Our COVID recovery rate is still well below the global average. Photo by George Calvelo, ABS-CBN
Culture Spotlight

Globally, PH ranks poorly in fight vs COVID: 23rd in fatality rate, 131st in recovery rate

Our neighbors are faring much better with their respective recovery rates: Cambodia, Brunei, and Thailand are all in the top 10 while Vietnam and Malaysia are 23rd and 26th, respectively. Singapore is 109th, and Indonesia is only a few notches better than us at 126th. BY BENJAMIN CO MD
ANCX | May 17 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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Refer to the link DOH.gov.ph  or up-to-date data or to COVID19.gov.ph. (The latter is not a secure site.) The new site for the Department of Health is user friendly, provides more information where a COVID19 tracker is seen. Readers can check their official site where Data Drop for raw data can be found. 

One useful site is COVID19stats, where one can see most of the DoH data in graph format.

The DoH reported 208 new cases, 74 new recoveries, and 7 new deaths. Compared to the global confirmed cases, the Philippines contributes to 0.26 percent of the cases and 0.26 percent of the deaths from COVID-19 in the world.

Disclaimers on the data: 

(1) These three parameters (new confirmed cases, new recoveries, new deaths) are not real-time data. The data provided by the Department of Health is the date of public announcement. Even global data will vary in time of reporting, depending on the capacity of that country. To date, the latency period of the Department of Health on reporting recoveries averages nine days (with more than 50 percent reported after eight days and more) and deaths averaging more than nine days (with around 45 percent being reported after eight days or more).

(2) Depending on where testing is done, RT-PCR test results take an average of one to two days to process. Barring any delays, all tests done should ideally be released within 48 hours (the earlier the better). However, the test results released from government facilities range from three to 14 days, probably due to an overwhelming number of tests being conducted as compared to private hospitals.

The announced new cases, recoveries, and deaths are the tally of reported cases of the day.

Comparison of daily new cases, deaths, and recoveries. There are now 3,459 closed cases

Case fatality rate is down at 6.58 percent (vs 6.62 percent global average, vs. 2.39 percent ASEAN average) and recovery rate is slightly up at 21.1 percent (vs. 38.4 percent world average, vs. 38.2 percent ASEAN average) for the day. 

The case fatality rate of the Philippines approaches the global average, which has gone down. Our death rate also does not compare favorably against our regional neighbor Indonesia, which is at 6.55 percent. We currently have the highest case fatality rate in ASEAN. In terms of recovery rate, while we have improved a bit, we are below the world average. We also have the poorest recovery rate in ASEAN. 

Outcomes of resolved cases
In terms or resolved cases, the table above shows that the Philippines ranks 131 out of 145 countries in terms of recoveries-to-closed cases ratio. Of our 3,459 closed cases, 76 percent are considered recovered while 24 percent had died. Our data shows we fare poorly on both recoveries and deaths when compared to the global average.

Globally, the Philippines ranks 23rd in death rate (6.58 percent CFR), and 131st in recovery rate (21.1 percent).

Case Fatality Rate by country

Case Recovery Rate (see rightmost column) by country

The figure below shows the trajectory of death rates in the Philippines since the start of the pandemic (date of recording of the first 5th death). The data is compared with South Korea’s numbers because, while they may have more confirmed cases than us, they have bent the curve. The Philippines has maintained a plateau with our reports on deaths.

Are we bending the curve? Trajectory of deaths in the Philippines

Doubling time lets us know the number of days it takes for the confirmed cases (or death rates) to double and can be determined linearly or exponentially. A logarithmic scale is the ideal graph to use. The doubling time in death rates is around nine days. The growth rate of cases is around 2.13 percent (based on the seven-day average).

 

DOH Reporting

More than half (452 cases) are posthumous results. This is the number of people who died before they were declared positive for SARS-CoV-2.

 

New cases per day

Of the 208 new cases announced today, all were tagged with residence information. One hundred seventy-four (83 percent) were from the NCR, 33 (16 percent) from other areas in the country, and 1 from Region VII. Region-level data is accurate, but cases by city are reported only for those that could be verified. There were quite a handful still for validation as of this report. 

In the NCR, 97 of the 174 cases are for validation as of this writing. The remaining 77 cases are from: Muntinlupa (21); Quezon City (11); Manila (10); Pasig (12); Pasay (9); Caloocan (7); Valenzuela and Malabon (4 each); Makati, Taguig, and Marikina (2 each); Pateros and San Juan with 1 apiece.

Region VII has one case from Lapu-Lapu, Cebu. 

Other areas with reports include: Laguna (3), Cavite (2), Quezon (2), Bulacan (1), Pampanga (2), Angeles City (1), La Union (1), and Samar (2), while the rest of the information remain for validation.

New daily cases, death and recoveries
The DoH website update shows a bar graph for daily cases, active cases, daily deaths, and daily recoveries. Based on the average number of patients in the last seven days, we should be testing the threshold of 225 new confirmed cases daily next week to see if we’re bending the curve. (This is based on a 10 percent decrease in the average cases for this week.)

 

The week that was 

(May 10 to 16, 2020. Note that all data are summaries up to yesterday and do not include data today. )

  • Over the past week, we had a total of 1,695 new confirmed cases, 113 new deaths, and 719 new recoveries. (Seven day average of 242 new cases/day, 16 new deaths/day, and 103 new recoveries/day). 
  • The National Capital Region (NCR) maintains its ~ 2 percent growth rate (2.07 percent) with 980 new confirmed cases over the week. NCR still has the most number of cases in the Philippines with a total of 7,922 cases as of yesterday.
  • Most number of total cases is still Quezon City (1,796), followed by Cebu City (1,544), Manila (1,009), ParaƱaque (569), Makati (542), Mandaluyong (540), Pasig (400), Taguig (358), Pasay (295), and Caloocan (293) rounding up the top 10 cities.
  • Cebu City saw a continued increase in cases at the beginning of the week, but had no reported cases for the past two days. Its seven-day growth rate declined from 3.5 percent to 2.68 percent over this week. Region VII has overtaken Region IV-A with the second most number of cases (1,755 total vs 1,399 total) as of yesterday. While Cebu has one of the highest number of cases in the country, it also has the lowest death rate (15 deaths in 1,544 cases, or 0.97 percent) in the country. 
  • Zamboanga City had the highest growth rate for the week with 15.55 percent. (Zamboanga City had 44 cases only on May 10 and ended last night with 121 cases. It had a total of 77 new confirmed cases just for the week.) The death rate in Zamboanga City is 1.65 percent (2 out of 121 confirmed cases).
  • The highest case fatality rate based on region (only for those with more than 50 total cases) is region I with 12 deaths (19 percent) in 62 cases. The Ilocos Region, however, has not reported a new case since April 30, 2020. In NCR, Pasig has the highest death rate with 48 deaths (12 percent) in 400 cases. 
  • Confirmed cases by age group: Children (0-18 years old) make up less than 6 percent, while senior citizens (60 years up) around 23 percent. The remaining 71 percent of the confirmed cases are between 20-59 years old.
  • Fatality rate by age group: 4.6 percent of deaths are children 0-18 years old while 71.4 percent of deaths belong to those 60 years old and up. 12 percent of deaths are between 20-59 years old.
  • Tests done: A total of 215,060 tests have been performed (1,966/million population). From May 10 to 14, 50,559 tests were done. On May 14 alone, the DoH reported 23,140 tests conducted! 

I appreciate the efforts of the Department of Health in improving the accuracy and consistency of the data on their website and their Data Drop. I am one with the agency in making sure that the information provided is understandable, consistent, and useful for public information. 

Good data saves lives and provides information for sound decision making.

As of this publication, there is no information provided on testing as the DoH is improving its mechanisms and systems. According to their READ ME FIRST information sheet, the DoH assumes no liability for any errors, omissions or inaccuracies in the data and its interpretations as information may change at any time without notice. 

To get in touch with the Department of Health, the COVID hotline is (02)894-COVID loc 1555.

 

Global statistics

Update as of 8PM 16 May 2020 (Saturday)

TOTAL CONFIRMED CASES: 4,734,378

TOTAL DEATHS: 313,459 (case fatality rate: 6.62 percent)

TOTAL RECOVERED: 1,818,236 (case recovery rate: 38.4 percent)

Total cases worldwide

Note that every reference has its own cut-off time for reporting. For the global data, WorldOMeters is used as its reference.

The total confirmed cases has passed the 4.7 million mark. The average trend in the past week has averaged 110,000 new confirmed cases daily with more testing being done worldwide. At the current growth rate at least one million new confirmed cases may be registered every nine to 10 days. This means there is a high probability that the five million mark will be reached on or before May 19, 2020. 

Total number of recoveries worldwide has surpassed the 1.8 million mark with significantly greater recoveries than deaths. 

The United States of America continue to lead globally in the number of total confirmed cases at 1,507,798 with a case fatality rate (CFR) of 5.98 percent with 90,113 total deaths recorded. The recovery rate for the US is up at 22.5 percent. Among the states, New York leads with almost 358,099 total confirmed cases and 28,134 total deaths with a CFR up at 7.86 percent. More almost 12 million tests have been done as of yesterday (36,136/million population). 

Russia now is second with 281,752 total confirmed cases, 2,631 total deaths (0.93 percent CFR), and 67,373 total recoveries (23.9 percent). 

On the other hand, Cambodia has not seen a new case for the last month and reported its last patient recovering. The country has a 100 percent recovery rate with no deaths reported. 

The median average of case fatality rates worldwide is lower at 6.62 percent. From the current data for the past two to three months, around 80 to 90 percent of patients are either asymptomatic or recover unremarkably. Almost 98 percent of the currently infected (active or positive) cases are mild or asymptomatic. 

As of this writing, of the 2,131,695 closed cases (cases which had an outcome), 85 percent (1,818,236) had recovered or discharged while 15 percent (313,459) died. 

Recoveries far outnumber the deaths with a ratio of approximately 6:1.