MANILA - The World Health Organization (WHO) on Thursday urged the Philippines to accelerate its COVID-19 vaccine rollout, most especially to senior citizens, before the more transmissible Delta variant becomes dominant in the country.
WHO Representative to the Philippines Dr. Rabindra Abeyasinghe warned that failure to do so might result in a higher number of COVID-related fatalities among the elderly population.
Some 60 percent of COVID-19 fatalities in the country are from this age group, according to the Department of Health. Abeyasinghe affirmed this.
As of June 29, only 8.5 percent of the 8.2 million elderly population in the Philippine government’s master list have been fully vaccinated against the coronavirus, while 28 percent received the first dose. Of this figure, over half are in Metro Manila, according to Abeyasinghe.
“We have no guarantee that we can indefinitely hold the Delta variant out… How long we can hold this is a matter of time… We have a unique window," he said.
"Before that happens, we need to try to vaccinate as many of our senior citizens as possible. If we fail to do that, it is likely that we are going to see a lot of deaths happening among the senior citizenry,” he added.
This is why, he said, the government should use the remaining and limited COVID-19 vaccine supply "in a rational manner" by prioritizing the elderly population.
“Because that way we will save more lives, not if the surge happens, but when the surge happens. That is what the global evidence is showing,” Abeyasinghe pointed out.
He also noted that 70 percent of the country’s healthcare workers, which belong to the A1 priority group, have already been fully vaccinated, with 95.8 percent receiving their first dose.
The WHO said the Delta variant is estimated to be 60 to 70% more transmissible than the Alpha variant. Very conservative estimates show that the Alpha variant, which first emerged in the UK, is about 70% more transmissible than the original COVID-19 virus.
“So the number of people being infected by the Delta variant is much higher,” Abeyasinghe said.
“Now we are seeing that Alpha is being replaced by Delta. So, for example, 90% of the new cases that are being confirmed in the United Kingdom are attributed to Delta variant. It’s the similar picture in many countries,” he added.
The DOH echoed Abeyasinghe's call to prioritize senior citizens in the COVID-19 vaccination, directing it to local government units.
“Data continues to show that as much as 60% of deaths are really coming from those greater than 60 years old. With the coming of the vaccines into the country, there is a greater need to make sure that our senior citizens are covered,” DOH Director Beverly Ho said.
COVID-19 vaccination in the Philippines was limited to the A1, A2 and A3 (individuals with comorbidity) priority groups from March until the first week of June.
The government then opened the inoculation to essential workers or A4, and the indigent population or A5 in the NCR Plus 8 area, but stressed that priority should still be given to the first three groups.
National Commission of Senior Citizens Chairperson Atty. Franklin Quijano attributes the low COVID-19 vaccine uptake among senior citizens to inadequate information on the vaccination program and the inability of some elderly population to go to vaccination sites.
“There are senior citizens who would like to have themselves vaccinated. Pero hindi nila alam kung sino ang lalapitan at saan… The details will really have to be spelled,” he said.
“The house-to-house thing may be very critical, especially because there are senior citizens who are not so ambulatory and would rather that they be vaccinated at home,” he added.
The WHO stressed it is necessary for LGUs to create special provisions that will make senior citizens feel safe enough to access the vaccines.
These include special lanes or COVID-19 vaccination sites, dedicated time slots, bringing the vaccination site closer to their community, doing house-to-house visits when possible, and providing transportation.
Some LGUs are already implementing these measures.
“Asking them to go out and get vaccines, they need to have comfort that they can safely go and get the vaccines and come back. That safety comes in having dedicated lanes. You cannot expect a 75-year-old person to wait 4 hours or 3 hours for a vaccine. We need to have fast tracked lanes that will recognize and respect the age and provide easier access. We cannot expect them to queue up with younger people,” Abeyasinghe said.
“Many of the senior citizens have problems in registering, in knowing where the vaccines are, in getting to vaccination sites… Many of them are movement problems. They cannot sometimes go to vaccination sites on their own. It may be necessary that we actually visit houses and vaccinate people in their houses,” he added.
Did the Philippines open up the COVID-19 vaccination to other priority groups too soon?
“As vaccines started coming in, many of the vaccines had very short shelf lives. And there was concern that the vaccines could expire, because of the slow uptake in the initial phases, and also because of the necessity to ensure that the economy is functional,” Abeyasinghe said.
“If you have an unlimited supply of vaccines, that is the correct approach. But when you have a limited supply of vaccines, how do you maximize its impact? That is why we are urging a clear focus on the priority groups. Certainly vaccinating economic frontliners is also important... But the maximum impact of the vaccines will come by prioritizing senior citizens and the comorbid populations,” he added.
Abeyasinghe noted, while COVID vaccines are becoming available for the adolescent population, the focus of the inoculations should be on the vulnerable sectors.
“We don’t see adolescents as very high risk. While it is important to have vaccines for those groups, the focus at this point and time should be in using the available vaccines to protect the most at-risk groups,” he said.
“As we reach higher coverage, and we move to younger age groups, having those safe and effective vaccines for younger age groups will bear fruit,” Abeyasinghe added.
He said the variants and the increased mobility of individuals are contributory factors in the COVID-19 surges seen.
“These increases in mobility around various events have contributed to the surge, but that doesn’t take away the fact that the variants of concerns, particulary the ones we talked about have increased transmissibility,” Abeyasinghe said.
“The increased transmissibility has been clearly documented and proven in many countries, including in Denmark, the UK, US, Israel. Transmissibility relates to real world transmissibility, it’s not about lab conditions,” he added.
SHIFTING OF VACCINATORS
Meanwhile, the DOH recommends that local governments limit to 8 hours the shift of health workers assigned to COVID-19 vaccination sites, in order to avoid errors.
This, after incidents of vaccinators failing to push the plunger of syringe during COVID-19 inoculation have been confirmed.
“We’ve recommended to our LGUs to make sure that the shifts of our healthcare workers participating in the vaccination program could be at around 8 hours only,” Ho said.
The DOH requested for “understanding” and asked the public to reach out to the “correct authority” in reporting vaccination errors.
“We ask for kind understanding but also constructive participation in cases like this,” Ho said.
“We kindly request the general public who have knowledge of these instances to actually reach out to the correct authority, could be through us, the DOH, or through the LGUs, so that these instances may be rectified or checked,” she added.
The Philippines this week extended a travel ban to keep out the Delta variant first detected in India until July 15, a ban covering India, Pakistan, Bangladesh, Sri Lanka, Nepal, the United Arab Emirates, and Oman.
Officials have so far confirmed at least 17 cases of the original Delta variant in Filipinos returning from India and other countries.
The government of India last week sounded the alarm on a mutation of the Delta variant, called "Delta Plus" which is more infectious.
Experts have feared that it could trigger new waves of COVID-19 infections around the world.
The new mutations, however, could be slowed by having a huge part of the population fully vaccinated against the virus, despite reports that some variants decreased the efficacy of the jabs.
As of June 27, the Philippines was able to administer at least 10.065 million vaccine doses, of which 2,527,286 are second doses.
The number of those fully vaccinated against the disease represent 4.36 percent of the minimum 58 million target to achieve population protection.