Readying for the ‘new normal’

During the first months of the pandemic, we held on to the hopes the world would get ahead of it once the vaccines against the novel coronavirus disease 2019 (COVID-19) are developed, distributed globally, and administered to as many people and population. Once that happens, we will get back to our normal way of life at the soonest time.

Several vaccine brands have been developed and rolled out to numerous countries around the world since then. However, nearly two years since the first COVID-19 case was detected in China, the pandemic-stricken countries are still facing the same problems due to mutations of the deadly virus. But the pandemic got worse. The COVID-19 variants have become more transmissible and can infect even children.

Thus, we saw the resurgence of COVID-19 pandemic anew in the United States (US), the United Kingdom (UK), the European Union (EU) member states, and other countries despite having inoculated more than enough of their populations where there have been a steady supply of anti-COVID vaccines.

Here in the Philippines, various local governments units (LGUs) have differing success in inoculating their constituents against the virus. There is also the perennial threat of cyclical surges following downgrade of quarantine restrictions.

As a result, our country’s recovery from the pandemic has been uneven and uncertain. As for “normal” -- well, what is normal anymore?

Our vulnerability to vaccine supply dynamics coupled with the glaring weaknesses in the pandemic response of the leaderships in LGUs has brought, at best, tentative gains in our fight against the virus.

As of this writing, 2.81 million Filipinos have been infected with COVID-19 and more than 45,000 have died since the outbreak struck us in January last year. Based from the National COVID-19 Dashboard of the Department of Health (DOH), a total of 70.2 million doses of various brands of anti-COVID vaccines have been administered all over the Philippines as of Monday. Of this total, 38.4 million Filipinos have been inoculated with their first dose while 31.8 million others have already been fully jabbed by their second dose and others got single-dose vaccines.

While these numbers look good, we are still far off from the 70 percent out of the total 110 million population to achieve the so-called “herd immunity.” The government earlier declared a target of 1.5 million people per day vaccination to achieve the “herd immunity” by December this year. That’s why President Rodrigo Duterte approved the holding of National Vaccination Days from Nov. 29 to Dec.1 to boost the government’s meeting this “herd immunity” target.

We now know that despite the availability of vaccines, these are not enough to stop the spread of the virus and its continuing, debilitating effects on our healthcare system and economy. What would allow us to step up our game in fighting COVID-19?

A good complement to a robust vaccination program is access to innovative treatments that have been approved by health authorities. Just last Sept. 24, the World Health Organization (WHO) updated its clinical care guidance to include the monoclonal antibodies casirivimab and imdevimab (known as Ronapreve outside the US and UK) for treatment of non-severe cases of COVID-19 who are at the highest risk of hospitalization. It is also ideal for patients with severe or critical illness who have not mounted an antibody response.

In July 2021, Japan fully approved Ronapreve antibody treatment for patients with mild to moderate cases. A month after, the UK regulators followed by granting a conditional marketing authorization to treat patients with confirmed acute COVID-19 infection. Other countries, including the US, have authorized Ronapreve for emergency or temporary use. It was reportedly used to treat former US president Donald Trump when he was hospitalized for COVID-19 last year.

On Oct. 1, our own Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for Ronapreve as treatment for COVID-19. Ronapreve is a cocktail of two monoclonal antibodies that, according to studies, reduces the risk of hospitalization and death by up to 70 percent in mild to moderate COVID-19 patients. The two ingredients, casirivimab and imdevimab, work together to prevent the SARS-CoV2 virus from infecting cells that line the respiratory tract.

Ronapreve is used in patients 12 years and older, weighing at least 40 kilos, and not requiring supplemental oxygen. It may be given as a single infusion into the vein for an injection under the skin – based on clinical trials. Developed by biotech firms Regeneron and Roche, Ronapreve is currently being used at St. Luke’s Medical Center and Makati Medical Center that were earlier given a compassionate special permit (CSP) by the FDA. So what is the next logical step?

The DOH has finally allowed all hospitals and LGUs to procure this anti-COVID medicine.

In a recent virtual town hall discussion, Dr. Rontgene Solante, chief of the Adult Infectious Diseases and Tropical Medicine Unit at San Lazaro Hospital, emphasized the need to move forward “because COVID-19 is not going away.”

Administrative and bureaucratic roadblocks should be hurdled right away to allow as many COVID-19 patients access to innovative treatments like Ronapreve. In fact, it should be made part of Philippine Health Corp. (PhilHealth) benefits under the COVID interventions and be available to all Filipinos especially those who cannot afford hospitalization and expensive medicines.

Imagine the lives that will be saved. Imagine the resources that can be freed up for those needing them more. Imagine the reduced strain on medical frontliners and the healthcare system in general.

Indeed it looks like we have to learn to live with the virus through a combination of aggressive vaccination, continued observance of health protocols, and access to treatments such as Ronapreve. This is the “new normal” that we had neither imagined nor contemplated in the beginning. Are we ready for it?