Hotspot alert: Calabarzon COVID-19 cases are on the rise 2
While fewer tests were conducted yesterday compared to the rest of the week, NCR gained even more cases as did Calabarzon. Photo by Mores Heramis, ABS-CBN News
Culture

Hotspot alert: Calabarzon COVID-19 cases are on the rise

While NCR has a sudden upsurge of cases, Region IV also accounted for quite a few overnight. BY BENJAMIN CO MD
ANCX | Apr 26 2020

Infectious diseases and clinical pharmacology expert Dr. Benjamin Co has been thankfully breaking down coronavirus numbers in his personal blog since the outbreak started. The perspective he provides is informative, and comforting in those who are craving for a clear picture of how we are faring against the virus. Dr. Co will share daily updates and analysis of the Department of Health reported numbers with ANCX. 

Additional notes from Dr. Co: “Cebu remains 5th,but the NCR has raked in a lot of cases. I think it’s due to the late submission of reports and the backlogs that account for the erratic daily data. Personally, I think they should stop reporting these if we can’t make heads or tails of whatever data they announce. I don’t think the number of new cases correlates with the number of tests as we did fewer tests yesterday. On a side note, watch out for Calabarzon.”

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Refer to the link DOH.gov.ph  or up-to-date data or to COVID19.gov.ph. (The latter is not a secure site.) The new site for the Department of Health is user friendly, provides more information but is still direly lacking in what the relevant information should be. I advise the readers to look through their official site. 

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COVID19stats.ph is a new site which gives you a very good summary of the Philippines data. (summary of those that are unable to access this site is seen below)

Hotspot alert: Calabarzon COVID-19 cases are on the rise 3

Overall situation. Of the total cases, 1,363 are considered resolved. There are 6,216 active cases based on the provided data.

Hotspot alert: Calabarzon COVID-19 cases are on the rise 4
Hotspot alert: Calabarzon COVID-19 cases are on the rise 5

Comparison of daily new daily cases, admissions, deaths and recoveries

The increase in admissions (59) in the last 24 hours is directly proportional to the number of new cases reported. Nevertheless, the number of deaths was single digit today (7 new deaths) and 70 new recoveries. This brings the case fatality rate lower at 6.61 percent and the recovery rate up at 11.3 percent for the day. 

The Department of Health site provides additional infographics now on the 17 accredited sites that are doing testing. One can scroll around it and obtain information on its maximum testing capacity and whether it has exceeded it or is underutilized. The figure below is a snapshot of the information on the covid19tracker site.

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Daily tests conducted per site

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Doubling time lets us know the number of days it takes for the confirmed cases (or death rates) to double and can be determined linearly or exponentially. The linear scale is used in this report which shows that the doubling time averages 25 days based on the 7 day average daily growth rate of 2.77 percent. (This is approximately seven days on a logarithmic scale). The longer the doubling time the lower the growth rate. The lower the growth rate, the closer come to “flattening the curve.” The data remains erratic most likely due to the timing of the reports coming in and being released by various testing facilities. 

Of the 7,579 cases to date, 1,363 have had outcomes—63 percent recoveries (862) and 37 percent deaths (501). 

The latency in reporting of the Department of Health remains at almost six days before a death and days before a recovery is announced publicly.

 

Are we testing enough?

The figure below shows that a total of 84,789 tests have been done (averaging 3,500 tests a day) with 76,090 individuals tested. Of the individuals tested, 9,262 tested positive (12.2 percent), and 66,640 (87.6 percent) have tested negative. There are, however, only 7,579 confirmed cases. This is explained by the fact that some patients have undergone retesting but have remained positive. There were 60 equivocal (0.1 percent) and 68 invalid tests (0.1 percent).

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SARS-CoV-2 Testing in the Philippines

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Number of tests conducted and number of individuals tested

The figures above that shows the tests conducted, number of people tested. For now, at least 12 percent of patients tested turned out positive while the remaining 88 percent were negative. 

Compared to the April 24 where 4,336 tests in 4,029 individuals were done, only 3,497 tests in 3,236 individuals were reported yesterday. 

 

New cases per day

In order to see how a curve is being flattened, one needs to look at the individual cases per day. The erratic data of new cases being reported is not attributable to more tests being done as the reporting is probably not real time and the delays in releasing the results will not be able to provide us a true picture of the “flattening of the curve” until all backlog results are accounted for and we start “flattening” the data. Otherwise, it would be meaningless just gathering data and trying to make heads or tails from them.

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Are we flattening the curve?

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New cases based on region

The table above shows that it was a busy day for the NCR. Of the 285 new cases announced by the Department of Health, 199 had information on their residence with NCR reporting 133 new cases and Calabarzon spiking at 40 new cases overnight. 

The top 10 cities with new cases were all from Metro Manila, with Manila raking in 21 new cases followed by Quezon City with 17 cases each. The table below summarizes this. Surprisingly, Baguio which has not seen a case for more than a week makes a comeback sharing 10th spot with Muntinlupa and Antipolo with six new cases each city.

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Top 10 cities with new cases

 

By demographics 

Majority of the cases are more than 25 years old. The pediatric age group (<18 years old) makes up only 2.5 percent of the total cases while the senior citizens make up almost 36.6 percent of the total. Notice now how the 25-54 year old age group have formed the bulk of COVID-19 cases. 

Recovery rates are better in those less than 54 years old with a mortality rate of more than 51 percent for senior citizens.

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Hotspot alert: Calabarzon COVID-19 cases are on the rise 14

 

By location: Most vs least COVID cases

Deciding which communities to extend, enhance or ease the ECQs will depend on data in each region. The total number of cases is not enough to say that most of the confirmed cases are found in that region. We need to remember that the density of the region and individual cities and municipalities are important parameters. 

The table below shows the cases by region. NCR has the most COVID cases followed by Region IV-A. 

Region I has the highest CFR at 22 percent (11 deaths in 51 cases), followed by region XI at 15 percent (17 deaths in 117 confirmed cases). The NCR has a CFR of 7 percent (351 deaths in 4,520 cases). The sudden surge in numbers in Region IV-A is another hot spot that should be monitored.

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Top ten regions with confirmed COVID-19 cases in the Philippines

Overnight we saw a change in numbers with many cities in the NCR bringing in more new cases

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Top ten cities with COVID-19 cases in the Philippines

One city outside of the National Capital Region is in the top ten of confirmed cases of COVID-19. Cebu City remains 5th spot with 384 confirmed cases and 6 deaths. Davao City remains in number 16 with 17 deaths of 103 cases, or a CFR of 16.5 percent, the highest among the urban cities in the country. 

The Department of Health hotline is (02)8-6517800 loc 1149-1150. People who present with fever and/or respiratory symptoms are encouraged to get in touch with the DoH.

 

Global statistics

Update as of 7pm 26 April 2020 (Sunday)

TOTAL CONFIRMED CASES: 2,923,783

TOTAL DEATHS: 203,319 (case fatality rate: 7 percent)

TOTAL RECOVERED: 837,611 (case recovery rate: 28.7 percent)

Note that every reference has its own cut-off time for reporting. For the global data, WorldOMeters is used as its reference.

The total cases is approaching the 3 million mark. The average trend in the past week has averaged ~85,000 confirmed cases daily.  With more testing being conducted all over the world, this is expected. 

The United States of America leads globally in the number of total cases at 960,896 with a lower case fatality rate (CFR) of 5.65 percent with over 54,000 total deaths recorded. The US had more than 35,000 new cases overnight attributable to more testing done. The recovery rate for the US is up at 12.3 percent. Among the states, New York leads with 288,313 cases with 21,908 deaths with a CFR lower at 7.6 percent. 

While the United States may have the highest number of cases and number of deaths in the world, Belgium is back on top with the highest case fatality rate at 15.26 percent (6917 deaths in 45,325 cases) and Bahamas in second at 14.1 percent (11 deaths in 78 cases). 9 countries with more than > 50 cases and no fatalities reported from COVID-19 are: Vietnam, Cambodia, Maldives, Uganda, Rwanda, Madagascar, Mozambique, Guinea-Bissau and Nepal.

Germany has the highest number of recoveries with 109,800 (70.1 percent) of 156,613 confirmed cases . Cambodia has the highest recovery rate at 95.9 percent (117 of 122 cases) and no deaths reported since their first case of COVID-19. Note that Cambodia has had no new case since April 13, 2020. The following countries have the lowest recovery rates: Netherlands (0.27 percent, 102 recovered from 37,384 cases), Norway (0.43 percent, 32 recovered from 7499 cases), and the United Kingdom (0.52 percent, 774 recovered from 149,569 cases). 

 

Top 20 Countries in the World with COVID-19 Cases 

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Total cases, recoveries, and deaths of top 20 countries with COVID-19 

The median average of case fatality rates is now at 7 percent and is predicted to climb to ~7.2 percent before the end of the month.