Dissecting Data: The road to 1 million COVID-19 cases in the Philippines

Warren de Guzman and Edson Guido, ABS-CBN News

Posted at Apr 27 2021 01:39 PM | Updated as of Apr 27 2021 09:22 PM

Patients are watched over by relatives and hospital aides inside the COVID-19 emergency room of the government hospital National Kidney and Transplant Institute on April 26, 2021 in Quezon City, which has declared overcapacity following a surge of COVID-19 infections in Metro Manila. Eloisa Lopez, Reuters

The Philippines has seen a lot of grim milestones this year in its struggle against the COVID-19 pandemic. Total COVID-19 cases grew by over 300,000 in just one month this year. The total breached 700,000 on March 26 before hitting 1,006,428 total cases on April 26, making April the worst month yet for the Philippine outbreak. 

ABS-CBN Data Analytics, data from DOH

The Philippines’ total confirmed COVID-19 cases are shown by the blue line in this chart by the ABS-CBN Data Analytics team. The line is trending upwards and the trend is still steep. 

The end of 2020 and the start of 2021 presented several challenges for the Philippines' fight against COVID. These included the holiday season, a more aggressive reopening of the economy, and the arrival of new COVID-19 variants. It seemed the new year was off to a good start when the initial numbers came out.

Then February came, and the numbers started revealing an ominous trend. At the time COVID-19 was killing Filipinos at its fastest rate in 7 months.

The highest COVID-19 fatality rate for 2021 was recorded in February at 2.16 percent. The total number of dead back then was 12,068. The total number of cases was at 559,288.

As of April 26, the fatality rate has gone down to 1.67 percent. However the number of dead has risen to 16,853, and the total number of cases has nearly doubled to 1,006,428. The number of cases is important, because the fatality rate is computed by dividing the total number of deaths by the total number of cases. 

It is good that the fatality rate has gone down, but it is important to note that the spike in COVID-19 cases helped bring it down from the highs hit in February. 

ABS-CBN Data Analytics, data from DOH

This chart shows us the number of total active cases. The spike in confirmed cases has also resulted in a spike in active cases, which peaked at 203,710 on April 17th. That made the Philippines the only country in Southeast Asia to reach more than 200,000 active cases since the start of the pandemic. 

After that grim milestone, the Philippine Health Department decided to change the way it reports COVID-19 recoveries. Usually, the DOH had only reported thousands of recoveries every Sunday. It was called OPLAN Recovery and this resulted in a crooked line graph for active cases which made it impossible to discern any clear trend from the data. This was not done in any other country outside the Philippines. 

The DOH’s move to a daily time-based tagging of recoveries starting April 18 is good because it will make the data more accurate. This was in fact the stated goal of the decision to move on from OPLAN Recovery. 

The DOH has since reported nearly 210,000 recoveries from April 18 to 26. As a result, a near vertical drop in active cases followed, from more than 200,000 to 74,623 in just nine days. 

Unfortunately, the previous practice of reporting only on Sundays has made the data reported before April 18 virtually incomparable to what is being reported now. 

How does the DOH tag recoveries?

The DOH protocol for tagging recoveries does not require repeat testing for COVID-19. All that is required for the discharge of a confirmed COVID patient from quarantine is the certified clearance of a licensed medical doctor. All patients with mild symptoms who have completed at least 10 days of isolation from the onset of the disease, and are asymptomatic for 3 consecutive days, are deemed recovered. All patients with moderate, severe, or critical symptoms who have completed 21 days of isolation in a hospital, and are asymptomatic for 3 straight days are deemed recovered. Asymptomatic confirmed cases who do not develop symptoms for 10 days are deemed recovered. 

It is also important to note that some recoveries were later retagged as deaths by the DOH.

The shift from weekly to daily reporting of COVID-19 recoveries is a welcome development. But again, the OPLAN Recovery that ran for several months has made this particular data set unreliable.

The reporting of confirmed COVID-19 cases meanwhile has been done daily from the get go. The data has some problems of its own, such as the continued failure of some testing laboratories to submit their reports in a timely manner. But this data set has been much more consistent than the DOH’s reporting of recoveries. 

ABS-CBN Data Analytics, data from DOH

This chart gives us a closer view of the spike in daily reported new cases and their 7-day moving average. The data clearly show the numbers reported in April 2021 dwarf all of 2020. From April 9 to 15 the Philippine Department of Health reported nearly 11,000 new cases per day. The good news is it has eased. The DOH has reported less than 10,000 cases for 8 straight days, and the 7-day average as of April 26 is 8,687. But that is still much higher than the peaks of 2020. 

ABS-CBN Data Analytics, data from DOH

This chart shows us confirmed COVID-19 cases inside the National Capital Region (NCR) and outside NCR. The darker bar graphs show NCR numbers, and they tell us the two-week ECQ and current MECQ enforced in the capital helped slow down the spread of the virus. The 7-day average in NCR of 3,522 new cases from April 20 to 26 is 22 percent lower compared to the 4,503 daily average from April 13 to 19, and much lower than the 5,500 cases averaged earlier in the month. The lighter bar graphs show numbers from outside the NCR, and they are much larger. This tells us the pandemic is more far-reaching than ever.

ABS-CBN Data Analytics, data from DOH

The best measure to determine how the pandemic is going is still the positivity rate, or the number of positive tests compared to the number of individuals tested. The World Health Organization’s benchmark for the easing of quarantine restrictions is 5 percent or lower for at least two weeks. The Philippines’ positivity rate had dipped or closed the gap toward that benchmark a few times in 2020. On April 2, 2021, the Philippine positivity rate was five times the benchmark at 25.2 percent. 

The 7-day moving average of the Philippine positivity rate however is now on a clear downtrend. It has been below 20 percent for 12 straight days averaging 17 to 18 percent. It will take a lot more work to cut it back down to 5 percent. 

ABS-CBN Data Analytics, data from DOH

This chart gives us a look at the Philippine health system in terms of intensive care unit or ICU bed occupancy. The number of beds counted here refer only to ICU beds reserved for COVID-19 patients. The Philippine Department of Health classifies ICU bed occupancy rates of 70 to 85 percent as high-risk, and anything above as critical.

The NCR is classified as high-risk, with a 71 percent occupancy rate. The NCR rate remained high even after measures to increase COVID beds, including the conversion of nearly 100 beds for ICU purposes in a hospital in Caloocan. 

Regions 2, 3, 4A, and the Cordillera Administrative Region or CAR all have occupancy rates above 80 percent. CAR was the first region where a new COVID variant was confirmed in the Philippines. Region 2 or the Cagayan Valley is in the critical zone with an 87 percent ICU bed occupancy. The region’s disaster response infrastructure was dealt a serious blow in late 2020 from severe flooding.

Several regions remain at high-risk even after the reported sharp increase in recoveries.

DOH

This chart from the DOH gives us a clear reading of COVID-19 fatalities in April. More than 3,500 deaths have been reported from April 1 to 26. This has surpassed the peak in 2020. Yes, the fatality rate is down, but April is still the deadliest month of the Pandemic, and the total could go higher as more data from the remaining days of April come in. 

Nearly 17,000 have died from COVID-19. Over 1 million have been afflicted by the virus. Thankfully, most of those sickened by the disease have recovered. However, the spike in confirmed cases is very real. The Philippines has been fighting the COVID-19 pandemic for over a year. There are some countries doing much worse. There are some countries that are beating the virus soundly. The data show the Philippines still has a long fight ahead.