Last week, it was reported that 45 members of the Presidential Security Group (PSG) are on quarantine for testing positive for COVID-19. All of them were asymptomatic, and they have supposedly been vaccinated less than six months ago. We’re not sure if this is the total number of infected members of the PSG or just the batch confirmed last week.

In a series of commentaries (“Doctor suggests six urgent steps that may help turn health crisis around,” 3/22/21; “More pragmatic solutions, not mass vaccination, while there’s surge,” 3/23/21; “My rejoinder on vaccination and ivermectin,” 3/30/21), we expressed two concerns, namely, that: (1) mass vaccination in hotbed areas with uncontrolled community transmission may be paradoxically triggering the propagation of the virus; and, (2) the efficacy of our vaccines may be short-lived due to rapid mutation of the virus and the development of vaccine-resistant variants, so we should not pin all hopes on it alone.

Because of the first concern, we suggested that in hotbed areas with uncontrolled transmission, mass vaccination should be suspended in the 20-40 age group who may become asymptomatic carriers and breeding ground for vaccine-resistant variants. They’re better off with just boosting their natural immunity and enabling their own “killer cells” to deal with the virus.

Once community transmission is controlled, then there’s no problem with vaccinating them. We have clear-cut parameters for determining if transmission is already controlled.

The experts promptly dismissed our “hypothesis” and suggestion as irresponsible, baseless and dangerous. But we replied that this is not a hypothesis; it’s supposed to be textbook knowledge that you don’t mass-vaccinate when there’s an infection outbreak. The report of the 45 COVID-positive PSG members partly validates this.

Asymptomatic carriers

Remember that the members of the PSG are swabbed regularly, so the 45 COVID-positive soldiers were properly diagnosed as asymptomatic cases, and promptly isolated.

You can just extrapolate that there are tens of thousands of these young, healthy adults who may have been vaccinated—and are asymptomatic carriers of the virus—unwittingly spreading the virus to their families, officemates, and every one they come in close contact with. Could they be contributing to the current surge?

This is one area in which we need full transparency of our scientists and vaccine manufacturers. There’s no question that vaccines can definitely prevent highly symptomatic and severe disease, but there’s no clear data showing they can prevent asymptomatic transmission. The reason is obvious: If you’re asymptomatic or symptom-free, you don’t get yourself swabbed or tested for COVID. So, no one knows. Meanwhile, the asymptomatic infected person spreads the virus around.

So, could it be that the vaccine may just be masking the symptom and definitely making it less severe, but it does not really significantly reduce transmission?

Slow pace

We’re just tossing the idea, so our expert task forces can really rationalize our vaccination program. We fully support targeted vaccination as an important part of our anti-COVID program, but we should not solely depend on it. From scientific and public health points of view, we should hedge our bets.

Our young health-care workers definitely need to be protected—for which we offered a plan—but vaccinating them during an outbreak may just be harming a good number of them and their loved ones.

We also don’t know the long-term effects of being asymptomatic carriers of the virus. There are now data showing it’s not as benign as we previously thought it was. What’s worse, they may be insidiously breeding “upgraded” variants of the virus that would be vaccine-resistant.So, we should really vaccinate the elderly and high-risk, most of whom are just staying at home and are not likely to spread the virus in the community. They also need maximum protection since they’re the ones who are likely to develop severe COVID-19.

The issue of vaccinated individuals turning into asymptomatic infected carriers won’t be so much of a problem if we’re able to vaccinate the majority of the population in three to four months, as the Israel experience has shown. Majority get protected quickly even if they get infected.

But if vaccination is at a slow pace, such as in France and many other countries including ours, there might even be a paradoxical increase in cases, as we observed was actually happening already. I don’t even want to call it a phenomenon because it seems to be a logical consequence of what uneven and suboptimal protection with a slow vaccination rollout may cause.

Regarding our second concern, we’re really running a crucial race with this cunning and deceitful virus. Madaya! At the rate it’s mutating, we’re afraid we have little time left before it mutates into such a formidable variant that will be resistant to all vaccines and treatments. It’s because we’re such generous hosts to this virus.

Holistic approach

We’re not fearmongering. We’re saying we can lick this virus for sure; that’s why we’re confident about envisioning ourselves resuming our pre-COVID activities in six months and enjoying once again a meaningful Christmas this year (“An advance Christmas wish,” 4/8/21). But we need to play smart from hereon. We just need to cut the lifeline of this virus and stop ourselves from unwittingly being used by it to breed and spread.Sorry for being makulit (persistent). We’ve been proposing a holistic, multipronged approach, rather than a mainly vaccine-centric strategy.

Here are the four pillars we proposed to our Department of Health.

1. Targeted vaccination (not mass vaccination), since even the experts are saying there’s a significant possibility that the vaccines may be rendered suboptimally effective after several months with the rapid development of vaccine-resistant virus mutations—so we can’t depend on vaccines alone.

2. Massive oral prophylaxis vs transmission which enhances natural immunity that can combat the virus regardless of its mutation (prophylaxis kits containing ivermectin + melatonin + other vitamins).

3. Enhancement of community interventions to prevent transmission (test, isolate, trace), and treat early disease more effectively with home-treatment pill kits (same components as prophylaxis kits but different doses) so as to prevent requiring hospitalization and healthcare exhaustion.

4. Mass cognitive behavioral therapy to minimize compliance fatigue, enhance health-promoting behavior and a victor’s, not victim’s, mindset in overcoming this crisis.

Total cost of pillars 2 to 4 is less than 10 percent of what is to be spent for a vaccine-centric strategy.

It can actually pay for itself. We lose around P50 billion a month with the economic slowdown. With this four-pronged plan, we just need to spend (for nos. 2-4) P5 billion a month for six months, and P2.5 billion a month indefinitely till the last vestige of COVID-19 remains.

But no pain, no glory! It will entail so much sacrifice on the part of the citizenry in the first three months as we all help in the implementation of this plan. Unless each of us puts in his or her own piece of the puzzle, the picture will never be complete.

As we stated in our vision, in six month’s time, COVID-19 can be reduced to the level almost close to that of the seasonal flu, and we can enjoy once more many (not all) of the things we used to enjoy during the pre-COVID days.

More than ever, we need people who can find a solution to the multifaceted COVID-19 problem we have, rather than those who can see a problem in every solution offered.