Health security

SKETCHES - Ana Marie Pamintuan (The Philippine Star) - April 9, 2021 - 12:00am

If the government wants COVID patients to opt for home isolation as much as possible to decongest hospitals, two things must be made widely accessible.

One is on-site testing for entire households where there are individuals manifesting possible COVID symptoms. People must be informed about what to watch out for, to know when testing is needed: unusually itchy throat, runny nose, fever that comes and goes, flu-like enervation and the surest symptom – loss of smell.

The specimens collected can then be brought to molecular laboratories, for results that can be released within just one day. People tend to go about their normal business while waiting for test results, thus spreading their virus. The shorter the wait, the quicker transmission can be curbed.

The other requirement is easily accessible information on all telemedicine providers – clinics or doctors’ names, addresses, and numbers where calls and text or Viber messages will get a response, even if delayed.

Once people are told that they are positive for COVID, they can access these telemedicine providers for advice on whether it’s OK to opt for home isolation.

Many people actually prefer not to go to hospitals, fearing their mild or asymptomatic affliction might get worse with so many sick people around them. Then there are all those horror stories of long waits outside hospitals. Plus they want to be in the company of familiar faces while recuperating, especially if many members of the household are infected. But they want to hear expert advice backing their decision.

With telemedicine, prescriptions can also be sent by Viber and delivered right at their doorstep. The telemedicine providers may also link up with hospitals for speedy referral and ambulance service in case the need arises.

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As UP Mathematics professor Guido David of the OCTA Research Team had declared – more as a warning than as a joke – the current surge could mean 8.5 million people being infected in the National Capital Region by the end of June. The NCR would have then achieved natural herd immunity.

Unfortunately, according to available medical literature, this natural immunity can last only from about three to eight months. Plus survivors can still be transmitters. The COVID virus is like the flu virus; it’s possible to be reinfected, although some epidemiologists say the next bout could be milder.

We would likely need annual COVID vaccinations. Obviously, this is a problem, considering the global vaccine situation. Even China, with four vaccines approved for general use in that country, has not completed its vaccination program to cover 70 percent of its nearly 1.4 billion population. India, home to the largest vaccine manufacturer in the world, is also struggling.

Still, those with local vaccine making capability clearly have an edge in this crisis. And it’s not just the advanced economies that are doing this.

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In our neck of the woods, we’re being left behind again. Taiwan, rejected for membership in the World Health Organization, has had one of the world’s best responses to COVID and is determined to produce its own vaccines. But Taiwan has always been high-tech. We should instead look at what other developing countries are doing.

In particular, our fellow developing Southeast Asian countries Vietnam and Thailand are rushing to put onstream their own vaccines by yearend or in the first quarter of 2022.

Last March 17, Hanoi announced it aimed to complete by the fourth quarter its very own COVID vaccine, Nanocovax, for widespread use by 2022. The jab, plus another called Covivac, are now undergoing human trials.

Four local companies are carrying out the vaccine research and development even as Vietnam rolled out the AstraZeneca jab on March 8.

Vietnam has an enviable COVID record. As of April 6, it had all of 11 new cases, bringing the total to 2,648, with 2,422 recoveries and 35 deaths. And yet here it is, at the regional forefront in domestic vaccine development.

And it’s not just COVID. Hanoi is set to roll out by the second quarter its vaccine against African swine fever – proudly made in Vietnam, and the world’s first jab against ASF.

Closing in on innovative Vietnam is (no surprise here) Thailand. On March 22, Bangkok also announced the start of human trials of its COVID vaccine, which is being developed by state-owned Government Pharmaceutical Organization together with Mahidol University’s Tropical Medicine Department and a US university. The vaccine uses inactivated virus to trigger immunity.

Phase two results are seen by yearend and deployment is targeted for next year. By this June, Thailand will also be producing locally the AstraZeneca vaccine.

The chairman of the Mahidol University Council, Piyasakol Sakolsatayadorn, announced at a press conference: “The vaccine, produced by Thais for Thais, is expected to be used next year.”

When will we hear about a vaccine “produced by Filipinos for Filipinos?”

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We used to be Asia’s R&D center for a wide range of scientific pursuits. Filipinos aren’t lacking in brains.

So far the COVID vaccine R&D project that is in the most advanced stage in the Philippines is the one based on yeast, which is being undertaken by molecular biologist and priest Nicanor Austriaco, another member of the OCTA Research Group. Even if the Duterte administration is not exactly enamored with OCTA or the Catholic Church, Father Nic deserves full support from the government. The private sector might also want to step in.

Father Nic might produce faster results even as the government gets serious about setting up a virology institute – something being pushed since last year by the Department of Science and Technology. Considering our bureaucratic processes, this institute could be fully operational only after the pandemic is over. And long after the NCR Plus has achieved natural herd immunity, with nearly everybody infected.

Still, the long process of getting the virology institute operational should not deter us from proceeding with the project.

We talk about food security; it’s time we also aimed for vaccine and health security. We use a lot of vaccines for many human and animal diseases. There could be more pandemics ahead. We can’t be forever at the mercy of the wealthy countries, home to the biggest vaccine manufacturers, waiting for all of them to complete their vaccinations first before they toss us what’s left over.

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