By Brontë H. Lacsamana

To contain the variant, doctors urge people to get COVID-19 jabs

TO PREVENT further spread of the Delta coronavirus variant which, as of this writing, has already infected 35 Filipinos, the Philippines must retain limited mobility by following restrictions and practicing safety protocols while vaccination has not yet reached its targets, according to experts at a July 16 online forum held by the University of the Philippines (UP).   

“The faster the vaccination rollout, the better the chances of stopping the highly transmissible Delta variant, but [with] the problem of vaccine inequity in the world, in the meantime, we’re waiting for the vaccination level to go up and we can’t really decrease restrictions,” said Dr. Franco A. Felizarta, a California-based infectious disease and internal medicine specialist who is also a member of the UP Medical Alumni Society in America.  

Of the 35 Delta cases, 11 were local transmissions. On the evening of July 19, the Health department reported 32 recoveries and three deaths.  

During the online forum, Dr. Felizarta stressed that the Philippines can’t afford to let people move around while the rate of vaccination remains low. “I know there’s a high economic cost with that, but that’s the only way to stop the variant because it’s already in the Philippines, and based on the data, it probably will become dominant in two to three months,” he said.  

WHY DELTA IS HIGHLY TRANSMISSIBLE  

Delta, the name given to the B.1.617.2 variant first found in India, has already been reported in 104 countries. It is fast catching up to the Alpha variant, which is present in 173 countries; and the Beta variant, found in 122 countries.  

One of the important parameters that makes Delta highly transmissible is its basic reproduction number (R0), which ranges from 5 to 8, said Dr. Felizarta. “The more contagious the variant, the higher the basic reproduction number,” he explained, citing a Lancet study that shows the original coronavirus from Wuhan only had an R0 of 2 to 3 compared to the Alpha variant at 4 to 5, and Delta at 5 to 8.  

This makes the Delta variant at least 50% more transmissible than Alpha, putting it at number one in terms of transmissibility, based on the World Health Organization’s weekly epidemiological updates on coronavirus disease 2019 (COVID-19). However, despite being able to spread faster, its disease severity, risk of reinfection, and impact on diagnostics have not really increased.  

“The symptoms are still the same. The only difference is, if you have a country with a high vaccination rollout, especially for the elderly, then most of the patients infected [by Delta] are younger and they have milder symptoms,” said Dr. Felizarta, referring to the cases in the United States, which has vaccinated almost 90% of its elderly.  

MORE JABS, MORE MOBILITY 

When it comes to fighting fast-spreading coronavirus variants like Delta, Dr. Felizarta emphasized that controlling mobility has to be accompanied by more jabs administered. 

“It really depends on the vaccine rollout. It’s really about the variant versus the speed of vaccine rollout,” he said.  

Based on data from the US Centers for Disease Control, the US has fully vaccinated 48.6% of its population, a majority with either Pfizer or Moderna. This has mobility to go back to baseline with almost no restrictions. Despite cases doubling due to Delta, deaths have decreased.   

Meanwhile, in the Philippines, Dr. Felizarta pointed out that the overall cases and deaths are decreasing — not because of vaccine rollout — but because of decreased mobility, which is still at about 50% of pre-pandemic mobility. “If vaccine rollout goes up to 50%, then you can increase mobility by easing the restrictions,” he said.  

Citing a Nature Medicine study published in June, he also maintained that the more people are vaccinated, the harder it will be for the virus to spread even among the unvaccinated. 

STRATEGIES MOVING FORWARD  

It’s important to strengthen prevention, detection, isolation, treatment, and reintegration (PDITR) strategies in addition to ramping up vaccination in the Philippines, according to Dr. Eva Cutiongco-de la Paz, director of the health program of the UP’s Philippine Genome Center.  

The government is already at door three of its four-door strategy in fighting the disease, she said. Door 1 involves preventing foreign entry into the Philippines; Door 2 involves screening, quarantine, and testing; Door 3 is PDITR plus vaccination; and Door 4 is strengthening health and critical capacity systems versus a surge. 

“Now that local cases of Delta variant have been detected in the country, we all need to do our part in preventing the local spread of the variant. Encourage those who have not been vaccinated to have their vaccination,” said Dr. Cutiongco-de la Paz.  

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