UNDER THE MICROSCOPE

Dr. Raymundo Lo

Here we go again. We’ve hardly gotten over the Delta variant surge and now, the Omicron variant is a WHO Variant of Concern (VOC). But before we get roiled up over it, let’s get our facts straight and current.

Yes, Omicron has mutations in several parts of its spike protein as well as other areas of its genome. It raises the possibility of vaccine escape and increased infectiousness. Note that these are still speculative so, until we have definite proof of these happening, let’s not let it rule our lives yet.

As for concern Omicron might evade detection, at least one manufacturer of COVID-19 RT-PCR kits has issued a statement saying their kit can still detect the Omicron variant. I expect other manufacturers to issue their own statements soon since most kits target two or more genes of SARS-CoV-2 which makes it highly unlikely that Omicron can evade detection by these kits. So, yes, it won’t escape detection.

Identifying it as Omicron will pose a problem. We are still dealing with limited capacity in gene sequencing to screen our positive cases for this and other variants simply because we have few facilities to do so. Before the Delta surge, our gene sequencing labs were having to choose a limited number of cases to sequence, hence almost all were from OFWs and a very few were from local transmissions. Add to that the fact that some kits have small volumes of samples to work with which prevents the cases they identify from being sequenced for identification of variants.

Because gene sequencing is laborious and time- and resource-intensive, manufacturers have come up with RT-PCR kits that can preliminarily identify variants of concern. These tests can be done readily by existing RT-PCR labs without additional investments in equipment or personnel. I expect this will happen for the Omicron variant. However, the hurdle here is that up to the present, not a single RT-PCR kit for VOC has been approved for use. It boggles the mind that here we have severely limited gene sequencing capacity and we’re not looking at possible solutions that have been presented to us. We’re always a step or two behind in this war.

Are we arguing to just do RT-PCR for VOC alone? No. What we’re saying is allow the RT-PCR labs to test for VOC and those that are identified can then be prioritized for gene sequencing by the Philippine Genome Center. This becomes imperative when there are a large number of cases like what happened earlier this year. The Delta surge has come and gone, yet this proposal has not been acted on. Now, we’re facing Omicron. Will the same thing happen again? Our RT-PCR labs are ready, willing and able to do variant testing. But we have to be allowed to do so.

On the international front, several countries have banned flights from South Africa and neighboring countries in an effort to prevent entry of Omicron. As the Delta experience showed, this is just prejudicial to the country/ies being banned when 1. We don’t know where it really started and 2. We don’t know how widespread the variant is now. The USA quickly banned South Africa arrivals. But Dr. Anthony Fauci, CDC Director said he wouldn’t be surprised if it is already in the country even though it hasn’t been definitively identified. Omicron has also been identified in Israel, Belgium, United Kingdom, Germany, Italy, Hong Kong, Netherlands, the Czech Republic and Australia.

The South African Minister of Health decried the haste with which her country has been made an international pariah. As Omicron cases spread, will more countries be banned? The Philippines has been quick to adopt the same travel bans and reimposed 14-day quarantines for the banned countries’ arrivals before the announcement. But it seems the moves are already a day late with the variant already traveling across the globe as we speak.

With all these in mind, what is the most sensible thing to do? It will only be a matter of time before we identify Omicron in the country though the DOH will say it has not yet been identified or that local transmission has occurred. These pronouncements hardly matter if we can just keep in mind the essential steps we need to do to address the spread of COVID-19, variant or not.

In the end, herd immunity through vaccination will be the best weapon we will have against the virus. While we still have to achieve herd immunity, let’s keep wearing our face masks, physical distance and refrain from eating with persons outside our bubble. Government alone cannot contain the virus. Our people will have to do their part. Let’s bear that in mind as we approach the Christmas holidays with its partying and merrymaking. We can’t afford more lockdowns. If our economy collapses, it will bring nearly everything down with it. As it is, we’re barely hanging on with our social fabric and spirit on the verge of being torn apart.