How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 2
There are still quite a few COVID cases with no complete residence information. Photo by Gigie Cruz, ABS-CBN News
Culture

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality?

Of these unknowns, 14,136 are declared to be from NCR alone. Given this glaring lack of information, our resident expert thinks that tracking the disease in Metro Manila is a nightmare. BY BENJAMIN CO MD
ANCX | Jul 25 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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[Disclaimer: Whatever is written here is based on information released by the Department of Health (DoH) at the time of publication. Whatever changes DoH makes in their data later on…well that’s a different story in itself and as they say in their disclaimer: “the total cases reported may be subject to change as these numbers undergo constant cleaning and validation.”]

With 2,019 confirmed cases out of 87 percent laboratory submissions, the total number of cases is at 78,412 as of July 25, 2020. 

National Capital Region (NCR) continues to rake in the majority of cases with 1,115 (or 55 percent) of the total cases. Cebu reported an unprecedented high of 479 new cases overnight. Two provinces in Region IV-A contribute to the top five: Cavite with 90 cases and Rizal with 52. Davao del Sur is in fifth with 41 cases.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 3

The number of active cases continues to climb from 50,063 to 50,763 in spite of the 1,278 recoveries reported. The new recoveries bring up the recovery rate to 32.85 percent from a previous of 32 percent. There were 20 reported deaths, bringing the fatality rate to 2.42 percent. 

Of the 20 deaths, 10 were from Region VII, 6 from NCR, 2 from Region III and one from Region IX. Of these, 13 deaths occurred in July, 4 in June, 2 in April and one way back in March.

Fifty one duplicates were removed from the total case count. Among these, 25 recovered cases and two deaths were removed after final validation. The health status of three (3) cases previously reported as recoveries were determined to be fatalities after final validation.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 4

As of July 24, 2020, we have 91 testing sites (68 RT-PCR and 23 GeneXpert laboratories) in the country. The Philippines has tested close to 1.2 percent of the total population as it registers 1,206,902 individual tests done. (As to how many are repeat tests from previous positive patients or new confirmed cases is not indicated.)

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 5

 

The data yesterday

The health agency initially reported 2,561 positive cases from 23,542 individuals tested for a daily positive rate of 10.9 percent for July 22. On review of the data for the same date, there were actually 2,983 positives bringing the daily rate up to 11.6 percent.

On July 23, 2020, 78 of 86 (91 percent) lab facilities reported 2,851 positives from 26,080 individuals tested or a daily rate of 10.9 percent. 

The Philippines has now tested 1,273,279 individuals (1.2 percent of the total population) with 103,963 positives from 1,186,217 individuals for a cumulative positive rate up at 8.8 percent.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 6

A comparison of the testing results from NCR and Region VII shows that the daily positive rate in these epicenters are above 10 percent (as is the national daily rate), and the cumulative positive rate, while higher in Region VII has significantly gone down since their ECQ. Both regions alone contribute to more than 80 percent of the daily total positive test results in country.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 7

Of the 2,103 new confirmed cases yesterday more than 60 percent (1,272) were from NCR. To date, NCR alone contributes to 55 percent of the total cases in the Philippines. The other major contributors are Region VII (16.4 percent) and Region IV-A (8.3 percent). These three regions alone are responsible for 80 percent of the confirmed cases in the Philippines. 

Top regions in terms of total number of cases are NCR (41,960), Central Visayas (12,539), Calabarzon (6,337), Central Luzon (1,941), and Davao Region (1,059). 

Top five regions reported yesterday were: NCR (1,272), Region VII (299), Calabarzon (282), Western Visayas (65) and Central Luzon (54). 

Only Cordillera Administrative Region had no reported case on July 24.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 8

That bothersome “unknown” category is back with 388 of the 1,272 cases (31 percent) in NCR classified as unidentified (no tagged location). And while there are noticeable increase in cases, a significant percentage is attributed to the “unknowns.” In short, they are positive cases with no tagged location. It is alarming because without proper geographical locations, one cannot estimate the extent of the surge and control the epidemic. How do you do contact tracing, tracking and isolation with an unknown?

To date, 23,611 cases have no city/municipality or any tagged location. Of these, 14,136 of them are declared to be from NCR alone. With close to 42,000 cases in NCR, this implies one-third have unknown location. This makes tracking the infection in Metro Manila a nightmare. 

Of the identified cases in NCR, the following cities had 40 or more cases: Quezon City (280), Manila (106), Caloocan (106), Makati (63), Taguig (58), Malabon (51), Pasig and Navotas (40 each). 

Other cities with double digit cases but less than 40 were: Las Piñas (34), Mandaluyong (31), Parañaque (29), Valenzuela (21), Pasay and Muntinlupa (18 each), Marikina (16), and San Juan (10). 

Pateros reported three cases yesterday.

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Among the other top regions outside of NCR, the following provinces in those regions had the highest cases: Bulacan with 37 cases in Region III, Laguna with 107 cases and Rizal with 83 cases in Region IV-A, Negros Occidental with 37 and Iloilo with 21 cases in Region VI, and Cebu with 291 cases in Region VII.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 10
How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 11

Region VII had the highest number of cases outside of NCR. Cebu City owned 108 of the 299 cases, with Lapu Lapu City reporting 47, Mandaue 32, Talisay 18, Consolacion 16, Danao City 15, and Liloan 11. Even Region VII was not spared of the unknowns yesterday. They had 10.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 12

Only a few cases separated Region VII from Region IV-A that reported 282 cases. The following cities in the region had the highest cases: Santa Rosa (40), Antipolo (25), Biñan (24), Cainta (20), Lucena C (17), Calamba (16), Taytay (16), and Cabuyao (12). As in NCR and Region VII, Region IV-A was not spared of the unknowns with 16 unidentified.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 13

Western Visayas had 65 cases yesterday with Iloilo City having the most cases at seven. However, 37 cities in that region reported at least one case of a positive case.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 14

Region III wraps up the top five regions yesterday. San Jose del Monte and Meycauayan in Bulacan reported nine and five cases, respectively.

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The seven-day moving average for new cases in the Philippines is almost 2,000 cases/day while the seven-day moving average for deaths is 32 deaths/day. This means that if we were to use the seven-day moving average, with seven-days left in the month, we would probably end July with 90,000 cases (+/- 2,500).

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 16
How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 17

Comparing the top five regions in the Philippines with data last July 20 and July 24 (five-day gap), NCR had around 1,000 cases per day. Cases per million population are also highest in both NCR and Region VII. Case fatality rate is highest in Region VII and Region XI, with the CFR of NCR (2.31 percent) lower than the national average (2.46 percent). The seven-day average growth rate in cases, however, is highest in NCR, with the over-all growth rate of cases in the Philippines, rising from 2.74 to 2.8 percent in just five days.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 18

Based on the top five cities, Cebu City has the highest number of total cases and cases per million population. It also has the highest case fatality rate although the growth rate has seemingly slowed down the last five days. Quezon City, Manila, Taguig and Caloocan round up the top cities contributing to the pool of coronavirus cases in the Philippines, with QC having the highest growth rate and case fatality rate and the shortest doubling time.

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The world

The world has a record high of close to 300,000 cases overnight, pushing the seven-day average close to 250,000 new cases per day. At this rate, this would mean that around one million new cases would be seen every four to five days. 

A total of 6,199 deaths were reported yesterday, driving the seven-day death average to 5,572 deaths/day. 

As the world sees more new daily cases, we also expect to see higher deaths after four to six weeks, commensurate to the surge in cases. 

The global case fatality rate is lower at 4.03 percent and is at 61.13 percent. Recovery rates are not very reliable indicators because they are subjective to the country’s definition of how and when they consider patients “recovered.” Death rates on the other hand, while more definitive of outcomes take a longer time to report and validate the cause of death.

How can we do contact tracing right when 23,611 COVID cases have no encoded city or municipality? 20

Data from WorldOMeters.info.

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The United States continues to dominate the contribution to global cases with a record high of 78,009 new cases overnight to bring the total number of cases to 4,248,492. They also reported 1,141 deaths overnight bringing their total deaths closer to 150,000 (case fatality rate = 3.5 percent). 

The top three states with new cases yesterday were: Florida (+12,444), California (+10,593), and Texas (+8,552). The more than 10,000 new cases reported in California was enough to displace New York from the top. California now has 442,938 total cases compared to 438,435 of New York. With the continued increase of cases in Florida, they will most likely overtake New York in the next three days.

Brazil stays in second spot with close to 2.35 million total cases with 58,249 new cases overnight and 1,178 new deaths. 

India had the third highest cases overnight with 48,892 new cases to total 1,337,022 for the country.

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Top 10 countries that had the highest new cases overnight were:

  • USA – 78,009
  • Brazil – 58,080
  • India – 48,892
  • South Africa – 13,944
  • Mexico – 8,438
  • Colombia – 7,168
  • Russia – 5,811
  • Argentina – 5,493
  • Peru – 4,895
  • Bangladesh – 2,548

The Philippines was number 16 among countries with the most number of cases reported in the world yesterday with 2,103 new cases. Indonesia was number 17 with 1,761 cases. 

While the Philippines may have fewer deaths reported than Indonesia, it has the most number of active cases in Southeast Asia. This makes it a cause of concern because every case should have a reported outcome. Outcomes are important parameters in determining how well we are doing in the pandemic. Just because they are not reported as deaths (yet) does not mean that they are alive.

Our seven-day average is now around 1,900 new cases/day and our gap with China is around 9,000 cases. Sweden moves down from 27th place to 29th and with the current number of cases in the country, the Philippines will likely displace both Ecuador and Sweden tomorrow to rise to two spots away from China. Only a little more than 5,000 cases separates the total cases of China and the Philippines.

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As reported last week, one Asian country to closely watch is Japan, which is seeing a second wave in the last few weeks. Yesterday it reported a record of 927 new cases bringing its seven-day average to 640 cases/day.

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