DOH shifts focus in COVID-19 response

DOH logo over photo of medical workers in PPE. STORY: DOH shifts focus in COVID-19 response

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MANILA, Philippines — The Department of Health (DOH) is shifting its focus in COVID-19 response from keeping virus transmission low to “reducing vulnerability” to make sure that hospitalizations and fatality rates remain at a minimum.

Alethea De Guzman, DOH Epidemiology Bureau director, said on Tuesday that the current “central strategy” was to vaccinate the population with COVID-19 primary doses and boosters as well as ensure adequate capacity to manage severe and critical infections.

“Mobility restrictions are no longer necessary with the current tools available,“ De Guzman said in an online forum, adding that the country has increased its vaccination coverage and improved its healthcare capacities.

But she added that masking and improving ventilation should remain as safeguards, while active surveillance of new variants, new case profiles, and infection clusters should likewise be maintained.

In addition, the DOH will mainly use three metrics to determine the alert levels of areas: total bed utilization rate, average daily attack rate and vaccination coverage. Other metrics — case growth rate, severe and critical admissions, deaths, and positivity rate — will only be used for “internal monitoring.”

Spike expected

According to De Guzman, the positivity rate is no longer a “proper measure of the actual COVID-19 situation.”

The DOH is also pushing for the “decoupling” of restrictions from alert levels, or the removal of mobility curbs in certain industries or areas, saying this was no “longer appropriate at this point.”

Based on the latest projections of the DOH’s FASSSTER team, the expected spike in daily COVID-19 cases nationwide due to holiday gatherings will be minimized to below 3,000 by the end of the year.

Hospital admissions due to COVID-19 will hover at around 800, mostly in Metro Manila, far from the 1,272 cases reported nationwide at the peak of a case surge due to the Delta variant. According to De Guzman, the forecasts are much lower than actual figures during the past holiday seasons because “vaccinations can minimize hospitalizations even with the emergence of new variants that are more transmissible.”

FASSSTER, which stands for Feasibility Analysis of Syndromic Surveillance using Spatio-Temporal Epidemiological Modeler, is made up of experts who analyze, survey and detect diseases.

New subvariants

Another epidemiologist, Dr. John Wong of EpiMetrics, sees another surge in infections due to gatherings during the holiday season.

“Without a masking mandate, ventilation becomes a more important measure to prevent aerosol spread,” he said.

With the looming hike in COVID-19 cases, De Guzman said the DOH was monitoring four Omicron sublineages for causing a new wave of cases in other countries based on global genome sequencing data: BF.7, BA.5.2, BQ.1.1 and BA.2.75.

BF.7, a sublineage of BA.5, has already been found in China and the United States. BA.5.2 has been detected as well in Beijing.

BQ.1.1 is causing another surge in cases in the US. It is a sublineage of BQ.1, the latest immune-evasive Omicron subvariant detected in the Philippines. BA.2.75 or “Centaurus” is already circulating in the country and quickly spreading in other countries as well.

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