AS people struggle to get precious slots in Philippine hospitals while Covid-19 infections surge, the resort to “do-it-yourself” treatments for the desperate may be gleaned from a spike in Google searches for, among others, the controversial veterinary drug Ivermectin, and for “oxygen tanks” which some families have been known to use at home after failing to get hospital treatment. This may be gleaned from data shared by iPrice Group’s research.
The research by the Southeast Asian e-commerce and information aggregator showed the gap between Filipinos’ Google searches on unapproved Covid-19 treatments and for vaccine registrations.
Wary of jabs, but risk takers
THERE’S a meager estimate of 1,430 Google searches on the keywords “vaccine registrations” in March 2021 at a time when authorities are trying to overcome people’s vaccine hesitancy. The interest in “googling” vaccine registrations is about 157 times lower than searches on an unapproved drug for Covid-19 (Ivermectin) and about 27 times lower than searches on oxygen tanks, according to iPrice’s research.
The number of Google searches for vaccine registrations from January to March (2,070) only accounts for 0.0047 percent of the country’s Google population, iPrice said.
Moreover, the research noted that data “seems to be backed up by Pulse Asia’s survey,” which revealed that 6 out of 10 Filipinos don’t want to get vaccinated against the Covid-19 due to doubts about the vaccines’ safety, efficacy and necessity.
This vaccine confidence issue, the research added, could be “problematic” for the country’s efforts to eradicate the virus, as studies show an estimated 50-80 percent of the population needs to be inoculated to achieve herd immunity.
However, the World Health Organization noted that the percentage to achieve herd immunity varies with each disease. For instance, measles requires 95 percent of the population to be vaccinated to achieve herd immunity.
“Bottom line, a large number of the population in the country needs to be inoculated to neutralize the spread of the coronavirus, and it seems that it may take a while for Filipinos to achieve this, given the figures above,” the research of iPrice Group stated.
Likewise, based on the numbers, it said, “there is a dire need to provide sufficient information on Covid-19 vaccines to the Filipino population.”
Unapproved drugs
SEARCHES on Ivermectin, an unapproved drug for Covid-19 (it was known for years as a veterinary drug to treat parasites), reached a “shocking” Google search volume of 224,110 in March 2021, a 687-percent increase compared to the previous month.
However, iPrice noted, people may have been starting to talk about Ivermectin even as early as February, “so if we compare the Google searches of March 2021 with November 2020, when there wasn’t much talk about it, the surge is much higher [2,705 percent].”
In April, the Google search interests in Ivermectin continue to grow as seen in Google Trends’ data.
This isn’t so surprising, since the public debate was thrown wide open with the recent letter-petition of various groups urging authorities to allow wide use of Ivermectin for Covid treatment, fueled by a congressman’s offer to distribute the drugs for free to Quezon City residents. Asked who will be liable for adverse effects, the lawmaker said, recipients will be signing waivers.
Based on recent developments, iPrice predicts the continuous upward trajectory of people’s interest in Ivermectin, which some scientists deem alarming.
Compassionate use
IN a Laging Handa press briefing on Thursday, the Food and Drug Administration (FDA) announced that it had already granted the request of one hospital for the “compassionate use” of Ivermectin.
“The application of a hospital for compassionate use of Ivermectin was granted because we are aware that this is an investigational product against Covid-19,” FDA Director General Rolando Enrique Domingo said, partly in Filipino.
Domingo clarified that despite the compassionate-use permit granted to the unnamed hospital, the distribution of Ivermectin as part of treatment for Covid-19 is still prohibited.
He said there are pending applications of two local manufacturers seeking a certificate of product registration for the drug, so it can legally be used internally as part of Covid treatment.
The FDA official stressed that only the hospital with the permit for its compassionate use for humans will be allowed to import the drug through a licensed importer.
Currently, Ivermectin is allowed for human topical use under prescription to treat external parasites. However, the use of oral or intravenous Ivermectin is only approved for animals, to prevent heartworm disease and external parasites.
The iPrice research noted that research by the United States FDA on Ivermectin is still hanging; thus, “they have not approved its use for Covid-19 patients.”
Experts have warned that taking unapproved drugs, including Ivermectin, can be “very dangerous” as such may interact with other medications or cause overdose, which can lead to “dangerous side effects and even death.”
On April 5, the Department of Health (DOH) reiterated that current Ivermectin products registered in the country are for “veterinary use” and are only allowed for the treatment of internal and external parasites as well as prevention of heartworm disease in animals; hence the issuance of FDA Advisory No. 2021-0526.
Moreover, the DOH cited studies from the Philippine Covid-19 Living CPG Reviewers of a systematic review of six randomized controlled trials. These showed that:
1. Ivermectin did not significantly reduce the risk of mortality among patients with mild to severe Covid-19 cases;
2. Ivermectin was not associated with a definite benefit of other clinically important outcomes such as clinical improvement at Day 6-10, clinical deterioration, and need for mechanical ventilation;
3. Ivermectin did not significantly reduce the duration of hospitalization and the time to resolution of symptoms; and
4. The rate of hospitalization discharge did not differ significantly between between the Ivermectin group and the placebo group;
Based on current evidence from randomized controlled trials, the DOH agrees with the Covid-19 Living CPG Reviewers and does not yet recommend the use of Ivermectin to treat Covid-19.
The DOH added: “Moreover, Dr. Rabindra Abeyasinghe, World Health Organization (WHO) Representative to the Philippines, has stated that there is no evidence that supports the use of Ivermectin to treat Covid-19, even as a preventive measure. The use of Ivermectin for Covid-19 has to be evaluated through clinical trials.”
However, in what some quarters called mixed signals, the DOH and FDA said they are open to allowing pharmacies for compounding Ivermectin.
Hoarding oxygen
WHILE the Ivermectin debate is being handled by the DOH and the FDA, authorities have only begun to be alerted to a possible hoarding of oxygen tanks, for which even some hospitals have been reportedly having trouble sourcing.
Google searches on oxygen tanks showed a similar trend as searches for Ivermectin, surging by 115 percent in March 2021 compared to February 2021, according to the iPrice research.
Searches on oxygen tanks have reached an all-time high of 39,160 throughout the year (from March 2020 to March 2021).
This trend, the iPrice Group research noted, happened in 2020 as well when searches also surged during the first wave in 2020, with an average of 24,277 searches from July to September, then tapering off as the daily cases declined.
“During this second wave, hospitals are experiencing a shortage of space and oxygen tanks. Thus, Filipinos are looking for oxygen tanks in case of worst-case scenarios.”
According to Google Trends, searches on oxygen tanks are also still in an upward trajectory in the first weeks of April, or a 376-percent surge in searches compared to March.
“This trend could be problematic,” the group lamented. “Since hospitals are already experiencing a shortage of oxygen tanks, the supply may be going to households that don’t need it instead of hospitals that are in dire need of it.”
It is not known, though, whether profiteers are in fact already driving the mad search for oxygen, or riding on the apparent desperation for do-it-yourself fixes. In one case, a family with two Covid cases but who took more than two days to get hospital slots decided to buy oxygen tanks and attach these, with health workers’ help, to their patients, as their oxygen levels dropped alarmingly low and they grew very weak. On the second day, the family member tasked to source oxygen could no longer find fresh sources and had to scour for hours to find replacement tanks for the patients.
On April 7, Health Undersecretary Maria Rosario Vergeire appealed to suppliers of oxygen tanks to regulate their sale to ensure sufficient supply for hospital use.
Vergeire made the appeal following reports that some individuals are buying oxygen tanks to store in their house amid the increasing number of Covid-19 cases and the dwindling hospital capacity to handle the severe and critical cases.
“I know what you feel right now, but this is not rational. First, it might cause you harm if you don’t really need it. Second, our supply in the hospitals might be depleted if all households will buy oxygen tanks,” the DOH official said, partly in Filipino.
Vergeire said that if a household is in need of oxygen tanks, they can ask help from their local officials and doctors.
“If they advise you that you need an oxygen tank, that’s the time that you get oxygen,” Vergeire reiterated.
As of April 7, the DOH said that of the active cases recorded (158,701), 762 or (0.5 percent) are critical. The DOH explained that a critical patient is one with impending or ongoing respiratory failure, in need of mechanical ventilation, or with evidence of end-organ damage or with septic shock.
There were also 477 (0.3 percent) moderate cases. A moderate case is a patient with clinical signs of non-severe pneumonia; 762 (0.5 percent) are severe, or those patients with clinical signs of severe pneumonia or severe acute respiratory infection.
On the utilization of intensive care unit (ICU) beds, 63 percent or 1,416 ICU out of 2,242 are occupied.
“The number of confirmed severe and critical cases may not necessarily correspond to occupancy of ICU beds and mechanical ventilators, as suspect and probable cases in severe or critical condition also utilize these resources,” the DOH explained.
Moving forward
Overall, according to the iPrice Group, these Google searches showed how Filipinos’ online interests may indicate the “country’s urgent state,” even a year after the pandemic hit.
“Many Filipinos are desperate for treatment and security as not all have the means to be treated in hospitals.”
The research indicated, added iPrice, that it’s safe to say that everyone just wants the virus to end, but this is harder to achieve when many Filipinos are reluctant to get the Covid-19 vaccine.
“There are information and studies available that ensure the safety of each vaccine. Looking at the number of daily cases recorded on Worldometer, countries that have begun their vaccination programs early on seem to show a decline in daily coronavirus cases in 2021. For instance, the UK reached 68,053 new cases on January 8, which dropped down to as low as 2,763 on April 7. The USA’s graph/curve seems to follow the same trend as well.”
These figures of the research alone showed that daily cases may dramatically decline once mass vaccination begins.
“For now, however, there is an urgent call to educate Filipinos about the Covid-19 vaccine,” the group urged.
Government’s vaccine rollout
AS of April 6, government reported 2,670 vaccination sites are giving Covid-19 jabs across all regions.
Of the total available 2.5 million doses, the DOH has distributed 1,936,600 (77 percent) doses throughout the country.
Of the distributed doses, a total of 922,898 doses have been administered to healthcare workers, senior citizens, and persons with comorbidities, a move to give added protection to almost a million at-risk and vulnerable Filipinos.
Of the total allocated doses, 872,21 (63.74 percent) have been administered for the first dose, while 50,685 (3.70 percent) have been administered for the second dose.
Image credits: AP/Aaron Favila
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