COVID-19

COVID-19 Weekly Watch: Omicron subvariants come to PH. Frequent boosters next?

Sofia Tomacruz
COVID-19 Weekly Watch: Omicron subvariants come to PH. Frequent boosters next?

'NEW NORMAL.' All seats are taken in a train in Metro Manila on the first day of Alert Level 1.

Rappler

This week of May 22, 2022, we look at what another Omicron subvariant means for the Philippines' pandemic response, booster updates, and how scientists assess potential futures for the virus

Coronavirus cases continue to fall in the Philippines, with an average of some 160 new cases reported daily in the previous week. The Department of Health (DOH) says the country remains at “minimal risk” for COVID-19.

Roughly 62% of all Filipinos have been fully vaccinated. 

Here’s what we’re watching this week of May 22, 2022: 

Another variant present

The DOH recently announced the first reported case of the BA.4 Omicron subvariant in a man who traveled to the Middle East last May 4. It is the second Omicron subvariant to be detected in the country.

  • Health officials say the man was asymptomatic and has his specimen collected on May 8 for testing. Little information was available on his close contacts, though the DOH called on all local governments to “proactively” seek the unvaccinated and those eligible for boosters. For the public, minimum health standards remain essential.
  • The BA.4 and BA.5 subvariants recently fueled a new wave of cases in South Africa. It is considered part of the Omicron family, and so it’s considered classified as a variant of concern. 
    • Emerging data that has yet to be peer-reviewed suggests that BA.4 and BA.5 could evade natural defenses from prior infection with the original Omicron variant. 
    • In terms of transmissibility, BA.4 is seen to spread faster, likely because of its ability to evade immunity from prior infection or vaccination, especially if the latter has waned over time. 
    • In terms of severity, there is no observed change yet compared to other Omicron subvariants. But a highly contagious, fast-spreading variant, as we learned, could still overwhelm health systems.
  • There are now two more Omicron subvariants in the Philippines: BA.4 and BA.2.12.1 – both of which have contributed to an increase in cases in South Africa and the United States, respectively. Prior to this, genome sequencing has detected the BA.1 and BA.2 subvariants. 
    • For Filipinos, this means higher risks of an increase in cases if minimum health standards, like mask wearing and good ventilation, are neglected. 
  • It may be tricky to see the increase in cases this time around considering peoples’ behavior has largely shifted and there is greater access to home tests, which aren’t counted in the country’s official case tally. 
  • The emergence of new subvariants underscores how COVID-19 remains a significant challenge for the next administration. The new government may be inheriting the health crisis at a potentially good moment, but it doesn’t mean the pandemic is no longer a problem or urgent. 
Booster updates

The US recently recommended a booster shot for children aged 5 to 11 to offer an extra layer of protection as infections and hospitalizations climb in the country. 

  • Dr. Sara Oliver, a US Centers for Disease Control and Prevention scientist, noted in a meeting with experts of the agency that studies showed about 70% of children in this age group in the US had evidence of prior infection. Evidence, however, also suggests that natural immunity from an Omicron infection may be weaker and less durable than protection from vaccination.
    • “The rise in pediatric hospitalizations during the Omicron surge suggests that immunity gained from infection is not sufficient to provide a broad population-level protection,” Oliver was quoted saying in The New York Times.
  • STAT News reported that the CDC expert panel didn’t debate whether to make a booster available to the age group. “Instead, the discussion focused on whether the CDC should tell parents and doctors that these children “should” receive the vaccine, or to give what is known as a permissive recommendation, saying that children “may” receive the booster dose.”
    • “Panelists came down resoundingly on the side of ‘should,” STAT reported. “Most of the panelists who voted yes also noted the large number of children in the age group who had not received the Covid vaccine, but they worried that the public might interpret weaker language as saying the vaccine was not important.”
    • Studies earlier showed that protection given by two doses of the vaccine against severe outcomes remained strong but offered little defense against infection with the Omicron variant in children aged 5 to 11. In kids aged 12 to 17, two doses offered little protection against hospitalization, but a booster significantly improved effectiveness of the vaccines, the Times noted. 
  • In the Philippines, minors, including those aged 12 to 17, have yet to be made eligible for boosters. An application by the DOH remains pending with the Food and Drug Administration. 
  • While additional doses may be on the way for more groups, at least 30% of Filipinos have yet to receive a single dose. Meanwhile, uptake of first boosters also remains slow with just 13.7 million or 25% of the 54.4 million eligible Filipinos having gotten their additional shot. 
Multiple reinfections?

A recent report by the Times offers a potential scenario of how humans may end up living with the virus in years to come: the possibly of multiple reinfections in an individual as the Omicron variant persists and more of its subvariants appear to demonstrate the ability to dodge immunity from prior infections. 

  • The TimesApoorva Mandavilli illustrates a pattern scientists are considering: “The central problem is that the coronavirus has become more adept at reinfecting people. Already, those infected with the first Omicron variant are reporting second infections with the newer versions of the variant – BA.2 or BA2.12.1 in the United States, or BA.4 and BA.5 in South Africa. Those people may go on to have third or fourth infections, even within this year.”
    • “That leaves everyone – even those who have been vaccinated multiple times – vulnerable to multiple infections,” Mandavilli said. 
  • The situation is even more plausible if more variants emerge, in which case more people would be susceptible to the virus, having only been exposed to its older forms. Contrast that with earlier in the pandemic, when “experts thought that immunity from vaccination or previous infection would forestall most reinfections.”
  • Where does that leave vaccines? Despite this possibility, vaccines remain extremely useful and life-saving since most who receive two to three doses see formidable protection against hospitalization, severe diseases and death. But it may require a shift in what vaccines can and can’t do, which includes preventing infection itself. 
    • But to keep up, experts say COVID-19 shots may need to be updated more quickly compared to flu shots. 
  • Jeffrey Shaman, an epidemiologist at Columbia University in New York told the Times: “If reinfection turns out to be the norm, the coronavirus is “not going to simply be this wintertime once-a-year thing…and it’s not going to be a mild nuisance in terms of the amount of morbidity and mortality it causes.”
  • Staying one step ahead of the virus and keeping transmission low likewise remain crucial. “The way to get it under control is not, ‘Let’s all get infected a few times a year and then hope for the best,’” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego.

In case you missed it: Senior citizens and frontline health workers are now eligible for a second booster in the Philippines, after health experts concluded that an additional shot was needed to increase protection among individuals in the high-risk groups. 

Those eligible may get an additional shot at least four months after receiving their first additional shot. More in this story:

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Philippines expands 2nd COVID-19 booster rollout to seniors, health workers

Philippines expands 2nd COVID-19 booster rollout to seniors, health workers

– Rappler.com

Sofia Tomacruz

Sofia Tomacruz covers foreign affairs and is the lead reporter on the coronavirus pandemic. She also writes stories on the treatment of women and children. Follow her on Twitter via @sofiatomacruz. Email her at sofia.tomacruz@rappler.com.