The virus says hi!

President Junior tested positive. He now knows for sure the virus is still around.

We are on Alert Level 1 and other than the face masks we still wear, we want to believe the pandemic is over. But not if the COVID Omicron virus can help it. Indeed, it seems to be saying hello there… Remember me?

Metro Manila, five other regions (CAR, and Regions 3, 4A, 4B and 6) have positivity rates above five percent. Some experts say the positivity rate set by the WHO at five percent is no longer as significant as hospital admissions.

The Department of Health (DOH) also reported that 91 percent of provinces, highly urbanized cities (HUCs) and independent component cities (ICCs) showed a sustained rise in COVID-19 cases.

The good news is, healthcare utilization rates remain at low risk in all regions, and severe and critical admissions are less than one percent of total admissions.

Dr. Edsel Maurice Salvana, an infectious disease expert at UP-PGH wrote on Facebook that “COVID-19 is starting to look more like the flu and less like SARS. But it isn’t there yet. COVID-19 is much, much more transmissible than the flu and is still about TWICE as deadly.”

Abroad, the concern is about the latest subvariants of Omicron, BA.4 and BA.5, which are now dominating COVID-19 transmissions in the United States.

Dr. Eric Topol, an American professor of molecular medicine who has been closely following COVID developments, wrote:

“The Omicron subvariant BA.5 is the worst version of the virus that we’ve seen. It takes immune escape, already extensive, to the next level, and, as a function of that, enhanced transmissibility, well beyond Omicron (BA.1) and other Omicron family variants that we’ve seen (including BA.1.1, BA.2, BA.2.12.1, and BA.4).

“You could say it’s not so bad because there hasn’t been a marked rise in hospitalizations and deaths as we saw with Omicron, but that’s only because we had such a striking adverse impact from Omicron, for which there is at least some cross-immunity (BA.1 to BA.5).

BA.5 is quite distinct and very fit, Dr. Topol writes.

“The question of course comes up as to whether BA.5 is more virulent or pathogenic, capable of inducing worse disease. We only have one experimental study on that so far and it was shown that BA.4 and BA.5 induced worse disease in the Syrian hamster model and more efficiently spread in lung cell cultures.

“Do the current vaccines work against BA.5? The new UKHSA report started to address this question, looking at symptomatic infections and severe disease, but it’s unclear.

“With the extent of BA.5’s immune evasion and the recent trends of lowered vaccine effectiveness vs severe disease (from 95 percent vs Delta with a booster to ~80 percent vs Omicron BA.1 or BA.2 with a booster) it would not be at all surprising to me to see further decline of protection against hospitalizations and deaths.”

Where are we here in the Philippines? DOH reports “that the latest sequencing results from June 29 to July 4 detected the following Omicron subvariants: seven BA.4 cases; 140 BA.5 cases; and 20 BA.2.12.1 cases.

“Of the 140 newly sequenced BA.5 cases - four are still in isolation; 129 were asymptomatic and have recovered; while seven still have their outcomes being verified.

“Their vaccination status is: 16 were fully vaccinated, three were unvaccinated, and 121 still have their status being verified.

“To date, the grand total of BA.5 cases detected in the Philippines is 233.”

If this latest variant is more infectious and better able to escape our immune defenses from vaccines and prior infections, how do we defend ourselves against BA.4 and BA.5?

Dr. Topol says we should continue to use such non-pharmacologic mitigating measures like high-quality masks (N95/KN95), physical distancing, ventilation and air filtration.

“Boosters would help, and it is noteworthy that for people age 50+ there is a substantial (14-fold) reduction for mortality as recently documented by the CDC for a 4th shot (previously published by the Israel investigators in multiple observational studies). That is a 99 percent reduction in mortality for four-shots vs 86 percent for three shots.”

The big question now, Dr. Topol said, is whether an Omicron booster, directed to BA.1, will help when that variant is no longer with us, and we will be close to 100 percent BA.5 within a matter of weeks. And no doubt there will be further troublesome variants that lie ahead, be they more in the Omicron family or in a whole new lineage.

“Should we wait for a BA.5 booster? That will take months, and it should be noted it took more than seven months for the Omicron BA.1 booster to be tested, a delay that is exceedingly long and unacceptable relative to the timing of validation and production of the original vaccines in 10 months during 2020…

“There is no right answer, but variant chasing is a flawed approach. By the time a BA.5 vaccine booster is potentially available, who knows what will be the predominant strain?

“All of this gets back to the vital need for a new generation of vaccines that are universal, that is variant-proof… And the pivotal importance of nasal vaccines to promote mucosal immunity and help block the transmission chain. These goals are paramount, along with more and better antiviral drugs, but they are not getting adequate traction or priority…

“It’s frankly sickening to watch this virus continue to outrun us, knowing we are so damn capable of getting ahead of it,” Dr. Topol concludes.

With President Junior catching the virus, he surely realizes we need a very competent new Health secretary that the public can trust. We also need a new IATF that is not dominated by the military, but will have more public health experts and economists. This COVID pandemic with nastier variants isn’t about to go away soon.

Boo Chanco’s email address is [email protected]. Follow him on Twitter @boochanco