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Recommendations to stop the new subvariant XBB 1.16, dubbed as Arcturus, from spreading in PH

April 29, 2023 People's Tonight 3884 views

Dr. Tony LeachonAnd continue full economic recovery

Where are we right now ?

LATEST COVID updates: Apr. 28 2023 DOH reported 858 new cases, 0 deaths (0 in NCR), 525 recoveries, 5293 active cases.

14.3% nationwide positivity rate, 331 cases in NCR, 55 in Laguna, 49 in Cavite.

NCR weekly positivity rate up to 14.3% as of April 27, 2023. This is up from 9% on April 20.

The good news is that deaths and hospitalizations in the NCR have remained low at 22% while NCR has reported close to zero deaths. (OCTA). Positivity rate (14.3 %) will continue to rise if we will not adhere to the minimum public health standards especially wearing of face masks. 😷.

2. Face masks. We respect DOH ‘s policies. In my humble opinion , the DOH should not turn a blind eye to the fact that wearing mandatory face masks is the only option we have given the low booster rate that we have as open the economy. People need definitive solutions. We can’t control mobility. But we can wear face masks conveniently to protect the people.

3. VIGILANCE needed. The public should be vigilant. Complacency hurts or even kills especially in vulnerable patients. Perhaps the mild symptoms and low hospitalization rate may be not be compelling reasons, but a sick workforce might affect productivity in the long run. The quality of life of people will be affected. Long COVID patients will be another problem moving forward.

A. PBBM meeting with USA Pres Joe Biden. – The Bivalent vaccines should be part of the long term strategy. President Bongbong Marcos , Jr should be able to discuss this matter with Pres. Joe Biden in the President‘s US visit. Through diplomatic channels , we can ask for stocks of bivalent vaccines to be allocated for commercialization for targeted populations in the Philippines.

B. Strategic role of the FDA. The FDA needs to fast-track the approval process for the regulatory documents in the Philippines submitted for the bivalent vaccines. There’s waning off the wall of immunity now and this is crucial to keep the economic workforce protected to support the efforts of the President and his finance and economic teams. To further explain the importance of the local FDA role . We need the FDA to approve the certificate of product registration so those willing to be vaccinated with this new vaccine will have access to it like in the USA.

The vaccines can be distributed to many large drug chain pharmacies all over the country. And with the new subvariant, XBB 1.16 dubbed as the Arcturus by the social media , the bivalent vaccines will be able to address the old Wuhan strain and the new sub variants eg Arcturus.

New subvariant XBB 1.16

First detected in India, Omicron subvariant XBB.1.16 – also known as “Arcturus” – has already been reported in over 30 countries. This is what we know about it so far. The World Health Organization (WHO) is carefully monitoring a new Omicron subvariant that is driving a surge of new COVID-19 cases in India.

The XBB.1.16 is a sublineage of Omicron, a WHO classified variant under interest due to its mutations that has a growth advantage (highly transmissible) and evades immune response to those vaccinated.

Thus it is responsible and has contributed for increase in the cases in 31 countries ,

XBB.1.16 – also known as “Arcturus,” the name of the brightest star in the northern celestial hemisphere – was detected in 31 countries as of March 27, including India , USA , Australia , Canada , Philippines , etc

The WHO upgraded it to “variant of interest” status in mid-April, with the number of countries now affected believed to be 34.

Scientists at the University of Tokyo suggest it could be about 1.17 to 1.27 times more infectious than Kraken, the last major Omicron sub-variant, making it likely to become the next dominant strain. “This is one to watch,” said Dr Maria Van Kerkhove, technical lead for COVID-19 response at the WHO, during a recent press conference.

Since the beginning of the coronavirus pandemic, the global health body has designated three labels to assess the potential risk of new COVID-19 strains: “variants of concern,” “variants of interest,” and “variants under monitoring”. Arcturus, on the other hand is now a “ variant of interest “ because of the “spread of the virus beyond borders,” according to Muhammad Munir, Professor of Virology & Viral Zoonoses at Lancaster University in the UK.

Is Arcturus more dangerous?

Arcturus, which was first identified in January, does not appear to be more severe than any previous COVID-19 strains.

The WHO considers the “severity” and “clinical considerations for the variant” as “low”.

According to the WHO, Arcturus has, however, one additional mutation in the spike protein, which shows “high-strength of evidence for increased risk of transmission and moderate-strength of evidence for immune escape. “

In other words, Arcturus appears to be more contagious than previous variants and “moderately” resistant to our immune power.

In February, WHO assessed that based on its genetic characteristics and available growth rate estimates, Arcturus was likely to increase COVID-19 cases globally.

India is the country experiencing more Arcturus cases, which has in turn led to a surge of infections, putting the country’s hospitals under alert.

However at present, there is no signal of this variant to cause an increase in severity though we still need to be vigilant and closely monitor ongoing cases. Just like any other Omicron sublineages , XBB.1.16 highly binds to the ACE2 receptors of the upper respiratory tract than to the lower lungs , thus it’s clinical manifestations are sore throat , runny nose , sore eyes ( in some cases) , low grade fever . And majority , symptoms duration last only from 3-5 days .

Besides these newly reported symptoms, Arcturus infections resemble earlier COVID-19 strains for which symptoms include coughing, having a scratchy throat, and a runny nose. Fatigue, body aches, headache, and congestion are also common signs. We are in a much better situation than we were since the beginning of this pandemic, but the threat isn’t over. We have to remain vigilant.

Among vulnerable populations, it can trigger more severe symptoms due to their age, and presence of comorbidities . Updated COVID bivalent vaccines will play an important role in preventing severe symptoms in the vulnerable population , and shorter duration of symptoms for the general population. The long-term scenario of COVID-19 is the continued emergence of immune evading variants such as XBB.1.16 which can drive frequent reinfections or breakthrough infections but no signals so far to cause more severe infections . Thus , It is expected that hospitalization and mortality will remain low except for the vulnerable populations like the elderly, the immunocompromised and those with comorbidities .

We should continue to encourage everyone to be vigilant, wear face masks in high risk areas, and get updated bivalent vaccines.

Health is wealth. An ounce of prevention is better than a pound of cure. By Dr. Tony Leachon

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Anthony C. Leachon, M. D.

Independent Health Reform Advocate

Past President ,
Philippine College of Physicians

Internist – Cardiologist
Manila Doctors Hospital

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