doon sa mga mga matay 62% or 60N abab. Ano pa bang data ang kailangan ishare natin? Ang lina-lina po. Pangatlo, kung yung pamilyang yung po ay mahirap, hindi naman natin sasabi ang baka masama pa yung pamilyang ng healthcare worker. So samantalang hindi po na sasama po yun. Enandam po yung ibang measures na pwede natin gawin, magsuot ng mask, social distancing, yung po ay avoiding large crowds. Pong kay magalala sa pagkat ang gusto talaga natin, IFDA approval kung saan na tapos na nila yung phase 3 trials. So makakaroon ang bakuna. So balit, pinapas-pasan din natin, gumagawa tayo ng paraan. Larun na kung maganda na may monitoring dito sa EUA, maganda yung bakuna. Bakit hindi? Kaya lang sabi nga ni Anna, ni Toni, nasa'yong age tag at saan ang matapos na nila yan. Okay. Thank you very much, Eric. That was a very good explanation. I'd like to call in Ted Robosa who is on the panel. Also Dean Charlotte Chong from the UP College of Medicine is also here so that we can, we're close to the top of the hour but I think we can still have a bit of a discussion and I have a question for all of you so let's include Ted. To see, can I add to the discussion muna? Can I ask a question? Because the question was asked about age tag. So my question is, and we're not familiar with this age tag because we never had this when I was using, we never had an age tag. So my question is, is the age tag a regulatory or a recommendatory body? That's my question because if it's recommendatory then the secretary of health decides if the FDA gives an EUA The DOH secretary can do it, right? If he wants to do and deliver the vaccines already with FDA approval of EUA. But if you say age tag is a regulatory body, even if the secretary of health wants to give it, he cannot give it. So that question, that legal question has to be answered. Is age tag recommendatory to the secretary of health or is it a regulatory body? Yeah, so can I answer Ted? Yeah, so according to R.A.1.1.2.2.3, the wording is that age tag can give a positive recommendation on drugs that fill health or department of health can purchase. But that positive recommendation is required. So in other words, if they give, say, these 10 vaccines are okay, then the DOH will decide, okay, of these 10, I think the most feasible are these three. So the wording is recommendatory, but because of the provisions that follow that statement, they do have a regulatory function because procurement can only be made based on a positive recommendation. So that's vague and that's how these lawyers want to put it, they want it vague. So my next question is, has the age tag done its work to give a recommendation for Pfizer and for Astra? Because FDA has done their job. So I think there are two steps we're missing. We are delaying the whole problem. I'm an emergency guy. To me, time is gold and if you don't do it fast, you will kill many people. So that to me is important. Even if you say it's regulatory, why couldn't they evaluate together at the same time? Why can't they sit down on one table and talk? Why can't FDA, as they issue the EUA, is already coordinating and submitting the same documents that the corporation submits to age tag? And age tag is already making with their heads and banging their heads. And when they come out with an EUA, there is an age tag, positive or negative recommendation. Yeah, I think they're actually doing it Ted, age tag and FDA. But I haven't heard a positive recommendation from age tag for the two EUA issued. So my expectation is dapat mayro na rin. Ted, this is Dr. Eric. So the age tag is an independent advisory. So Tony and I have shared information. They already have started their work for Pfizer and now AstraZeneca. They don't want to preamp because there are some legal complications. And I'm sure if they're finished with this, it's just there and maybe they already shared it to those who will make decisions. And so, therefore, this can be part of our promotion to the Congress and Senate so that they can pass the required law on this. Thank you, Ted. I ask this question from the point of view of emergency because I feel we deceived the president on this one. We asked the president, when we were negotiating for vaccine for pre-order, we couldn't pre-order with all the president because we have no authority. It is not in our FDA. So the president issues in December, December 1, I think, the authority to FDA to issue an EUA. If the problems are put forth to the president and the leader of the land, we would be able to put out solutions. We shouldn't put the solution after we're already there at the edge of the cliff because napat ang solution na co-foreseen ang mga talp especially in an emergency. Okay, Raymond wants to say something. Raymond, go ahead. Okay, so if you go to hta.gov.ph, you will see the members of HTA. And since may ninong, Dr. Tony Dances says that we have to declare. I'm declaring that I'm a member of HTA. So part of it means that we have done the work with regard to the timing po with regards to, dapat po sa bayisana ang pag-evaluate ng nga near na na mabigyan ang EUA. Like na konyari po, si AstraZeneca yesterday was given. That's exactly what we had in terms of an alignment meeting with all of the independent vaccine bodies that we had together with the Secretary of Health and the vaccines are, Alam yun nga nangasin makasama kami nung. So yung po, with the National Adverse Event group, the night tag, all of the groups that was in the slide of Dr. Dances, we have already had that alignment. But the very, very important point is to have that immediate timing with regards to transparency of the documentation that needs to be evaluated. So that we are not, I mean, in terms of public perception, it doesn't seem like there is a delay or delay na laying that happened. So that we work immediate in terms of having an EUA and we hit the ground running when it arrives. Thank you, Raymond. Dean Charlotte Tong. Charlotte, are you there? Yeah, so see. Yeah, we do want to see something, Charlotte. Well, actually, I've been listening. It's very heartening that we now have increased values of doctors believing in these vaccines and would be willing to be vaccinated because initially the figures were very low, even among healthcare workers. I think this webinar series is actually going to increase the number of, it will lessen the vaccine hesitancy among healthcare workers. But I believe that there could still be improvements in the timing. I agree with Dr. Ted that kung kailangan ang masmaraming tao working together at a more expeditious way, I think that's very important because the public's really clamoring for the vaccines already and our economy needs that boost already. So if you are able to give the authorization and have the vaccines as early as possible, it will be a great help to the Filipino people. Thank you very much, Charlotte. Charlotte Tong is the Dean of the UP College of Medicine. We're approaching the top of the hour and so Raymond, can we go through our evaluation and then we're going to ask our panelists for their parting words for George. Although some people already say we need a part two. Yes, ma'am. Dr. Susie, before I go into that, sorry, there's really one question that is very pertinent po, and it has to do with those who are post-COVID and do they need or kailangan po ba na mabakunaan sila, or wag na sila mabakunaan, mabakunaan or anything like that. Maybe we can have Dr. Dads or Dr. Ong Lim to comment on that before we go into the assessment. Okay, yung sage recommendations for Pfizer and Moderna, if you had past infection, you can be vaccinated. But they also mentioned if there are scar supplies ng vaccine and because antibodies have been documented for those who had COVID for at least nine months, you can delay it, ay naman yung antibodies ko, but nobody is saying that you cannot get vaccinated. Ang exception lang are those who are acutely infected with SARS-CoV-2, but ay hindi nila sinabi kung anong interval na the earliest that can they take the vaccine. Of course, that's the information we have from WHO sage that can change anytime. Thank you. Okay, anyone else wants to add to that answer? Okay, so we're going to do a round of what should I say, parting messages for the audience and we certainly will consider a part two. The chat box is overflowing with part two please. So we will definitely consider that and see how we can get that organized. But I'd like to ask everyone to give their parting words to our audience. We'll start with Anna Ong Lim. Thank you, ma'am Susie. I think from my end, what I'm seeing in this discussion really is that over and above the issue of safety, we're really dealing with a bigger issue which is trust and vaccine confidence. And when we recognize that these are the main concerns that people have because we're able to identify the problem more accurately, then we're halfway towards the solution. There was a comment in the chat box that said healthcare workers need to have a more cerebral discussion with their patients about this topic. I'd like to beg to disagree because it's not just information that's going to solve the problem. There's a lot of trust building that needs to be done. And I think one of the more constructive ways that we can move towards this during this time where we don't have the vaccines yet is to really take advantage of this time, identify those elements that are causing people to have doubts in the system, in vaccines and address those questions if it needs to be an informational campaign, then so be it. If it needs to be an exercise of showing that people can be confident that the system is not going to be gamed or bypassed, then so be it. But as long as what we need to do really is to identify these issues more precisely so we can have a more focused solution. Thank you. Thank you very much, Anna. Eric. Okay. Ang pag-ahanda po ng Department of Health, katuwang po ang mga local government unit, ay based on the assumption na pagdumating ang vacuna ay mahaba po yung pila at hindi po langawin ang mga vacuna centers. Subalit sa aming pag-alala sa pagkat siya mga survey ay medyo may malaking numero na ay magpabakuna, maran ding mangyarin na langawin yung mga vacuna centers. Mas maganda po na magtulungan tayo para mahaba po yung pila sa pagkat ito ang vacuna is our way out para tayong magkaroon ng new normal. Hindi pwede yung pagkakasakit natin ang basehan ng herd immunity. Itong vacuna ay makakatulung po at siyan ay hinintairin natin yung mga resulta. Wala po nang sasabi magiging successful tayo, malay natin baka tayo ay pumalpak. Subalit ayo po ng pamalaan at nang ating lat na papalpak tayo. So bilang Pilipino, kailangan mag-isip tayo, wag tayong basa mag-dibigay ng salita na sa tingin natin ay hindi naman pala tayong dapat magsabi noon. At kung may opinion po tayo, i-check po natin yan baka yan ay makasama. Tandaan yung po asapagbabakunang ito hindi lang yung sarili natin nilig tas yung nasa mga mal natin sa buhay. So para sa inyong po lahat mag-isip po tayo, magtulungang po tayo sa pagkat-iisa lang na yunin natin, iligtas natin ng ating bansa kamanan. Thank you very much Dr. Erick Tayem. Tony, go ahead. Well yeah, my message to everyone is that it's important to protect vaccine trust and confidence. But I think we have to look at it in a different way. We can't just protect it by talking about it. We need to earn that trust and people will believe us and we earn that trust through vigilance. We need to be vigilant about the science, we need to be vigilant about the process, we need to be vigilant and protect the institutions. There's so many people working hard in government na hindi na natutulogin, we need to protect them so they can do their work. Do their work shocks, appeal to our leaders, let's tone down the noise to our businessmen. Let's listen to the people who have been assigned by law to protect that process of earning vaccine trust. Let's leave accreditation, let's talk. I mean the accreditation, the health technology, the three processes. Health technology regulation, it has to come first. And then health technology assessment follows after that. And then health technology management which is with DOH and the LGUs follows. They come one after the other and we need to protect those processes and be vigilant because that's how we earn trust. Hindi po'y ding sabihin lang natin. We need to show them that yes, we are looking after these people and making sure they're heard and helping them so that their voices can arise above the noise. So, I mean we all have some contribution to that noise, I think. And that's why I'm hesitant to say today na we should use this one or that one and this one safer than that one. Wala naman kaming tayong sinasabing ganun ngayon, di ba? Let's wait for the verdict. It's there. We're waiting for the legal mandate so that HTAC can do its work. In the future, we should put them up there where they belong as the group that will protect us and help us choose. They will represent the people, di ba? Pinakita ko sa process kasama yung talking to the people. They will help the people choose. They will guide the people. So, let's wait for what they're going to say. Thank you very much, Tony Dance. Ted, your parting words. Okay, parting words, get vaccinated. I think it's an emergency. I'm an emergency guy. So, I triad, I use little information as possible to make a decision that is life or death. So, if the vaccine comes, the FDA approves it and you're online, get that vaccine. Okay. Okay, Raymond. Thank you to our panelists for those very simple, very direct, really excellent takeaway messages po. What we are showing right now in the polls are the results of our very first question. Sorry, the second survey question. Number one, how do we know if a COVID-19 vaccine is safe? The answer by 91% of respondents is all of the above as being shown on number two, how can decision makers ensure safety of COVID-19 vaccines? Ang answer po ng karamihan again, 91% is all of the above. A drug, all about safety and efficacy. So, may johati po, 54% through 47% falls and then number four, their answer to our question. And this is where we got 85% of the respondents say that COVID-19 vaccines are safe po. But before we go ahead to our closing remarks, may we ask TVUP to flash on the screen our assessment questions to our panel experts, for our panel experts. There we go. So for those who are attending po, for the very first time, this is something that we normally do after each webinar. And we hope that a lot of you who are still on the webinar will key in your input po. The first one, I'll just read it off the list. The first one mentions a panelist demonstrated thorough knowledge of the topic. At least were well prepared and organized. Number two, number three, the panelist spoke clearly and audibly. Number four, they use appropriate language with technical medical jargons adequately explaining. And number five, I learned new perspectives and knowledge from the panelist on managing virus-key COVID-19 health issues. So tulit-tuloy lang po ang pagsagot, hindi pa po namin to eco-close as I turn the floor over to Dr. Sisi. We have our closing remarks from Chancellor of UP Manila, Dr. Carmen Sita-Pangilia. Enchiet, please take the floor. Yes, so thank you. Thank you to everybody for staying on to the very end. So here is a summary of the things that have been discussed. Dr. Ted Herbosa, Executive Vice President of the University of the Philippine System and National Advisor of IAPF, has given us a short history of the webinar series. He was with us from day one and after the initial success of webinar number one, it has continued to the next 38 weeks. Dr. Herbosa Appli said, we do not know what we don't know. And thus, in this webinar series, we invite the real experts who understand what is happening. We had two speakers today. The first speaker was Dr. Tony Danz, who actually started with a very interesting interactive poll to a question we were asked to participate in a possible decision making. The points raised were, if you had the following data, free month efficacy, the cost of the two doses, accessibility to all, the side effects, effectiveness against the UK variant, and the duration of protection. And what is interesting is that as Dr. Danz gave us the options, our decisions changed. And he told us, we really only have information for the first two. The three month efficacy that has been published and the cost for two doses. So what does he say? The decision, the choice is a very complicated decision. But in the process, there is confusion and what is important is that we do not lose trust on the vaccine. Actually, Dr. Danz gave us a very simplified, it's a graph. No, it's not even a graph. It's a picture of the process. And I urge you to go back and go back to the replay and take a look at the process of approval. Wherein he shows that the process actually involves many groups. The groups involved in research and development. The core agents is like FDA, DOH, the LGUs. The core processes as well as the support groups. So actually all of us are actually part of the process. But he highlighted a few things. He said that FDA is in charge of safety and efficacy. Can it work? HTAC will tell us will it work. Effectiveness, efficacy and conflicts of interest. But DOH is the responsibility of making sure that it is equitable. Dr. Danz gave a long discussion on the work of HTAC and I urge the audience to actually learn more on what HTAC is doing because they will actually, they are helping in the final decision. As Dr. Danz said, we are waiting for a positive recommendation because they're looking at responsiveness to magnitude and severity, safety and efficacy, social impact, affordability, viability, responsiveness to equity and household financial impact. So it's difficult to say that at the end of the day, we're looking for a decision. But now after the lecture of Dr. Danz, we can see that it's a very complicated process. So he actually ended his talk by saying, so the question now is the COVID-19 save and he has actually modified it. He said, are the COVID-19 vaccines safe enough as of January 29? And if I may just quote him, he said that the agencies are untainted, the processes are maintained and their mandates protected from political, commercial and self-interest. He said, it depends. So at the end of the day, we must trust the process. We must trust FDA, trust DOH and we have to be vigilant. Our second presenter is Dr. Eric Tayag from the Department of Health, gave us an update on the cases. Worldwide, there are 93 million cases with 2.6 million deaths. In the Philippines, the burden is 10 to 50 cases per 100,000 population. Dr. Tayag has this very important slide. I think that we must remember when he said that first, we must save lives. And he said, remember ICT, number one, individual health measures, face mask, facial distancing, number two is community quarantine and number three is T3 strategy, test, trace and treat. Now, what is interesting with the presentation of Dr. Tayag is that he gave us a series of issues that bring confusion to the general public. And the general public actually includes as the doctors and nurses and the midwives. We talked about the news items and the deaths, allergies, rushing the vaccine, opinions on the mRNA, not having tested so many. All of these are actually adding to the confusion. That is in the part of COVID-19. But he said, we have another history that's actually affecting our trust. And that is actually our history with adentacia. The history, they've had a recent survey showing that only 67% of doctors want to be vaccinated and 57% of the nurses. And we have to work on this. And we're happy that in this webinar we have more health practitioners who are actually interested. I'd like to recommend that everybody take a look at the sage recommendations because they actually give us, they adequately explains who should be vaccinated, who should not and I will not go through them. But just to make probably just one point that they clarified at the end during the open forum that everybody should really be vaccinated. And if ever you've had the, if you ever had COVID and you've got enough antibodies and maybe it can be postponed. So I urge you to please read up on the sage recommendations. He actually ends his talk by telling us it's no longer strut, it's no longer T3, it's now T4. He said test, trace, treat and take the vaccine. But we do have a responsibility of making sure that we promote the vaccination to our people. So once again he said, vaccines will not save lives, vaccination saves lives. Dr. Ang Lim is, Dr. Anna Ang Lim, a pediatric infectious disease expert as well as a clinical trial, vaccine trialist and one of the advices for ITF is his reaction to the two talks. He actually acknowledged the process that was presented by Dr. Danz. As he said, listening to the process and walking the process makes us feel a lot better that this is being undertaken by government and this is really very reassuring. And that the decision is based on scientific rigor up to built-in safeguards that's being brought on by government. She moves on by saying that opinion polls really pose a challenge to us health professionals because a great majority of the people in the audience are health professionals because we must correct this wrong information. So the second point, the other point that Dr. Ang Ang only mentioned is that we've got to clarify three things. Vaccine confidence is different from vaccine trust and vaccine safety. Now since she is a clinical vaccine trialist, she did mention, she shared something about rare incidence. She said that coincidence does not equate with causality. But we have to monitor all rare events because it is a responsibility and it adds to vaccine confidence. So the challenge is really the speed of making a positive recommendation that has been expressed, also expressed by Dr. Ted Hervosa and our College of Medicine Dean, Charlotte Chong. As to their final words, I mean these are words of let me say wisdom that we must remember. From Dr. Anna, she said over and above, over and above, safety, we are dealing with trust and confidence. From Dr. Eritayag, government wants to succeed and be careful with opinions which may affect the trust of people on vaccine. From Dr. Tony, he said protect vaccine trust and confidence. We have to earn the trust, the vigilance about the science, the process and the institutions. Listen to those assigned by law and government to talk. Let us wait, be vigilant. And as Dr. Ted said, this is an emergency. So let's wait for the vaccine and be vaccinated. Back to you, Susie and Raymond. Thank you very much. That's Chancellor Manchit Padilla of University of Manila. And gosh, okay. We will do a, we will do a, we wanted to show the poll results. All right. So we're just putting that up on the screen now, Raymond. So mainly strongly agree. Yes, very, very consistent with our previous webinars, Dr. Susie. I mean, this is not arduably, but this is definitely our highest and most attended na webinar. We almost reached our 3,000 attendee capacity for today. So that was really impressive. And we almost reached the 4,800 mark for our registrants. So we hope to be able to sustain the interest of our regular attendees, regular na ko. And participants later on. Okay. For our sneak peek next week, Dr. Susie. Okay. Thanks, Raymond. I think while I'm doing this sneak peek, can we put in the chat box, the link, the YouTube, where they're going to go on YouTube? Because people are asking how they can, how they can view it, no? So Raymond, maybe we can put that in the chat box while we're saying goodbye. But so many of you want the same group talk again. So we're going to talk offline and then we can get them together. They're all very, very busy, but I think they're smiling. They're going to indulge us and have another session at some point. But we are not leaving the topic of vaccines next week. And in fact, we have an equally compelling topic next week. We are going to talk about or we're going to try to answer the question who should not be vaccinated? And we're going to have Nina Burba who is infectious disease specialist in the Philippine General Hospital and Dr. Shelley de la Vega who is the leading gerontologist in the country who will talk about older persons, seniors. I'm sure you all have questions around this. You have parents, you have grandparents. Even if we have the vaccine, should they be vaccinated? When do you not vaccinate a senior? So be with us next week. We're not leaving the vaccination topic. And we will get this same group together. Again, I actually really appreciated you having a discussion on yourselves. That was very cool and very interesting. All right. So until next week, we'll see you again. Together, let us talk COVID deaths. See you. Raymond, over to you. Thank you. And really a huge thanks and we really appreciate that our experts took the time out to join us in this webinar to share their nuggets of wisdom ng kaangapan ni Chancellor Menchit. And thank you also, Dr. Suzy. It has been another rather successful and probably our most successful webinar today. So bakita-kita po tayo let. Next week, same time, same channel. Let us work together, beat COVID-19 and stop COVID deaths ang Dr. Raymond Francis Sarmiento. We hope to see you again next week, Friday at 12 noon at 7 PM. So please keep safe, keep healthy and see you online. I look into myself and ask, do I have strength to carry on? My God, our love is this gone and leave you here to keep me strong. I'm here to hold the line. I'll keep my word until my... His name to realize is fine to be afraid. Just hold on to the word he gave. This time we'll come to pass because this salvation makes a last. You'll carry you to see the break of day. The other's pain before my fears. The other's vows before my tears. But right behind the mask I look into myself and ask, do I have strength to carry on? My God, our love is this gone and leave you here to keep me strong. I'm here to hold the line. I'll keep my word until my... His name to realize is fine to be afraid. The other's vows before my tears. But right behind the mask I look into myself and ask, do I have strength to carry on? My God, our love is this gone and leave you here to keep me strong. My God, our love is this gone and leave you here to keep me strong. I'm here to hold the line. The other's vows before my tears.