A group of physicians has served caution against public complacency amid relaxed mobility restrictions and increased economic activity across the country, even as they urged the government to pursue an aggressive vaccination program to protect the people against new variants and further infection surges.
The Department of Health (DOH) reported that it had detected the first case of Omicron BA.2.12, a COVID subvariant, deemed responsible for the rise in the number of cases in the United States.
“COVID and influenza are here to stay,” said Dr. Ralph Villalobos, a pulmonary medicine specialist of the University of the Philippines-Philippine General Hospital, during last month’s annual convention of the Philippine College of Chest Physicians.
“We must manage respiratory infections as we return to normal life,” he said.
During the convention titled “Innovating with the Speed of Need,” Dr. Rontgene Solante, chair of the Adult Infectious Disease and Tropical Medicine Department and Fellowship Program at the San Lazaro Hospital, identified the various treatment options for influenza.
Among these antiviral medications recommended for influenza treatment were oseltamivir, baloxavir, zanamivir and peramivir, he said. They have no significant drug-to-drug interactions with COVID-19 drugs, especially with tocilizumab, remdesivir, or any drugs like steroids.
Baloxavir, particularly, has been proven effective and well tolerated in otherwise healthy patients, and is also effective in high-risk patients, as found in a Phase III trial conducted globally. It is associated with fewer complications.
“It is important to control influenza, especially at the viral phase,” Dr. Solante said. “When you miss that opportunity of treating the viral phase, treatment may not be effective anymore.”
“When you have patients with influenza, over that of COVID-19, the risk of superimposed infections is higher in influenza than in COVID-19,” he added.
Meanwhile, monoclonal antibodies available in the Philippines like Casirivimab & Imdevimab [a drug granted emergency use authorization by the Philippine Food and Drug Administration], can be given anytime once the patient has the symptoms as long as within seven days from the onset of symptoms.
The drug has been proven to prevent as high as 50-60% among patients from developing severe infections, Dr. Solante said.
“Early interventions can keep patients out of the hospital, or can keep high risk patients from developing severe COVID-19,” he added.
Dr. Jubert Benedicto, chair of the CCU-Management Action Team and Vice-Chair for Patient Service, Department of Medicine, University of the Philippines – Philippine General Hospital, said the World Health Organization has recommended that countries prepare for co-circulation of influenza and COVID-19.
“Clinicians in the frontline need to decide if they are dealing primarily with an influenza infection,” he said. “Surveillance studies are needed since both diseases can present in a similar manner. Only testing can distinguish between the COVID and influenza virus infections and identify the viruses’ co-infection.”
Moreover, additional testing is especially important for patients with influenza who have a high risk of acquiring bacterial super-infections, he said.
He emphasized the importance of access in terms of making the proper diagnostic tests available to the public. “We need to mobilize everything,” he said. “The whole gamut of the health system.”
Dr. Anna Ong-Lim, associate professor and attending pediatrician at the University of the Philippines – Philippine General Hospital and president of the Pediatric Infectious Disease Society of the Philippines, said people should think twice before taking antibiotics for flu-like symptoms, because recurrent exposure and sub-optimal treatment can contribute to drug resistance.
“This can lead to other health threats and be a contributor to the next pandemic,” she said.
She believes that in the event of another COVID outbreak, the public can count on the best efforts from healthcare professionals to carry the country through any crisis.
“Life doesn’t stop because these diseases are around,” she said. “We will shift from a pandemic emergency response to a mindset that thinks about COVID-19 as something that will stay, and learning to live with it to the best extent possible.
Dr. Ong-Lim said the country has to get more people vaccinated and prevent the virus from mutating any further.