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The Philippines was one of the countries that briefed public health specialists on how they responded to the swine flu pandemic that broke out in 2009, in an international symposium recently organized by The Sasakawa Peace Foundation and the Tohoku University Graduate School of Medicine. In the symposium in Tokyo, Dr. Remigio Olveda, director of our health department’s Research Institute for Tropical Medicine, said that in the early weeks of the outbreak, their laboratories were overwhelmed by the number of specimen or samples sent by people who thought they had symptoms of the flu. When the pandemic was controlled, however, the populace seemed to have become complacent. He told Newsbreak’s Miriam Grace A. Go that we should take this “quiet” period to fast track preparations for any future outbreaks, or we would be beset by the same old problems.
The Philippines has the third lowest mortality rate (per 100,000 population) from influenza pandemics. Is this an accurate picture, given our limited reporting and surveillance capacity?
The number of deaths related to H1N1 (swine flu) in the Philippines may be close to accurate because there were only few serious cases, and they submitted specimen for laboratory confirmation.
So you didn’t encounter difficulty convincing people to come forward, unlike some countries?
During the outbreak, people were concerned if they had influenza-like illness, if these were related to H1N1. So there was no unwillingness. We were, in fact, overwhelmed by the number of samples submitted to us—to the point that the number of our trained personnel was not enough, and there was not enough laboratory space for the expansion of lab activities.
And then you were, in a way, also overwhelmed by the challenge of dealing with the media, like your colleagues from other countries said they were.
Majority of the media were looking for sensational stories. The problem is, when one reporter does bad reporting, we can’t find another group in the media who would say [otherwise]. Like the case [cited by] Thailand, they (the media) think we’re hiding something when we don’t reveal too many details about the victims and their cases. But our foremost concern is the protection of victims. And if there are events that will aggravate the situation, we can’t reveal them until the issue is resolved, because it may cause panic.
Speaking of panic, how possible is a second wave of the H1N1 pandemic in the Philippines?
It’s possible, but not as serious [as the first outbreak]. So far, the only second wave that happened was in Thailand.
Dr. [Hiroshi] Oshitani said another pandemic is very possible and it could be more virulent. Do we have a pandemic preparedness or response plan?
We have. Even before the pandemic, the DOH (Department of Health) already had one. The agriculture department is also involved because of the animals [that could contract the virus]. Remember that we were expecting H5N1 (bird flu) virus to break out, so we were preparing for that, but H1N1 (swine flu) happened.
Before the pandemic the plan was not ready for signing. The President has to sign it for it to be official. We have to settle the gaps [in the plan]. But since we’re in the post-pandemic period, it’s so quiet. If we have to [finalize the plan], it has to be fast, because if there is a second wave, the same problems might be encountered.
You have a surveillance program in Region 8. Is it only in Region 8?
It’s the most recent [undertaking]. We have 16 sentinel surveillance sites. Initially we chose areas that were close to international travel, poultry, and migratory birds. We were really expecting the avian influenza, not expecting that another influenza (swine) would break out. We expected the virus to come first to poultry, then human, then outbreak. That’s not what happened.
Is one of Mongolia’s control measures possible in RP—setting up government social protection funds to buy vitamins and food for poor households, so they can be protected?
So far, the impact of vitamins, Vitamin C, and herbal products in preventing influenza infection is questionable. For now, it’s really only vaccine and antiviral that will do. Even if they (vitamins) are proven [to be effective], I don’t think we have enough resources for that. The best [prevention] is really protecting yourself, preventing physical contact [with those infected], and have proper nutrition.
How about the vaccines—do we have enough?
To cover everybody, we do not have enough vaccines. The first donation from WHO (World Health Organization) was allocated for health workers and pregnant women.
But there’s reportedly low uptake of vaccines. Thailand used only 25% of their supply. They said we only used 21%. What happened?
During the morbidity week (the period when people manifested symptoms), everybody was looking for vaccine, but now it’s quiet, so people have time to raise all sorts of questions: Are the vaccines safe, was the preparation safe? Those who should be taking the vaccines are not as many as we expected.
How many should be taking the vaccine?
If you compute only the high risk group, 10 million dosage would be needed at the first vaccination delivery. After that, all should get it.
What’s our capability to produce our own vaccines?
We cannot produce. We have research to produce, done by the UP Marine Science Institute, RITM, with support from the DOST (Department of Science and Technology), and in collaboration with the University of Utah.
We’re still far [from producing them]. Using the traditional [vaccine], we don’t have resources in terms of facilities. Using the recombinant vaccine, it will take 3 to 5 years just to develop the candidate, ready for up-scaling to a certain amount. Then to commercial [quantity]. So 2 more stages, 5 to 10 years.
The DOST is providing funds for the initial production. The private sector right now has no capacity [to produce] commercially. It’s the government that can do it, with support from funding agencies
The Philippines has the third lowest mortality rate (per 100,000 population) from influenza pandemics. Is this an accurate picture, given our limited reporting and surveillance capacity?
The number of deaths related to H1N1 (swine flu) in the Philippines may be close to accurate because there were only few serious cases, and they submitted specimen for laboratory confirmation.
So you didn’t encounter difficulty convincing people to come forward, unlike some countries?
During the outbreak, people were concerned if they had influenza-like illness, if these were related to H1N1. So there was no unwillingness. We were, in fact, overwhelmed by the number of samples submitted to us—to the point that the number of our trained personnel was not enough, and there was not enough laboratory space for the expansion of lab activities.
And then you were, in a way, also overwhelmed by the challenge of dealing with the media, like your colleagues from other countries said they were.
Majority of the media were looking for sensational stories. The problem is, when one reporter does bad reporting, we can’t find another group in the media who would say [otherwise]. Like the case [cited by] Thailand, they (the media) think we’re hiding something when we don’t reveal too many details about the victims and their cases. But our foremost concern is the protection of victims. And if there are events that will aggravate the situation, we can’t reveal them until the issue is resolved, because it may cause panic.
Speaking of panic, how possible is a second wave of the H1N1 pandemic in the Philippines?
It’s possible, but not as serious [as the first outbreak]. So far, the only second wave that happened was in Thailand.
Dr. [Hiroshi] Oshitani said another pandemic is very possible and it could be more virulent. Do we have a pandemic preparedness or response plan?
We have. Even before the pandemic, the DOH (Department of Health) already had one. The agriculture department is also involved because of the animals [that could contract the virus]. Remember that we were expecting H5N1 (bird flu) virus to break out, so we were preparing for that, but H1N1 (swine flu) happened.
Before the pandemic the plan was not ready for signing. The President has to sign it for it to be official. We have to settle the gaps [in the plan]. But since we’re in the post-pandemic period, it’s so quiet. If we have to [finalize the plan], it has to be fast, because if there is a second wave, the same problems might be encountered.
You have a surveillance program in Region 8. Is it only in Region 8?
It’s the most recent [undertaking]. We have 16 sentinel surveillance sites. Initially we chose areas that were close to international travel, poultry, and migratory birds. We were really expecting the avian influenza, not expecting that another influenza (swine) would break out. We expected the virus to come first to poultry, then human, then outbreak. That’s not what happened.
Is one of Mongolia’s control measures possible in RP—setting up government social protection funds to buy vitamins and food for poor households, so they can be protected?
So far, the impact of vitamins, Vitamin C, and herbal products in preventing influenza infection is questionable. For now, it’s really only vaccine and antiviral that will do. Even if they (vitamins) are proven [to be effective], I don’t think we have enough resources for that. The best [prevention] is really protecting yourself, preventing physical contact [with those infected], and have proper nutrition.
How about the vaccines—do we have enough?
To cover everybody, we do not have enough vaccines. The first donation from WHO (World Health Organization) was allocated for health workers and pregnant women.
But there’s reportedly low uptake of vaccines. Thailand used only 25% of their supply. They said we only used 21%. What happened?
During the morbidity week (the period when people manifested symptoms), everybody was looking for vaccine, but now it’s quiet, so people have time to raise all sorts of questions: Are the vaccines safe, was the preparation safe? Those who should be taking the vaccines are not as many as we expected.
How many should be taking the vaccine?
If you compute only the high risk group, 10 million dosage would be needed at the first vaccination delivery. After that, all should get it.
What’s our capability to produce our own vaccines?
We cannot produce. We have research to produce, done by the UP Marine Science Institute, RITM, with support from the DOST (Department of Science and Technology), and in collaboration with the University of Utah.
We’re still far [from producing them]. Using the traditional [vaccine], we don’t have resources in terms of facilities. Using the recombinant vaccine, it will take 3 to 5 years just to develop the candidate, ready for up-scaling to a certain amount. Then to commercial [quantity]. So 2 more stages, 5 to 10 years.
The DOST is providing funds for the initial production. The private sector right now has no capacity [to produce] commercially. It’s the government that can do it, with support from funding agencies