As Cebu City conducts testing in big numbers, it is now the third highest city in the country in terms of new COVID-19 cases. Photo from Mayor Edgardo Labella's Facebook account
Culture Spotlight

65 new cases came from Cebu City yesterday, the most of any city in the country

While its COVID-19 death counts remain relatively low, Cebu City is still a major cause for concern. BY BENJAMIN CO MD
ANCX | Apr 30 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. 

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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 where a COVID19 tracker is seen. Readers can check their official site where Data Drop for raw data can be found. 

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COVID19stats.ph is a new site which gives you a very good summary of the Philippines data. Most of the screenshot data is from this site. We can all help the developers cover their costs by donating the equivalent to a cup of coffee.

Overall situation. Of the total cases, 1,611 are considered resolved (65 percent recovered and 35 percent died)

Comparison of daily new daily cases, deaths and recoveries

There are three parameters in the figure above. New daily cases which are up at 276 new cases, new daily deaths are down at 10 and only 20 new recoveries. This brings the case fatality rate up at 6.69 percent (vs 7.11 percent world average) and the recovery rate steady at 12.3 percent (vs 30.7 percent world average) for the day.

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 median doubling time is 24 days based on the seven-day average daily growth rate of 2.83 percent. (This is approximately 7 days on a logarithmic scale). The lower the growth rate, the longer the doubling time.

Provided as added information in real-time is the number of probable cases (14,338), suspect cases (2,938) and number of healthcare workers affected by COVID-19. Of the 1,619 HCWs affected, they comprise almost 20 percent of the confirmed cases.

The latency in reporting of the Department of Health remains at almost seven days before a death and more than 8 days before a recovery is announced publicly.

The posthumous results are now at 321. Which means that this is the number of people who have died before they were declared positive.

 

Are we testing enough?

The figure below shows that a total of 104,146 tests have been done (averaging almost 4500 tests a day) with 93,526 individuals tested. Of the individuals tested, 10,282 tested positive (11 percent), and 83,105 (89 percent) have tested negative. There are, however, only 8,488 confirmed cases. This is explained by the fact that some patients have undergone retesting yet remained positive.

SARS-CoV-2 Testing in the Philippines

Number of tests conducted and number of individuals tested

The figures above show the tests conducted, number of people tested. For now, at least 11 percent of patients tested turned out positive while the remaining 89 percent were negative. It is possible that the increase in new confirmed cases may be due to more testing in the past days. The usual turnaround time for RT-PCR averages two to three days.

 

New cases per day

Flattening of the curve is based on continuous daily data. There needs to be a trend in the reporting of new daily cases so that we know where we are. If there is a long latency time in reporting of new cases, new recoveries and new deaths, the quality of the data is not a reliable source in determining how effective an intervention (in this case the ECQ) is at lowering the cases in the community. The figure below shows the overall trend of new cases in the Philippines.

When testing is ramped up, we expect to see some of the cases go up. In order to see if we’ve managed to control the outbreak in the Philippines, we will need to see a decline in the fatality rates.

Are we flattening the curve?

New cases based on region

Of the 276 new cases announced by the Department of Health, 243 were tagged with their residence (a large improvement from the lacking data yesterday). One hundred thirty-six cases were from Luzon (129 from NCR alone), 106 in the Visayas (105 in Central Visayas), and one in Mindanao.

Cities with more than three new cases reported

The table above provides the new cases by city. It is disturbing that Cebu City has the highest number reported cases overnight with 62 new cases. As a matter of fact, Cebu City has moved up to the third spot with the most number of new cases in the Philippines although its case fatality rate remains the lowest (five deaths in 480 cases).

The reports on demography and by location in general will now be provided every SUNDAY so that the whole week summary is provided.

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 8pm 30 April 2020 (Thursday)

TOTAL CONFIRMED CASES: 3,231,054

TOTAL DEATHS: 228,403 (case fatality rate: 7.1 percent)

TOTAL RECOVERED: 1,007,230 (case recovery rate: 31.2 percent)

Total cases worldwide 

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 has crossed the three million mark. The average trend in the past week has averaged ~80000 confirmed cases daily with more testing being done worldwide. The total number of recoveries has passed the one million mark.

The United States of America leads globally in the number of total confirmed cases as they cross the million mark at 1,064,572 with a high case fatality rate (CFR) of 5.8 percent with 61,669 total deaths recorded. The US had almost 30,000 new cases overnight with more than 6M tests done (18,549 tests/M population). The recovery rate for the US is slightly higher at 13.84 percent. Among the states, New York leads almost 306,158 total confirmed cases and 23,474 total deaths with a CFR stable at 7.7 percent.

While the United States may have the highest number of cases and number of deaths in the world, the United Kingdom now has the highest case fatality rate up at 15.8 percent (26,097 deaths in 165,221 cases). 8 countries with more than > 50 cases AND zero (0) fatalities reported from COVID-19 are: Vietnam, Cambodia, Uganda, Rwanda, Madagascar, Mozambique, Central African Republic and Nepal.

Cambodia has the highest recovery rate at 97.54 percent (119 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 (0.31 percent), Norway (0.42 percent), and the United Kingdom (0.51 percent).

The median average of case fatality rates worldwide is now up at 7.11 percent but is predicted to hover at 7 percent. With more recoveries over the whole pandemic cycle, probably the fatality rates should go down to depict the true mortality rate after the pandemic.