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Are we out of the woods yet? Looking back at PH's 2021 COVID-19 response and if the 'endemic' is ever in sight

By SAAB LARIOSA Published Dec 23, 2021 11:46 am

If there's one thing we all had to learn this year, it's how to live with the pandemic. 

From the highly uncertain atmosphere of 2020, when many were still trying to understand the behavior of COVID-19 while waiting for the vaccines, the latter part of 2021 has somehow provided a breath of fresh air for Filipinos with the loosening of restrictions and the continuous rollout of jabs. 

There are now over 45 million Filipinos fully vaccinated against COVID-19 according to Dec. 22 data from the Department of Health (DOH), nearing half of the country's total population.

From peaking to as high as 26,000 infections last September in a Dela variant-triggered wave, infections have subsided as of late in the low hundreds. 

Even then, the country still ranks as the worst place to be during the pandemic for three times in a row according to Bloomberg’s COVID Resilience ranking, something that Malacañang has taken exception to.

We can take certain risks para makabawi rin ang mga businesses, para rin makabalik din ‘yung kabuhayan. It’s a balance.

Though we may not have completely returned to our pre-pandemic lives, there is still the question of whether or not there will even be an end to the pandemic that has been a part of our lives for two years now, and counting.

Calculated risks

Although some public gatherings are now starting to happen again, University of the Philippines professor and OCTA Research Group's David Guido wants to make it clear: "We're not out of the woods, we want to state that as a fact. We may think we are, but we can't say for sure."

Guido added that whatever lockdown scenario the Philippines finds itself in, it's simply the result of taking calculated risks when it comes to balancing the country's COVID-19 situation and helping the economy back on its feet.

The Philippines will be ending the year under Alert Level 2, the second lowest classification that allows more businesses to operate. Indoor establishments and activities are allowed at a maximum of 50% capacity for fully vaccinated individuals, while outdoor activities are capped at a 70% capacity.

"The virus is still here, but we support moving down alert levels because at this time we feel like the risk has decreased significantly, and we can take some risks, kasi this is the time na we’re healing in terms of the health," said Guido.

"Hospitals have improved, and occupancy has increased. So now, it’s time for us to focus on our businesses and help them recover — that is the goal right now... we can take certain risks para makabawi rin ang mga businesses, para rin makabalik din ‘yung kabuhayan. It’s a balance."

Guido added the establishments should still strictly enforce public health standards and capacity limits under Alert Level 2, even as decreasing cases may impart a sense of complacency.

"Kapag sinabing 50% capacity, it should be 50% capacity, kapag sinabing 70% capacity, then 70% capacity only. Kapag sinabing vaccinated only, sana strict ang implementation," said Guido.

"Kailangan patuloy pa rin ‘yung vaccination and kailangan patuloy pa rin ang pagsunod sa health protocols."

The endemic stage

On Nov. 11, way before the onset of the Omicron variant and when the country was experiencing a downtrend of cases, Health Secretary Francisco Duque III shared the possibility of the Philippines entering an endemic phase. This phase is said to happen when a population achieves a certain measure of immunity through vaccination, eventually reining in a once lethal virus.

“Preparations for a pandemic are almost similar to the endemic status. We just need to continuously enhance it when we shift to endemic for us to be able to contain it,” said Duque during that time.

One such country that has experienced its own successful endemic situation is Portugal, which has one of the world's highest COVID-10 vaccination rates with more than 90% of its 10 million population fully vaccinated and ongoing booster shots. Portugal, however, have recently been experiencing an uptick in infections due to the Omicron variant.

The benefit of moving to this [endemic] metric is to reduce the need to raise the alert levels that scare the people when cases go up. It will facilitate a shift in the mindset of the people to live with the virus.

"Ito ‘yung sinasabi nilang endemic phase. It’s low enough that we’re not threatened. We can go out, resume our lives, we may still need to wear our facemasks, but it will not threaten the hospital system," Guido explained.

"We have to live with COVID the same we live with the flu and cold. Ibig sabihin, flu happens, cold happens, some people will get sick and we face that," Guido said. "Gano’n ‘yung outlook, which means that we don’t expect that the cases will go down to zero. If it goes down to zero, maganda ‘yon, but we will probably have to manage it even if we’re down 1,000 cases per day."

Socioeconomic Planning Secretary Karl Kendrick Chua shared a similar sentiment when he proposed that the government ought to start treating the virus as endemic by changing the approach in monitoring COVID-19. 

Rather than basing national decisions on data such as the daily positive cases, total deaths, and others, Chua urged that the country's monitoring system be focused on severe or critical COVID-19 cases, case fatality ratio, and the share of deaths to the number of infections and vaccination rates.

"The benefit of moving to this metric is to reduce the need to raise the alert levels that scare the people when cases go up. It will facilitate a shift in the mindset of the people to live with the virus," Chua said in a Dec. 3 speaking engagement.

"If there are 20,000 cases but if 95% are mild, then we may be reacting too much,” he added.

The threat of Omicron

The emergence of the highly transmissible Omicron, however, have been dampening hopes that the world is turning a corner. Scientists for now are still poring over the data to figure out if Omicron, which was first discovered in South Africa, also causes more severe symptoms.

With the U.S. seeing a surge of cases and an expected lockdown return amid the new variant, the public and the market are now on edge. As of writing, Omicron is the most dominant strain in the U.S, with over 73% new COVID-19 cases three weeks after its first case.

Portugal, with its high vaccination rate and apparent 'endemic' situation, has also reported close to 50% of new COVID cases from the Omicron variant, causing the country to once again impose strict lockdown regulations amid the holidays.

With the Philippines reporting its first three Omicron cases in the span of two weeks, Guido reiterates that if it weren't acted upon quickly, a surge is "almost certain to happen." 

"Optimistically, we don't think that the surge will be as bad as the Delta or Alpha surge back in March because we have significant vaccinations now. We don't think that hospitals will be overwhelmed even if we have an increase in cases but it will still affect things," said David.

On Dec. 22, the DOH shortened the interval for COVID-19 booster shots in the Philippines from six months to three months, following the recommendation of vaccine experts in the country.

"We are exploring all possible options to safely mitigate the effects of the more transmissible variants of COVID-19. The approval came at an opportune time as several countries also re-strategized in light of the Omicron and other COVID-19 variants that may emerge,” Duque said.

Will it ever be over?

There is no telling when exactly a pandemic will end, but scientific experts from Pfizer have theorized that with new variants like Omicron, it may take until 2024 for COVID to transition to a worldwide endemic state.

“When and how exactly this happens will depend on the evolution of the disease, how effectively society deploys vaccines and treatments, and equitable distribution to places where vaccination rates are low,” Pfizer chief scientific officer Mikael Dolsten said.

"The emergence of new variants could also impact how the pandemic continues to play out... but this transition may look different based on where you are in the world. For instance, countries with high vaccine coverage and plentiful boosters may soon settle into predictable spikes of COVID-19 during the winter months when the environmental conditions are more favorable to virus transmission," said Dolsten.

Ultimately, Guido said that we have to confront the possibility that COVID-19 and its unpredictability will always be a part of our lives, but that doesn't mean we don't move on to the next phase.

"We can be cautious and still plan for the next phase."