Despite the detection several cases of the XBB.1.9.1 COVID-19 variant in the Philippines, the World Health Organization (WHO) said Friday it does not expect “outbreaks of massive proportions” to happen.
Dr. Babatunde Olowokure, WHO Western Pacific Regional Office Emergency Director, said the detection of the sub-variant in the country should be looked at positively as it only shows that systems are working to monitor variants.
This developed as the WHO emergency committee is set to meet again inMay to determine whether COVID-19 still constitutes a public health emergency of international concern.
Data from the Department of Health (DOH) showed that from April 3 to 11, the country has detected 39 cases of the XBB.1.9.1 variant that was recently added to the list of variants under monitoring by the WHO. The total number has reached 54 since March.
“The transmissibility, yes, we recognize, this may be a challenge. But I think, as we have seen, there’s a slight increase in cases, so we are not looking at an outbreak of massive proportions, but I think, at the moment, we’re looking at something which appears to be controllable,” Olowokure said.
The regional office noted an observed increase of COVID-19 cases in the Philippines but reminded the public to interpret the numbers with caution, given the decline testing and surveillance.
Despite the slight increase, which may be attributable to the recent Holy Week break, Olowokure said indicators being closely monitored do not point to a rise in risk.
“Does it reflect an increase in hospitalizations and increase in severity in terms of people being hospitalized in ICU units or an increase in the number of deaths. So, we have not seen that at this time.”
“It is not a concern but we continue to monitor, we continue to look at the severity and if we do see an increase, of course, we will be in touch with the DOH and to see how we can support,” he added.
Because of the manageable situation in the Philippines, as well as some governments already declaring the end of the emergency at their level, questions are being raised whether the country would be doing the same.
In its latest surveillance report, the DOH said the subvariant wasadded to the list of variants under monitoring by the World Health Organization on March 30.
“The variant was initially flagged due to its increasing global prevalence and higher growth advantage. The variant has been detected in 63 countries or jurisdictions across six continents, according to sequence submissions in GISAID [Global Initiative on Sharing All Influenza Data],” the DOH said.
Olowokure said Friday that while countries may say the emergency has ended based on their own context, the public health emergency of international concern declared by the WHO since 2020 remains in place.
He also said that they are in constant communication with the Department of Health and are willing to provide advice on the matter should the agency seek it.
So far, the WHO said COVID-19 cases have decreased overall in the Philippines and are only seeing a slight rise in cases.
What they are looking at more closely, like the DOH, is disease severity and the number of hospitalized patients. These indicators remain low, which is why Olowokure said the Philippines is on the right track.
In a related development, the person-to-person transmission of H3N8 bird flu or human avian influenza is “extremely rare,” Olowokure said Friday amid a recorded death in China.
“What we need to understand is that with these human cases of avian influenza, transmission from person to person is extremely rare. So therefore, the situation for humans in this regard is that we do remain vigilant,” he said in a press conference.
“We need to provide information regarding risks and most of that risk relates to sick, dying, or dead poultry and also their attendance at wet markets,” Olowokure added.
The WHO official said most human cases result from “individual cases having contact with dead or dying poultry [and] it does not come from the poultry industry.”
Olowokure said the WHO is working together with different global organizations to ensure proper monitoring and response should there be more cases of human avian influenza.
Following the Health Department’s detection of several cases of COVID XBB.1.9.1, the doctor said this must be looked at positively as it only shows that the systems put in place to detect and monitor variants are working.
The health body recognizes that, in terms of transmissibility, the new variant may be a challenge. But with only a slight increase in cases for the Philippines, they are not looking at outbreaks of massive proportions.
The WHO Western Pacific Region has yet to relay the specific date in May for the emergency committee meeting. The last time it gave recommendations to the WHO Director General was in January where it said that COVID-19 still constitutes a public health emergency of international concern.
About 199 samples were sequenced by the University of the Philippines – Philippine Genome Center Main and Mindanao branches last April 3 to 11.
Out of these, 114 or 57.29 percent were classified as XBB including 30 XBB.1.5 cases and the 39 XBB.1.9.1 cases.
Thirty-five of the 39 XBB.1.9.1 cases were tagged local — 22 from Davao Region; seven from Ilocos Region; four from the National Capital Region; and one each from Central Visayas and Soccsksargen.
The remaining four case were returning overseas Filipinos (ROF).
Previously, the country has logged 15 cases of the subvariant.
“Currently available evidence for XBB.1.9.1 does not suggest any differences in disease severity and/or clinical manifestations compared to the original Omicron variant,” the DOH said.
“Limited information is available for the variant and researchers are currently characterizing the variant in terms of transmissibility, immune evasion, and ability to cause more severe disease.”
The remaining samples sequenced during that period were classified as BA.2.3.20 with 70 cases; XBC, two cases; CH.1.1, one case; BQ.1, one case; and BA.2, one case.
“Among the BA.2.3.20 cases detected, one was classified as a ROF and the remaining cases were local cases from Cagayan Valley, Central Luzon, CALABARZON, Central Visayas, and the Davao Region,” the DOH said.
The reported BQ.1 and XBC cases were from the Davao Region while the CH.1.1 case was from Region 4-B (Mimaropa).
As of March 22, the WHO has labeled BA.2.75, BQ.1, CH.1.1, and XBF as variants under monitoring and XBB.1.5 as variant of interest.
The European Centre for Disease Prevention and Control has labeled BA.2.75, BQ.1, XBB, and XBB.1.5 as variant of interest; and CH.1.1, BN.1, and XBC as variants under monitoring as of March 23.
Earlier this week, the WHO reported that a woman died from H3N8 bird flu in China. It is the first known human fatality from the avian influenza strain, according to an Agence France-Presse report.
H3N8 is known to have been circulating since 2002 after first emerging in North American waterfowl. It is known to infect horses, dogs, and seals.
It had not been detected in humans before two prior non-fatal cases emerged — both also in China — in April and May last year.
