PH records highest deaths in over 6 decades, with COVID as no. 2 leading cause

Wena Cos, ABS-CBN News

Posted at Feb 03 2022 08:09 PM | Updated as of Feb 04 2022 02:01 PM

Workers process the body of fatalities during the enhanced community quarantine in Metro Manila at the Baesa Crematorium in Novaliches on May 5, 2020. Fernando G. Sepe Jr., ABS-CBN News
Workers process the body of fatalities during the enhanced community quarantine in Metro Manila at the Baesa Crematorium in Novaliches on May 5, 2020. Fernando G. Sepe Jr., ABS-CBN News

MANILA - The Commission on Population (POPCOM) reported that the recorded increase in deaths in the Philippines in 2021 is the country's highest mortality rate in 63 years, or since World War 2. 

The Philippines recorded 768,504 deaths between January and November 2021, according to the latest data published by the Philippine Statistics of Authority (PSA), with 154,562 more deaths than in 2020.

The top 10 causes of deaths recorded in 2021 had COVID-19 (confirmed by RT-PCR tests) in third place:

  1. Ischemic heart diseases (narrowed heart arteries)
  2. Cerebrovascular diseases (conditions that affect blood flow and vessels of the brain)
  3. COVID-19 virus identified (confirmed deaths with RT-PCR)
  4. Neoplasms or tumors
  5. Diabetes mellitus
  6. Hypertensive diseases
  7. Pneumonia
  8. COVID-19 virus not identified (diagnosed but with no confirmatory RT-PCR up to time of death)
  9. Other heart diseases
  10. Chronic lower respiratory diseases

POPCOM said that 1 in 10 deaths in the country was directly attributed to the coronavirus disease. 

However, Undersecretary Dr. Juan Antonio Perez III said in an interview with ABS-CBN News that if the number of confirmed COVID-19 deaths were added to the number of deaths diagnosed with COVID-19 but did not receive confirmatory tests until the time of death, COVID-19 would rank as the second leading cause of death in 2021.

"One can attribute over half of that or 51% to COVID-19, and the rest to ischemic heart disease, hypertensive disease and other illnesses—the cases which also went up in that time frame,” Perez said in a statement. 

Another factor which affected mortalities was decreased access to health services due to patients being more hesitant to go to COVID-19 high-risk areas.

“Dahil nakatutok ang health systems sa COVID, medyo naiwanan yung ibang mga may sakit. Hindi sila nakakuha ng karampatang atensyon kaya marami yung namatay sa kanila kasi pag di ka nakikita ng doktor, maaaring may kumplikasyon o paglala na hindi nagawan ng lunas ng doktor," Perez said.

(We have been so focused on COVID that other diseases may not have been given enough attention. People with other diseases may not have been able to get the medical attention they need because of the pandemic, which may have led to their conditions worsening.)

Preliminary data also show that the National Capital Region, Southern Tagalog or CALABARZON, and Central Luzon topped the regions with the most number of recorded deaths due to COVID-19 in 2021.

Number of Registered Deaths Due to COVID-19 by Region of Usual Place of Residence, Philippines: January to September 2021 (partial), as of 29 October 2021. Courtesy: Philippine Statistics Authority 
Number of Registered Deaths Due to COVID-19 by Region of Usual Place of Residence, Philippines: January to September 2021 (partial), as of 29 October 2021. Courtesy: Philippine Statistics Authority 


Perez also said the increase in deaths may be indicative that the country's health systems are not strong enough. 

"Mortality is indicative of the strength of a health system. Yung buong health system ang may implication dito, ang kanilang strength, ang strength ng health system is the one indicative of mortality. That’s the most important takeaway na may problema ang ating sistema ng pangkalusugan, nagkukulang ang local health systems," Perez said.

(The implication is on the strength of the entire health system. Our health system and local health systems have a problem.)

The strength of health systems in communities should also be looked since the Department of Health (DOH) is focused on COVID-19 cases in hospitals. 

"Pagdating sa COVID, karamihan ng nakikita ng DOH yung sa ospital, pero lumalabas sa report ng PSA [Philippine Statistics Authority] na mas maraming namamatay sa komunidad. Sa bahay, di na umaabot sa ospital, isang senyal din ito na yung pagtutok ng resources natin, nakatutok sa ospital, pero baka nagkukulang tayo ng tutok sa komunidad," Perez explained. 

(The DOH is focused on COVID deaths in hospitals, but the PSA report shows that there are people dying of COVID in communities. This might also mean our resources are focused on hospitals and we might have to put more resources in communities.)

Perez also cautioned against claims made by a group called Concerned Doctors and Citizens Philippines (CDC Ph) that the increase in number of deaths may be correlated to the COVID-19 vaccination roll-out. 

CDC Ph is pushing for further investigation on the reported increase in what it described as "excess deaths" recorded in 2021, particularly from March to September.

Perez agreed that the recent increase in cases should be looked into further, but discouraged immediately linking it to the COVID-19 vaccine.

"I agree, we should really establish why, ano yung mga causes during those months for those deaths to go up (what are the causes of deaths behind those particular months)," he said.

"There is no evidence that the mortalities are due to the vaccines, except for two cases that have been listed as vaccine-related deaths. Unfortunately, death certificates will not indicate vaccination status, so it’s almost impossible to find out," he added. 

Perez advised that the reporting of Adverse Events Following Immunization (AEFIs) should be implemented and monitored more strictly to gain conclusive data. 

"Under that system, the regional offices of DOH should be told if there are AEFIs, dapat imbestigahan yun (we should investigate), and I think they should be reported. It’s very easy to attribute it to that [deaths to vaccines], but many times when you investigate, there are other reasons. I’m not dismissing 'yung position ng CDC Ph, but whenever there’s such an event, please report it so DOH can take action through the adverse events."

The 768,000 deaths in 2021 might be higher as data for that year excludes deaths recorded in December 2021. 


Meanwhile, the Department of Health is trying to harmonize with the PSA their systems and processes in validating deaths caused by COVID-19, Health Undersecretary Maria Rosario Vergeire said Wednesday, as she noted that the numbers being reported by the two agencies are not the same.

As of February 1, 2022, the DOH has reported only a total of 54,054 deaths due to COVID-19 since the start of the pandemic in 2020. 

But according to the PSA, registered deaths due to COVID-19 in the country accounted for a total of 75,285 deaths from January to October 2021 alone. This is on top of the 27,967 deaths due to the coronavirus registered by the PSA for the entire year of 2020.

In a televised interview Wednesday, Vergeire explained the discrepancy in the data of both agencies.

"Kailangang maintindihan ng ating mga kababayan, talagang hindi magtutugma ang numero at datos ng PSA with the data of the DOH. Ang PSA kumukuha sila ng datos galing sa mga death certificates na sina-submit ng mga LGUs at mga implementing units nila. Ngayon, kapag titignan natin yan, kung ikukumpara sa datos namin, yung sa datos namin vinavalidate pa namin,” Vergeire said during the Laging Handa briefing.

(The DOH and PSA will not match because PSA gets data from death certificates submitted to local government units, while the DOH verifies the causes of death.)

“So you might find in the death certificates na ang pangunahing ikinamatay ng tao maaari ay vehicular accident, so kinukuha yun at tinatala na COVID na rin. As compared to the DOH, kung saan kapag vinalidate natin ang cause of death, kapag sinabing vehicular accident at incident na lang ang COVID, ang pangunahing pagkamatay ay vehicular accident, not COVID. So kaya hindi po talaga magtutugma ang DOH at PSA sa ngayon,” she explained.

(Some death certificates may identify a death as COVID-19 if the person who died incidentally had COVID when they died in a vehicular accident, versus DOH which would classify such a case as a vehicular accident.)

“So we are trying to harmonize our systems and process with the PSA para eventually po magtutugma na tayo and they can also adopt the validation process the DOH is doing.”

- with reports from Pia Gutierrez, ABS-CBN News

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