With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 2
An aerial view of Capas National Shrine in Pampanga. Today, the province is one of the biggest contributors of new COVID cases. Photo by Jopetsy on Wikimedia Commons
Culture

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally

It is just behind fellow surprise province Leyte, and COVID hotspots NCR, Laguna, and Cavite. Today’s tally also brings the country’s total past 220,000. BY BENJAMIN CO MD
BENJAMIN CO MD | Aug 31 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.”]

The Health Agency reports 3,446 confirmed cases for the last day of August 2020. This brings our running total to 220,819 coronavirus cases since the beginning of the pandemic. 

National Capital Region (NCR) has 1,900 cases, which is 55 percent of today’s total. However, only 1,528 of these (80 percent) are recent, with the remaining 372 as backlogs (some as far back as March.)

The surprise of the day? While Calabarzon has 497 total cases, 442 (89 percent) of which are recent (August 18 to August 31), Leyte and Pampanga have joined the top five. 

There are now 59,699 active cases with 2.5 percent being either severe or critically ill. 

Twenty-three (23) cases were removed from the total case count (no reason provided).

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 3

The Health Agency divides its report either as recent (last 14 days) or as “backlogs.”

Of the 3,446 cases today, 2,965 (86 percent) are recent (from the period August 18 to 31, 2020). The bulk of the backlogs are from August 1 to 17 (405 cases) and July (45 cases), with cases still being reported all the way back from March for NCR and Region IVA.

Top five regions aside from NCR and Calabarzon are Central Luzon in third, Eastern Visayas in fourth, and Western Visayas in fifth.

“Of the 3,446 cases reported today, 2,959 (86 percent) do not have information on date of onset of illness, 89 do not have information on date of specimen collection, while 75 do not have information on both.” (Yet the Department of Health uses the Date of Onset of Illness in their reporting for some inexplicable reason.)

“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.”

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 4

There were a handful of recoveries today, bringing the recovery rate to 71.4 percent while 38 new deaths brings down the case fatality rate to 1.61 percent. 

NCR continues to have the highest cases and the highest deaths with 19 (50 percent) of the announced deaths today, followed by Region IVA with nine deaths. 

Of the 28 deaths, 31 were reported this month, four occurred last July, and three last June.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 5

There are 113 testing facilities (85 RT-PCR and 28 GeneXpert) in the country. Data for August 30 reported today, shows 2,417,360 individuals tested. Our cumulative positivity rate is at 10.6 percent, which is quite far off from the five percent and below that is desired. This means we’re still not testing enough.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 6

 

The day yesterday

Testing capacity

As of August 29, 2020, a total of 2,398,620 individuals have been tested. There were 3,572 positives from 30,550 individuals tested on that day with reports coming from 86 of 107 testing labs. 

Daily positive rate is up at 12.3 percent (previous 11.2), while cumulative positive rate is steady at 10.6 percent. 

Among the 3,572 positives that day, 2,567 were from 36 out of 40 testing centers in NCR (72 percent of total). Daily positive rate of NCR is up at 14.7 percent (previous 14.5) and cumulative positive rate down at 12.4 percent. 

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 7

The summary

As of yesterday, the Philippines had 217,396 confirmed cases with NCR owning 56 percent of the total cases in the country.

For August 29, 2020, NCR had 2,207 new confirmed cases with Regions IVA, III, VIII, and VI rounding up the top regions.

ROFs account for the fourth highest number of contributors to positive cases (10,063 total) overall with 292 cases reported yesterday.

There were eight individuals with no tagged location on a regional level.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 8

 

The unknown

There were 29 unknowns (0.67 percent) with no tagged location on various levels among the top five regions: eight with no known region, five with no known province (three in Calabarzon, one in Eastern Visayas, and one in Western Visayas). The rest were unknowns on a city/municipality level.

Even NCR had 14 unknowns at this level.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 9

 

The known

A dozen cities in Mega Manila continue to report three digits, with Quezon City (of course) in front with 353 cases. Valenzuela, Manila, Caloocan, Pasay, Makati, Taguig, Pasig, Mandaluyong, Parañaque, Marikina, and Muntinlupa. 

The following had double digits: Navotas, Las Piñas, Malabon, Pateros, and San Juan. 

There were 14 with no tagged location at this level.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 10

The following provinces had the highest cases for their respective region: Laguna for Region IVA, Bulacan for Region III, Leyte for Region VIII, and Iloilo for Region VI.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 11
With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 12

Region IVA reported a total of 864 cases yesterday with the provinces of Laguna, Cavite, Batangas and Rizal reporting triple digits. 

But it was the city of Calamba that led in the overall haul recording 100 cases. Twenty five cities/municipalities had double digits, with Cabuyao reporting 72 cases. 

There are four cases with no tagged location on this level.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 13

Region III was in third with Bulacan registering the most number of cases on a provincial level. 

On a city/municipality level, San Jose del Monte, Marilao, and Angeles had double digit cases.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 14
With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 15

Region VIII climbs to fourth spot with Leyte and Western Samar reporting the highest number. 

On a city/municipality level, Tacloban reported 34 cases, overtaking Catbalogan which is now in second with 24 cases. 

There was one unknown case from this region.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 16

Region VI is in fifth place with the province of Iloilo reporting the highest number of cases (63) and Iloilo City owning 48 (76.2 percent) of them. 

There was one unidentified case on this level of reporting.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 17
With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 18
With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 19

 

The world

Twenty five million. 

The global case fatality rate is at 3.36 percent and recoveries at 69.6 percent. As the number of confirmed cases increase, the fatality and recovery rates slow down. [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.”]

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 20

Data from WorldOMeters.info.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 21

The United States has now more than 6.1 million cases with California, Texas and Florida reporting the top three cases yesterday. 

Brazil remained in second with more than 3.8 million cases but has been seeing a down trend for confirmed cases in the past week with a seven-day average of around 37,000 cases/day.

[Note that the Americas follow a trend in reporting. On weekends, their numbers are down, which means they’re not actively reporting data 24/7.]

India remains in third spot globally but continues to have the highest number of new confirmed daily cases in the world as it breaks another record high of 79,457 new cases the previous day. It also ranked first globally in death count.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 22

The top 10 countries contributing to the pool of coronavirus cases for August 30, 2020 were:

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 23

The top 10 countries with highest deaths reported for August 30, 2020 included the Philippines for the second straight day, this time rising a notch higher at 9th place from 10th spot the other day.

With 116 new COVID cases, Pampanga is one of top provincial contributors to the country’s overnight tally 24

 

The Reproduction Number (Rt) and what it can and cannot tell you

Rt should not be used as a single metric in determining whether we are “doing better” or a guide to “reopening” the economy. Case rates and death rates are valuable metrics to include when considering making reopening decisions. 

The daily effective reproduction number (Rt) is computed to characterize the spread rate of the coronavirus. What it is trying to tell us is “the expected number of secondary infectious cases produced by a primary infectious case.”

Hence, it is used to determine the “potential for epidemic spread” at a specific time given the presence (or absence) of control measures (i.e., face masks, face shields, distancing, lockdowns, limited number of people assembling at a given place at a given time, etc. ). 

If Rt>1, the virus will spread out in whatever calculated multiples and the disease has the potential to become an epidemic. If Rt=1, the virus will spread locally and the disease is endemic. If Rt<1 the virus will stop spreading and the disease will eventually go away as long as the metric is sustained. The lower the Rt (closest to 0), the more ideal the scenario. 

In short, what does Rt tell us? Specifically, it measures the transmission rate (how rapid is the spread on a given day). Mathematically, it is a relative (not absolute) measure on the multiplicative scale. Hence, there are multiple variables that can affect the stability of the Rt value. 

For example as of August 28, 2020, Rt in Mega Manila was 0.85 (0.84-0.87, 95 percent confidence interval) while that of Western Samar was 1.4 (1.27-1.54, 95 percent confidence interval). But the cases in NCR are 30 times that of the cases in Western Samar. So how does that even make sense? 

Simply put, the cases in NCR have stabilized. It’s more or less the same number daily for the last month and has even slightly declined. Unlike Western Samar that has seen spikes and increase in cases over the pst week. This means that the epidemic is spreading faster in Western Samar than it is in Mega Manila. 

Because Rt is a relative measure, it cannot be relied on with absolute certainty and other absolute measure such as the number of new cases (e.g., doubling time and positive rates from testing) and death rates should be taken into consideration as well. The Rt can tell us where the trajectory of the disease is heading but it is the daily case rate that tells us the size of the infected population, the number of lives the virus has infected and of course, the number of people that will require medical attention and isolation. 

These limitation of Rt should be kept in mind. It is a relative parameter. And it should be used in conjunction with absolute parameters that provide definitive and concrete data on the overall condition of a community affected by the pandemic.

Let’s see what data September brings. Tomorrow is the first day of the final month of the third quarter storm.