Tricycle drivers undergo testing in Marikina amid the modified enhanced community quarantine. Overall data trends are doing much better for the country. Photo by Mark Demayo, ABS-CBN News
Culture Spotlight

New reported COVID cases in NCR fall under 100 for the first time

Also, our fatality rate has fallen considerably while our growth rate is at an all-time low. BY BENJAMIN CO MD
ANCX | May 21 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. 

One useful site is COVID19stats, where one can see most of the DoH data in graph format.

The DoH reported 213 new cases, 68 new recoveries, and 4 new deaths. Compared to the global confirmed cases, the Philippines contributes to 0.26 percent of the cases and 0.25 percent of the deaths from COVID-19 in the world.

Disclaimers on the data: 

(1) These three parameters (new confirmed cases, new recoveries, new deaths) are not real-time data. The data provided by the Department of Health is the date of public announcement. Even global data will vary in time of reporting, depending on the capacity of that country. To date, the latency period of the Department of Health on reporting recoveries averages almost 10 days (with more than 50 percent reported after eight days and more) and deaths averaging almost 9.5 days (with around 46 percent being reported after eight days or more). 

(2) Depending on where testing is done, RT-PCR test results take an average of one to two days to process. Barring any delays, all tests done should ideally be released within 48 hours (the earlier the better). However, the test results released from government facilities range from three to 14 days, probably due to an overwhelming number of tests being conducted when compared to private hospitals.

The announced new cases, recoveries, and deaths are tally of reported cases for the day. 

Figure 1. Comparison of daily new daily cases, deaths and recoveries. There are now 3,846 closed cases.

Case fatality rate is down at 6.3 percent (vs 6.46 percent global average, vs. 2.41 percent ASEAN average) and recovery rate is slightly up at 22.3 percent (vs. 39.9 percent world average, vs. 41.8 percent ASEAN average) for the day. 

The case fatality rate of the Philippines has considerably lowered with less deaths being reported the past several days.

Table 1. Outcomes of resolved cases.

Table 1 shows that in terms of resolved cases, the Philippines ranks 133 out of 148 countries in terms of recoveries-to-closed cases ratio. In the ASEAN region, while we have 3,846 closed cases, 78 percent are considered recovered while 22 percent died. 

Globally, the Philippines is much lower now at 29th place (from a previous 25th place) in death rate (6.3 percent CFR), but has gone down to 135th spot in recovery rate in spite of our slight gain in recoveries (22.33 percent).

Table 2. The first column shows the case fatality rate while the rightmost column shows the recovery rate of these countries. We are 29th in terms of death rates while 135th in terms of recovery rates. 

Figures 2 and 3 below show the trajectory of death rates in the country since the start of the pandemic (date of recording of the first 5th death). Currently the doubling time for deaths on the logarithmic curve is approaching almost every 10 days. The Philippines has maintained a plateau with reports on deaths.

Figure 2. Trajectory of cases of deaths in the Philippines.

Figure 3. Are we bending the curve? Trajectory of deaths in the Philippines (compared to South Korea data for illustrative purposes).

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 seven-day average daily growth rate is down to at 1.75 percent.

Using a seven-day rolling average provides more useful information on what is happening with the pandemic. It smoothens the curve and corrects some errors in data or latent reporting systems. Because we already have data for more than two months, we can actually track how well we’re doing at “bending the curve” of daily cases and total confirmed deaths from COVID-19. Figure 4 below shows three countries: the Philippines, South Korea, and Thailand. The Y axis represents daily confirmed cases while the X axis representa the total confirmed deaths. 

The current data shows an actual slowing down in the number of daily confirmed cases and a plateau in the reported deaths for the Philippines. If the decline is sustained over the week, this will mean that most likely the trajectory will go down further (similar to the trajectories of South Korea and Thailand) and we will finally be on the path to bending the curve.

Figure 4. Daily cases vs deaths due to COVID-19.
 

DOH Reporting

More than half (457 cases) are posthumous results. This is the number of people who died before they were declared positive for SARS-CoV-2.

 

New cases per day

Of the 213 new cases announced today, all were tagged with residence information. Ninety-eight (46 percent) are from the NCR, 98 (46 percent) are from Region 7, and 17 (8 percent) are from others. NCR cases and Region 7 cases are now both equal, and this is the first time that the number of cases in the NCR is below 100. 

As of this writing, of the 98 cases in NCR, Muntinlupa leads the pack with 16 cases, followed by Pasay (7); Taguig (6); Quezon City (4); ParaƱaque, Makati and Marikina (3 each), and one apiece for Manila, Pateros and Valenzuela. The remaining 53 are for validation.

Region VII has 98 cases. Cebu City has 8, Cebu Province 78, Mandaue 9, Lapu-Lapu 1, and Bohol 1. This is a big leap in the region considering that there were few to almost no cases in the past several days. And since there is no update on testing capacity on the DoH website, I surmise that there is a surge in capacitance testing in Region VII. The last recorded testing at the VSMMC was May 15, 2020 with 28 tests done. 

Other areas with reports include: Laguna (2), Cavite (1), Batangas (4), Quezon (1), Albay (1), Camarines Norte (1), and Leyte (1). The remaining cases in the provinces or for repatriates are for validation.

Figure 5. New daily cases, death and recoveries.

The DoH website update shows a bar graph (Figure 5) for daily cases, active cases, daily deaths, and daily recoveries. The current trend shows that based on the average number of patients in the last seven days we should be testing the threshold of 225 new confirmed cases daily next week to see if we’re bending the curve. (Based on a 10 percent decrease in the average cases of 242 last week, for this week). 

 

Testing Capacity

As of May 15, 2020, based on the DoH Data Drop and DoH website, there was a total of 224,633 tests conducted (or an average of 9,639 tests daily for the past seven days) with 207,823 total individuals tested. The current capacity of the Philippines is 35 testing centers—30 licensed RT-PCR laboratories and five GeneExpert laboratories—accredited to conduct testing for SARS-CoV-2 in the country. Nevertheless, it would be helpful that we have information on actual daily testing as it has been almost a week where no data is provided regarding the testing capacity. 

The overall scenario: we have prolonged the doubling time (approaching 10 days using a logarithmic scale), decreased the growth rate which is now at 1.75 percent (all time low), lowered the death rate significantly (averaging 12 cases in the last week), and decreased admissions in hospitals. If we continue this trend in the next week, we should be doing much better at the start of June. 

Hope springs eternal.

To get in touch with the Department of Health, the COVID hotline is (02)894-COVID loc 1555.

 

Global statistics

Update as of 8PM 21 May 2020 (Thursday)

TOTAL CONFIRMED CASES: 5,104,952

TOTAL DEATHS: 329,997 (case fatality rate: 6.46 percent)

TOTAL RECOVERED: 2,034,790 (case recovery rate: 39.9 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.

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The total confirmed cases is past the five million mark. The average trend in the past week has begun to fluctuate between 100,000 to 120,000 new confirmed cases daily with more testing being done worldwide. At the current growth rate at least one million new confirmed cases may be registered every nine to 10 days. The six million mark is projected to be breached on or before May 31, 2020. 

Total number of recoveries worldwide passed the two million mark with significantly greater recoveries than deaths. 

The United States of America continue to lead globally in the number of total confirmed cases at 1,593,039 with a case fatality rate (CFR) of 5.96 percent with 94,941 total deaths recorded. The recovery rate for the US is up at 23.3 percent. Among the states, New York leads almost 364,249 total confirmed cases and 28,758 total deaths with a CFR at 7.9 percent. More than 14 million tests have been done as of yesterday (42,849/million population). 

Russia now is second with 317,554 total confirmed cases, 3,099 total deaths (0.98 percent CFR), and 92,681 total recoveries (29.2 percent). 

On the other hand, Cambodia has not seen a new case for the last month and reported its last patient recovering. The country has 100 percent recovery rate with no deaths reported. 

The median average of case fatality rates worldwide is lower at 6.46 percent. From the current data for the past two to three months, around 80 to 90 percent of patients are either asymptomatic or recover unremarkably. Almost 98 percent of the currently infected (active or positive) cases are mild or asymptomatic. 

As of this writing, of the 2,364,787 closed cases (cases which had an outcome), 86 percent (2.034,790) had recovered or discharged while 14 percent (329,997) died. The remaining 2,749,165 cases are still active. 

Recoveries far outnumber the deaths with a ratio of approximately 6.2:1.