The Philippines reported its lowest positivity rate in 18 months on November 14, with 3.9% of 40,996 tests coming back positive. The figure is below the 5% threshold the World Health Organization (WHO) has urged countries to meet, and is the lowest the country has seen since May 2020.
Although wider access is still needed, the number is nonetheless a significant marker in the country’s battle against the virus that was in its grimmest phase for most of 2021.
Here’s what we’re watching this week of November 15, 2021:
Health authorities are readying to roll out coronavirus booster shoots in what could be just a matter of weeks. It awaits word on two more fronts: locally, from the Food and Drug Administration (FDA); globally, from the WHO’s Strategic Advisory Group of Experts (SAGE).
- The FDA has received applications from Pfizer, AstraZeneca, Sinovac, and Sputnik V to amend their emergency use authorizations (EUA) to allow the administration of third doses and booster shots. The agency’s expert panel and the Philippines’ vaccine expert panel are currently reviewing data from manufacturers, with a decision possible in the coming days.
- The WHO SAGE is expected to give its complete position on the issue of booster shots in mid-November. Philippine health officials said the group’s take will be part of its considerations on when boosters could be accessible in the country. Experts guiding the vaccine drive say their recommendations could change depending on the position taken by the WHO SAGE.
- But, there’s also the issue of timing. If an EUA for boosters is granted before the WHO SAGE comes out with its decision, this could serve as basis to move forward with the administration of additional shots, Health Undersecretary Maria Rosario Vergeire said recently.
- Health Undersecretary Myrna Cabotaje earlier said the country currently has enough supplies to give out boosters to health workers and the elderly vaccinated at least six months ago, once the program is green lit. Based on recent estimates, some 5 million doses may be needed for this.
- Either way, public health experts and infectious disease epidemiologists stress that no matter when boosters are rolled out, the government can’t afford to lose sight of the unvaccinated.
- Epidemiologist Dr. John Wong added in a recent piece that reaching unvaccinated seniors is five times more effective in preventing hospitalizations compared to giving boosters: “A million vaccine doses given to the elderly can prevent 10,000 hospitalizations if given as primary series vaccinations, but can prevent only about 2,100 hospitalizations if given as boosters.”
- Vergeire likewise pointed out in a mix of English and Filipino: “Based on evidence and the experience of other countries where boosters are available, the unvaccinated are what causes the increase in cases. Not the lack of boosters.”
On Alert Level 1
The Duterte government wants to reopen Metro Manila further to Alert Level 1, the lowest and loosest quarantine level where there are no prohibited activities and all establishments are allowed to be fully operational. The targeted timeline is December, when public spaces are typically packed for the holiday season, consumption is high, and Filipinos traditionally gather with families.
- To downgrade alert levels further, these conditions need to be met:
- Low-risk classification needs to be sustained for at least two “incubation periods,” or at least one month.
- The area needs to be at “low risk” in terms of cases and health care utilization.
- 70% of all senior citizens and persons with comorbidities should be fully vaccinated, while 70% of the total target population should also be covered.
- Establishments will need to secure the government’s safety seal that ideally ensures health standards are in place to keep such public spaces safe. (The government is still discussing thresholds to measure this.)
- So far, Metro Manila meets most of these conditions. The region has been on Alert Level 2 since November 5, and will continue to be so until November 30. Vaccination coverage is also at about 90% of the targeted population – or 63% of the region’s total population.
- The DOH earlier said that the metrics it used to decide alert levels “is non-appealable, is non-debatable.” What can be tweaked are interventions in each classification.
- Meanwhile, the alert level system has officially gone nationwide. It took longer than expected, but keeps with the government’s staunch position that a return to wide-scale lockdowns is unfeasible because it is too costly.
New testing strategies
Health officials and medical experts will sit down on November 15 to discuss, among other things, testing methodologies that may be used in the coming months as the pandemic continues to evolve.
- The DOH said that self-testing strategies will be among topics discussed when it meets with the consensus panel of expert from the Philippine COVID-19 living recommendations group.
- Aside from vaccination, testing will continue to play a key role in mitigating the impact of the virus. But access remains limited, with PCR tests still expensive for workers and other options few and far between in the country.
- COVID-19 treatments like Merck’s Molnupiravir and Pfizer’s Paxlovid are also underscoring the need for wide and accessible testing.
- As a refresher on how important testing is in responding to the health crisis, consider its implication on other resources: “Where might you need to shift vaccines? Where do you put more contact tracers? Where do you build more isolation facilities? We still need to do testing [to help determine that]?” health systems specialist Albert Domingo told Rappler in an interview on the government’s pandemic checklist.
Eyes on Europe
Europe has continued to show an increasing trend in cases and deaths in recent week, with 26 or 42% of 61 countries having reported increases of 10% or more in cases, as of November 9. Russia, the United Kingdom, and Turkey were among countries that reported the highest numbers of cases.
- How did that happen? WHO COVID-19 Technical Lead Maria Van Kerkhove said the pattern seen across Europe and the world were “entirely predictable.”
- It’s the product of a mix of factors, including loose health restrictions and limited vaccine uptake: “When you lift public health & social measures in the context of variants, increased social mixing & limited vaccination, you’re going to see the virus thrive,” she said.
- Read this Rappler piece where experts explained to us why vaccines alone won’t be enough to end the pandemic and why other response measures are still so crucial.
- The UK is worth looking at since it provides a glimpse of what to avoid. Epidemiologist Tim Spector of the King’s College London told the New York Times: “The trouble is that the government has gone from ‘operation fear’ that we had a year ago to ‘operation complacency’…. It’s a massive switch.”
- England has some of the loosest restrictions, following its opening up on “Freedom Day” last July 19. There are also many crowded indoor gatherings, less prevalent mask wearing, and no requirements to show proof of vaccination or a negative test yet for entry to places like nightclubs and other venues.
- Analysts say infections in school-age children are also driving the increase in cases. The UK was slower to approve vaccines, with regulatory approval announced in September – weeks after many students had returned to school. But high vaccination rates among adults have so far kept hospitalizations manageable, officials said.
- Meanwhile, Europe bucked the global trend in deaths: the region reported a 10% increase, while all other regions saw negative changes in the recent week, compared to seven days prior.
In case you missed it: What does it mean when COVID-19 becomes endemic? WHO experts explain there’s no calculation or algorithm for this, and while it’s been pointed to as the future of the virus, “endemic does not mean that it’s not dangerous…or that we give up.”
Watch this clip below: