MANILA, Philippines – The Philippines reported a decline in coronavirus infections, with average cases at 224 per day from the week of April 12 to April 18 – 17% lower than the week before. The number of COVID-19 beds in intensive care units remains as low-risk, along with total beds dedicated for COVID-19 patients. 

Here’s what we’re watching this week of April 24, 2022: 

Vaccination lags

The Duterte administration is down to its last two months spearheading the government’s coronavirus vaccine drive and, to date, a significant gap remains between the number of people who have gotten vaccinated (roughly 60% of Filipinos) and the portion of the population that has expressed willingness to get a shot (about 87%). 

• Vaccination has slowed over the past three months, despite ample supply now available and all Filipinos at least five years old and above eligible to get vaccinated. 
• The gap between the number of people who want to get vaccinated and those who actually have reflects the lack of access people face in trying to get their shots. Rappler earlier flagged this as the biggest hurdle facing the Philippines’ vaccine drive in 2022.
  • Officials have tried to remedy this by holding vaccination days and setting up smaller vaccine sites that bring doses closer to people – think pharmacies, transportation terminals, even house-to-house activities. But the gap remains.
• Has the Philippines hit a wall? This would be the case if the number of Filipinos fully vaccinated against COVID-19 actually matched willingness to get vaccinated as reflected in recent public surveys. A gap as large as some 27 percentage points between the two means efforts are falling short to get doses in the arms of those who want them.
• At this point, officials have said it is increasingly difficult to find more people to vaccinate. Government data shows where the most effort is needed: the unvaccinated elderly population, the Bangsamoro Autonomous Region in Muslim Mindanao, unboosted seniors and vulnerable groups, among others. 
• Despite the easing of restrictions and lower case numbers, vaccination has always remained urgent. It’s still the most effective way to stave off a surge in cases and save lives. 
  • And in the face of waning immunity, staying up to date with our vaccines – where one has gotten the number of doses he or she is eligible for at the moment – means you protect not only yourself but the people around you.
  • Epidemiologist Dr. John Wong of public health research firm EpiMetrics earlier cautioned that with the current number of people vaccinated, the Philippines still remains vulnerable to outbreaks. “Without vaccination, we’re probably just in between surges. We cannot sustain the low level with the current level of vaccination that we have,” Wong told Rappler previously.

Omicron splintering

In the United States, a new subvariant is spreading and may be competing with the original Omicron, as well as some of its offshoots like BA.2. 

• Data from the US Centers for Disease Control and Prevention showed that BA.2, which made up 75% of current cases, displaced the original Omicron variant. But BA.2 may now be competing with its own subvariant, BA.2.12.1, which makes up 19% of COVID-19 cases.
• It’s still early, but the new subvariant may have a growth advantage. The New York State Department of Health earlier said that BA.2.12 and BA.2.12.1 which were sublineages of BA.2 were likely causing a spike in cases in parts of New York. 
• Initial data suggests that Omicron’s sublineages don’t behave substantially different from the original Omicron in terms of severity or its ability to evade immunity. 
• But caution and vigilance is still necessary. The further splintering of Omicron shows that even when a strain becomes dominant, it continues to evolve. As long as the virus is allowed to spread significantly, it remains possible for it to evolve into more dangerous forms. 

Bivalent vaccine

Moderna earlier announced that its bivalent vaccine candidate, which combines equal mRNA amounts of spike proteins from the original SARS-CoV-2 strain and the Beta variant, appeared to offer better protection against newer variants.

• Based on data that has yet to be peer-reviewed, the bivalent vaccine provided stronger protection against variants, including Omicron, compared to its original vaccine. 
  • Results from another bivalent vaccine Moderna is developing – this time combining mRNA from the original virus and Omicron – are expected later in 2022. 
• The company said antibodies produced from a 50-microgram dose of the bivalent vaccine were about twice that of the existing Moderna booster dose. 
• STAT News reported that while the news offers hope for better COVID-19 boosters in the future, one limitation of the study was that it was “impossible to say whether the antibody boost provided by mRNA-1273.211 vaccine prevents infections or severe disease better than the existing booster.”
• The development comes as experts around the world are looking to form a more efficient and sustainable COVID-19 vaccination strategy. 
• Health officials have also been adamant that governments, not pharmaceutical companies, should decide the composition of shots, STAT reported. (This is what the World Health Organization does for influenza vaccines.)
  • “These data are a reminder that those decisions can be tough. What would experts do when faced with booster shots with several different compositions? Will adding new strains work similarly for different types of vaccines? There are a huge number of open questions,” it said. 

Paxlovid guidance

The WHO strongly recommended giving the anti-viral pill Paxlovid to mild and moderate COVID-19 patients at highest risk of hospitalization because they are either unvaccinated, immunocompromised, or older, saying it is the “best therapeutic choice for high-risk patients to date.”

• The health agency’s recommendation was based on data from two randomized controlled trials involving 3,078 patients which showed the risk of hospitalization was reduced by 85% following the treatment. 
• The WHO did not recommend the pill for patients at low risk for hospitalization since benefits were found to be “negligible.”
• The WHO also pointed out the need for “prompt and accurate testing” in ensuring the treatment would be successful since the pill can only be given while the disease is in its early stages.
• Access must also be equitable. The WHO again called out Pfizer for the “lack of transparency,” which is making “it difficult for public health organizations to obtain an accurate picture of the availability of the medicine, which countries are involved in bilateral deals and what they are paying.”
• “WHO is extremely concerned that – as occurred with COVID-19 vaccines – low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment,” it said. 

In case you missed it:  Since a “new normal” was declared on March 1, 2022, over half of the Philippines have now seen quarantine restrictions relaxed, with all establishments and public transport allowed to operate at full capacity.  How does this affect the virus in the Philippines? 

Watch this Rappler explainer and listen to what health experts have to say:

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– Rappler.com