The Philippines is grappling with a Covid-19 surge that has accelerated at a pace not seen since the start of the pandemic. But fewer people are severely ill than in previous waves, an encouraging sign for countries bracing for a similar rise in cases.
The government said last week there was a “very high” likelihood that the Omicron variant had fueled the latest outbreak, which began after the Christmas and New Year holiday period, though sequencing results have also shown that the Delta variant is still spreading in the country.
What is clear is that infections appear different. Hospitals are not yet overwhelmed. Patients are showing up at health care facilities with other illnesses and then learning they have the coronavirus. People are recovering faster.
The outbreak in the Philippines adds to a growing body of evidence worldwide that the Omicron variant may not be as deadly as feared, especially among the vaccinated. Still, experts are urging caution.
Already, the surge has caused a run on medicines, and the rapid transmissibility of the virus could create new opportunities for more dangerous mutations to spread. Hospitals could be crushed in a country with one of the lowest vaccination rates in Asia, a region that is still bracing for its first wave of Omicron infections.
“This is really different, a different surge compared to Delta,” said Dr. Rontgene Solante, chief of the Adult Infectious Diseases and Tropical Medicine Unit at the government-run San Lazaro Hospital in Manila. “Here you have a high number of cases, but the hospitalization rate is still manageable.”
The trend, if sustained, offers a glimmer of hope for the Philippines, one of the Asian countries hardest hit by the pandemic. It shut schools for 20 months and imposed one of the world’s longest lockdowns, exacerbating widespread poverty. More than 52,900 people in the country have died from Covid-19.
Last Wednesday, Dr. Maria Rosario Vergeire, the under secretary of health, said at a news briefing that the government would tweak its policies on controlling Covid, given evidence that Omicron is a more transmissible yet milder strain of the virus.
Starting last Thursday, contact tracing efforts were rolled back. Testing will focus on diagnosing people at risk, such as seniors and those with comorbidities. People with symptoms will be encouraged to isolate immediately. The government said it has shortened the isolation period for vaccinated people infected with Covid to seven days, down from 10 days.
The rules are being relaxed even as the virus is still circulating at a ferocious speed. The latest data on Monday showed that the test positivity rate has exceeded 46 percent. This means nearly one in two of those tested are turning up positive for Covid-19. Cases are doubling every three to four days, according to government data.
The number of active Covid-19 cases in the Philippines hit 290,938 on Monday, a record, and sharply up from 10,095 a month ago. Health experts say the true number is far higher because the government does not count antigen rapid tests in its tally. What gives them hope is that many patients seem to be recovering quickly.
Two days after returning from a vacation with her family to the city of Olongapo, Cai de Leon came down with a cough and a fever. Her blood pressure started climbing. On Jan. 3, she checked herself into the hospital after her oxygen level dropped to 94. She had Covid.
Ms. de Leon, who lives in Manila, had been vaccinated with China’s Sinovac and a Moderna booster shot. At the hospital she received Molnupiravir, an antiviral treatment, and was discharged after four days in the hospital.
“I’m still in isolation and I still have a terrible cough, but I’m already out of the woods,” said Ms. de Leon, 37. “If I didn’t have those vaccines, I’d fear for my life.”
Though Ms. de Leon, like many patients, was treated quickly, hospitals are on edge. Thousands of health care workers are falling ill. Nurses and doctors who test positive must quarantine for at least five days, overburdening an already stretched health care system. The government said this week that 8 percent of the country’s health care workers have had to be quarantined or hospitalized because of the virus.
The number of hospitalized children is up between 30 percent and 40 percent compared with September 2021, when the Delta variant ravaged the country. In Manila, parents are struggling to get fever and cough medicines before pharmacies run out. Last Monday, the government announced plans to begin vaccinating children younger than 11.
The Philippines has one of the lowest vaccination rates in Asia, having fully inoculated only about 50 percent of its population. Health experts warn that when many people are infected, there are more opportunities for the virus to mutate, potentially becoming more dangerous. Hospitalizations could accelerate, especially in provinces with lower vaccination rates.
Dr. Jose Rene De Grano, president of the Private Hospitals Association, said there were initial reports of a rising number of cases in hospitals outside Metro Manila, including North Luzon, South Luzon, Visayas and Mindanao. “Although the symptoms are milder, it should not make us complacent,” Dr. De Grano said.
“Even though we think that this infection is milder, especially in vaccinated people, we still have to do our darn best to slow it down, so that it doesn’t mutate so fast,” said Dr. Edsel Salvana, an adviser to the Philippine government on Covid-19. “Then it’s going to be a different story again.”
Despite the outbreak, the number of people with severe illness has not increased in the Philippines. In the Metro Manila region, where more than 96 percent of the eligible population is fully vaccinated, the government said the number of severe Covid cases has fallen to around 20 percent of total cases. The number of mild and asymptomatic cases is now around 60 percent.
Doctors in Manila report that one of the starkest differences between the new infections and those in previous Covid waves is the clear lungs that they detect in X-rays and CT scans. During the previous Delta surge, patients showed up with what doctors called “burned out lungs.” Many required ventilators to breathe.
The spokesman for the Philippine General Hospital, Jonas del Rosario, said only a few Covid-19 patients being brought to the hospital’s emergency room these days have respiratory problems. “Now, we can hardly see patients who need to be intubated or put on oxygen,” he said at a press briefing earlier this month.
Dr. Salvana, who is also an infectious disease specialist, said he saw one recent patient in his late 80s who was infected with Covid. He had weak lungs and a history of pneumonia, but when his doctors conducted a CT scan, they found that his lungs were clear.
“We were going: ‘What?’ The radiologist was saying: ‘This can’t be right,’” Dr. Salvana said.
On Jan. 3, Rogeselle Monton, who has H.I.V., came down with a case of Covid-19. He developed a sore throat, cough and a cold, and was hospitalized on Jan. 7 after discovering blood in his stool. He was later diagnosed with pneumonia.
Mr. Monton, 30, had received two shots of AstraZeneca, and a booster dose of the Pfizer vaccine in December. “Maybe if I were not boosted, my condition might have been worse,” he said.
After determining that Mr. Monton’s oxygen level was stable, doctors last week gave him the green light to go home.
