Pandemic fatigue

Large parties are back. From images I’ve seen of some of the recent gatherings, people are ditching their masks altogether, and not just to eat and pose close together for pictures.

Perhaps even beso-beso is back. I wouldn’t know, since I’m still turning down all invitations to parties whether big or small as well as one-on-one meetings, despite being fully vaccinated and boosted.

I will probably be among the last in the country to ditch masking and ease up on manic hand hygiene.

The reason is my personal nightmare with COVID. There are vulnerable members of my household including my mother.

But others who also went through COVID hell are probably suffering from pandemic fatigue. They prefer to believe they have sufficient hybrid immunity to live with the virus, mask-free and distancing-free.

What about the risk of infection, re-infection? We Filipinos are supposed to be fatalistic by nature: the attitude is, que sera, sera.

Supermarket and mall personnel continue to wear masks, and they have alcohol dispensers all over. But in public markets, most vendors have ditched their masks, unless a customer expresses concern or points it out.

Increasingly I’ve also been seeing groups of teens without masks and behaving as if the pandemic is over. Two years of their youth have been stolen from them so I can understand why they would want to enjoy being carefree again.

*      *      *

The complacency is not confined to minors. Dr. Nina Gloriani, who chairs the Vaccine Expert Panel of the Technical Working Group for COVID-19 vaccines, told us last week on One News’ “The Chiefs” that booster uptake is low even among health frontliners, despite warnings from experts that the efficacy of the primary doses is confirmed to wane after a few months.

The health frontliners were naturally the first to be hit by COVID. We lost so many doctors, nurses and other health workers of all ages (and they also lost their loved ones) throughout the pandemic.

I asked Doctor Gloriani if perhaps the booster-hesitant frontliners are those who have had one or two bouts with COVID and believe that combined with their primary vaccine doses, they have achieved sufficient hybrid immunity.

She said this is possible. She herself is looking forward to her second booster – heterologous or different from the vaccine brands she has received so far, which she says is slightly more effective than getting the same brand or a homologous booster.

Pfizer and Moderna say their vaccines, used as second boosters, have been found to be effective against the highly contagious Omicron sub-variant and its even more infectious mutations.

But other reports say boosters also have waning efficacy against the emerging mutations, whose unique characteristics are so different from the original Wuhan virus for which the current vaccines are formulated. The theory is that the new virus mutants might require entirely new types of vaccines.

Unless the current vaccines undergo radical reformulation, we might need periodic boosting for protection against the continually mutating virus. Infectious disease experts pushing for boosters or a fourth dose point out that certain afflictions like rabies require up to five shots.

Such reports could also be contributing to booster hesitancy.

A major contributor to complacency and the belief that the pandemic is over has to be the sight of massive crowds at campaign rallies. Every image reinforces the belief.

After the Omicron surge in January, the government also seemed to be in a hurry to present an image of a return to normalcy. Some suspect that it might be an election-related move, or part of efforts to show that the Duterte administration has beaten COVID by the end of its term at noon of June 30.

Long before the Omicron surge, the government had already given up on contact tracing. This year it stopped providing daily updates on COVID cases. It never took up proposals to provide free RT-PCR tests at least to the poor, although some local government units offered this on their own.

Enforcement of COVID health protocols had almost disappeared even before the de-escalation to Alert Level 1 in many areas. This was despite warnings from the World Health Organization that such moves were contributing to fresh COVID spikes in highly vaccinated countries.

*      *      *

On April 23, Our World in Data tracking showed 206 new COVID cases in the Philippines, bringing the total to 3.68 million, with a one-week daily average of 208. There were 61 deaths, for a total toll of 60,179.

No one can tell at this point how accurate the data might be. People are no longer getting tested for mild symptoms. Many are resorting to self-administered home antigen tests (including kits not registered with the Food and Drug Administration), whose positive results are not reported unless the infection requires hospitalization and a confirmatory RT-PCR test.

In our country, many people are now familiar with the protocols for home isolation and protecting other members of the household from infection. People treat mild symptoms with ordinary medication such as paracetamol. If it works, they see no need to get an RT-PCR test, the cheapest of which is the saliva test of the Philippine Red Cross at P1,500.

This is despite warnings from infectious disease experts that even a mild case of Omicron can weaken the immune system and trigger complications for those with a pre-existing health condition, leading to a fatal heart attack or stroke.

We don’t know how many such deaths are recorded as COVID-related. But I know from sad personal experience that there are such COVID-induced deaths, so I’m heeding the experts’ warnings about continued adherence to the safety protocols: masking, distancing, hand hygiene.

The question is how long people need to continue observing the protocols. Nina Gloriani says she will likely keep wearing masks for life in crowded places and when traveling using mass transport. This has become common in places such as Japan, South Korea and Taiwan.

Then there are the boosters. I know 50-year-olds who are hoping for inclusion soon in the second booster program, because their workplaces are considered high-risk areas for virus transmission.

On the other hand, we are seeing that many of those on the priority list for first and second boosters seem to believe COVID has become like the seasonal flu for which periodic vaccination is optional, and they now feel free to resume their pre-pandemic life.

Unfortunately, the coronavirus is such an unpredictable pathogen that only time will tell who’s right. In the meantime, pandemic fatigue could be raising the risk of COVID resurgence.