ANALYSIS: Rising COVID-19 positivity rate and ICU bed occupancy belie DOH optimism on COVID-19 fight

Warren de Guzman and Edson Guido, ABS-CBN Data Analytics

Posted at Jul 17 2020 04:52 PM | Updated as of Jul 17 2020 08:01 PM

Health Secretary Francisco Duque appeared upbeat on the Philippines’ battle against COVID-19 at the last Pre-SONA forum held by government on Wednesday. He said controversially that the Philippines had already flattened the curve so to speak, implying COVID-19 was on the decline here. He had to clarify what he meant, but he still insisted things are improving. 

Duque said, “We have successfully flattened the curve since April. The metrics for saying arriving at that conclusion of flattening the curve is one, case doubling time of the COVID-19 infection has actually become longer. It used to have a very short case doubling time of 2.5 days during the initial phase of the pandemic. The other metric to say that we have flattened the curve is also the mortality doubling time has also got longer and is now in the moderate risk classification.”

While Duque is technically correct, there are other important factors to consider.

This chart shows the number of daily tests conducted via the blue bars, and the 7-day moving average in a line. The average number of tests conducted every day is now above 20,000. This is still below the 30,000 daily test target for the end of May, but it is a much better number compared to the early stages of the COVID-19 pandemic. This means any information we compare from the early stages of the outbreak to what we have today will be inferior, because testing is much more widespread and comprehensive now.

The increase in testing allows the government to find more positive cases, if indeed there are more. This chart shows us clearly that there are. The number of positive individuals found everyday has increased, and the 7-day moving average is now above 2,000. If you go back to the case doubling rate Secretary Duque was talking about, the doubling rate in the early days involved hundreds of cases. Now we are dealing with thousands of new cases every day.

So, while there’s an improvement in case doubling time, we’re still seeing more cases each day. That is not contradictory. And it is the exponential nature of the virus that overwhelms the healthcare system.

The positivity rate, reflected in this blue line chart and orange bar graph, compares the number of positive cases found everyday with the number of individuals tested per day. This is a better measure for comparing the magnitude of the outbreak across the timeline, given the disparity in testing. A lower positivity rate means less positive cases are being found compared to the number of daily tests.

With the number of tests increasing, the positivity rate should be headed down. But as shown by the blue line, it is headed higher. On July 15, the positivity rate hit 11.2%. That is close to the positivity rates hit in April. It is also a significant setback from the roughly 6% positivity rate in June. This is a clear sign COVID-19 is still a problem.

Taking a look at the geographic data, we find the number of new cases is spiking in key economic hubs, including the heart of the Philippine economy, the National Capital Region (NCR). In terms of daily cases reported shown by the red bars, and the 7-day moving average shown by the blue line. The line chart is trending higher, and NCR just reported 1,886 new cases in a single day. That is the highest 1-day total yet. 

Region 4-A, home to many export and manufacturing centers, is also seeing a spike. Laguna, shown in red, Cavite, shown in orange, and Rizal, shown in green, are all surging. NCR and CALABARZON (Cavite, Laguna, Batangas, Rizal, Quezon) are the biggest regional contributors to gross domestic product.

Region 7, including Cebu, has also shown a spike in COVID-19 cases. But the 7-day moving average shown by the blue line shows conditions are improving, likely thanks to recently implemented stricter quarantine conditions. Central Visayas is the largest regional economy outside Luzon.If there were any regions COVID-19 needed to be stamped out for the Philippine economy to recover from its first contraction in over two decades, these regions would definitely top the list.

Here is another data set showing deteriorating conditions in key economic hubs. This graph shows the number of intensive care unit or ICU beds occupied by COVID-19 patients. Note, all of the beds counted here were set aside for COVID-19 patients. The totals do not constitute the total number of ICU beds in each region. If you look at NCR, it has 372 occupied ICU beds as of July 15. Under the grey portion, it shows NCR only has 189 vacant ICU beds for COVID-19. This means the heart of the Philippine economy has more COVID-19 ICU beds occupied than vacant beds at a time the number of COVID-19 cases being found there is spiking. NCR has the highest ICU bed occupancy rate in the Philippines at 66%, very close to the danger zone. CALABARZON is in the same predicament. Region 7 meanwhile has improved, with 71 vacant beds compared to 69 occupied.

What Health Secretary Duque said is true, the doubling rate of COVID-19 and the mortality rate in the Philippines have slowed. These are the results of hard work from the health department and all of the frontliners in the Philippine healthcare system. Unfortunately, the fight against the dreaded viral disease in key economic hubs appears to be going south. A sustained outbreak in these areas could be deadly for the Philippine economy, which is forecast by the government to contract by up to 3.4% this year. 

Presidential spokesperson Harry Roque has also said that if things get worse, tighter quarantine conditions could be enforced in NCR, a likely death blow to any hopes for an early economic recovery.