Will Omicron trigger the transition from pandemic to endemic?
When I had my son admitted to Makati Medical Center last Dec. 12, 2021, he was just one of a handful of COVID-19 patients admitted there. That day, there were 402 new cases and 11,255 active ones. Of the new cases, 98 were from Metro Manila.
Compare that to 10,775 new cases on Jan. 5 with active cases at 39,974.
Just when we were getting our hopes high that things were getting better, the post-holiday infection surge hit us intensely like a bad hangover. Many believe that the massive crowds that went holiday shopping and all the holiday parties and events contributed to the massive infections.
You know it’s real when you call and order food from two of your neighbors just to receive a quick, apologetic reply that they have suspended selling indefinitely due to someone contracting COVID.
Data don’t lie when the queue for medicine translates to probably an hour or more of waiting in line. It is hard to deny that a national emergency lurks when just a few weeks ago I was alone for an RT-PCR and now the drive through the swab line is a few blocks long.
Plagued with many questions, I attended the town hall meeting organized by Go Negosyo regarding the state of COVID in the Philippines. The panel of speakers, led by Presidential Adviser and Go Negosyo founder Joey Concepcion and MMDA chairman Benhur Abalos, included Health Secretary Francisco Duque III, DOST vaccine expert and panel member Dr. Rontgene Solante, and OCTA research fellows Dr. Guido David and Fr. Nicanor Austriaco.
Ever the prime mover of opening business up for the vaccinated or the “bakuna bubble,” PA Joey Concepcion was actively campaigning this time for booster shots for all employees. On the 22nd month of the pandemic, he said that many businesses have slowly recovered and moving to a stricter lockdown would be counterproductive. He threw his full support behind the Metropolitan Manila Development Authority’s new resolution for the unvaccinated to remain home. He also admonished all establishments to be very strict in checking vaccination cards.
Abalos reported on the exponential growth of cases from Christmas to the first few days of January. He showed the growth rate in cases in Metro Manila over a two-week period. From a -51-percent growth rate in cases from Nov. 21 to Dec. 18, it became 285 percent from Dec. 4 to 31 then surged to 1,095 percent from Dec. 7 to Jan. 3. He pointed out that while there were only 484 active cases last Christmas Day, that number ballooned to 7,778 by Jan. 3.
This prompted the MMDA to create the resolution to limit the mobility of unvaccinated individuals who should remain at home at all times (it’s like they are in ECQ) except for the procurement of essential goods and services. To properly manage the surge, he further announced that 2,481 contact tracers would be rehired.
He further enlisted their requirements, such as a steady supply of RT-PCR test kits, triage hotlines and telemedicine to decongest the hospitals. Chairman Abalos stated that the occupancy rate in the 95 isolation units managed by the local government units stood at 34.15 percent last Jan. 1 versus the 65.61 percent last September during the Delta surge.
While he admitted that the resolution is quite controversial, it should not be taken as a discriminatory move since it is meant to protect the vulnerable segment (in this case, the unvaccinated). He stressed that this is just an emergency move due to the surge and will be relaxed as cases abate.
For his part, Health Secretary Duque congratulated the MMDA for thinking out of the box in pushing for the breakthrough resolution. He proceeded by giving updates on the current implementation of Alert Level 3, the vaccination rollout, and the endemic preparedness plan.
As of Jan. 3, Duque said that 50 million have been fully vaccinated nationwide and 1.9 million have received their booster shots. He mentioned that while the vaccination of children from five to 11 years old has been approved, they need a little bit more time to ensure operational efficiency.
He believed that there is no reason for metro-wide lockdowns, which will further damage businesses, as long as everyone cooperates. Granular lockdowns are more appropriate, which is why they remind mayors when they monitor their numbers rising.
“Remind everyone to adhere to all safety and quarantine protocols. Isolate, isolate, isolate for 10 days after positive confirmation. Quarantine for seven days if vaccinated, and 14 days if unvaccinated if you were exposed to someone who tested positive,” Secretary Duque stressed.
According to the recent runs of the Philippine Genome Center, most of the cases are still the Delta variant.
Secretary Duque is confident that with everyone’s cooperation, “we can successfully navigate our way with the more transmissible but less virulent Omicron.”
What will be alarming, though, is the sheer quantity of people who will get sick, of which the government has the twin goal of not breaching the “red zone” (high risk) of hospitals and to protect the vulnerable in society. “Eighty-five percent of those in ICUs are not vaccinated. So we need to focus on the vaccination and booster program,” he added.
Dr Rontgene Solante of San Lorenzo Hospital reviewed the current therapeutic protocol of hospitals for COVID. For the exposed but uninfected, there are monoclonal antibodies that prevent the entry of COVID (Bamlanivimab-etesivimab and Casirivimab-imdevimab). Sotrovimab is added for mild to moderate cases. Then there are the antivirals such as Molnupiravir, Paxlovid and Remdesivir.
He said that while the effectiveness of Molnupiravir to prevent hospitalization is only 30 percent, the viral load decreased by 50 percent after three days, and 80 percent on the fifth day of administration. While Molnupiravir has been in the country for a few months, Paxlovid, which has just been approved by the FDA, is yet to arrive. The DOH has started talks with its maker, Pfizer, for a local supply.
Completing the treatment cocktail are the immune modulators that help restore normal immune function, specifically against the cytokine storm. Under this category are Baricitinib, Dexamethasone and Tocilizumab. Dr. Solante confirmed that the latter is still in very low supply in the country.
The doctor, whom Concepcion lauded for his pivotal role in the decrease of the waiting period for the booster from six months down to three from one’s last vaccination, as well as the inclusion of youth for vaccination, affirmed that their main goal as doctors is to prevent mortality.
Fr. Nic Austriaco was the last to present data. A Filipino-American molecular biologist and professor, made the most impact with his straight-to-the-point delivery of facts, but always with the hopeful twist.
He said we should brace ourselves because the number of infected individuals will be off the roof. While considerably milder, the great number will still generate a sizeable amount of people who would need to be hospitalized.
“We should change our mindset,” Fr. Nic advised. “We should stay home and consult remotely to also help and protect the hospital. It will look scary in the next few weeks, the numbers will be large, but do not be terrified.”
After presenting data that those who got Omicron developed antibodies that protect them against all COVID variants, someone asked if it is better to just go out and catch it then. “Trying to make yourself sick is not really a smart idea. We know most people will survive but we don’t know if you are part of those that will survive. People still die due to Omicron,” he warned.
After all the reunions and partying, it’s time to cocoon at home and wait for Omicron to pass. “Hopefully this is the beginning of the end, and we can look at the last 24 crazy months as a thing of the past,” Fr. Nic said.
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