MANILA, Philippines – Newly sworn-in President Ferdinand Marcos Jr. has yet to name his secretary of the Department of Health (DOH).

In a statement on Saturday, July 2, the DOH said that “everything is status quo until new directives from the President come in.”

“The country’s COVID-19 response actions, along with actions for all other non-COVID health matters, continue through senior DOH officials supervising specific bureaus, offices, and units. We await and are ready for the announcement of the next secretary of health,” the DOH added.

So far, two names are being floated to be the next DOH chief. A private hospitals’ group has recommended pandemic task force adviser Dr. Ted Herbosa. They did not specify, though, why they were recommending him. Meanwhile, former presidential adviser for entrepreneurship Joey Concepcion has also recommended Herbosa or DOH technical adviser Dr. Edsel Salvaña to be the next DOH chief.

“I believe that either of them at the DOH helm will help the government keep COVID-19 under control and maintain our health in good standing, which will keep our economy running at full capacity,” Concepcion said.

Why this matters

The secretary of health is a very crucial Cabinet position during this time, as the official would inherit the country’s battle against the pandemic.

The Duterte government had been criticized for appointing military men to the top positions of the country’s pandemic inter-agency task force. 

The whole country was placed under quarantine for months in the early days of the pandemic which was patterned after the decades-long tactics of the military on border controls in its fight against armed groups. Health experts were sidelined. 

Marcos’ DOH chief is also expected to come up with a new strategy for fighting the virus, especially now that the country is experiencing a surge in infections again.

From June 25 to July 1, the country recorded 6,399 new cases, translating to 914 daily cases. However, the healthcare utilization rate remains at “low risk” in all regions, as severe and critical cases were at less than 1.5% of total hospital admissions.

The DOH flagged Lucena City, Bohol, and Tawi-Tawi for having “moderate to critical” healthcare utilization.

The DOH attributed the current spike in cases to the entry of Omicron subvariants, people’s increased patterns of mobility, and their waning immunity due to the slow uptake of boosters.

Lucena City, Bohol, and Tawi-Tawi are at moderate to critical healthcare utilization. @rapplerdotcom pic.twitter.com/yJ7ZZ2TX1p

— Michelle Abad (@michelleabad_) July 1, 2022

Daily COVID-19 cases in the Philippines might reach up to around 17,105 by the end of July if Filipinos continue their current level of compliance with minimum public health standards (MPHS), like wearing masks, washing hands, and physical distancing, the DOH said.

Citing projections from the FASSSTER (Feasibility Analysis of Syndromic Surveillance Using Spatio-Temporal Epidemiological Modeler), a disease surveillance tool adopted by the DOH, health authorities reported that compliance with MPHS has dropped by 20% to 22%.

The DOH also reported a projection of around 3,800 to 5,300 new cases daily in the middle of July if the compliance rate stays steady.

Revised metrics for alert level system

On Tuesday, June 28, or two days before the Marcos administration assumed office, Duterte health secretary Francisco Duque III announced that the two-week positive growth rate had been scrapped as a gauge in determining the country’s alert level system. (READ: GUIDE: Localized lockdown, alert level system for Metro Manila)

Duque said that the two-week growth rate had “lost its significance and relevance” and was an “alarmist metric.” For instance, Duque said, some areas posted a 300% growth in COVID-19 infections just because cases went from zero to three during a given period.

What’s left as metrics are the average daily attack rate or the proportion of a population in a given area that got the virus, as well as the healthcare utilization rate.

“The revision of this alert level metrics, we will put more weight on hospital bed utilization instead of cases. This will be continued until the public gets used to it,” Health Undersecretary Maria Rosario Vergeire said in a separate press briefing.

The revision of the metrics for the alert level system would result in more areas being classified as low risk.

Reformulated COVID-19 vaccine as booster

The United States Food and Drug Administration (FDA) has advised vaccine manufacturers to update their COVID-19 vaccines to target variants, specifically Omicron.

• According to a Health Line report, the reformulation would provide broader immunity against highly contagious Omicron subvariants while ensuring the same protection against severe illness and death brought by the original vaccines.
• The New York Times reported that the US FDA was leaning toward a combination of the existing vaccine and one tailored to two subvariants of Omicron, BA.4 and BA.5. According to new estimates from the Centers for Disease Control and Prevention, BA.4 and BA.5 make up more than half of the new cases in the US.
  • “Our goal today is to try to address a situation that we are concerned about in the fall. We have a situation where roughly half of Americans have only received two vaccines to protect them against COVID-19, and for the other half that has received a booster, all of those individuals will have waning immunity as we move into the fall months,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.
• The Courthouse News Service reported that while the existing vaccines still confer high levels of protection against severe disease outcomes for all variants, the data suggests a reformulated booster targeting Omicron is needed.
  • “We are behind, so considering these questions now before there is a need is actually very important. So, we can’t always wait for the data to catch up,” said Dr. Hayley Altman-Gans, a professor of pediatrics at Stanford University Medical Center.
• In the Philippines, Vergeire said there were no ongoing “negotiations” to procure the reformulated vaccines for Omicron.
  • “No vaccine maker has finished the trials. I think they are midway of Phase II and Phase III. For us to approve their emergency use authorization and for us to administer these, the vaccines should be at the Phase III trial. We don’t have ongoing negotiations about that yet,” Vergeire said in Filipino.

– Rappler.com