This week is a critical week for the management of the COVID-19 pandemic in the Philippines. How we manage the surge in cases in the NCR, and the vaccine roll out with the first tranche of Sinovac vaccines, will have a lasting impact on the future of this pandemic.

Surge in NCR

First, the surge in the NCR: it is becoming clearer every day that there is an ongoing surge of new cases in Metro Manila. According to the pandemic curve published by the DOH on its COVID-19 tracker, there were 956 new cases recorded on February 22, 2021. The last time the capital recorded such a high daily caseload was on September 18, 2020, which was five months ago. Then, the DOH reported 959 daily cases. 

The spike in cases has been particularly troubling in Pasay City, which to date has locked down 55 barangays in response to the surge. However, it is not clear at this time if these localized lockdowns have successfully quelled the spread of the pandemic in the LGU. With around 80 new cases daily and growing, contact tracing becomes increasingly difficult to do effectively. This threatens to spill over into the adjacent LGUs in the capital, and we are already seeing large spikes in new cases in the other cities of Metro Manila. 

What is happening? In my view, the data suggests that we are looking at the beginning of a UK variant-driven surge in the NCR. This is not unexpected. First, in recent weeks, the DOH and the PGC have reported cases of the UK variant, called the B117 variant, in the NCR and surrounding provinces that were untraceable to recent travelers. This meant that B117 was already in community transmission. It was just a matter of time before the B117 variant would trigger an explosive surge, in the same way it has done in the UK, Ireland, Portugal, and Israel. 

Second, I have heard of anecdotal evidence of recent clusters of COVID-19 cases in the NCR where one family member has infected five or more relatives in the same household in just a few days. The ancestral variant of SARS-CoV-2, called B1, which has been in the Philippines since the last surge in the NCR in June/July, has a secondary attack rate in the household of around 20%. This means that we should expect one family member to infect just one other member in a family of six. Though still anecdotal, the higher household rates of transmission in the current surge in the NCR suggest that we are dealing with a more infectious variant that is spreading in Metro Manila. This would be B117.

I am waiting for the DOH and the PGC to complete the genome sequencing of SARS-CoV-2 isolates from current active cases in the NCR. I am expecting them to report a growing percentage of B117 variants in the capital. However, we cannot wait until this information comes in. We have to treat this surge as if it is a B117 surge, because if we wait too long, everything will be lost. 

The challenge of a B117 surge is that other countries have discovered that ordinary measures like social distancing, masking, and contact tracing, measures that had successfully mitigated the previous variants of SARS-CoV-2 in previous surges, were not able to properly contain the spread of B117. This variant is highly transmissible and explosive in its growth. Only a national lockdown of many weeks was able to curb the spread of the B117 pandemic in England. This was also the experience in Israel, Portugal, and Ireland. 

This week, the IATF has to intervene to ensure that this surge of COVID-19 does not overwhelm the capital region in the way it threatened to do so in Region VII. Numerous localized lockdowns will have to be used throughout the capital. If the surge in the NCR can be contained this week, we will be able to breathe a collective sigh of relief. Otherwise, we will be talking about another lockdown for the entire capital, and we will be talking about it very soon.

Vaccine rollout

Second, the vaccine rollout: The first tranche of COVID-19 vaccines, several hundred thousand doses from Sinovac, arrived in the Philippines this week, and vaccinations have begun.

Already, I have heard of significant resistance to the Sinovac vaccine. I have heard of Filipino residents from Region III who were open to being vaccinated but who are now rejecting the Chinese vaccine. Surveys show that citizens in the NCR just don’t want anything to do with Sinovac. This is tragic because how this first week plays out will shape public perception of the rest of the national vaccine program. And Filipinos rejecting the first vaccine they are offered will poison the imaginations of their kababayans who are watching them on social media!

And this did not have to happen! Bickering among our elected officials about Sinovac and Sinopharm for the past several months has left a bitter taste in the mouths of many Filipinos. They have heard their senators claim that the Chinese vaccines are substandard and the fruit of political intrigue or corruption. They have heard their own FDA claim that these vaccines are not good enough for their healthcare workers or our lolos and lolas, even though it passes the 50% efficacy threshold established by the WHO, and has been approved for widespread use in other countries. Now, the national government has rejected the recommendations of the FDA and are vaccinating healthcare workers anyway. 

For the past month, the DOH has been telling us that every vaccine that is approved by the FDA is safe and effective. And yet in the past few days, the IATF has claimed that the FDA made a mistake: Sinovac is in fact good enough for healthcare workers. This is chaos! If the FDA is unreliable, then how can we trust what it will do with the other vaccines to come? Even my mother does not want to be vaccinated with Sinovac anymore!

This week, the national government needs to focus its messaging to increase confidence in the Sinovac vaccine. There are three things it needs to make clear. First, protection against COVID-19, whether it is 50% or 62% or 95% protection, is better than 0% protection. The Sinovac vaccine will protect every citizen from serious illness and death. Therefore, the choice is simple: no protection for the next many months and the possibility of severe disease and death, or protection from these deadly outcomes especially at the beginning of a B117 surge in the NCR.

Second, the Sinovac vaccine has an advantage that the Western-made vaccines do not have. It will protect Filipinos against the South African B1.351 variant. It may not be as efficacious as Pfizer or Moderna, but it has a broader range of protection against SARS-CoV-2 variants. Notably, South Africa stopped its vaccination campaign earlier this year when it found that the AZ vaccine was not effective against its homegrown variant. If you want to be protected from the many different variants of SARS-CoV-2 around the world, then you would pick Sinovac over Pfizer or Moderna or AstraZeneca.

Third, if you want a “better” vaccine, you can get it next year when the vaccine supply will be more adequate for global demand. This is only the first of many COVID-19 vaccines we will be receiving over the next decade. If you do not have a car, wouldn’t you buy a Toyota this year if it were the only car available? Would you not rather have any car than keep walking without one? Especially if you knew that you could get a BMW next year?

Finally, as they say in the United States, the national government and the LGUs must walk the talk. The president and all our elite politicians, including the mayors of our most significant LGUs, will need to be vaccinated with Sinovac this week in front of the national media. Filipinos will only believe the messaging of the national government if they see their elected officials receive the Chinese shot that everyone says is safe and effective. Let us stop bickering and let us stop fighting each other. Instead, let us work together to kill this virus.

This week is a critical week for the management of the COVID-19 pandemic in the Philippines. May God give us the wisdom and the political will to manage it well. – Rappler.com

Reverend Fr. Nicanor Austriaco, OP is Visiting Professor of Biological Sciences at the University of Santo Tomas, and an OCTA Research Fellow.