Expect more COVID-19 deaths next month, infectious disease experts say as PH cases rise

MANILA — With more than 3,000 COVID-19 cases reported daily since the start of the month, infectious disease experts said on Tuesday that they expect a higher number of deaths in the country, though figures may come in later because of delayed reporting.

“What you are seeing as cases now, you’re not going to see them die today. The outcomes will be seen 4 to 8 weeks later, especially for the severe ones. They’re intubated, they’re in the ICU. They take a longer course of illness,” said Dr. Benjamin Co, Pediatric Infectious Diseases Section Chief of the University of Santo Tomas Hospital, during a virtual forum hosted by the Foreign Correspondents Association of the Philippines (FOCAP).

The Department of Health previously said that while those with mild cases are able to recover within 14 days, those with severe symptoms and in critical condition might take more than 20 days of recovery.

Co said the number of deaths are already higher than before but these are from cases that happened in previous months.

Dr. Anna Lisa Ong-Lim, Infectious and Tropical Disease Section Chief of the Philippine General Hospital, agreed with Co.

“The numbers we are seeing are a reflection of the cases that we picked up conservatively about a month ago,” she said.

“If you consider the fact that our rise has been happening primarily within this month or the tail-end of last month, makikita pa lang natin ang increase in mortality rate next month. So abangan na natin 'yun (we’ll see the increase in mortality rate next month. So we should expect that),” she said.

Ong-Lim said it is impossible to keep the number of deaths low when the number of cases are high.

Co also pointed out that the government should not be assessing the situation based on case fatality rate.

The case fatality rate is among percentages shared by the Department of Health (DOH) in its weekly updates. The DOH defines it as “the proportion of people who die from COVID-19 among all individuals diagnosed with the disease over a certain period of time."

As of August 17, the case fatality rate of the Philippines is at 1.63%. The DOH compared it with the global rate of 3.49%. That day, the number of total COVID-19 cases in the country was at 164,474 while the number of deaths was at 2,681.

But Co said the case fatality rate is “one of the poorest estimates of the pandemic.”

“Because the denominator is very large - the number of cases- are much much greater, it makes the numerator (deaths), whatever the number is, look small. So you get a case fatality rate that is significantly low,” he explained.

“People misinterpret the case fatality rate. And interchangeably use it as mortality rate, which are two different things. The mortality rate is something you compute only at the end of the pandemic,” Co said.

He pointed out that the DOH is still reporting deaths from previous months, as far back as March.

“It takes quite some time to validate data on their end. So we are not seeing the complete picture at the moment,” he said of the deaths reported by the government.