We opened 2022 with caseloads soaring to levels not seen since September 2021 – the last time COVID-19 infections peaked in the country due to a surge partly driven by the Delta variant. This time around, it’s the hypertransmissible Omicron we’re watching, as it is poised to shatter records set by Delta. Current cases at the 20,000’s are nearing the country’s previous peak of over 26,000 cases, while the positivity rate is already at a new high of 40%. 

After capping 2021 with all areas of the country on Alert Level 2 – the second to the least strict quarantine classification – officials held off on plans to shift the country to Alert Level 1. Instead, several areas are back on Alert Level 3, as the country’s Omicron wave has yet to crest. Hospitalizations have not yet hit alarming levels, but the rate at which admissions are increasing is markedly faster, especially in Metro Manila. 

Here’s what we’re watching in the coming week of January 10, 2022:

Making sense of Omicron’s explosive growth

It’s been just a little over a month since Omicron was designated as a variant of concern, but with more of our friends and family infected with COVID-19, it seems the virus is closer to us than ever. Yet, the portion of cases needing hospitalizations seemed to be lower than in previous increases.

How worried should you be? 

In this edition of weekly watch, we’ll tackle what Omicron means for the virus, the government’s response, and personal activities.

What it means for the virus

Before the end of 2021, the World Health Organization (WHO) warned that Omicron had the potential to overtake Delta, which up until then had been regarded as the fastest and fittest variant. Fast forward to where we are today, January 2022, and we can see this is somewhat playing out across the world: 

• In the Philippines, it took just three weeks for cases to go from lower tallies not seen since the beginning of the pandemic, back to peak levels we hoped to leave far behind. Other countries feel Omicron’s explosive growth, too. 
  • Based on the WHO’s latest epidemiological update, cases grew by 71% in the recent week, after nearly 9.5 million new cases were reported worldwide. 
  • That’s the highest number of cases reported so far in a week’s time – and it comes as we enter the third year of living under this crisis. Yet, it is still an underestimate because we know there are backlogs due to the holidays, rapid antigen tests that do not get counted, and testing centers that are simply overwhelmed by demand. 
• Based on current patterns seen in countries, Omicron appeared to be two to three times as likely to spread as Delta, the New York Times reported. Its ability to spread so well has seen cases double in about two to four days.
  • Locally, the Department of Health (DOH) said cases appeared to be doubling every 2.2 days. 
  • Scientists are still figuring out what makes Omicron better at spreading, but clues point to the variant being “particularly good at infecting cells in the nose” – meaning when people breathe they can release new virus particles – and its ability to evade antibodies produced by vaccines and previous infections, the Times said. 
• The experience of other countries showed Omicron may peak faster than previous variants, but this is something that might not be entirely applicable to the Philippines, epidemiologist Dr. John Wong said. 
  • “These are countries with very high vaccination rates and levels of immunity which we don’t have,” Wong told Rappler. 
• Omicron’s ability to spread far and wide quickly means it is that much harder to control transmission. It also means that the chances of you getting the virus are higher now than they were before. 
• And because it continues to spread, the virus continues to evolve. So while some people are calling Omicron a possible “golden ticket out of the pandemic,” it’s “wishful thinking at this point,” the WHO warned. 

• Data so far continues to suggest that Omicron is less severe than Delta, but by no means should we consider it “mild.” Just like other forms of the coronavirus, Omicron is still hospitalizing and killing people, the WHO pointed out.  
  • It’s true that, as of the moment, Omicron seems to be leading to less admissions compared to the previous Delta wave. DOH figures so far showed that .6% to .8% of cases needed hospitalization during this current increase, compared to 2.8% during the Delta increase in cases. 
  • But because cases are spreading so fast, hospitals are nonetheless inundated .Even if a smaller portion of cases may need hospital care with this variant, because Omicron is so contagious, the absolute number of people needing admission will be large enough to push our hospitals even further to the brink. 
    • The Philippines also has too many people unvaccinated (some 48%) to rest on the variant’s seemingly lower severity. 
  • The growth in admissions collides with the fact that more health workers are now sick and still coping from the toll of previous surges. 
  • Continuing to think of the variant as mild sees us repeating old mistakes: in the early days of the pandemic, many were quick to dismiss COVID-19 as something similar to the flu. We’ve learned by now that, truly, we underestimate the virus at our own peril.

In this regard, “Omicron’s main threat is its extreme contagiousness,” noted the Atlantic’s science reporter Ed Yong. And with billions of people around the world still unvaccinated and transmission remaining high, new variants can still emerge. 

• Let’s not forget Delta is still circulating, too. WHO COVID-19 technical lead Maria Van Kerkhove said in a recent press conference that there were 30 sub-lineages of Delta experts were tracking. 

What it means for our response

The ability of Omicron to spread so quickly means there will be less room for error and greater need for quick action in the government’s response. There have been significant updates to policies and key developments underway: 

• With tests harder to secure now because of increased demand, growing backlogs, and limited manpower, health officials have put heavy emphasis on the necessity of isolating or going into quarantine right away – and especially if you do not have access to testing.
• Because more health workers are getting infected with COVID-19, shorter quarantine and isolation periods for fully vaccinated workers were approved by the government so that our healthcare systems can keep functioning. 
• Nationwide stay-at-home orders for the unvaccinated were issued, limiting their movement only to work-related and essential matters. 
• The interval for booster doses was reduced from six months to three months for two-dose vaccines, and two months for the Janssen vaccine. This is similar to moves taken by counties like the United Kingdom, Israel, and Germany. 
  • Meanwhile, other counties like South Korea have also placed expiration dates on vaccination cards in hopes of pushing people to get boosters. 
• Self-administered rapid antigen tests may soon be available as the government calls for registrations from manufacturers and is crafting guidelines on their use, as well as how they might fit into surveillance systems. 
• Health care utilization is currently measured by the number of beds, though this is dependent on manpower that is increasingly running short. The government’s task force is studying whether the number of health workers able to work should be part of data it tracks to assess the COVID-19 situation in the country.

As COVID-19 lingers and Omicron progress, some of the other issues we’ll be watching closely in the government’s response include how officials plan to reach the over 2 million unvaccinated seniors, what investments will be made to improve ventilation, and how testing costs might be lowered for the public.

What it means for our vaccines

Despite the rise of Omicron, vaccines still reduce the risks of developing severe disease, hospitalization, or dying due to COVID-19 – and more so if you’re boosted. That’s a great a reason as any to get the vaccine if you haven’t yet, or to get your booster if you’re already eligible.

• In previous weeks, we learned that Omicron’s numerous mutations in its spike protein brings a reduction in vaccine efficacy against infection and transmission. But recent preliminary studies suggest that, while the variant may undermine some of the protection from shots, T-cells were still holding up against Omicron.
  • T-cells are the body’s defense against virus-infected cells and are much harder to study compared to antibodies. What they do is recognize infected cells and destroy them, making it harder for the virus to develop severe forms of the disease.
  • Researchers from South Africa, Australia, Hong Kong, and the Netherlands have suggested this to be the case, with initial evidence showing T-cells still recognized Omicron. 
  • It’s also worth noting that with the increase in cases, DOH data has shown that as of January 2 in Metro Manila, 85% of those in the ICU are the unvaccinated.

• One area where more data is needed is on the performance of inactivated vaccines like Sinovac and Sinopharm. The WHO said it was “still early days” for the two inactivated vaccines, but that it was interested in having data on the effectiveness and clinical performance of the shots, especially against severe outcomes. 
  • In the context of Omicron, many studies on vaccines have so far involved mRNA shots like those of Pfizer and Moderna. The two shots are available in the Philippines, but it’s also just two among several. So it would be “kind of careless to presume an mRNA vaccine is going to perform the same way as an inactivated vaccine or a viral vector vaccine,” said Dr. Benjamin Co, an infectious disease and clinical pharmacology specialist. 
  • In the waiting for data, the WHO acknowledged that the two vaccines play important roles for global supply of shots. It currently comprised nearly 20% of doses shipped through COVAX.
  • Dr. Bruce Aylward, senior advisor to the WHO director-general, also cautioned against discounting it entirely. While “we have more data for some vaccines than we do for others…we have to be very careful that we don’t think an absence of data is an absence of impact,” he said. 
    • The vaccines still offer protection against other variants and, with more evidence in support of mixing and matching shots, performance of these vaccines can likewise be enhanced, said Dr. Kate O’Brien, WHO director of immunization, vaccines, and biologicals. 

• Because vaccines continue to work, widespread and equal vaccination across the globe is more crucial than ever. 
  • We still have a long way to go: 9 billion doses have been administered worldwide, but there were still 92 countries that could not meet targets to vaccinate 40% of their populations. Among that, 36 weren’t even able to achieve 10% coverage before 2022.
  • “Unless and until we get vaccines to every country, to every vulnerable person, to everyone who needs a vaccine then I’m afraid we will be sitting here at the end of 2022 having somewhat the same conversation, which in itself would be a great tragedy,” said WHO Health Emergencies Program Executive Director Dr. Michael Ryan.

What it means to you and me

All of this is understandably overwhelming, and in some ways it can feel like we’re back in 2020. But even with Omicron’s extraordinary contagiousness, practicing the same health measures like masking, distancing, and ensuring good ventilation will continue to protect us.

• “You just need to do them more assiduously, more often, and you need to be more careful about where you go, how long you spend, where you spend your time, and how you protect yourself,” Ryan said. 
• Now is not the time to sink into complacency since the urgency of stemming transmission of COVID-19 continues to grow by the day. 
• Neither should you risk getting infected or treat Omicron less seriously because of the feeling that “eventually everybody is going to get it.” There’s no way knowing how the virus will hit you or a loved one, nor can you pick and choose which variant you might encounter along the way. 
  • “Even in the most optimistic scenario, in which a post-vaccination infection does really turbocharge a vaccinated person’s immune responses, the durability of the most primo effects is still a wild card,” The Atlantic reported. 
• “We are asking everyone to play a part in this. We are asking governments to have rational, evidence-based, tailored, comprehensive policies with a layered approach of all of these different types of interventions that keep people safe. Essentially do it better, do everything that we have been advising better, more comprehensively, more purposely,” Kerkhove said. 

In case you missed it: If you’re eligible and thinking about getting a booster shot, Rappler has put together this guide on how you could get a booster and what you should expect after getting boosted, based on the experience of people who have gotten their additional jabs:

– Rappler.com