Delta variant in Cebu

DOCTOR EDSEL Maurice Salvana, a molecular epidemiologist from the University of the Philippines, said the Delta variant of the Covid-19 is now in Cebu and is causing the large spike in cases in the province.

Dr. Edsel Maurice Salvana (Image: Facebook)

Salvana wrote on his Facebook page that some of the Delta outbreaks in Mindanao have been linked through whole genome analysis to returning Filipinos who entered through the Cebu airport. While it might have been impossible to completely stop Delta from coming in, it could have been further slowed down, he said. 

“We warned that if Delta got into Cebu due to lax border control, a bad surge was forthcoming. Delta is now in Cebu causing a large spike in cases, overwhelming their healthcare system,” he said. 

He also explained last June 21, the Technical Advisory Group (TAG) of the Department of Health was asked to brief President Duterte on the need for stringent facility-based border control of our international ports of entry. Given that previous variants of concern had entered the Philippines from international sources, the TAG wanted to make sure that returning Filipinos were properly quarantined and tested prior to being allowed into the community. 

Salvana said the presentation was in response to the initiative of Cebu province to modify the 10-day facility-based quarantine plus four-day home quarantine, with a test on the seventh day. “We explained to the President that if a person contracts COVID-19 during his or her flight, a 10-day mandatory facility-based quarantine would neutralize almost all risk of bringing in a new variant of concern to the Philippines. We recommended testing on the seventh day with an RT-PCR and an additional four days of LGU-monitored home quarantine for good measure,” he said. 

“Cebu wanted to test people on arrival and monitor them at home, which was inconsistent with our recommendations. The TAG felt that this would miss almost all cases of infection acquired en route to our country, since it typically takes three or more days for RT-PCR tests to turn positive from the time of exposure. In addition, they could potentially expose their families to a variant of concern,” he added. 

He said it was the first time they presented the threat of the Delta variant to the President and his cabinet. He said during his presentation, he outlined the threat of Delta as the newest variant of concern. Delta, or B.1.617.2, was first described in India. It is the most transmissible COVID-19 variant yet. 

Salvana said the horrific surge of cases in India was still fresh in the minds of many people. “Hospitals were completely overwhelmed, people were gasping for breath amid widespread oxygen shortages, and parking lots became makeshift crematoriums. As Delta started to spread across the world, scientists found that vaccines were less effective in preventing transmission, and that people sickened with Delta were more likely to have severe disease and die,” he said. 

He also cited Israel, which had one of the highest rates of vaccination worldwide, which was starting to see a spike in Delta cases despite their impressive inoculation rate. In the UK, he said, a significant number of partially vaccinated people were getting sick, although the vaccines continue to protect against severe disease. 

And in Australia, a limousine driver acquired Delta after chauffeuring some airline crew, according to Salvana. “When he went to a mall, he transmitted Delta to two other people. What was extremely worrisome is that these infected people only had fleeting contact with him, no more than a few minutes. This was in contrast to the usual 15 minutes of exposure needed to be considered a high-risk close contact. The TAG’s message to the President was clear. We needed stringent border control to slow down the introduction of Delta. Otherwise, our healthcare system could get overwhelmed by an exponential rise in cases,” he said. 

Salvana said after the briefing, Duterte was concerned enough to reiterate the face shield mandate even for outdoor use. This was in response to the report that Delta was also up to 40 percent more transmissible outdoors. “He ordered the DILG to ensure that Cebu followed the stringent border control measures as recommended by the Interagency Task Force for Emerging Infectious Diseases (IATF-EID), and that genomic surveillance continued to look for incoming and local cases of Delta. Despite the President’s directives, Cebu remained in favor of their less stringent protocols. Some IATF-EID and TAG members, including myself, went to Cebu at the end of June and presented the threat of Delta to the Cebu Provincial Board,” he said. 

The national government’s Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-MEID) led by Health Secretary Francisco Duque also stood firm on the travel protocols imposed in the country. Duque’s group met provincial government officials headed by Governor Gwendolyn Garcia and lawmakers in June after Cebu eased its health protocols on returning Filipino worker.

Duterte said that Cebu must follow the IATF-MEID guidelines and protocols. “So I leave the fate of Governor Garcia sa DILG. There are some mechanics that can be put in action to, well, compel obedience, not because we want to be mas marunong but remember I said, all our decisions are based on what the medical people say, period,” Duterte said. “I see the wisdom in her view but I said the overwhelming notion among us in government and the medical doctors simply do not agree with her.” (Cebu Examiner)