A health care worker at a swabbing activity in Quezon City. We now have a total of 129,913 COVID cases. Photo by George Calvelo, ABS-CBN
Culture Spotlight

The Philippines has been averaging more than 4,000 COVID cases and more than 20 deaths a day.

In the past week alone, 28,732 new confirmed cases and 170 new deaths were reported. With just over a week until the lifting of MECQ, the race to control the numbers is even more pressing. BY BENJAMIN CO MD
ANCX | Aug 09 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 3,109 cases reported from 82 out of 99 laboratories, we will definitely breach the 130,000 mark tomorrow.

National Capital Region (NCR) contributes to 55 percent of the total with fewer cases (1,700) today.

Cebu is back in the top five aside from three other provinces from Region IVA: Laguna, Cavite, and Rizal. 

A total of 1.3 percent of the active cases (approximately 780) are classified as either severe or in critical condition. 

Eighty-one (81) cases were removed from the total cases with no reason provided.

The Health Agency provides a tabular breakdown of the newly reported cases by region and date of onset of illness. 

The basis for the 3,109 cases today?

For the period of July 27 – August 9, there were 2,055 “cases reported by region and date of onset of illness.”

Over 1,000 cases are reported backlogs and subdivided as follows: 772 for the period July 1 to July 26, 59 for June, 118 for May, 58 diagnosed intake of April and 47 as far back as March. Majority of the backlogs came from NCR. As a matter of fact, if you look at. the data, only 992 of the 1,700 cases in NCR are recent (July 27 to August 9). The same is true for Calabarzon, where 320 are current, while 172 were backlogs. 

“Of the 3,109 cases reported today, 2,572 do not have information on date of onset of illness, 130 do not have information on date of specimen collection, and 118 do not have information on both.” How this kind of disclaimer or description provides helpfulness in dissecting the data leaves me in awe. 

“In cases where date of onset of illness is missing, the date of specimen collection (minus three days) was used as proxy. In cases where both date of onset of illness and date of specimen collection are missing, the report date (minus nine days) were used as proxy.”

The number of active cases has jumped close to 60,000 with only 654 recoveries (or 21 percent of the total cases) today. Our recovery rates drop further to 52 percent (vs. the global recovery rate of 64.2 percent and the ASEAN recovery rate of 75 percent). Incidentally, there were 78 duplicate recoveries which are removed from the total recoveries. 

There were 61 reported deaths today. And while the fatality rate is slightly up at 1.75 percent with total deaths at 2,270 since the start of the pandemic.

As expected, the death tolls were mostly from Region VII with 36 reported followed by NCR with 16 deaths. The others were: Region with 3, Region IX with 2, Region IVA with 2, Region VI and VIII with one each.

Testing data showed that as reported by August 9 for data from August 8, the Philippines has tested 1,647,735 individuals (1.51 percent of the total population) with 100 accredited facilities (76 RT-PCR and 24 GeneXpert laboratories).

 

The data yesterday

As of August 7, 2020, 1,623,316 individuals have been tested yielding 1008 positive from 31,702 individual tested. Reports came from 79 of 94 laboratories. Daily positivity rate is up at 12.6 percent (from 11.9 percent) and our cumulative positive rate remains at 9.8 percent.

With 4,226 cases yesterday, the Philippines is back on 10th spot in the world with the most number of cases reported. 

NCR has now close to 70,000 as it leads over all other regions in the haul. Overall, NCR contributes to 55 percent of the total cases in the country. 

The other regions in the top five as of yesterday are Region VII, Region IVA, Region III, and Region VI. 

There are 5,089 total unidentified individuals to date. 

Among the five top regions that contributed to yesterday’s haul were NCR (2,669), Calabarzon (658), Central Visayas (133), Western Visayas (101), and Central Luzon (81). 

There were 152 repatriates among the cases, while 90 individuals had no tagged location by region (2.13 percent). 

More than 60 percent of the cases yesterday from NCR alone with 2,669 cases.

 

The unknowns

The unknowns are back, with 280 (6.6 percent) having no tagged location o various levels: 90 no known region, 33 with no known province (two from Region III and 31 from Region IVA), while the remaining had no known city/municipality. NCR (again) had the most positive cases with no tagged location on a city level. 

A total of only 36 (1 percent) had no tagged location on various levels: six with no known region, while the rest had no known municipality/city. NCR had the highest number of untagged locations at 19 cases, but even that was a good number yesterday. (Fingers crossed on sustaining this.)

 

The known

Of the 2,669 cases from NCR, 139 (5.2 percent) had no tagged city. 

Almost all the cities had triple digits. Quezon City had 331 cases followed by Manila with 284, Makati with 246, Parañaque with 220 and Taguig with 210. Other cities with three digits but less than 200 cases were Pasay, Las Piñas, Navotas, Mandaluyong, Valenzuela, and Caloocan.

Cities with double digits but with more than 50 cases were Malabon, Muntinlupa, and Marikina. 

The cities of Pateros and San Juan hard less than 50 cases but still recorded double digits.

 

Among the top regions, the following provinces reported the highest cases in that region Laguna with 285 cases for Region IVA, Cebu with 125 cases in Region VI, Iloilo with 61 cases for Region VI and Bulacan with 51 in Region III.

Region IVA was responsible for 16 percent of the cases with Laguna, Cavite and Rizal reporting triple digits. A total of 66 cities and municipalities reported cases in Calabarzon.

On a city/municipality level, Santa Rosa led with 85 cases, followed by Biñan and San Pedro.

Region VII is back in the top five regions with most cases. On a city/municipality level, Cebu City reported 38 cases, with Mandauae and Lapu-Lapu reporting double digits as well from 29 cities/municipalities. There was one case that a had no tagged location on this level.

Thirty-four cities/municipalities reported cases in Region III, with San Jose del Monte (in Bulacan) reporting 14 cases. There were six unidentified cases in the region.

Region VI was fifth yesterday with Iloilo reporting 43 cases and the rest of the 39 cities/municipalities claiming the remaining cases.

As of yesterday, the seven-day average for cases in the Philippines was at 4,105 cases/day while that for deaths at 24 deaths/day.

 

The week in review

This was one of the worst weeks in data. 

  • The Philippines for the first time lands among the top ten countries in the world with the most daily number of cases for almost the whole week. It had a day when it ranked 7th. From August 2 to 8, 2020 alone, 28,732 new confirmed cases and 170 new deaths were reported. 
  • The Philippines ranks 22nd in the world in terms of most number of cases. This week alone, the country overtook Indonesia and Canada. 
  • NCR now contributes 55 percent of the total cases with Region VII 13.7 percent and Region IVA 12.7 percent. These three regions alone account for more than 80 percent of the total cases in the Philippines.
  • Daily positivity rate for newly confirmed COVID-19 cases in the country is up as evident in the graph below where we now exceed >10 percent positivity daily. While testing in the country has exceeded 30,000 tests a day, the daily positivity rate continues to rise, meaning to say that there are more infected people than being reported.

Confirmed deaths take a see-saw ride with case fatality rates lower than last week. Caution should be taken in the interpretation of CFRs. Basically, it is a mathematical equation that takes into consideration number of confirmed deaths over number of confirmed cases. During an outbreak, it is a poor measure of the mortality risk of the disease, as many factors are responsible for data on deaths and cases. 

  • The reader and reporter should bear in mind that because some of the patients who are critically ill are at highest potential for dying, the increasing number of cases is a cause for concern because the outcomes of these patients will be reported in four to eight weeks (as seen in the death reports daily where some deaths reported go as far back as March to June).
  • The Philippines now has 1,184 cases/million population (which will vary depending on location, for example in NCR it is close to 5,000 per million population) and deaths by population is 21 per million. 

 

The World

With a little more than 250,000 cases reported daily, the world is set to pass the 20 million total Coronavirus cases in the next few hours. 

There a little less than 5,000 deaths yesterday, the seven-day average for death remains above 5,000 deaths/day but slightly lower than the previous day. 

The global case fatality rate is lower at 3.68 percent and recoveries remain at 64.23 percent. [Recovery rates are not very reliable indicators because they are subjective based on the country’s definition of how and when they consider patients “recovered.” There are some countries also that do not count recoveries like the U.K and Denmark. Death rates on the other hand, while more definitive of outcomes take a longer time to report and validate.]

Data from WorldOMeters.info.

The United States has passed the five million cases mark with Florida, California and Texas reporting the top three cases yesterday. The United States reported the highest number of deaths yesterday with 976. 

Brazil remains in second and has surpassed the three million mark with close to 50,000 cases yesterday.

India remains in third with 2,156,433 million cases with the highest number of cases reported yesterday. 

Colombia is now eighth in the world in total number of cases, displacing Chile. Spain remains in 10th place.

The top ten countries with the highest number of cases yesterday were:

  • India – 65,156
  • USA – 54,199
  • Brazil – 46,305
  • Colombia – 9,674
  • South Africa – 7,712
  • Peru – 7,137
  • Mexico – 6,717
  • Argentina – 6,134
  • Russia – 5,212
  • Philippines – 4,131

As of publication, we have barely eight days left before MECQ is lifted. With an economy that is badly hit due to the lockdown system at controlling the propagation of the infection in the community, it is time to come up with strategies addressing both the welfare of the healthcare workers and the rebooting the economy.

Without a doubt, the large contraction (-16.5 percent) of the Philippine economy in the second quarter of 2020 is a cause for alarm as well. While lockdowns are helpful during the beginning, when the total number of cases are few, it is a challenge to continue implementing this style of control in the spread of the virus. 

Time and again, we have reiterated that only with good, accurate and quality data can anyone provide measurable solutions at addressing the challenges in reopening the economy in the midst of a pandemic. 

These strategies come in two intensities: mitigation and suppression.

All the best plans should now be toward working at opening the economy during a pandemic, with minimal harm to health. This is one war we can all win if we work as one.

We need to slow the rate of infection. But easier said than done. And this is where our individual responsibilities on personal behavior matters. As the reproduction rate remains above 1, the pandemic develops with single peak because of the build-up of herd immunity.

The goal of suppression is to reduce the reproduction rate below 1 and keep the total number of infections so low that herd immunity will never be achieved. But that hope lies in a vaccine to provide that immunity. And that is all that it is for now. Hope.

In the meantime, we all need to adjust to the reality that we will need to co-exist with the virus, and that other people’s lives matter.